The determinants of physician and pharmacist utilization and equity of access under Korean universal health insurance

This study examines the social and behavioral determinants of two types of primary care, seeing a physician or a pharmacist, for Koreans and evaluates the equity of the Korean national health insurance system. The study applies the Aday and Andersen access framework to cross-sectional data from the 1992 Korean National Health Interview Survey (N = 21,841).^ The study found that in Korea, the elderly were most likely, and children least likely, to have used physician services. Women, household heads, those in small families, and the less educated were more likely than their counterparts to use physician and pharmacist services. Health status and need were important determinants of Koreans seeing a doctor or a pharmacist. Differences in need substantially accounted for the original differences observed between subgroups. Resources associated with having insurance coverage, a regular source of care, and place of residence (rural/urban) ameliorated to some extent the subgroup differences in the use of physicians' and pharmacists' services among Koreans. They were also major independent predictors of access. Having insurance remains a particularly important predictor of who uses physician services. Among the insured, trade-offs in the use of physician and pharmacist services were found in the current system, i.e., uninsured and poor Koreans were more likely to use pharmacist services, while insured and rural Koreans were more likely to use doctor services. Among the insured, cost sharing rates are lower for physician than for pharmacist services. Self-employed persons were less likely than government and industrial workers to use physician services. An underlying expectation under universal health insurance was that the Korean health care system would be equitable. The research results, however, did not fully support this expectation.^ The policy implications of these findings are that measures are required to extend insurance coverage to the uninsured, to equalize differences in benefit packages between health plans, and to expand the availability of physicians in rural areas. Further research is also needed to understand those who do not currently have a regular source of care and why and the access barriers that may exist for selected demographic subgroups (those in large families and unmarried or divorced/widowed persons). ^

Interhemispheric cerebral blood flow balance during recovery of motor hand function after ischemic stroke - a longitudinal MRI study using arterial spin labeling perfusion

BACKGROUND Unilateral ischemic stroke disrupts the well balanced interactions within bilateral cortical networks. Restitution of interhemispheric balance is thought to contribute to post-stroke recovery. Longitudinal measurements of cerebral blood flow (CBF) changes might act as surrogate marker for this process. OBJECTIVE To quantify longitudinal CBF changes using arterial spin labeling MRI (ASL) and interhemispheric balance within the cortical sensorimotor network and to assess their relationship with motor hand function recovery. METHODS Longitudinal CBF data were acquired in 23 patients at 3 and 9 months after cortical sensorimotor stroke and in 20 healthy controls using pulsed ASL. Recovery of grip force and manual dexterity was assessed with tasks requiring power and precision grips. Voxel-based analysis was performed to identify areas of significant CBF change. Region-of-interest analyses were used to quantify the interhemispheric balance across nodes of the cortical sensorimotor network. RESULTS Dexterity was more affected, and recovered at a slower pace than grip force. In patients with successful recovery of dexterous hand function, CBF decreased over time in the contralesional supplementary motor area, paralimbic anterior cingulate cortex and superior precuneus, and interhemispheric balance returned to healthy control levels. In contrast, patients with poor recovery presented with sustained hypoperfusion in the sensorimotor cortices encompassing the ischemic tissue, and CBF remained lateralized to the contralesional hemisphere. CONCLUSIONS Sustained perfusion imbalance within the cortical sensorimotor network, as measured with task-unrelated ASL, is associated with poor recovery of dexterous hand function after stroke. CBF at rest might be used to monitor recovery and gain prognostic information.

Trends in utilization of computer tomography (CT) scans for victims of motor vehicle collision (MVCs) in a level I trauma center from 1996 to 2006

Purpose. To evaluate trends in the utilization of head, abdominal, thoracic and other body regions CTs in the management of victims of MVC at a level I trauma center from 1996 to 2006.^ Method. From the trauma registry, I identified patients involved in MVC's in a level I trauma center and categorized them into three age groups of 13-18, 19-55 and ≥56. I used International Classification of Disease (ICD-9-CM) codes to find the type and number of CTs examinations performed for each patient. I plotted the mean number of CTs per patient against year of admission to find the crude estimate of change in utilization pattern for each type of CT. I used logistic regression to assess whether repetitive CTs (≥ 2) for head, abdomen, thorax and other body regions were associated with age group and year of admission for MVC patients. I adjusted the estimates for gender, ethnicity, insurance status, mechanism and severity of injury, intensive care unit admission status, patient disposition (dead or alive) and year of admission.^ Results. Utilization of head, abdominal, thoracic and other body regions CTs significantly increased over 11-year period. Utilization of head CT was greatest in the 13-18 age group, and increased from 0.58 CT/patient in 1996 to 1.37 CT/patient in 2006. Abdominal CTs were more common in the ≥56+ age group, and increased from 0.33 CT/patient in 1996 to 0.72 CT/patient in 2006. Utilization of thoracic CTs was higher in the 56+ age group, and increased from 0.01 CT/patient in 1996 to 0.42 CT/patient in 2006. Utilization of other CTs did not change materially during the study period for adolescents, adults or older adults. In the multivariable analysis, after adjustment for potential confounders, repetitive head CTs significantly increased in the 13-18 age group (95% CI: 1.29-1.87, p=<0.001) relative to the 19-55 age group. Repetitive thoracic CT use was lower in adolescents (95% CI: 0.22-0.70, p=<0.001) relative to the 19-55 age group.^ Conclusion. There has been a substantial increase in the utilization of head, abdominal, thoracic and other CTs in the management of MVC patients. Future studies need to identify if increased utilization of CTs have resulted in better health outcome for these patients. ^

Infectious diseases, immune status, and health insurance among child care providers in Houston, Texas

The objectives of this study were to compare female child-care providers with female university workers and with mothers of children in child-care centers for: (1) frequency of illness and work loss days due to infectious diseases, (2) prevalence of antibodies against measles, rubella, mumps, hepatitis B, hepatitis A, chickenpox and cytomegalovirus (CMV), and (3) status regarding health insurance and job benefits.^ Subjects from twenty child-care centers and twenty randomly selected departments of a university in Houston, Texas were studied in a cross-sectional fashion.^ A cluster sample of 281 female child-care providers from randomly selected child-care centers, a cluster sample of 286 university workers from randomly selected departments and a systematic sample of 198 mothers of children from randomly selected child-care centers.^ Main outcome measures were: (1) self-reported frequency of infectious diseases and number of work-days lost due to infectious diseases; (2) presence of antibodies in blood; and (3) self-reported health insurance and job benefits.^ In comparison to university workers, child-care providers reported a higher prevalence of infectious diseases in the past 30 days; lost three times more work-days due to infectious diseases; and were more likely to have anti-core antibodies against hepatitis B (odds ratio = 3.16 95% CI 1.27-7.85) and rubella (OR 1.88, 95% CI 1.02-3.45). Child-care providers had less health insurance and job-related benefits than mothers of children attending child-care centers.^ Regulations designed to reduce transmission of vaccine and non-vaccine preventable diseases in child-care centers should be strictly enforced. In addition policies to improve health insurance and job benefits of child-care providers are urgently needed. ^

Prevalence and risk factors of asthma and work -related asthma among U.S. adults: Data from the Third National Health and Nutrition Examination Survey, 1988--1994

This cross-sectional analysis of the data from the Third National Health and Nutrition Examination Survey was conducted to determine the prevalence and determinants of asthma and wheezing among US adults, and to identify the occupations and industries at high risk of developing work-related asthma and work-related wheezing. Separate logistic models were developed for physician-diagnosed asthma (MD asthma), wheezing in the previous 12 months (wheezing), work-related asthma and work-related wheezing. Major risk factors including demographic, socioeconomic, indoor air quality, allergy, and other characteristics were analyzed. The prevalence of lifetime MD asthma was 7.7% and the prevalence of wheezing was 17.2%. Mexican-Americans exhibited the lowest prevalence of MD asthma (4.8%; 95% confidence interval (CI): 4.2, 5.4) when compared to other race-ethnic groups. The prevalence of MD asthma or wheezing did not vary by gender. Multiple logistic regression analysis showed that Mexican-Americans were less likely to develop MD asthma (adjusted odds ratio (ORa) = 0.64, 95%CI: 0.45, 0.90) and wheezing (ORa = 0.55, 95%CI: 0.44, 0.69) when compared to non-Hispanic whites. Low education level, current and past smoking status, pet ownership, lifetime diagnosis of physician-diagnosed hay fever and obesity were all significantly associated with MD asthma and wheezing. No significant effect of indoor air pollutants on asthma and wheezing was observed in this study. The prevalence of work-related asthma was 3.70% (95%CI: 2.88, 4.52) and the prevalence of work-related wheezing was 11.46% (95%CI: 9.87, 13.05). The major occupations identified at risk of developing work-related asthma and wheezing were cleaners; farm and agriculture related occupations; entertainment related occupations; protective service occupations; construction; mechanics and repairers; textile; fabricators and assemblers; other transportation and material moving occupations; freight, stock and material movers; motor vehicle operators; and equipment cleaners. The population attributable risk for work-related asthma and wheeze were 26% and 27% respectively. The major industries identified at risk of work-related asthma and wheeze include entertainment related industry; agriculture, forestry and fishing; construction; electrical machinery; repair services; and lodging places. The population attributable risk for work-related asthma was 36.5% and work-related wheezing was 28.5% for industries. Asthma remains an important public health issue in the US and in the other regions of the world. ^

Contextualización teórica del acto pedagógico en la enseñanza y el aprendizaje del proyecto arquitectónico: el caso de la E.T.S.A.M.

El taller de proyectos constituye el núcleo de la enseñanza arquitectónica. Estudiar sus procesos educativos en la actualidad implica la contextualización teórica del acto educativo y la revisión histórica de la evolución de su estructura social. Esta estructura, es heredera de la larga tradición del taller donde los maestros de obra, artesanos, arquitectos y artistas, se ocupaban desde siempre de la enseñanza de la construcción, de la artesanía, del diseño arquitectónico y del arte. Los aprendices se sometían a la autoridad de sus maestros y pasaban horas practicando, produciendo y aprendiendo junto a ellos. Con la aparición de las primeras Academias de arte y posteriormente de arquitectura, se evidenció un progresivo interés de los Estados hacía los productos artísticos y arquitectónicos. La consideración de las artes y de la arquitectura como proyecto estatal, supuso la construcción lenta, pero consolidable, de un proyecto educativo paralelo, coexistiendo simultáneamente con los talleres de los maestros, pero sin posibilidad de integración, hasta mucho más tarde. La “teoría”, que es de lo que se ocupaba la academia, con la “práctica” que es lo que se desarrollaba en el taller, no encontraban fácilmente la manera de encajarse y complementarse mutuamente en un proyecto educativo común. Las concepciones educativas de ambos, afrontaban la enseñanza y el aprendizaje desde puntos de vista también diferentes; mientras la Academia representaba el conocimiento validado y explicitado, en el taller se trabajaba con un conocimiento tácito e implícito. En la práctica artística del taller era donde se producía el aprendizaje mientras que en la Academia es donde se validaba. Esta estructura llegó en muchas ocasiones a situaciones extremas, no siendo casual que las más grandes crisis registradas en la historia de la enseñanza de las artes, coincidieran con un aumento de la distancia entre estas dos “instituciones”, talleres y academias. Por otra parte, parece que cualquier proyecto o concepto innovador, se ha fundado sobre la redistribución de estos equilibrios perdidos. En dicho contexto, en el campo de la educación y especialmente en el siglo XX, surge un debate que se estructura en base a los fines de la educación, contemplando dos posturas bien diferenciadas. Una de ellas sostiene como fin primordial de la educación, el desarrollo de la conciencia y la reciprocidad social del individuo. La otra, fija como fin el desarrollo de su singularidad. La búsqueda del equilibrio entre ambas, parte del interés por fomentar el crecimiento de lo que cada ser humano posee de individual, armonizándolo con la unidad orgánica del grupo social al que pertenece (Read 2010, 33). Sobre esta tensión se han basado muchos de los discursos pedagógicos y especialmente los aquí usados. La estructura social en los talleres de proyectos arquitectónicos, presenta hoy día una máxima integración entre las dos instituciones, el taller y la Academia, tanto a nivel del espacio, donde tiene lugar la enseñanza, como a nivel conceptual y pedagógico. Los talleres de proyectos poseen un formato de enseñanza y aprendizaje que constituye un paradigma (Schön, 2008) no solo dentro, sino también fuera del campo arquitectónico. Bajo este formato se complementa el aprendizaje práctico con el teórico y la producción, con la validación del conocimiento. Aunque tal estructura pedagógica presenta importantes variaciones entre unas escuelas de arquitectura y otras, los principales procesos que tienen lugar, son lo suficientemente similares, como para poder ser examinados desde una perspectiva común. Esta investigación, estudia el taller de proyectos desde un aspecto pedagógico, que contempla tanto los discursos educativos, como la historia de la evolución del taller como constructo social. El análisis se estructura sobre los elementos fundantes del acto didáctico: un sujeto que aprende, un sujeto que enseña, un método, la estrategia o procedimiento a través del que se enseña, un contenido y el propio acto docente (Sánchez Cerezo, 1994, 530). Además, se han añadido otros dos elementos que se consideran fundamentales para llevar a cabo el estudio: el contexto de la enseñanza, tanto el tangible como el intangible y la evaluación de la enseñanza y del aprendizaje. El caso de estudio de la presente investigación se sitúa en la Escuela de Arquitectura de Madrid en la actualidad. Sin embargo, no se pretende generar un retrato exacto de esta institución sino utilizarla como ejemplo principal en el desarrollo de los capítulos del método, contenido, acto docente y contexto, en los que también se introducen ejemplos de otras escuelas de arquitectura que amplían los argumentos presentados que constituyen la contextualización teórica del acto pedagógico en los talleres de proyectos arquitectónicos. ABSTRACT Design studio constitutes the core of architectural education. To study its current educational processes involves a theoretical approach of its educational praxis and an historic revision of how its social structure evolved. This structure is inherited from the long tradition of the workshop in which master masons, craftsmen, architects and artists have always been in charge of teaching construction, crafts, architectural design and art. Apprentices were subjected to the authority of their teachers and spent hours practicing, producing and learning along with them. With the establishment of the first Academies of Art and later of Architecture, the interest of the State in artistic and architectural products started growing. The understanding of arts and architecture as a state project entailed the slow, but robust development of a parallel education project. This project coexisted with the masters’ workshops, without the possibility of integration between two, until much later. It was difficult to find a way to synthesize academic “theory” with workshop “practice”. The workshops’ and the Academy's conception about teaching and learning differed significantly. While the Academy represented a verified and explicit knowledge, the workshop worked with a tacit and implicit knowledge. The workshops produced education through artistic practice, while the the Academy organized and verified knowledge. This dual framework has on occasions reached extremes. It is no accident that the biggest known crises in the history of arts education coincide with an increase in the distance between these two "institutions", the workshops and Academies. Furthermore, it seems that most innovative concepts or projects have been founded on restoring the lost balance between the two. In this context, in the field of education, and especially during the 20th century, a debate that contemplated the purpose of education and resulted in two quite differentiated approaches, emerged,. One position claims as the primary purpose of education the development of social awareness and mutuality in individuals. The other approach sets as a purpose developing each student's uniqueness. The quest for the right balance between these two positions is based on the assumption that the general purpose of education is to foster the growth of what is individual in each human being, at the same time harmonizing the individuality thus educed with the organic unity of the social group to which the individual belongs (Read, 2010, 33). This tension forms the basis for many pedagogical discourses, especially the ones utilized in this dissertation. The social structure of architecture studios today demonstrates a very high level of integration between the two institutions, the workshop and the Academy, both in terms of space —where the teaching takes place— as well as on a conceptual and pedagogical level. Architecture studios today have developed a format for teaching and learning that has established a paradigm (Schön, 2008) , not only in architecture, but also in other fields. Under this paradigm, practical and theoretical learning, as well as production and verification of knowledge, complement each other. And although this pedagogical structure presents important variations among different schools of architecture, the principal processes that take place in the studio are sufficiently similar so as to be examined from a common perspective. This research examines the architecture studio from a pedagogical point of view, that takes into account both the educational discourses, as well as the historical evolution of the workshop as a social structure. The analysis presented here is structured on the fundamentals of the teaching act: an individual learning, an individual teaching, a method, strategy or procedure for teaching and learning, the content and the teaching act itself (Sánchez Cerezo, 1994, 530). Two extra elements that were considered essential for carrying out this study have also been added: the context in which teaching takes place, tangible as well as intangible, and the evaluation of teaching and learning. The Madrid School of Architecture in the present day served as a case study. However the aim is not to generate an accurate portrayal of this school but to use it as the principal example for the development of the chapters of method, content, teaching act and context. In addition to that, examples from other schools of architecture are introduced in order to further the presented arguments that constitute the theoretical contextualization of the pedagogical act in architecture studios.

The role of surface loops (residues 204-216 and 627-646) in the motor function of the myosin head.

A characteristic feature of all myosins is the presence of two sequences which despite considerable variations in length and composition can be aligned with loops 1 (residues 204-216) and 2 (residues 627-646) in the chicken myosin-head heavy chain sequence. Recently, an intriguing hypothesis has been put forth suggesting that diverse performances of myosin motors are achieved through variations in the sequences of loops 1 and 2 [Spudich, J. (1994) Nature (London) 372, 515-518]. Here, we report on the study of the effects of tryptic digestion of these loops on the motor and enzymatic functions of myosin. Tryptic digestions of myosin, which produced heavy meromyosin (HMM) with different percentages of molecules cleaved at both loop 1 and loop 2, resulted in the consistent decrease in the sliding velocity of actin filaments over HMM in the in vitro motility assays, did not affect the Vmax, and increased the Km values for actin-activated ATPase of HMM. Selective cleavage of loop 2 on HMM decreased its affinity for actin but did not change the sliding velocity of actin in the in vitro motility assays. The cleavage of loop 1 and HMM decreased the mean sliding velocity of actin in such assays by almost 50% but did not alter its affinity for HMM. To test for a possible kinetic determinant of the change in motility, 1-N6-ethenoadenosine diphosphate (epsilon-ADP) release from cleaved and uncleaved myosin subfragment 1 (S1) was examined. Tryptic digestion of loop 1 slightly accelerated the release of epsilon-ADP from S1 but did not affect the rate of epsilon-ADP release from acto-S1 complex. Overall, the results of this work support the hypothesis that loop 1 can modulate the motor function of myosin and suggest that such modulation involves a mechanism other than regulation of ADP release from myosin.

Efficacia della formazione alla salute e sicurezza sul lavoro: fattori di successo e criticità

Background: sulla base delle evidenze emerse dalle rassegne sistematiche in materia (Johnstone, 1994; Cohen et al.,1998; Robson et al., 2012; Burke et al., 2006; Ricci et al., 2015) si è ipotizzato che la formazione alla salute e sicurezza sul lavoro sia maggiormente efficace quando non è presentata come obbligatoria e venga articolata su più livelli di apprendimento, attraverso metodologie adeguate per ogni livello, con docenti che abbiano caratteristiche corrispondenti allo specifico obiettivo di apprendimento e la cui durata sia parametrata all’obiettivo stesso. Obiettivo di questa ricerca è valutare se esista e quanto sia intensa la relazione causale tra la formazione alla sicurezza sul lavoro e i suoi effetti sul miglioramento delle conoscenze, degli atteggiamenti, dei comportamenti, degli esiti per la salute, del clima di sicurezza aziendale, del controllo comportamentale percepito dai lavoratori, delle condizioni operative e procedure interne, oltre l’eventuale effetto di moderazione determinato da caratteristiche socio-demografiche dei partecipanti e dal gradimento della formazione. Metodo: la variabile indipendente è costituita dell’intervento formativo erogato, articolato in tre condizioni: formazione obbligatoria, formazione non obbligatoria, gruppo di controllo: sono stati posti a confronto due interventi di pari durata (16 settimane, per 10h complessive), realizzati con identiche modalità (step1 audio-visivo; step2 affiancamento su lavoro da parte del preposto; step3 discussione di auto-casi), ma differenziati rispetto all’essere presentati uno come formazione obbligatoria, l’altro come non obbligatoria. I due gruppi sono anche stati confrontati con un gruppo di controllo per il quale la formazione è prevista successivamente. I partecipanti sono stati assegnati in modo casuale al gruppo con obbligo formativo, senza obbligo formativo, di controllo. Sono stati presi come indicatori (variabili dipendenti) per valutare l’effetto della formazione: I livello – conoscenze: riconoscimento o produzione di un maggior numero di risposte corrette. II livello – atteggiamenti e credenze: maggiore propensione a mettere in atto comportamenti auto ed etero protettivi. III livello – comportamenti: comportamenti osservati più adeguati per la tutela della salute propria e altrui. IV livello – salute: maggior grado di benessere bio-psico-sociale auto-riferito. Le misure di esito consistono nella variazione tra la rilevazione iniziale e ogni rilevazione successiva, sulla base delle diverse misure registrate per ognuno dei quattro livelli dell’intervento formativo. Lo stesso confronto del tempo è stato realizzato per le misure del clima di sicurezza aziendale, del controllo comportamentale percepito dai lavoratori, delle condizioni operative e procedure interne, oltre l’eventuale effetto di moderazione determinato da caratteristiche socio-demografiche dei partecipanti e dal gradimento della formazione, quest’ultimo misurato solo immediatamente al termine dell’intervento. Risultati: le condizioni di intervento non differiscono in termini di efficacia, la formazione determina infatti gli stessi risultati per i partecipanti del gruppo obbligo formativo e di quello non obbligo, con una significativa differenza post-intervento rispetto al gruppo di controllo. La formazione ha un effetto forte nel miglioramento delle conoscenze che solo parzialmente decade nel tempo, ma comunque mantenendo un livello maggiore rispetto ai valori iniziali. In relazione al miglioramento di atteggiamenti e comportamenti sicuri nel lavoro al Videoterminale, l’effetto della formazione è modesto: per gli atteggiamenti si registra solo un miglioramento verso l’applicazione delle procedure come utili realmente e non come mero adempimento, ma tale effetto decade entro quattro mesi riportando i partecipanti su valori iniziali; i comportamenti invece migliorano nel tempo, ma con deboli differenze tra partecipanti alla formazione e gruppo di controllo, tuttavia tale miglioramento non decade in seguito. Non si registrano invece effetti della formazione nella direzione attesa in termini di esiti per la salute, per il miglioramento del clima di sicurezza e come maggior controllo comportamentale percepito, non risultano nemmeno dati evidenti di moderazione degli effetti dovuti a caratteristiche socio-demografiche dei partecipanti. Inoltre emerge che il gradimento per la formazione è correlato con migliori atteggiamenti (strumento audio-visivo), il miglioramento del clima di sicurezza e un maggior controllo comportamentale percepito (studio di auto-casi), ovvero gli step che hanno visto l’intervento di formatori qualificati. Infine, la formazione ha determinato migliori condizioni operative e l’adeguamento delle procedure interne. Conclusioni: la presente ricerca ci consente di affermare che la formazione erogata è stata efficace, oltre che molto gradita dai partecipanti, in particolare quando il formatore è qualificato per questa attività (step1 e 3). L’apprendimento prodotto è tanto più stabile nel tempo quanto più i contenuti sono in stretta relazione con l’esperienza lavorativa quotidiana dei partecipanti, mentre negli altri casi il decremento degli effetti è alquanto rapido, di conseguenza ribadiamo la necessità di erogare la formazione con continuità nel tempo. E’ risultato comunque modesto l’effetto della formazione per migliorare gli atteggiamenti e i comportamenti nel lavoro al VDT, ma, al di là di alcuni limiti metodologici, sono obiettivi ambiziosi che richiedono più tempo di quanto abbiamo potuto disporre in questa occasione e il cui conseguimento risente molto delle prassi reali adottate nel contesto lavorativo dopo il termine della formazione. Le evidenze finora prodotte non hanno poi chiarito in modo definitivo se attraverso la formazione si possano determinare effetti significativi nel miglioramento di esiti per la salute, anche eventualmente attraverso interventi di supporto individuale. Inoltre l’assenza di differenze significative negli effetti tra i partecipanti assegnati alla condizione di obbligo e quelli di non obbligo, eccezion fatta in direzione opposta alle attese per la misura del danno da lavoro, suggeriscono che nell’erogare la formazione, occorre sottolineare in misura molto rilevante l’importanza dell’intervento che viene realizzato, anche qualora esistesse una prescrizione normativa cogente. Infine, la ricerca ci ha fornito anche indicazioni metodologiche e misure valide che invitano ad estendere questa formazione, e la sua valutazione di efficacia, a diversi comparti economici e svariate mansioni. Nel fare questo è possibile fare riferimento, e testare nuovamente, un modello che indica la corretta percezione del rischio (conoscenza) come fattore necessario, ma non sufficiente per ottenere, con la mediazione di atteggiamenti favorevoli allo specifico comportamento, azioni sicure, attraverso le quali si rinforza l’atteggiamento e migliorano le conoscenze. La formazione, per raggiungere i propri obiettivi, deve tuttavia agire anche sui meccanismi di conformismo sociale favorevoli alla safety, questi originano da conoscenze e azioni sicure e reciprocamente le rinforzano.

The Effect of the Farmer Assurance Provision of the Consolidated and Continuing Appropriations Act, 2013 on Biodiversity and Global Food Security

A rider to a US law, the Consolidated and Continuing Appropriations Act, 2013, known as the Farmer Assurance Provision, encourages the large-scale genetic modification and global distribution of agricultural crops, thereby undermining the Food and Agriculture Organization of the United Nations' determination that food security rests on biodiversity. The rider blocks the US Department of Agriculture's mandate to prohibit farmers from growing crops from biotechnological seeds where the courts have found that this farm practice may cause damage to human health and/or degrade the environment. Despite genetically modified organisms (GMOs) reducing unwanted traits in plants, the paper supports the UN's mission for biodiversity and that more long-term testing was (and is) needed for GMO products, developed from 1994 on, before a hasty piece of Congressional legislation as was made in this case.

The effects of bicycle accommodations on bicycle/motor vehicle safety traffic operations. Final report.

Federal Highway Administration, Washington, D.C.

Using linked data to evaluate medical and financial outcomes of motor vehicle crashes in Connecticut.

Federal Highway Administration, Washington, D.C.

Using linked data to evaluate severity and outcome of injury by type of object struck (first object struck only) for motor vehicle crashes in Connecticut.

Federal Highway Administration, Washington, D.C.

The relationship between motor carrier economic regulation and highway safety.

Transportation Department, Office of the Assistant Secretary for Policy and International Affairs, Washington, D.C.

An evaluation of head restraints - Federal Motor Vehicle Safety Standard 202.

Mode of access: Internet.

Passenger car fuel economy, EPA and road : a report to the Congress in response to the National Energy Conservation Policy Act of 1978, public law 95-619, title IV, part 1, section 404 /

"September 1980"--Cover.