Three-color white electroluminescence from a single polymer system with blue, green and red dopant units as individual emissive species and polyfluorene as individual polymer host

A white electroluminescent single polymer system with both high electroluminescence efficiency and excellent color rendering index (CRI) value is developed by covalently attaching blue, green, and red dopant units as individual light-emitting species to the side chain of polyfluorene as individual polymer host. A luminous efficiency of 8.6 cd A(-1), CIE coordinates of (0.33, 0.36) and CRI value of 88 was demonstrated with their single-layer devices.

White electroluminescence from a single-polymer system with simultaneous two-color emission: Polyfluorene as blue host and 2,1,3-benzothiadiazole derivatives as orange dopants on the side chain

Four single polymers with two kinds of attachment of orange chromophore to blue polymer host for white electroluminescence (EL) were designed. The effect of the side-chain attachment and main-chain attachment on the EL efficiencies of the resulting polymers was compared. The side-chain-type single polymers are found to exhibit more efficient white EL than that of the main-chain-type single polymers. Based on the side-chain-type white single polymer with 4-(4-alkyloxy-phenyl)-7-(4-diphenylamino-phenyl)-2,1,3-benzothiadiazoles as the orange-dopant unit and polyfluorene as the blue polymer host, white EL with simultaneous orange (lambda(max) = 545 nm) and blue emission (lambda(max) = 432 nm/460 nm) is realised. A single-layer device (indium tin oxide/poly(3,4-ethylenedioxythiophene)/polymer/Ca/Al) made of these polymers emits white light with the Commission Internationale de l'Eclairage coordinates of (0.30,0.40), possesses a turn-on voltage of 3.5 V, luminous efficiency of 10.66 cd A(-1), power efficiency of 6.68 lm W-1, and a maximum brightness of 21240 cd m(-2).

White electrolumineseence from a single-polymer system with simultaneous two-color emission: Polyfluorene as the blue host and a 2,1,3-benzothiadiazole derivative as the orange dopant on the main chain

New single-polymer electroluminescent systems containing two individual emission species - polyfluorenes as a blue host and 2,1,3-benzothiadiazole derivative units as an orange dopant on the main chain - have been designed and synthesized. The resulting single polymers are found to have highly efficient white electroluminescence with simultaneous blue(lambda(max) = 421 nm/445 nm) and orange emission (lambda(max) = 564 nm)from the corresponding emitting species. The influence of the photoluminescence (PL) efficiencies of both the blue and orange species on the electroluminescence (EL) efficiencies of white polymer light-emitting diodes (PLEDs) based on the single-polymer systems has been investigated. The introduction of the highly efficient 4,7-bis(4-(N-phenyl-N-(4-methylphenyl)amino)phenyl)-2,1,3-benzothiadiazole unit to the main chain of polyfluorene provides significant improvement in EL efficiency. For a single-layer device fabricated in air (indium tin oxide/poly(3,4-ethylenedioxythiophene): poly(styrene sulfonic acid/polymer/Ca/Al), pure-white electroluminescence with Commission Internationale de l'Eclairage (CIE) coordinates of (0.35,0.32), maximum brightness of 12 300 cd m(-2), luminance efficiency of 7.30 cd A(-1), and power efficiency of 3.34 lm W-1 can be obtained.

Caring for Alaska Native prostate cancer survivors in primary care: a survey of Alaska Tribal Health System providers.

BACKGROUND: Little is known about the constraints of optimizing health care for prostate cancer survivors in Alaska primary care. OBJECTIVE: To describe the experiences and attitudes of primary care providers within the Alaska Tribal Health System (ATHS) regarding the care of prostate cancer survivors. DESIGN: In late October 2011, we emailed a 22-item electronic survey to 268 ATHS primary care providers regarding the frequency of Prostate Specific Antigen (PSA) monitoring for a hypothetical prostate cancer survivor; who should be responsible for the patient's life-long prostate cancer surveillance; who should support the patient's emotional and medical needs as a survivor; and providers' level of comfort addressing recurrence monitoring, erectile dysfunction, urinary incontinence, androgen deprivation therapy, and emotional needs. We used simple logistic regression to examine the association between provider characteristics and their responses to the survivorship survey items. RESULTS: Of 221 individuals who were successfully contacted, a total of 114 responded (52% response rate). Most ATHS providers indicated they would order a PSA test every 12 months (69%) and believed that, ideally, the hypothetical patient's primary care provider should be responsible for his life-long prostate cancer surveillance (60%). Most providers reported feeling either "moderately" or "very" comfortable addressing topics such as prostate cancer recurrence (59%), erectile dysfunction (64%), urinary incontinence (63%), and emotional needs (61%) with prostate cancer survivors. These results varied somewhat by provider characteristics including female sex, years in practice, and the number of prostate cancer survivors seen in their practice. CONCLUSIONS: These data suggest that most primary care providers in Alaska are poised to assume the care of prostate cancer survivors locally. However, we also found that large minorities of providers do not feel confident in their ability to manage common issues in prostate cancer survivorship, implying that continued access to specialists with more expert knowledge would be beneficial.

Obama's law : analysis of a breakthrough law on healthcare access and lessons for the Portuguese health system management

ABSTRACT - The Patient Protection and Affordable Care Act shook the foundations of the US health system, offering all Americans access to health care by changing the way the health insurance industry works. As President Obama signed the Act on 23 March 2010, he said that it stood for ���the core principle that everybody should have some basic security when it comes to their health care���. Unlike the U.S., the Article 64 of the Portuguese Constitution provides, since 1976, the right to universal access to health care. However, facing a severe economic crisis, Portugal has, under the supervision of the Troika, a tight schedule to implement measures to improve the efficiency of the National Health Service. Both countries are therefore despite their different situation, in a conjuncture of reform and the use of new health management measures. The present work, using a qualitative research methodology examines the Affordable Care Act in order to describe its principles and enforcement mechanisms. In order to describe the reality in Portugal, the Portuguese health system and the measures imposed by Troika are also analyzed. The intention of this entire analysis is not only to disclose the innovative U.S. law, but to find some innovative measures that could serve health management in Portugal. Essentially we identified the Exchanges and Wellness Programs, described throughout this work, leaving also the idea of the possibility of using them in the Portuguese national health system.

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

La formation des soci��t��s fond��es sur la connaissance, le progr��s de la technologie de communications et un meilleur ��change d'informations au niveau mondial permet une meilleure utilisation des connaissances produites lors des d��cisions prises dans le syst��me de sant��. Dans des pays en voie de d��veloppement, quelques ��tudes sont men��es sur des obstacles qui emp��chent la prise des d��cisions fond��es sur des preuves (PDFDP) alors que des ��tudes similaires dans le monde d��velopp�� sont vraiment rares. L'Iran est le pays qui a connu la plus forte croissance dans les publications scientifiques au cours de ces derni��res ann��es, mais la question qui se pose est la suivante : quels sont les obstacles qui emp��chent l'utilisation de ces connaissances de m��me que celle des donn��es mondiales? Cette ��tude embrasse trois articles cons��cutifs. Le but du premier article a ��t�� de trouver un mod��le pour ��valuer l'��tat de l'utilisation des connaissances dans ces circonstances en Iran �� l���aide d'un examen vaste et syst��matique des sources suivie par une ��tude qualitative bas��e sur la m��thode de la Grounded Theory. Ensuite au cours du deuxi��me et troisi��me article, les obstacles aux d��cisions fond��es sur des preuves en Iran, sont ��tudi��s en interrogeant les directeurs, les d��cideurs du secteur de la sant�� et les chercheurs qui travaillent �� produire des preuves scientifiques pour la PDFDP en Iran. Apr��s avoir examin�� les mod��les disponibles existants et la r��alisation d'une ��tude qualitative, le premier article est sorti sous le titre de ��Conception d'un mod��le d'application des connaissances��. Ce premier article sert de cadre pour les deux autres articles qui ��valuent les obstacles �� ��pull�� et ��push�� pour des PDFDP dans le pays. En Iran, en tant que pays en d��veloppement, les probl��mes se situent dans toutes les ��tapes du processus de production, de partage et d���utilisation de la preuve dans la prise de d��cision du syst��me de sant��. Les obstacles qui existent �� la prise de d��cision fond��e sur des preuves sont divers et cela aux diff��rents niveaux; les solutions multi-dimensionnelles sont n��cessaires pour renforcer l'impact de preuves scientifiques sur les prises de d��cision. Ces solutions devraient entra��ner des changements dans la culture et le milieu de la prise de d��cision afin de valoriser la prise de d��cisions fond��es sur des preuves. Les crit��res de s��lection des gestionnaires et leur nomination inappropri��e ainsi que leurs rempla��ants rapides et les diff��rences de paiement dans les secteurs public et priv�� peuvent affaiblir la PDFDP de deux fa��ons : d���une part en influant sur la motivation des d��cideurs et d'autre part en d��truisant la continuit�� du programme. De m��me, tandis que la s��lection et le remplacement des chercheurs n'est pas comme ceux des gestionnaires, il n'y a aucun crit��re pour encourager ces deux groupes �� soutenir le processus d��cisionnel fond��s sur des preuves dans le secteur de la sant�� et les changements ult��rieurs. La s��lection et la promotion des d��cideurs politiques devraient ��tre bas��es sur leur performance en mati��re de la PDFDP et les efforts des universitaires doivent ��tre compt��s lors de leurs promotions personnelles et celles du rang de leur institution. Les attitudes et les capacit��s des d��cideurs et des chercheurs devraient ��tre encourag��s en leur donnant assez de pouvoir et d���habiliter dans les diff��rentes ��tapes du cycle de d��cision. Cette ��tude a r��v��l�� que les gestionnaires n'ont pas suffisamment acc��s �� la fois aux preuves nationales et internationales. R��duire l�����cart qui s��pare les chercheurs des d��cideurs est une ��tape cruciale qui doit ��tre r��alis��e en favorisant la communication r��ciproque. Cette question est tr��s importante ��tant donn�� que l'utilisation des connaissances ne peut ��tre renforc��e que par l'��troite collaboration entre les d��cideurs politiques et le secteur de la recherche. Dans ce but des programmes �� long terme doivent ��tre con��us ; la cr��ation des r��seaux de chercheurs et de d��cideurs pour le choix du sujet de recherche, le classement des priorit��s, et le fait de renforcer la confiance r��ciproque entre les chercheurs et les d��cideurs politiques semblent ��tre efficace.

Analyses of cataract surgery performed by the Unified Health System in Brazil, 2006-2007

Objective. Estimate cataract surgical rates (CSR) for Brazil and each federal unit in 2006 and 2007 based on the number of surgeries performed by the Unified Health System to help plan a comprehensive ophthalmology network in order to eliminate cataract blindness in compliance with the target set by the World Health Organization (WHO) of 3 000 cataract surgeries per million inhabitants per year. Methods. This descriptive study calculates CSR by using the number of cataract surgeries carried out by the Brazilian Unified Health System for each federal unit and estimates the need for cataract surgery in Brazil for 2006-2007, with official population data provided by the Brazilian Institute of Geography and Statistics. The number of cataract surgeries was compared with the WHO target. Results. To reach the WHO goal for eliminating age-related cataract blindness in Brazil, 560 312 cataract surgeries in 2006 and 568 006 surgeries in 2007 needed to be done. In 2006, 179 121 cataract surgeries were done by the Unified Health System, corresponding to a CSR of 959 per million population; in 2007, 223 317 were performed, with a CSR of 1 179. With the Brazilian Council of Ophthalmology estimation of 165 000 surgeries each year by the non-public services, the CSR for Brazil would be 1 842 for 2006 and 2 051 for 2007. The proportions needed to achieve the proposed target were 38.6% in 2006 and 31.6% in 2007. Conclusions. Human resources, technical expertise, and equipment are crucial to reach the WHO goal. Brazil has enough ophthalmologists but needs improved planning and infrastructure in order to eliminate the problem, aspects that require greater financial investment and stronger political commitment.

Trends in Morbid Obesity and in Bariatric Surgeries Covered by the Brazilian Public Health System

Obesity is an increasingly serious public health problem on a global level. Morbid obesity, defined as a body mass index greater than 40 kg/m(2), is associated with increased mortality and a high burden of obesity-related morbidities. To study the prevalence of morbid obesity in Brazil, three national anthropometric surveys were reanalyzed. Data about bariatric surgeries were obtained from the Ministry of Health Hospital Information System, which is available online. A 255% rise in the prevalence of morbid obesity was observed, starting at 0.18% in 1975-1976 and growing to 0.33% in 1989 and 0.64% in 2002-2003. There was a higher rate in the South in the first two surveys, but the prevalence in the Southeast rose steadily, reaching 0.77% in 2002-2003 and overtaking the South. Since 1999, the Brazilian Unified Health System has covered surgical treatment for morbid obesity. From 2000 to 2006, there was a sixfold increase in the number of surgeries, which topped the 2,500 mark in 2006. The geographic distribution of these surgeries is heavily concentrated in the Southeast, the most developed region of Brazil, where there is also the highest prevalence of morbid obesity. This was followed by the Southern region. The figures for the rise in morbid obesity in Brazil are startling, especially the increase among men. This is a situation that calls for further study, alongside measures to encourage the adoption of healthy lifestyles. Preventive measures aimed at slowing down or reversing the obesity epidemic are urgently required.

Health system context and implementation of evidence-based practices-development and validation of the Context Assessment for Community Health (COACH) tool for low- and middle-income settings

Background: The gap between what is known and what is practiced results in health service users not benefitting from advances in healthcare, and in unnecessary costs. A supportive context is considered a key element for successful implementation of evidence-based practices (EBP). There were no tools available for the systematic mapping of aspects of organizational context influencing the implementation of EBPs in low- and middle-income countries (LMICs). Thus, this project aimed to develop and psychometrically validate a tool for this purpose. Methods: The development of the Context Assessment for Community Health (COACH) tool was premised on the context dimension in the Promoting Action on Research Implementation in Health Services framework, and is a derivative product of the Alberta Context Tool. Its development was undertaken in Bangladesh, Vietnam, Uganda, South Africa and Nicaragua in six phases: (1) defining dimensions and draft tool development, (2) content validity amongst in-country expert panels, (3) content validity amongst international experts, (4) response process validity, (5) translation and (6) evaluation of psychometric properties amongst 690 health workers in the five countries. Results: The tool was validated for use amongst physicians, nurse/midwives and community health workers. The six phases of development resulted in a good fit between the theoretical dimensions of the COACH tool and its psychometric properties. The tool has 49 items measuring eight aspects of context: Resources, Community engagement, Commitment to work, Informal payment, Leadership, Work culture, Monitoring services for action and Sources of knowledge. Conclusions: Aspects of organizational context that were identified as influencing the implementation of EBPs in high-income settings were also found to be relevant in LMICs. However, there were additional aspects of context of relevance in LMICs specifically Resources, Community engagement, Commitment to work and Informal payment. Use of the COACH tool will allow for systematic description of the local healthcare context prior implementing healthcare interventions to allow for tailoring implementation strategies or as part of the evaluation of implementing healthcare interventions and thus allow for deeper insights into the process of implementing EBPs in LMICs.

Neural Network-Based Approach for Identification of the Harmonic Content of a Nonlinear Load in a Single-Phase System

In this paper an alternative method based on artificial neural networks is presented to determine harmonic components in the load current of a single-phase electric power system with nonlinear loads, whose parameters can vary so much in reason of the loads characteristic behaviors as because of the human intervention. The first six components in the load current are determined using the information contained in the time-varying waveforms. The effectiveness of this method is verified by using it in a single-phase active power filter with selective compensation of the current drained by an AC controller. The proposed method is compared with the fast Fourier transform.