Efeito de diferentes divisões territoriais na flutuação aleatória de indicadores socioeconômicos relacionados à determinação social da saúde

This research aimed to analyse the effect of different territorial divisions in the random fluctuation of socio-economic indicators related to social determinants of health. This is an ecological study resulting from a combination of statistical methods including individuated and aggregate data analysis, using five databases derived from the database of the Brazilian demographic census 2010: overall results of the sample by weighting area. These data were grouped into the following levels: households; weighting areas; cities; Immediate Urban Associated Regions and Intermediate Urban Associated Regions. A theoretical model related to social determinants of health was used, with the dependent variable Household with death and as independent variables: Black race; Income; Childcare and school no attendance; Illiteracy; and Low schooling. The data was analysed in a model related to social determinants of health, using Poisson regression in individual basis, multilevel Poisson regression and multiple linear regression in light of the theoretical framework of the area. It was identified a greater proportion of households with deaths among those with at least one black resident, lower-income, illiterate, who do not attend or attended school or day-care and less educated. The analysis of the adjusted model showed that most adjusted prevalence ratio was related to Income, where there is a risk value of 1.33 for households with at least one resident with lower average personal income to R$ 655,00 (Brazilian current). The multilevel analysis demonstrated that there was a context effect when the variables were subjected to the effects of areas, insofar as the random effects were significant for all models and with different prevalence rates being higher in the areas with smaller dimensions - Weighting areas with coefficient of 0.035 and Cities with coefficient of 0.024. The ecological analyses have shown that the variable Income and Low schooling presented explanatory potential for the outcome on all models, having income greater power to determine the household deaths, especially in models related to Immediate Urban Associated Regions with a standardized coefficient of -0.616 and regions intermediate urban associated regions with a standardized coefficient of -0.618. It was concluded that there was a context effect on the random fluctuation of the socioeconomic indicators related to social determinants of health. This effect was explained by the characteristics of territorial divisions and individuals who live or work there. Context effects were better identified in the areas with smaller dimensions, which are more favourable to explain phenomena related to social determinants of health, especially in studies of societies marked by social inequalities. The composition effects were better identified in the Regions of Urban Articulation, shaped through mechanisms similar to the phenomenon under study.

(Appendix) Gephyrocapsa coccolith abundance and holocene paleotemperature assessment

A global sea surface temperature calibration based on the relative abundance of different morphotypes within the coccolithophore genus Gephyrocapsa in Holocene deep-sea sediments is presented. There is evidence suggesting that absolute sea surface temperature for a given location can be calculated from the relative abundance of Gephyrocapsa morphotypes in sediment samples, with a standard error comparable to temperature estimates derived from other temperature proxies such as planktic foraminifera transfer functions. A total of 110 Holocene sediment samples were selected from the Pacific, Indian, and Atlantic Oceans covering a mean sea surface temperature gradient from 13.6° to 29.3°C. Standard multiple linear regression analyses were applied to this data set, linking the relative abundance of Gephyrocapsa morphotypes to sea surface temperature. The best model revealed an r**2 of 0.83 with a standard residual error of 1.78°C for the estimation of mean sea surface temperature. This new proxy provides a unique opportunity for the reconstruction of paleotemperatures with a very small amount of sample material due to the minute size of coccoliths, permitting examination of thinly laminated sediments (e.g., a pinhead of material from laminated sediments for the reconstruction of annual sea surface temperature variations). Such fine-scale resolution is currently not possible with any other proxy. Application of this new paleotemperature proxy may allow new paleoenvironmental interpretations in the late Quaternary period and discrepancies between the different currently used paleotemperature proxies might be resolved.

Downwelling spectral irradiance as measured in different depths, remote sensing reflectance and phytoplankton pigment concentration during POLARSTERN cruises ANT-XXIV/1, ANT-XXIV/4, ANT-XXVI/4 and Maria S. Merian cruise MSM18/3

The composition and abundance of algal pigments provide information on phytoplankton community characteristics such as photoacclimation, overall biomass and taxonomic composition. In particular, pigments play a major role in photoprotection and in the light-driven part of photosynthesis. Most phytoplankton pigments can be measured by high-performance liquid chromatography (HPLC) techniques applied to filtered water samples. This method, as well as other laboratory analyses, is time consuming and therefore limits the number of samples that can be processed in a given time. In order to receive information on phytoplankton pigment composition with a higher temporal and spatial resolution, we have developed a method to assess pigment concentrations from continuous optical measurements. The method applies an empirical orthogonal function (EOF) analysis to remote-sensing reflectance data derived from ship-based hyperspectral underwater radiometry and from multispectral satellite data (using the Medium Resolution Imaging Spectrometer - MERIS - Polymer product developed by Steinmetz et al., 2011, doi:10.1364/OE.19.009783) measured in the Atlantic Ocean. Subsequently we developed multiple linear regression models with measured (collocated) pigment concentrations as the response variable and EOF loadings as predictor variables. The model results show that surface concentrations of a suite of pigments and pigment groups can be well predicted from the ship-based reflectance measurements, even when only a multispectral resolution is chosen (i.e., eight bands, similar to those used by MERIS). Based on the MERIS reflectance data, concentrations of total and monovinyl chlorophyll a and the groups of photoprotective and photosynthetic carotenoids can be predicted with high quality. As a demonstration of the utility of the approach, the fitted model based on satellite reflectance data as input was applied to 1 month of MERIS Polymer data to predict the concentration of those pigment groups for the whole eastern tropical Atlantic area. Bootstrapping explorations of cross-validation error indicate that the method can produce reliable predictions with relatively small data sets (e.g., < 50 collocated values of reflectance and pigment concentration). The method allows for the derivation of time series from continuous reflectance data of various pigment groups at various regions, which can be used to study variability and change of phytoplankton composition and photophysiology.

Trajetórias e fatores associados a qualidade de vida de mães de recém-nascidos pré-termos de muito baixo peso até três anos após o parto

Preterm birth is a public health problem worldwide. It holds growing global incidence rates, high mortality rates and a risk of the long-term sequelae in the newborn. It is also poses burden on the family and society. Mothers of very low birth weight (VLBW) preterm infants may develop psychological disorders, and impaired quality of life (QoL). Factors related to mothers and children in the postpartum period may be negatively associated with the QoL of these mothers. The aim of this study was to assess factors possibly associated with the QoL of mothers of VLBW preterm newborns during the first three years after birth. Mothers of VLBW preterm answered the World Health Organization Quality of Life (WHOQOL)-bref and the Beck Depression Inventory (BDI) in five time points up to 36 months postpartum, totalizing 260 observations. The WHOQOL–bref scores were compared and correlated with sociodemographic and clinical variables of mothers and children at discharge (T0) and at six (T1), twelve (T2), 24 (T3) and 36 (T4) months after the delivery. We used the Kruskal Wallis test to compared scores across different time points and correlated WHOQOL-bref scores with the sociodemographic and clinical variables of mothers and preterm infants. Multiple linear regression models were used to evaluate the contribution of these variables for the QoL of mothers. The WHOQOL–bref scores at T1 and T2 were higher when compared to scores in T0 in the physical health dimension (p = 0.013). BDI scores were also higher at T1 and T2 than those at T0 (p = 0.027). Among the maternal variables that contributed most to the QoL of mothers, there were: at T0, stable marital union (b= 13.60; p= 0.000) on the social relationships dimension, gestational age (b= 2.38; p= 0.010) in the physical health dimension; post-hemorrhagic hydrocephalus (b= -10.05; p= 0.010; b= -12.18; p= 0.013, respectively) in the psychological dimension; at T1 and T2, Bronchopulmonary dysplasia (b= -7.41; p= 0.005) and female sex (b= 8,094; p= 0.011) in the physical health dimension and environment, respectively. At T3, family income (b= -12.75’ p= 0.001) in the environment dimension, the SNAPPE neonatal severity score (b= -0.23; p= 0.027) on the social relationships dimension; at the T4, evangelical religion (b= 8.11; p= 0.019) and post-hemorrhagic hydrocephalus (b: -18.84 p: 0.001) on the social relationships dimension. The BDI scores were negatively associated with WHOQOL scores in all dimensions and at all times points: (-1.42 ≤ b ≤ -0.36; T0, T1, T2, T3 and T4). We conclude that mothers of preterm infants VLBW tend to have a transient improvement in the physical well-being during the first postpartum year. Their quality of life seems to return to levels at discharge between two and three years after delivery. The presence of maternal depressive symptoms and diagnosis of post-hemorrhagic hydrocephalus or BDP are factors negatively associated with the QoL of mothers. Social, religious and economic variables are positively associated with the QoL of mothers of VLBW preterm.

To what extent does the Health Professions Admission Test-Ireland predict performance in early undergraduate tests of communication and clinical skills? – An observational cohort study

Background: Internationally, tests of general mental ability are used in the selection of medical students. Examples include the Medical College Admission Test, Undergraduate Medicine and Health Sciences Admission Test and the UK Clinical Aptitude Test. The most widely used measure of their efficacy is predictive validity.A new tool, the Health Professions Admission Test- Ireland (HPAT-Ireland), was introduced in 2009. Traditionally, selection to Irish undergraduate medical schools relied on academic achievement. Since 2009, Irish and EU applicants are selected on a combination of their secondary school academic record (measured predominately by the Leaving Certificate Examination) and HPAT-Ireland score. This is the first study to report on the predictive validity of the HPAT-Ireland for early undergraduate assessments of communication and clinical skills. Method. Students enrolled at two Irish medical schools in 2009 were followed up for two years. Data collected were gender, HPAT-Ireland total and subsection scores; Leaving Certificate Examination plus HPAT-Ireland combined score, Year 1 Objective Structured Clinical Examination (OSCE) scores (Total score, communication and clinical subtest scores), Year 1 Multiple Choice Questions and Year 2 OSCE and subset scores. We report descriptive statistics, Pearson correlation coefficients and Multiple linear regression models. Results: Data were available for 312 students. In Year 1 none of the selection criteria were significantly related to student OSCE performance. The Leaving Certificate Examination and Leaving Certificate plus HPAT-Ireland combined scores correlated with MCQ marks.In Year 2 a series of significant correlations emerged between the HPAT-Ireland and subsections thereof with OSCE Communication Z-scores; OSCE Clinical Z-scores; and Total OSCE Z-scores. However on multiple regression only the relationship between Total OSCE Score and the Total HPAT-Ireland score remained significant; albeit the predictive power was modest. Conclusion: We found that none of our selection criteria strongly predict clinical and communication skills. The HPAT- Ireland appears to measures ability in domains different to those assessed by the Leaving Certificate Examination. While some significant associations did emerge in Year 2 between HPAT Ireland and total OSCE scores further evaluation is required to establish if this pattern continues during the senior years of the medical course.

Relationships Between Current and Past Binge Drinking and Systolic Blood Pressure in Young Adults.

PURPOSE: Heavy episodic (i.e., "binge") drinking (i.e., ≥five drinks/occasion) is highly prevalent among young adults; those who binge do so four times per month on average, consuming nine drinks on average on each occasion. Although it is well established that chronic heavy drinking (≥two alcoholic beverages per day) increases the risk of hypertension, the relationship between binge drinking and blood pressure is not well described. Our aim was to describe the relationship between frequency of binge drinking, both current (at age 24 years) and past (at age 20 years), and systolic blood pressure (SBP) at age 24 years. METHODS: Participants (n = 756) from the longitudinal Nicotine Dependence in Teens study reported alcohol consumption at ages 20 and 24 years and had SBP measured at age 24 years. We examined the association between binge drinking and SBP using multiple linear regression, controlling for sex, race/ethnicity, education, monthly drinking in high school, cigarette smoking, and body mass index. RESULTS: Compared to nonbinge drinkers, SBP at age 24 years was 2.61 [.41, 4.82] mm Hg higher among current monthly bingers and 4.03 [1.35, 6.70] mm Hg higher among current weekly bingers. SBP at age 24 years was 2.90 [.54, 5.25] mm Hg higher among monthly bingers at age 20 years and 3.64 [.93, 6.35] mm Hg higher among weekly bingers at age 20 years, compared to nonbinge drinkers. CONCLUSIONS: Frequent binge drinking at ages 20 and 24 years is associated with higher SBP at age 24 years and may be implicated in the development of hypertension.

Retrieval of grassland biophysical parameters using multitemporal optical and radar satellite data

The amount and quality of available biomass is a key factor for the sustainable livestock industry and agricultural management related decision making. Globally 31.5% of land cover is grassland while 80% of Ireland’s agricultural land is grassland. In Ireland, grasslands are intensively managed and provide the cheapest feed source for animals. This dissertation presents a detailed state of the art review of satellite remote sensing of grasslands, and the potential application of optical (Moderate–resolution Imaging Spectroradiometer (MODIS)) and radar (TerraSAR-X) time series imagery to estimate the grassland biomass at two study sites (Moorepark and Grange) in the Republic of Ireland using both statistical and state of the art machine learning algorithms. High quality weather data available from the on-site weather station was also used to calculate the Growing Degree Days (GDD) for Grange to determine the impact of ancillary data on biomass estimation. In situ and satellite data covering 12 years for the Moorepark and 6 years for the Grange study sites were used to predict grassland biomass using multiple linear regression, Neuro Fuzzy Inference Systems (ANFIS) models. The results demonstrate that a dense (8-day composite) MODIS image time series, along with high quality in situ data, can be used to retrieve grassland biomass with high performance (R2 = 0:86; p < 0:05, RMSE = 11.07 for Moorepark). The model for Grange was modified to evaluate the synergistic use of vegetation indices derived from remote sensing time series and accumulated GDD information. As GDD is strongly linked to the plant development, or phonological stage, an improvement in biomass estimation would be expected. It was observed that using the ANFIS model the biomass estimation accuracy increased from R2 = 0:76 (p < 0:05) to R2 = 0:81 (p < 0:05) and the root mean square error was reduced by 2.72%. The work on the application of optical remote sensing was further developed using a TerraSAR-X Staring Spotlight mode time series over the Moorepark study site to explore the extent to which very high resolution Synthetic Aperture Radar (SAR) data of interferometrically coherent paddocks can be exploited to retrieve grassland biophysical parameters. After filtering out the non-coherent plots it is demonstrated that interferometric coherence can be used to retrieve grassland biophysical parameters (i. e., height, biomass), and that it is possible to detect changes due to the grass growth, and grazing and mowing events, when the temporal baseline is short (11 days). However, it not possible to automatically uniquely identify the cause of these changes based only on the SAR backscatter and coherence, due to the ambiguity caused by tall grass laid down due to the wind. Overall, the work presented in this dissertation has demonstrated the potential of dense remote sensing and weather data time series to predict grassland biomass using machine-learning algorithms, where high quality ground data were used for training. At present a major limitation for national scale biomass retrieval is the lack of spatial and temporal ground samples, which can be partially resolved by minor modifications in the existing PastureBaseIreland database by adding the location and extent ofeach grassland paddock in the database. As far as remote sensing data requirements are concerned, MODIS is useful for large scale evaluation but due to its coarse resolution it is not possible to detect the variations within the fields and between the fields at the farm scale. However, this issue will be resolved in terms of spatial resolution by the Sentinel-2 mission, and when both satellites (Sentinel-2A and Sentinel-2B) are operational the revisit time will reduce to 5 days, which together with Landsat-8, should enable sufficient cloud-free data for operational biomass estimation at a national scale. The Synthetic Aperture Radar Interferometry (InSAR) approach is feasible if there are enough coherent interferometric pairs available, however this is difficult to achieve due to the temporal decorrelation of the signal. For repeat-pass InSAR over a vegetated area even an 11 days temporal baseline is too large. In order to achieve better coherence a very high resolution is required at the cost of spatial coverage, which limits its scope for use in an operational context at a national scale. Future InSAR missions with pair acquisition in Tandem mode will minimize the temporal decorrelation over vegetation areas for more focused studies. The proposed approach complements the current paradigm of Big Data in Earth Observation, and illustrates the feasibility of integrating data from multiple sources. In future, this framework can be used to build an operational decision support system for retrieval of grassland biophysical parameters based on data from long term planned optical missions (e. g., Landsat, Sentinel) that will ensure the continuity of data acquisition. Similarly, Spanish X-band PAZ and TerraSAR-X2 missions will ensure the continuity of TerraSAR-X and COSMO-SkyMed.

Effect of Performance Feedback on Perceived Knowledge and Likelihood to Pursue Continuing Education

The purpose of this study was to assess the effect of performance feedback on Athletic Trainers’ (ATs) perceived knowledge (PK) and likelihood to pursue continuing education (CE). The investigation was grounded in the theories of “the definition of the situation” (Thomas & Thomas, 1928) and the “illusion of knowing,” (Glenberg, Wilkinson, & Epstein, 1982) suggesting that PK drives behavior. This investigation measured the degree to which knowledge gap predicted CE seeking behavior by providing performance feedback designed to change PK. A pre-test post-test control-group design was used to measure PK and likelihood to pursue CE before and after assessing actual knowledge. ATs (n=103) were randomly sampled and assigned to two groups, with and without performance feedback. Two independent samples t-tests were used to compare groups on the difference scores of the dependent variables. Likelihood to pursue CE was predicted by three variables using multiple linear regression: perceived knowledge, pre-test likelihood to pursue CE, and knowledge gap. There was a 68.4% significant difference (t101= 2.72, p=0.01, ES=0.45) between groups in the change scores for likelihood to pursue CE because of the performance feedback (Experimental group=13.7% increase; Control group= 4.3% increase). The strongest relationship among the dependent variables was between pre-test and post-test measures of likelihood to pursue CE (F2,102=56.80, p<0.01, r=0.73, R2=0.53). The pre- and post-test predictive relationship was enhanced when group was included in the model. In this model [YCEpost=0.76XCEpre-0.34 Xgroup+2.24+E], group accounted for a significant amount of unique variance in predicting CE while the pre-test likelihood to pursue CE variable was held constant (F3,102=40.28, p<0.01,: r=0.74, R2=0.55). Pre-test knowledge gap, regardless of group allocation, was a linear predictor of the likelihood to pursue CE (F1,102=10.90, p=.01, r=.31, R2=.10). In this investigation, performance feedback significantly increased participants’ likelihood to pursue CE. Pre-test knowledge gap was a significant predictor of likelihood to pursue CE, regardless if performance feedback was provided. ATs may have self-assessed and engaged in internal feedback as a result of their test-taking experience. These findings indicate that feedback, both internal and external, may be necessary to trigger CE seeking behavior.

Establishing a Baseline Measurement of Intercultural Competence of Ukrainian Faculty: Setting the Stage for Domestic and Global Intercultural Understanding

Post-Soviet Ukraine is in a time of upheaval and transition. Internal relations between pro-Western and pro-Russian supporters have deteriorated in the light of recent political events of Euro Revolution, Russia’s occupation of the Crimean peninsula, and the militant confrontations in the southeastern regions of the country. In the light of these developments, intercultural competence is greatly needed to alleviate domestic tensions and enable effective intercultural communication with the representatives of different cultures within the country and beyond its borders. This study established a baseline of psychometric estimates of intercultural competence of Ukrainian higher education faculty. A sample of 276 professors of different academic majors from one university in Western Ukraine participated in the research. The Global Perspective Inventory (GPI; Merrill, Braskamp, & Braskamp, 2012) was chosen as a research instrument to measure intercultural competence of the faculty members. The GPI takes into account cognitive, intrapersonal, and interpersonal domains, each of which contains two scales reflective of theories of cultural development and intercultural communication – Cognitive-Knowing, Cognitive-Knowledge, Intrapersonal-Identity, Intrapersonal-Affect, Interpersonal-Social Responsibility, and Interpersonal-Social Interaction. Because the research instrument has neither been previously used as a measure of intercultural competence, nor administered in Ukraine, it was cross-validated using a Table of Specification (Newman, Lim, & Pineda, 2013) and two sets of factor analyses. As a result, a modified version of the GPI was created for use in Ukraine. Multiple linear regression analyses were used to test relationships between the participants’ GPI scores on intercultural competence, and several independent variables that consisted of academic discipline, intercultural experience, and how long the participants taught at the university. The analyses determined a positive relationship between the scores on three out of six scales of the original version and two out of five scales of the modified version of the GPI and all the independent variables simultaneously. The relationship between the faculty responses on the six scales of both GPI versions and the independent variables controlling for each other produced mixed results. A unique role of intercultural professional development in predicting intercultural competence was discussed.

Multivariate Techniques in Biomechanical Analysis

This work outlines the theoretical advantages of multivariate methods in biomechanical data, validates the proposed methods and outlines new clinical findings relating to knee osteoarthritis that were made possible by this approach. New techniques were based on existing multivariate approaches, Partial Least Squares (PLS) and Non-negative Matrix Factorization (NMF) and validated using existing data sets. The new techniques developed, PCA-PLS-LDA (Principal Component Analysis – Partial Least Squares – Linear Discriminant Analysis), PCA-PLS-MLR (Principal Component Analysis – Partial Least Squares –Multiple Linear Regression) and Waveform Similarity (based on NMF) were developed to address the challenging characteristics of biomechanical data, variability and correlation. As a result, these new structure-seeking technique revealed new clinical findings. The first new clinical finding relates to the relationship between pain, radiographic severity and mechanics. Simultaneous analysis of pain and radiographic severity outcomes, a first in biomechanics, revealed that the knee adduction moment’s relationship to radiographic features is mediated by pain in subjects with moderate osteoarthritis. The second clinical finding was quantifying the importance of neuromuscular patterns in brace effectiveness for patients with knee osteoarthritis. I found that brace effectiveness was more related to the patient’s unbraced neuromuscular patterns than it was to mechanics, and that these neuromuscular patterns were more complicated than simply increased overall muscle activity, as previously thought.

COPING STRATEGIES AND PSYCHOLOGICAL WELL-BEING AMONG BHUTANESE REFUGEES RESETTLED IN OTTAWA, CANADA

Since 2008, more than 6000 Bhutanese refugees have been resettled in over 21 communities across Canada, with nearly 300 individuals residing in Ottawa. This resettling process is associated with physical and psychological stress, as individuals acclimatize to a new country. A lack of understanding of the impact of this transition exists. This study assessed the relationship between coping strategies and psychological well-being of Bhutanese refugees resettled in Ottawa. A cross sectional survey of a representative sample of Bhutanese adults (n = 110) was conducted between November and December 2015. Coping strategies and psychological well-being were measured using the Brief COPE and General Well-being (GWB) scales. The total GWB mean score of 69.04 ± 12.09 suggests that respondents were in moderate distress. GWB did not significantly differ by sex, marital status, religion, employment, part time or full time job, or length of stay in Canada. Using multiple linear regression, significant independent variables from univariate analysis with GWB (age, education, positive reframing, self-blame and venting) were modeled to determine the best predictors of general well-being (GWB, F (11, 96) = 3.61, p < .001, R² = 21.2%). Higher levels of education and positive reframing were associated with greater GWB scores while self-blame and ages 41-50 were inversely associated with general well-being. It was found that above 66% of the unemployed participants were from age groups 41 and above. This finding suggests that career guidance services and vocational training to address unemployment may benefit this community. Nurses can provide support and counselling to assist refugees to minimize the use of negative coping strategies like self-blame and venting and promote positive coping strategies. Further, collaboration between nurses, other interdisciplinary professionals and community organizations is necessary to address social determinants of health and enhance refugee psychological well-being.

Associates of an elevated natriuretic peptide level in stable heart failure patients:implications for targeted management

BACKGROUND: Persistently elevated natriuretic peptide (NP) levels in heart failure (HF) patients are associated with impaired prognosis. Recent work suggests that NP-guided therapy can improve outcome, but the mechanisms behind an elevated BNP remain unclear. Among the potential stimuli for NP in clinically stable patients are persistent occult fluid overload, wall stress, inflammation, fibrosis, and ischemia. The purpose of this study was to identify associates of B-type natriuretic peptide (BNP) in a stable HF population.

METHODS: In a prospective observational study of 179 stable HF patients, the association between BNP and markers of collagen metabolism, inflammation, and Doppler-echocardiographic parameters including left ventricular ejection fraction (LVEF), left atrial volume index (LAVI), and E/e prime (E/e') was measured.

RESULTS: Univariable associates of elevated BNP were age, LVEF, LAVI, E/e', creatinine, and markers of collagen turnover. In a multiple linear regression model, age, creatinine, and LVEF remained significant associates of BNP. E/e' and markers of collagen turnover had a persistent impact on BNP independent of these covariates.

CONCLUSION: Multiple variables are associated with persistently elevated BNP levels in stable HF patients. Clarification of the relative importance of NP stimuli may help refine NP-guided therapy, potentially improving outcome for this at-risk population.

Tooth replacement for partially dentate elders: a willingness-to-pay analysis

Objectives: The primary aim of this study was to investigate partially dentate elders' willingness-to-pay (WTP) for two different tooth replacement strategies: Removable Partial Dentures (RPDs) and, functionally orientated treatment according to the principles of the Shortened Dental Arch (SDA). The secondary aim was to measure the same patient groups' WTP for dental implant treatment.Methods: 55 patients who had completed a previous RCT comparing two tooth replacement strategies (RPDs (n=27) and SDA (n=28)) were recruited (Trial Registration no. ISRCTN26302774). Patients were asked to indicate their WTP for treatment to replace missing teeth in a number of hypothetical scenarios using the payment card method of contingency evaluation coupled to different costs. Data were collected on patients' social class, income levels and other social circumstances. A Mann-Whitney U Test was used to compare differences in WTP between the two treatment groups. To investigate predictive factors for WTP, multiple linear regression analyses were conducted.Results: The median age for the patient sample was 72.0 years (IQR: 71-75 years). Patients who had been provided with RPDs indicated that their WTP for this treatment strategy was significantly higher (€550; IQR: 500-650) than those patients who had received SDA treatment (€500; IQR: 450-550) (p=0.003). However patients provided with RPDs indicated that their WTP for SDA treatment (€650; IQR: 600-650) was also significantly higher than those patients who had actually received functionally orientated treatment (€550; IQR: 500-600) (p<0.001). The results indicated that both current income levels and previous treatment allocation were significantly correlated to WTP for both the RPD and the SDA groups. Patients in both treatment groups exhibited little WTP for dental implant treatment with a median value recorded which was half the market value for this treatment (€1000; IQR: 500-1000).Conclusions: Amongst this patient cohort previous treatment experience had a strong influence on WTP as did current income levels. Both treatment groups indicated a very strong WTP for simpler, functionally orientated care using adhesive fixed prostheses (SDA) over conventional RPDs. Clinical significance: Partially dentate older patients expressed a strong preference for functionally orientated tooth replacement as an alternative to conventional RPDs.

Assessing trends in land use change in the Borana rangeland Ethiopia as one cause of greenhouse gas emissions and carbon sequestration variations

Landnutzungsänderungen sind eine wesentliche Ursache von Treibhausgasemissionen. Die Umwandlung von Ökosystemen mit permanenter natürlicher Vegetation hin zu Ackerbau mit zeitweise vegetationslosem Boden (z.B. nach der Bodenbearbeitung vor der Aussaat) führt häufig zu gesteigerten Treibhausgasemissionen und verminderter Kohlenstoffbindung. Weltweit dehnt sich Ackerbau sowohl in kleinbäuerlichen als auch in agro-industriellen Systemen aus, häufig in benachbarte semiaride bis subhumide Rangeland Ökosysteme. Die vorliegende Arbeit untersucht Trends der Landnutzungsänderung im Borana Rangeland Südäthiopiens. Bevölkerungswachstum, Landprivatisierung und damit einhergehende Einzäunung, veränderte Landnutzungspolitik und zunehmende Klimavariabilität führen zu raschen Veränderungen der traditionell auf Tierhaltung basierten, pastoralen Systeme. Mittels einer Literaturanalyse von Fallstudien in ostafrikanischen Rangelands wurde im Rahmen dieser Studie ein schematisches Modell der Zusammenhänge von Landnutzung, Treibhausgasemissionen und Kohlenstofffixierung entwickelt. Anhand von Satellitendaten und Daten aus Haushaltsbefragungen wurden Art und Umfang von Landnutzungsänderungen und Vegetationsveränderungen an fünf Untersuchungsstandorten (Darito/Yabelo Distrikt, Soda, Samaro, Haralo, Did Mega/alle Dire Distrikt) zwischen 1985 und 2011 analysiert. In Darito dehnte sich die Ackerbaufläche um 12% aus, überwiegend auf Kosten von Buschland. An den übrigen Standorten blieb die Ackerbaufläche relativ konstant, jedoch nahm Graslandvegetation um zwischen 16 und 28% zu, während Buschland um zwischen 23 und 31% abnahm. Lediglich am Standort Haralo nahm auch „bare land“, vegetationslose Flächen, um 13% zu. Faktoren, die zur Ausdehnung des Ackerbaus führen, wurden am Standort Darito detaillierter untersucht. GPS Daten und anbaugeschichtlichen Daten von 108 Feldern auf 54 Betrieben wurden in einem Geographischen Informationssystem (GIS) mit thematischen Boden-, Niederschlags-, und Hangneigungskarten sowie einem Digitales Höhenmodell überlagert. Multiple lineare Regression ermittelte Hangneigung und geographische Höhe als signifikante Erklärungsvariablen für die Ausdehnung von Ackerbau in niedrigere Lagen. Bodenart, Entfernung zum saisonalen Flusslauf und Niederschlag waren hingegen nicht signifikant. Das niedrige Bestimmtheitsmaß (R²=0,154) weist darauf hin, dass es weitere, hier nicht erfasste Erklärungsvariablen für die Richtung der räumlichen Ausweitung von Ackerland gibt. Streudiagramme zu Ackergröße und Anbaujahren in Relation zu geographischer Höhe zeigen seit dem Jahr 2000 eine Ausdehnung des Ackerbaus in Lagen unter 1620 müNN und eine Zunahme der Schlaggröße (>3ha). Die Analyse der phänologischen Entwicklung von Feldfrüchten im Jahresverlauf in Kombination mit Niederschlagsdaten und normalized difference vegetation index (NDVI) Zeitreihendaten dienten dazu, Zeitpunkte besonders hoher (Begrünung vor der Ernte) oder niedriger (nach der Bodenbearbeitung) Pflanzenbiomasse auf Ackerland zu identifizieren, um Ackerland und seine Ausdehnung von anderen Vegetationsformen fernerkundlich unterscheiden zu können. Anhand der NDVI Spektralprofile konnte Ackerland gut Wald, jedoch weniger gut von Gras- und Buschland unterschieden werden. Die geringe Auflösung (250m) der Moderate Resolution Imaging Spectroradiometer (MODIS) NDVI Daten führte zu einem Mixed Pixel Effect, d.h. die Fläche eines Pixels beinhaltete häufig verschiedene Vegetationsformen in unterschiedlichen Anteilen, was deren Unterscheidung beeinträchtigte. Für die Entwicklung eines Echtzeit Monitoring Systems für die Ausdehnung des Ackerbaus wären höher auflösende NDVI Daten (z.B. Multispektralband, Hyperion EO-1 Sensor) notwendig, um kleinräumig eine bessere Differenzierung von Ackerland und natürlicher Rangeland-Vegetation zu erhalten. Die Entwicklung und der Einsatz solcher Methoden als Entscheidungshilfen für Land- und Ressourcennutzungsplanung könnte dazu beitragen, Produktions- und Entwicklungsziele der Borana Landnutzer mit nationalen Anstrengungen zur Eindämmung des Klimawandels durch Steigerung der Kohlenstofffixierung in Rangelands in Einklang zu bringen.

Sysselsättningseffekter i svenska aktiebolag av införandet av RUT-avdraget : En Difference-in-Differenceanalys

Detta arbete har gjorts med syftet att utvärdera sysselsättningseffekterna i svenska aktiebolag av införandet av RUT-avdraget. RUT-avdraget infördes 2007 och innebär att privatpersoner kan få göra skattereduktion för olika typer av hushållsarbeten. Datamaterialet som används i denna studie är bokföringsdata för alla Sveriges aktiebolag mellan 2000 – 2010, aggregerat till tresiffriga SNI-koder för alla de svenska kommunerna. Utifrån datamaterialet har RUT-avdragets sysselsättningseffekter analyserats med hjälp av en Difference-in-Differencemodell. Resultatet visar att RUT-avdraget gjort att 6930 nya arbeten har skapats i de svenska aktiebolag som ingår i RUT-sektorn. Detta innebär alltså att RUT-avdraget har haft en positiv effekt på sysselsättningen.