Members of "The Samoan Expeditionary Force" who made the supreme sacrifice in the Great War, 1914-1918

[by Stephen John Smith, late 5th (Wellington) Regiment, secretary Samoa administration in military occupation, 1915-1918]

The association between mental health and cigarette smoking in active duty military members

Previous research has shown an association between mental health status and cigarette smoking. This study examined four specific mental health predictors and the outcome variable any smoking, defined as smoking one or more cigarettes in the past 30 days. The population included active duty military members serving in the United States Army, Air Force, Navy and Marine Corps. The data was collected during the 2005 Department of Defense Survey of Health Related Behaviors Among Active Duty Military Personnel, a component of the Defense Lifestyle Assessment Program. The sample size included 13,603 subjects. This cross sectional prevalence study consisted of descriptive statistics, univariate analysis, and multivariate logistic regression analysis of the four mental health predictors and the any smoking outcome variable. Multivariate adjustment showed an association between the four mental health predictors and any smoking. This association is consistent with previous literature and can help guide public health officials in the development of smoking prevention and cessation programs.^

Improving disclosure of medical errors: Including patients and family members in the disclosure process

Over the last decade, adverse events and medical errors have become a main focus of interest for the standards of quality and safety in the U.S. healthcare system (Weinstein & Henderson, 2009). Particularly when a medical error occurs, the disclosure of medical errors and its practices have become a focal point of the healthcare process. Patients and family members who have experienced a medical error might be able to provide knowledge and insight on how to improve the disclose process. However, patient and family member are not typically involved in the disclosure process, thus their experiences go unnoticed. ^ The purpose of this research was to explore how best to include patients and family members in the disclosure process regarding a medical error. The research consisted of 28 qualitative interviews from three stakeholder groups: Hospital Administrators, Clinical Service Providers, and Patients and Family Members. They were asked for their ideas and suggestions on how best to include patients and family members in the disclosure process. Framework Analysis was used to analyze this data and find prevalent themes based on the primary research question. A secondary aim was to index categories created based on the interviews that were collected. Data was used from the Texas Disclosure and Compensation Study with Dr. Eric Thomas as the Principal Investigator. Full acknowledgement of access to this data is given to Dr. Thomas. ^ The themes from the research revealed that each stakeholder group was interested and open to including patients and family members in the disclosure process and that the disclosure process should not be a "one-way" avenue. The themes gave many suggestions regarding how to best include patients and family members in the disclosure process of a medical error. Secondary aims revealed several ways to assess the ideas and suggestion given by the stakeholders. Overall, acceptability of getting the perspective of patients and family members was the most common theme. Comparison of each stakeholder group revealed that including patients and family members would be beneficial to improving hospital disclosure practices. ^ Conclusions included a list of recommendations and measureable appropriate strategies that could provide hospital with key stakeholders insights on how to improve their disclosure process. Sharing patients and family members experience with healthcare providers can encourage a shift in culture where patients are valued and active in participating in hospital practices. To my knowledge, this research is the very first of its kind and moves the disclosure process conversation forward in a patient-family member inclusion direction that will assist in improving disclosure practices. Future research should implement and evaluate the success of the various inclusion strategies.^

Harmonization of trade in services by APEC members

This study maps out the degree of services trade liberalization by the APEC members toward achieving a Free Trade Area of the Asia-Pacific (FTAAP) and makes some comparative analyses. The study finds that the commitment level differs greatly between sensitive and less sensitive sectors, and that the commitment level under the ASEAN Framework Agreement (AFAS) package 8 is the highest among the four FTAs studied. It also finds that there are cross-country and sector-wide similarities in the pattern of service sector commitment under and across each of the FTAs; this implies that the shared domestic sensitivities can be overcome by an APEC-wide economic cooperation scheme for enhancing competitiveness (through, e.g., the Trans-Pacific Strategic Economic Partnership Agreement or TPP).

A repairability index for reinforced concrete members based on fracture mechanics

This paper proposes a repairability index for damage assessment in reinforced concrete structural members. The procedure discussed in this paper differs from the standard methods in two aspects: the structural and damage analyses are coupled and it is based on the concepts of fracture and continuum damage mechanics. The relationship between the repairability index and the well-known Park and Ang index is shown in some particular cases.

Design equations for reinforced concrete members strengthened in shear with external FRP reinforcement formulated in an evolutionary multi-objective framework

Methods for predicting the shear capacity of FRP shear strengthened RC beams assume the traditional approach of superimposing the contribution of the FRP reinforcing to the contributions from the reinforcing steel and the concrete. These methods become the basis for most guides for the design of externally bonded FRP systems for strengthening concrete structures. The variations among them come from the way they account for the effect of basic shear design parameters on shear capacity. This paper presents a simple method for defining improved equations to calculate the shear capacity of reinforced concrete beams externally shear strengthened with FRP. For the first time, the equations are obtained in a multiobjective optimization framework solved by using genetic algorithms, resulting from considering simultaneously the experimental results of beams with and without FRP external reinforcement. The performance of the new proposed equations is compared to the predictions with some of the current shear design guidelines for strengthening concrete structures using FRPs. The proposed procedure is also reformulated as a constrained optimization problem to provide more conservative shear predictions.

Fracture of concrete structural members subjected to blast

If reinforced concrete structures are to be safe under extreme impulsive loadings such as explosions, a broad understanding of the fracture mechanics of concrete under such events is needed. Most buildings and infrastructures which are likely to be subjected to terrorist attacks are borne by a reinforced concrete (RC) structure. Up to some years ago, the traditional method used to study the ability of RC structures to withstand explosions consisted on a choice between handmade calculations, affordable but inaccurate and unreliable, and full scale experimental tests involving explosions, expensive and not available for many civil institutions. In this context, during the last years numerical simulations have arisen as the most effective method to analyze structures under such events. However, for accurate numerical simulations, reliable constitutive models are needed. Assuming that failure of concrete elements subjected to blast is primarily governed by the tensile behavior, a constitutive model has been built that accounts only for failure under tension while it behaves as elastic without failure under compression. Failure under tension is based on the Cohesive Crack Model. Moreover, the constitutive model has been used to simulate the experimental structural response of reinforced concrete slabs subjected to blast. The results of the numerical simulations with the aforementioned constitutive model show its ability of representing accurately the structural response of the RC elements under study. The simplicity of the model, which does not account for failure under compression, as already mentioned, confirms that the ability of reinforced concrete structures to withstand blast loads is primarily governed by tensile strength.

Behaviour of Concrete Structural Members Subjected to Air Blast Loading

Numerical analysis is a suitable tool in the design of complex reinforced concrete structures under extreme impulsive loadings such as impacts or explosions at close range. Such events may be the result of terrorist attacks. Reinforced concrete is commonly used for buildings and infrastructures. For this reason, the ability to accurately run numerical simulations of concrete elements subjected to blast loading is needed. In this context, reliable constitutive models for concrete are of capital importance. In this research numerical simulations using two different constitutive models for concrete (Continuous Surface Cap Model and Brittle Damage Model) have been carried out using LS-DYNA. Two experimental benchmark tests have been taken as reference. The results of the numerical simulations with the aforementioned constitutive models show different abilities to accurately represent the structural response of the reinforced concrete elements studied.

Regulation of the human p21/WAF1/Cip1 promoter in hepatic cells by functional interactions between Sp1 and Smad family members

The cell cycle inhibitor p21/WAF1/Cip1 is expressed in many cell types and is regulated by p53-dependent and p53-independent mechanisms. p21 is an important regulator of hepatocyte cell cycle, differentiation, and liver development, but little is known about the regulation of its synthesis in hepatocytes. We report herein that the p21 gene is constitutively expressed in human hepatoma HepG2 cells. Deletion analysis of the p21 promoter showed that it contains a distal (positions −2,300/−210) and a proximal (positions −124 to −61) region that act synergistically to achieve high levels of constitutive expression. The proximal region that consists of multiple Sp1 binding sites is essential for constitutive p21 promoter activity in hepatocytes. This region also mediates the transcriptional activation of the p21 promoter by members of the Smad family of proteins, which play important role in the transduction of extracellular signals such as transforming growth factor β, activin, etc. Constitutive expression of p21 was severely reduced by a C-terminally truncated form of Smad4 that was shown previously to block signaling through Smads. Smad3/4 and to a much lesser extent Smad2/4 caused high levels of transcriptional activation of the p21 promoter. Transactivation was compromised by N- or C-terminally truncated forms of Smad3. By using Gal4-Sp1 fusion proteins, we show that Smad proteins can activate gene transcription via functional interactions with the ubiquitous factor Sp1. These data demonstrate that Smad proteins and Sp1 participate in the constitutive or inducible expression of the p21 gene in hepatic cells.

Diversification, expression, and γδ T cell recognition of evolutionarily distant members of the MIC family of major histocompatibility complex class I-related molecules

Distant relatives of major histocompatibility complex (MHC) class I molecules, human MICA and MICB, function as stress-induced antigens that are broadly recognized by intestinal epithelial γδ T cells. They may thus play a central role in the immune surveillance of damaged, infected, or otherwise stressed intestinal epithelial cells. However, the generality of this system in evolution and the mode of recognition of MICA and MICB are undefined. Analysis of cDNA sequences from various primate species defined translation products that are homologous to MICA and MICB. All of the MIC polypeptides have common characteristics, although they are extraordinarily diverse. The most notable alterations are several deletions and frequent amino acid substitutions in the putative α-helical regions of the α1α2 domains. However, the primate MIC molecules were expressed on the surfaces of normal and transfected cells. Moreover, despite their sharing of relatively few identical amino acids in potentially accessible regions of their α1α2 domains, they were recognized by diverse human intestinal epithelial γδ T cells that are restricted by MICA and MICB. Thus, MIC molecules represent a family of MHC proteins that are structurally diverse yet appear to be functionally conserved. The promiscuous mode of γδ T cell recognition of these antigens may be explained by their sharing of a single conserved interaction site.