A Test of Performance of Breast MRI Interpretation in a Multicentre Screening Study

Objectives: The aim of this study was to assess the consistency and performance of radiologists interpreting breast magnetic resonance imaging (MRI) examinations. Materials and Methods: Two test sets of eight cases comprising cancers, benign disease, technical problems and parenchymal enhancement were prepared from two manufacturers' equipment (X and Y) and reported by 15 radiologists using the recording form and scoring system of the UK MRI breast screening study [(MAgnetic Resonance Imaging in Breast Screening (MARIBS)]. Variations in assessments of morphology, kinetic scores and diagnosis were measured by assessing intraobserver and interobserver variability and agreement. The sensitivity and specificity of reporting performances was determined using receiver operating characteristic (ROC) curve analysis. Results: Intraobserver variation was seen in 13 (27.7%) of 47 of the radiologists' conclusions (four technical and seven pathological differences). Substantial interobserver variation was observed in the scores recorded for morphology, pattern of enhancement, quantification of enhancement and washout pattern. The overall sensitivity of breast MRI was high [88.6%, 95% confidence interval (CI) 77.4-94.7%], combined with a specificity of 69.2% (95% CI 60.5-76.7%). The sensitivities were similar for the two test sets (P=.3), but the specificity was significantly higher for the Manufacturer X dataset (P

Enhancing Life in the Hyper-surveillance Mini-world of a Space Station: The Role of Situation Awareness, Communication, and Reality TV in the Life of Astronauts

This is the third article of a series entitled Astronauts as Audiences. In this article, we investigate the roles that situation awareness (SA), communications, and reality TV (including media communications) might have on the lives of astronauts in remote space communities. We examined primary data about astronauts’ living and working environments, applicable theories of SA, communications, and reality TV (including media communications). We then surmised that the collective application of these roles might be a means of enhancing the lives of astronauts in remote space communities.

Emerging Structures of Farmer Cooperatives in Vietnam: Case studies from the Mekong Delta

Four farmer groups for mango production and marketing were formed in 2002 in southern Vietnam in response to government support for the creation of market oriented farmer cooperatives. The role and structure of these groups is considered in terms of the degree to which they conform to internationally recognised principles for cooperative formation. Each of the farmer groups studied has evolved in different ways and their degree of compliance with the principles of cooperation varies widely. It is evident that state intervention and market forces may give rise to cooperative structures that differ from that intended under the principles surrounding cooperative law.

Articulating wider smartphone emerging security issues in the case of M-government in Turkey

For the last several years, mobile devices and platform security threats, including wireless networking technology, have been top security issues. A departure has occurred from automatic anti-virus software based on traditional PC defense: risk management (authentication and encryption), compliance, and disaster recovery following polymorphic viruses and malware as the primary activities within many organizations and government services alike. This chapter covers research in Turkey as a reflection of the current market – e-government started officially in 2008. This situation in an emerging country presents the current situation and resistances encountered while engaging with mobile and e-government interfaces. The authors contend that research is needed to understand more precisely security threats and most of all potential solutions for sustainable future intention to use m-government services. Finally, beyond m-government initiatives' success or failure, the mechanisms related to public administration mobile technical capacity building and security issues are discussed.

Patients' perceptions and experiences of transitions in diabetes care: a longitudinal qualitative study

Objective To examine patients' perceptions and experiences over time of the devolvement of diabetes care/reviews from secondary to primary health-care settings. Design Repeat in-depth interviews with 20 patients over 4 years. Participants and setting Twenty type 2 diabetes patients recruited from primary- and secondary-care settings across Lothian, Scotland. Results Patients' views about their current diabetes care were informed by their previous service contact. The devolvement of diabetes care/reviews to general practice was presented as a 'mixed blessing'. Patients gained reassurance from their perception that receiving practice-based care/reviews signified that their diabetes was well-controlled. However, they also expressed resentment that, by achieving good control, they received what they saw as inferior care and/or less-frequent reviews to others with poorer control. While patients tended to regard GPs as having adequate expertise to conduct their practice-based reviews, they were more ambivalent about nurses taking on this role. Opportunities to receive holistic care in general practice were not always realized due to patients seeing health-care professionals for diabetes management to whom they would not normally present for other health issues. Conclusions It is important to educate patients about their care pathways, and to reassure them that frequency of reviews depends more on clinical need than location of care and that similar care guidelines are followed in hospital clinics and general practice. A patients' history of service contact may need to be taken into account in future studies of service satisfaction.

On Li’s Coefficients for Some Classes of L-Functions

AMS Subj. Classification: 11M41, 11M26, 11S40

Efficacy of educational interventions to reduce homophobia on the *college campus

Homophobic attitudes, irrational fears and negative attitudes against gay men and lesbians exist on the college campus (Lance, 2002; Rankin, 2003). Educators wishing to change these attitudes need to know what types of intervention would be effective. This investigation empirically assessed the degree of homophobia in a group of college students, and changes in the degree of homophobia following two levels of educational intervention that were rooted in educational theories and social contact theory. A 25-item scale developed by Hudson and Ricketts to measure the degree of negative attitudes toward gay men and lesbians was used in English classes at a southeastern university. This study examined the relationship between different demographic groups and the degree of change obtained as a result of the interventions. ^ Findings did not suggest that either interaction with gay men and lesbians in the form of a speaker panel or viewing a “coming out” episode of the Ellen show reduced homophobia to a significant extent. Results did demonstrate the Caribbeans and right wing authoritarians tend to be more homophobic. Post hoc analysis investigated factors that may have contaminated the interventions. Speaker Identification was a significant predictor of change in degree of homophobia. ^

Efficacy of Educational Interventions to Reduce Homophobia on the College Campus

Homophobic attitudes, irrational fears and negative attitudes against gay men and lesbians exist on the college campus (Lance, 2002; Rankin, 2003). Educators wishing to change these attitudes need to know what types of intervention would be effective. This investigation empirically assessed the degree of homophobia in a group of college students, and changes in the degree of homophobia following two levels of educational intervention that were rooted in educational theories and social contact theory. A 25-item scale developed by Hudson and Ricketts to measure the degree of negative attitudes toward gay men and lesbians was used in English classes at a southeastern university. This study examined the relationship between different demographic groups and the degree of change obtained as a result of the interventions. Findings did not suggest that either interaction with gay men and lesbians in the form of a speaker panel or viewing a “coming out” episode of the Ellen show reduced homophobia to a significant extent. Results did demonstrate the Caribbeans and right wing authoritarians tend to be more homophobic. Post hoc analysis investigated factors that may have contaminated the interventions. Speaker Identification was a significant predictor of change in degree of homophobia.

Making personalised nutrition the easy choice: Creating policies to break down the barriers and reap the benefits

Personalised diets based on people’s existing food choices, and/or phenotypic, and/or genetic information hold potential to improve public dietary-related health. The aim of this analysis, therefore, has been to examine the degree to which factors which determine uptake of personalised nutrition vary between EU countries to better target policies to encourage uptake, and optimise the health benefits of personalised nutrition technology. A questionnaire developed from previous qualitative research was used to survey nationally representative samples from 9 EU countries (N = 9381). Perceived barriers to the uptake of personalised nutrition comprised three factors (data protection; the eating context; and, societal acceptance). Trust in sources of information comprised four factors (commerce and media; practitioners; government; family and, friends). Benefits comprised a single factor. Analysis of Variance (ANOVA) was employed to compare differences in responses between the United Kingdom; Ireland; Portugal; Poland; Norway; the Netherlands; Germany; and, Spain. The results indicated that respondents in Greece, Poland, Ireland, Portugal and Spain, rated the benefits of personalised nutrition highest, suggesting a particular readiness in these countries to adopt personalised nutrition interventions. Greek participants were more likely to perceive the social context of eating as a barrier to adoption of personalised nutrition, implying a need for support in negotiating social situations while on a prescribed diet. Those in Spain, Germany, Portugal and Poland scored highest on perceived barriers related to data protection. Government was more trusted than commerce to deliver and provide information on personalised nutrition overall. This was particularly the case in Ireland, Portugal and Greece, indicating an imperative to build trust, particularly in the ability of commercial service providers to deliver personalised dietary regimes effectively in these countries. These findings, obtained from a nationally representative sample of EU citizens, imply that a parallel, integrated, public-private delivery system would capture the needs of most potential consumers.

CROSS-LINGUISTIC TRANSFER OF SPELLING SKILLS IN SPANISH-SPEAKING ADULT ESL LEARNERS

Spelling is an important literacy skill, and learning to spell is an important component of learning to write. Learners with strong spelling skills also exhibit greater reading, vocabulary, and orthographic knowledge than those with poor spelling skills (Ehri & Rosenthal, 2007; Ehri & Wilce, 1987; Rankin, Bruning, Timme, & Katkanant, 1993). English, being a deep orthography, has inconsistent sound-to-letter correspondences (Seymour, 2005; Ziegler & Goswami, 2005). This poses a great challenge for learners in gaining spelling fluency and accuracy. The purpose of the present study is to examine cross-linguistic transfer of English vowel spellings in Spanish-speaking adult ESL learners. The research participants were 129 Spanish-speaking adult ESL learners and 104 native English-speaking GED students enrolled in a community college located in the South Atlantic region of the United States. The adult ESL participants were in classes at three different levels of English proficiency: advanced, intermediate, and beginning. An experimental English spelling test was administered to both the native English-speaking and ESL participants. In addition, the adult ESL participants took the standardized spelling tests to rank their spelling skills in both English and Spanish. The data were analyzed using robust regression and Poisson regression procedures, Mann-Whitney test, and descriptive statistics. The study found that both Spanish spelling skills and English proficiency are strong predictors of English spelling skills. Spanish spelling is also a strong predictor of level of L1-influenced transfer. More proficient Spanish spellers made significantly fewer L1-influenced spelling errors than less proficient Spanish spellers. L1-influenced transfer of spelling knowledge from Spanish to English likely occurred in three vowel targets (/ɑɪ/ spelled as ae, ai, or ay, /ɑʊ/ spelled as au, and /eɪ/ spelled as e). The ESL participants and the native English-speaking participants produced highly similar error patterns of English vowel spellings when the errors did not indicate L1-influenced transfer, which implies that the two groups might follow similar trajectories of developing English spelling skills. The findings may help guide future researchers or practitioners to modify and develop instructional spelling intervention to meet the needs of adult ESL learners and help them gain English spelling competence.

Propuestas para garantizar la solvencia fiscal y financiera en el municipio de Envigado

El presente trabajo de investigación pretende generar propuestas para garantizar la solvencia fiscal y financiera en el municipio de Envigado, solvencia que permitirá realizar con eficiencia, eficacia y efectividad la gestión necesaria para el logro de las soluciones a los problemas y necesidades de la comunidad, haciendo que se mejore el desarrollo económico y social con mejor calidad de vida. Igualmente la solvencia financiera propiciará un mejor posicionamiento del municipio en el Rankin del Departamento Nacional de Planeación y Ministerio de Hacienda en los indicadores de desempeño fiscal e integral, según las diferentes categorías del Formato Único Territorial (FUT) que reporta el municipio trimestralmente, como también el cumplimiento de las metas del Plan de Desarrollo Municipal. De acuerdo con lo anterior, el municipio de Envigado requiere mantener patrimonio suficiente para poder pagar la deuda pública, los pasivos exigibles y contingentes, tanto en el corto como en el largo plazo. Igualmente debe buscar siempre mantener condiciones de liquidez inmediata, es decir disponibilidad de dinero en las cuentas financieras bancarias a la vista que le permitan hacer frente a sus obligaciones. La investigación se fundamenta en el análisis y la síntesis, mediante el proceso de investigación aplicada respecto del marco referencial, buscando con relaciones de causa efecto en una matriz de riegos y mediante la evaluación, la acción y la valoración de impacto financiero. El actual trabajo tiene la razón de hacerse, ya que el municipio de Envigado carece de un proceso de planeación financiera adecuado que presupueste los ingresos, apropie los egresos y ejecute los mismos con equidad, eficiencia y efectividad, y le permita tener la solvencia fiscal para que preste eficazmente sus funciones en búsqueda de mejor desarrollo económico y social para la comunidad. El análisis de la investigación se hará obteniendo información de diversas fuentes, tales como: El Sistema local de Planeación Municipal - SLPM, Plan Estratégico Territorial – PET, Plan de Ordenamiento Territorial – POT, Políticas Públicas y Planes Sectoriales, Plan de Desarrollo Municipal, Planes Zonales de Desarrollo, Presupuesto Participativo, Programa de Gobierno, Marco Fiscal de Mediano Plazo, Plan Plurianual de Inversiones, Plan Operativo Anual de Inversiones, Plan Financiero, Presupuesto Anual y Plan Anual de Caja- PAC. La administración central municipal de Envigado debe garantizar a sus acreedores y a su comunidad en general la solvencia fiscal y financiera, así como la de sus nueve entes descentralizados para asegurar el buen desarrollo económico y social, pero también para evitar caer en ley 550 de 1999, ley de insolvencia fiscal, que ha dejado a muchos municipios con un estigma difícil de mejorar en el mediano plazo, lo anterior independientemente de las sanciones disciplinarias, pecuniarias y penales que reciben las administraciones responsables por acción u omisión al no orientar al municipio hacia la solvencia fiscal y financiera. La Ley 550 de 1999 desarrolla los artículos 334 y 335 de la Constitución Política de Colombia, estableciendo y regulando los instrumentos de intervención estatal en la economía, y en el capítulo quinto (V) regula su aplicación a las entidades territoriales y descentralizadas del nivel territorial, tales como los departamentos, municipios o distritos. Tener solvencia fiscal y financiera en el municipio evitará que se incumpla la mencionada Ley, que se tenga que celebrar un convenio interadministrativo entre el municipio y el ministerio de Hacienda y crédito público, con la obligación de corregir las deficiencias que presente en su capacidad de operación y en el cumplimiento de sus obligaciones pecuniarias, para que pueda recuperarse dentro del plazo estipulado y en las condiciones que se hayan previsto en el mismo acuerdo. (Art. 5 de la ley 550). Este convenio tiene efecto vinculante, tanto para los municipios como para la totalidad de los acreedores.

Clinical outcome after first and recurrent hemorrhage in patients with untreated brain arteriovenous malformation

Background and Purpose: The morbidity from spontaneous hemorrhage of untreated brain arteriovenous malformations (AVM) is not well described. Methods: The 241 consecutive AVM patients (mean age 3716 years, 52% women) from the prospective Columbia AVM Databank initially presenting with hemorrhage were evaluated using the Rankin Scale (RS) and the National Institute of Health Stroke Scale (NIHSS). From the 241 AVM patients, 29 (12%) had subsequent intracranial hemorrhage during follow-up. For further comparisons, 84 non-AVM patients with intracerebral hemorrhage from the Northern Manhattan Study (NOMAS) served as a control group. Results: In 241 AVM patients presenting with hemorrhage the median RS was 2 and the median NIHSS was 1 (49% RS 0 to 1, 61% NIHSS 2). The median time between hemorrhage and clinical evaluation was 11 days (mean 219 days). Recurrent AVM hemorrhage during follow-up resulted in no significant increase in morbidity (median RS 2, P0.004; median NIHSS 3, P0.322; time between hemorrhage and study evaluation: median 55 days, mean 657 days). Among AVM-hemorrhage subtypes, parenchymatous AVM hemorrhage was associated with higher stroke morbidity (odds ratio, 2.9; 95% CI, 1.5 to 5.8 for NIHSS 2) than nonparenchymatous hemorrhages. Parenchymatous AVM hemorrhage had a significantly better outcome (median NIHSS 1) than non-AVM related hemorrhage (median NIHSS 12; P0.0001). Conclusions: Hemorrhage, either at initial presentation or during follow-up of untreated AVM patients appears to carry

Granulocyte-colony-stimulating factor mobilizes bone marrow stem cells in patients with subacute ischemic stroke: the Stem Cell Trial of Recovery EnhanceMent After Stroke (STEMS) Pilot Randomized, Controlled Trial (ISRCTN 16784092)

Background and Purpose - Loss of motor function is common after stroke and leads to significant chronic disability. Stem cells are capable of self-renewal and of differentiating into multiple cell types, including neurones, glia, and vascular cells. We assessed the safety of granulocyte-colony-stimulating factor (G-CSF) after stroke and its effect on circulating CD34 stem cells. Methods - We performed a 2-center, dose-escalation, double-blind, randomized, placebo-controlled pilot trial (ISRCTN 16784092) of G-CSF (6 blocks of 1 to 10 g/kg SC, 1 or 5 daily doses) in 36 patients with recent ischemic stroke. Circulating CD34 stem cells were measured by flow cytometry; blood counts and measures of safety and functional outcome were also monitored. All measures were made blinded to treatment. Results - Thirty-six patients, whose mean SD age was 768 years and of whom 50% were male, were recruited. G-CSF (5 days of 10 g/kg) increased CD34 count in a dose-dependent manner, from 2.5 to 37.7 at day 5 (area under curve, P0.005). A dose-dependent rise in white cell count (P0.001) was also seen. There was no difference between treatment groups in the number of patients with serious adverse events: G-CSF, 7/24 (29%) versus placebo 3/12 (25%), or in their dependence (modified Rankin Scale, median 4, interquartile range, 3 to 5) at 90 days. Conclusions - ”G-CSF is effective at mobilizing bone marrow CD34 stem cells in patients with recent ischemic stroke. Administration is feasible and appears to be safe and well tolerated. The fate of mobilized cells and their effect on functional outcome remain to be determined. (Stroke. 2006;37:2979-2983.)

The Virtual International Stroke Trials Archive

Background and Purpose - Stroke has global importance and it causes an increasing amount of human suffering and economic burden, but its management is far from optimal. The unsuccessful outcome of several research programs highlights the need for reliable data on which to plan future clinical trials. The Virtual International Stroke Trials Archive aims to aid the planning of clinical trials by collating and providing access to a rich resource of patient data to perform exploratory analyses. Methods - Data were contributed by the principal investigators of numerous trials from the past 16 years. These data have been centrally collated and are available for anonymized analysis and hypothesis testing. Results - ”Currently, the Virtual International Stroke Trials Archive contains 21 trials. There are data on 15 000 patients with both ischemic and hemorrhagic stroke. Ages range between 18 and 103 years, with a mean age of 6912 years. Outcome measures include the Barthel Index, Scandinavian Stroke Scale, National Institutes of Health Stroke Scale, Orgogozo Scale, and modified Rankin Scale. Medical history and onset-to-treatment time are readily available, and computed tomography lesion data are available for selected trials. Conclusions - This resource has the potential to influence clinical trial design and implementation through data analyses that inform planning. (Stroke. 2007;38:1905-1910.)