963 resultados para Scaled Advice


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Domestic action on climate change is increasingly important in the light of the difficulties with international agreements and requires a combination of solutions, in terms of institutions and policy instruments. One way of achieving government carbon policy goals may be the creation of an independent body to advise, set or monitor policy. This paper critically assesses the Committee on Climate Change (CCC), which was created in 2008 as an independent body to help move the UK towards a low carbon economy. We look at the motivation for its creation in terms of: information provision, advice, monitoring, or policy delegation. In particular we consider its ability to overcome a time inconsistency problem by comparing and contrasting it with another independent body, the Monetary Policy Committee of the Bank of England. In practice the Committee on Climate Change appears to be the ‘inverse’ of the Monetary Policy Committee, in that it advises on what the policy goal should be rather than being responsible for achieving it. The CCC incorporates both advisory and monitoring functions to inform government and achieve a credible carbon policy over a long time frame. This is a similar framework to that adopted by Stern (2006), but the CCC operates on a continuing basis. We therefore believe the CCC is best viewed as a "Rolling Stern plus" body. There are also concerns as to how binding the budgets actually are and how the budgets interact with other energy policy goals and instruments, such as Renewable Obligation Contracts and the EU Emissions Trading Scheme. The CCC could potentially be reformed to include: an explicit information provision role; consumption-based accounting of emissions and control of a policy instrument such as a balanced-budget carbon tax.

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BACKGROUND: Risk factors for early mortality after pulmonary embolism (PE) are widely known. However, it is uncertain which factors are associated with early readmission after PE. We sought to identify predictors of readmission after an admission for PE. METHODS: We studied 14 426 patient discharges with a primary diagnosis of PE from 186 acute care hospitals in Pennsylvania from January 1, 2000, to November 30, 2002. The outcome was readmission within 30 days of presentation for PE. We used a discrete proportional odds model to study the association between time to readmission and patient factors (age, sex, race, insurance, discharge status, and severity of illness), thrombolysis, and hospital characteristics (region, teaching status, and number of beds). RESULTS: Overall, 2064 patient discharges (14.3%) resulted in a readmission within 30 days of presentation for PE. The most common reasons for readmission were venous thromboembolism (21.9%), cancer (10.8%), pneumonia (5.2%), and bleeding (5.0%). In multivariable analysis, African American race (odds ratio [OR], 1.19; 95% confidence interval [CI], 1.02-1.38), Medicaid insurance (OR, 1.54; 95% CI, 1.31-1.81), discharge home with supplemental care (OR, 1.40; 95% CI, 1.27-1.54), leaving the hospital against medical advice (OR, 2.84; 95% CI, 1.80-4.48), and severity of illness were independently associated with readmission; readmission also varied by hospital region. CONCLUSIONS: Early readmission after PE is common. African American race, Medicaid insurance, severity of illness, discharge status, and hospital region are significantly associated with readmission. The high readmission rates for venous thromboembolism and bleeding suggest that readmission may be linked to suboptimal quality of care in the management of PE.

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ABSTRACT: Apprenticeship is a period of increased risk of developing work-related respiratory allergic diseases. There is a need for documents to provide appropriate professional advice to young adults aiming to reduce unsuitable job choices and prevent impairment from their careers. The present document is the result of a consensus reached by a panel of experts from European and non-European countries addressed to allergologists, pneumologists, occupational physicians, primary care physicians, and other specialists interested in this field, which aims to reduce work-related respiratory allergies (rhinoconjunctivitis and asthma) among allergic or nonallergic apprentices and other young adults entering the workforce. The main objective of the document is to issue consensus suggestions for good clinical practice based on existing scientific evidence and the expertise of a panel of physicians.

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The appears to be no chemical manufacture of antimalarial drugs is Brazil. Technology at laboratory process level has been developed for chloroquine, mefloquine, pyrimethamine and cycloquanil, but not perfected nor scaled-up, largely for economic reasons and market uncertainty. Development of primaquine has been contracted but it will run into the same difficulty. Manufacturing capacity for sulfadoxine was registred in the SDI by Roche. A project to produce artemisinine and its derivates is under way at UNICAMP-CPQBA but is hampered by low content in the plant. Proguanil could be produced easily, but apparently no attempt has been made to do so. Quinine is imported on a large scale mostly for softdrink production. Since malarial treatment falls largely within responsability of the Government health authorities, manufacture of drugs in Brazil will depend on an assured medium-term purchase order made to a potential local manufacturer, since competition in the world market is scarcelyviable at the present moment.

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El uso de indicadores es una herramienta muy útil cuando intervienen varios factores dentro de un mismo estudio o comparación. En el presente proyecto se ha propuesto una metodología para evaluar un programa específico de acciones para la mejora de la calidad del aire (ProAire) en la ciudad guanajuatense de León, México. Se trata de la propuesta de indicadores ambientales, de salud, económicos y sociales que puedan aplicar en acciones del ProAire para evaluar su puesta en marcha y cómo, mediante toda la información recopilada a lo largo de este estudio, se van a aplicar estos indicadores, que van a dar una idea sobre cómo se está desarrollando el ProAire y si éste requiere de alguna modificación para mejorar. Al aplicarse los indicadores, se realiza un balance de cuáles son las acciones más importantes ambientalmente y socialmente y se hace hincapié en la necesidad de prestarles mayor atención. También se describen varias propuestas de mejora y consejos a aplicar en el programa para que éste sea más eficiente y los actores implicados puedan desarrollar sus acciones con mayor rapidez. Mediante el presente estudio se puede comprobar cómo de importante es la sociedad y los recursos económicos dentro de la problemática medioambiental.

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The authors complement the description of Triatoma matsunoi Fernandez-Loayza, 1989 and present the morphology of the male external genitalia, characterized by the presence of conjuntiva process (PrCj) denticulate, basal plate (Eplb) too long and median process pygophore (PrP) showing the apex streched and the surface rugose and scaled. The specimens examined (holotype [male symbol] and allotype [female symbol]) were deposited in the Collection Herman Lent of Triatomines of the Instituto Oswaldo Cruz, IOC, Rio de Janeiro, Brazil.

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Whiteflies and whitefly-transmitted viruses are some of the major constraints on European tomato production. The main objectives of this study were to: identify where and why whiteflies are a major limitation on tomato crops; collect information about whiteflies and associated viruses; determine the available management tools; and identify key knowledge gaps and research priorities. This study was conducted within the framework of ENDURE (European Network for Durable Exploitation of Crop Protection Strategies). Two whitefly species are the main pests of tomato in Europe: Bemisia tabaci and Trialeurodes vaporariorum. Trialeurodes vaporariorum is widespread to all areas where greenhouse industry is present, and B. tabaci has invaded, since the early 1990’s, all the subtropical and tropical areas. Biotypes B and Q of B. tabaci are widespread and especially problematic. Other key tomato pests are Aculops lycopersici, Helicoverpa armigera, Frankliniella occidentalis, and leaf miners. Tomato crops are particularly susceptible to viruses causingTomato yellow leaf curl disease (TYLCD). High incidences of this disease are associated to high pressure of its vector, B. tabaci. The ranked importance of B. tabaci established in this study correlates with the levels of insecticide use, showing B. tabaci as one of the principal drivers behind chemical control. Confirmed cases of resistance to almost all insecticides have been reported. Integrated Pest Management based on biological control (IPM-BC) is applied in all the surveyed regions and identified as the strategy using fewer insecticides. Other IPM components include greenhouse netting and TYLCD-tolerant tomato cultivars. Sampling techniques differ between regions, where decisions are generally based upon whitefly densities and do not relate to control strategies or growing cycles. For population monitoring and control, whitefly species are always identified. In Europe IPM-BC is the recommended strategy for a sustainable tomato production. The IPM-BC approach is mainly based on inoculative releases of the parasitoids Eretmocerus mundus and Encarsia formosa and/or the polyphagous predators Macrolophus caliginosus and Nesidiocoris tenuis. However, some limitations for a wider implementation have been identified: lack of biological solutions for some pests, costs of beneficials, low farmer confidence, costs of technical advice, and low pest injury thresholds. Research priorities to promote and improve IPM-BC are proposed on the following domains: (i) emergence and invasion of new whitefly-transmitted viruses; (ii) relevance of B. tabaci biotypes regarding insecticide resistance; (iii) biochemistry and genetics of plant resistance; (iv) economic thresholds and sampling techniques of whiteflies for decision making; and (v) conservation and management of native whitefly natural enemies and improvement of biological control of other tomato pests.

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Mounting evidence for acquired immunity to schistosomiasis in humans supports the case for immunological intervention. On the other hand, rapid reinfection poses a threat to younger age groups due to the slow maturation of natural resistance. However, rational approaches, based on advances in immunology and molecular biology, have substantially increased the odds of producing an effective vaccine. Since the parasite cannot replicate in the human host and serious morbidity generally occurs only after a relatively long period of heavy worm burden, complete protection against infection is not essential. The chances of success would increase if more than one of the various host/parasite interphases were targeted, for example reducing morbidity through decreased worm loads as well as through suppression of egg production. Several promising schistosome antigens have now reached an advanced phase of development and are currently undergoing independent confirmatory testing according to a standardized protocol. A few molecules are being contemplated for scaled-up production but, so far, only one has reached the stage of industrial manufacture and safety testing. Since schistosomiasis cannot realistically be controlled by a single approach, vaccination is envisaged to be implemented in conjunction with other means of control, notably chemotherapy.

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Característiques psicosocials i judicials dels menors víctimes d’abús sexual Els delictes contra la llibertat sexual a la infància són un greu problema social, atesa l’especial vulnerabilitat dels menors i els efectes que el delicte pot suposar en el seu desenvolupament. En el cas dels menors que arriben al sistema judicial, aquesta vulnerabilitat augmenta pel possible efecte de la victimització secundària. Aquesta recerca parteix de la necessitat de conèixer de manera objectiva les característiques dels menors presumptes víctimes d’abús sexual derivats a l’Equip d’Assessorament Tècnic Penal de Barcelona, atès que, si bé hi ha múltiples estudis descriptius amb aquest tipus de població en altres territoris nacionals o en altres països, mai no s’havia realitzat un estudi d’aquestes característiques en el servei de l’EATP. En aquest estudi es van analitzar les dades de 100 menors presumptes víctimes de delictes contra la llibertat sexual, denunciats a la província de Barcelona i derivats al nostre servei per demanda judicial durant un període d’un any. Les principals variables analitzades es van agrupar en les àrees següents: antecedents del delicte (personals i sociofamiliars), variables relacionades amb el delicte (variables judicials, del presumpte agressor i de la intervenció del nostre servei) i conseqüències judicials, personals i sociofamiliars del delicte. Els resultats de l’estudi destaquen que la majoria dels menors són nascuts a Catalunya, tenen més de nou anys i les tres quartes parts són nenes. La meitat de les famílies tenen un perfil tradicional i l’altra meitat són monoparentals o reconstituïdes; es valora un estil educatiu adequat en la majoria dels casos. Es copsa una escassa presència d’antecedents familiars significatius. En els menors predominen els trets de personalitat de submissió, conformisme i introversió, i presenten una escassa psicopatologia prèvia. Predominen els abusos sexuals crònics realitzats per una persona de l’entorn familiar del menor. En general, els testimonis dels menors sobre l’abús resulten globalment creïbles, i és molt baixa la proporció dels testimonis no creïbles. Les principals seqüeles psicològiques copsades en els menors són la simptomatologia ansiosa i posttraumàtica, i hi predominen també els sentiments de rebuig envers l’agressor.

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Características psicosociales y judiciales de los menores víctimas de abuso sexual El objetivo es conocer las características psicológicas, sociodemográficas y judiciales de los menores que denuncian delitos contra la libertad sexual en la provincia de Barcelona. La muestra está formada por 100 menores presuntas víctimas de delitos contra la libertad sexual denunciados en la provincia de Barcelona y atendidos por el Equipo de Asesoramiento Penal a la instancia judicial.

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El projecte ha d’establir xarxes per posar en contacte els diferents continguts, reflexions i recursos docents emprats per professors d’art medieval de la UB i la URV s’ha dut a terme adaptant-se a diferents conjuntures. Una modificació sorgida durant el desenvolupament del projecte deriva de la transformació que han de patir els actuals plans d’estudis enfront dels nous títols de grau. Els lligams plantejats en funció d’unes determinades assignatures s’ha vist alterat quan la seva definició i durada ha variat dins els nous plans d’estudis, en la preparació dels quals han intervingut diversos membres del projecte, tant des del Consell d’estudis com des de la Comissió promotora del grau d’història de l’art. Malgrat tot, els diferents professors hem elaborat materials específics per a la docència de les actuals assignatures, incloent un extens ventall de presentacions en PowerPoint, que abasten les distintes matèries implicades. A més de les classes i pràctiques pròpies de cada assignatura, vàrem dur a terme el cicle de conferències Imatges Indiscretes. Art i devoció a l’Edat Mitjana, per tal d’aproximar l’alumnat a la recerca desenvolupada pels membres del grup (incloent becaris i alguns invitats procedents d’altres universitats), ampliant l’oferta formativa més enllà dels formats més predeterminats. És en curs la publicació del cicle en forma de dossier docent. Si aquesta activitat s’orientava vers els continguts relatius a l’art medieval, també hem promogut una reflexió adreçada vers una problemàtica general específicament docent amb un Seminari de docència sobre a història de l’’art en el qual han participat, a més del grup, un ampli ventall de professors del Departament d’Història de l’Art de la UB, així com docents d’altres universitats i professionals vinculats a l’exercici de la disciplina. Tant el seminari com el cicle de conferències són propostes a les quals és previst donar continuïtat en futures convocatòries.

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Between 1927 and 1931 Marie Bonaparte had herself operated upon her clitoris three times. She did so against Freud's advice with whom she was in analysis. Among psychoanalysts these operations are still often regarded as "errors" or aberrations. But for Marie Bonaparte, who was in various ways familiar with physics and a somatic approach, surgery was the first choice, psychoanalysis only a possible alternative. She was not impressed by the skepticism of her colleagues, and adhered even more emphatically to her own strategy

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This document describes Health Impact Assessment (HIA) and the steps involved in HIA.  It gives advice based on the experience of HIA practitioners and provides tools to help carry out these steps and adapt HIA to local circumstances. This guidance manual explains what Health Impact Assessment (HIA) is and the stages involved in conducting it. It has been revised and updated based on the experience of HIA practitioners and includes new tools which have been developed to assist each step of the HIA process. It aims to provide a user friendly and practical framework to guide policy-makers and practitioners in undertaking HIA. All HIA tools contained in this guidance and further information on HIA may be found at http://www.publichealth.ie/hia

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This pilot Health Impact Assessment (HIA) exercise was conducted as part of the ‘Policy Health Impact Assessment for the European Union’, commissioned by the European Commission ’s Directorate Generale Health and Consumer Protection (DG Sanco). The project is coordinated by Liverpool University and the research partners are from Ireland, Germany and the Netherlands. The aim of the European project is to develop a HIA methodology for assessing the health impacts of EU policies and activities. The purpose of the pilot HIA in Ireland was to test the methodology produced in the first phase of the project in 2002. The policy chosen for assessment was the European Employment Strategy. The Irish pilot used a range of methods suggested in the draft methodology but concentrated particularly on the participatory aspects of HIA. A key stakeholder group with knowledge of employment (including decision makers in labour market policy) was established to provide expert advice and support. Other methods used included policy analysis, information gathering from key informants, community profiling (including demographic and labour force data), data analysis, literature review, the production of a report and the development of recommendations.

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“Decent Food for All” (DFfA) was a three-year integrated, partnership-based programme committed to reducing food poverty and addressing inequalities in physical and financial access to safe healthy food in the Armagh and Dungannon area of Northern Ireland. DFfA is led by the Armagh and Dungannon Health Action Zone (ADHAZ) and involves the delivery of a range of programmes and workshops which provide practical community based focused help and advice on food issues and nutrition. A comprehensive research and evaluation programme entitled ‘All-island learning from the Decent Food for All programme’ runs throughout the lifetime of the programme, which ensures effective evaluation, and the sharing of best practices and experiences. The research and evaluation program is coordinated by the Institute of Public Health in Ireland (IPH) with cooperation from ADHAZ. Funding for the research is provided by the Food Safety Promotion Board. To take into account background changes not directly attributable to the DFfA Programme a matched comparison area was selected in the Newry/Mourne area of Co. Down. An accurate measure of the changes that have occurred over the period of the DFfA programme is required. Valid estimates of change are based on measures before and after the programme. Pre-test and post-test community surveys provide a wide range of measures. This fact-book highlights the findings from the pre-test community survey.The aims of the pre-test survey were to:- Provide pre-test measures of the Key Performance Indicators underpinning the Key Expected Outcomes of the DFfA programme;- Identify factors influencing these pre-test measures; and- Contribute to the development of the programmes in DFfA.