834 resultados para Epidemiological Research Design


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[EN] This work presents the findings of a participatory research program evaluating the outcomes of an Italian sports program for minors at risk. Using a participatory evaluation approach enabled an evaluation-research close to the real objectives and useful for monitoring and e-planning actions, starting from an initial exploration of the different stakeholders’ views of the project itself. The research design is presented in the form of a case study, emphasizing the continuous involvement of the project’s stakeholders in the evaluation process. The outcomes here presented make evident how the participatory evaluation project allowed a targeted and ongoing monitoring at group level as well as at individual level with the minors involved in the project.

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Rita Cannas presents a PhD thesis in Economics (Geo-Economic curriculum) which is titled “Public Policies for Seasonality in Tourism from a Territorial Perspective. Case Studies in Scotland and Sardinia”. The specific area of the research is public policies for contrasting seasonality in tourism in peripheral areas. Seasonality has seen such as a problem in terms of social and economics patterns especially for those local communities which are situated in peripheral areas. The research explores what, how and for who, public policies, that have been in place in Scotland and Sardinia over the last 10-5 years, are working and what kind of results these have produced. The research has empirical and theoretical implications for studying tourism seasonality. It aims to highlight the local supply patterns of the phenomenon investigated, and to improve knowledge about the strategies and the policies that have been adopted in the two territorial contexts (Scotland and Sardinia) for contrasting or modifying seasonality in tourism. The type of subject and the research questions have suggested the adoption of an interpretative theoretical perspective and a qualitative methodological approach, although a set of quantitative secondary data is also required for understanding main tourism's characteristics and for analyzing the specificity of seasonality. Interview with key actors of the local system in Scotland and Sardinia is the method chosen to collect primary data. In total the researcher has done 20 interviews in deep. Case studies are chosen both as unity of analysis and research strategy. The main findings of the research show a different and complex scenario about quality and quantity of public policies and strategies in tourism in the two case studies. The role of local resources is quite strategic on delivering tourism services and on counteracting seasonality. Events, festival are the main demand-side strategies. From a supply-side the principles policies are focused on quality of services, technology, high skills, sustainability. Partnership between public and private sector seems to be a fundamental way to work in order to attain changes and outcomes. The research has a strong research design, provides coherent results, and it has been done paying attention to the validation of the whole process.

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L’obiettivo del presente progetto di ricerca era determinare se l’utilizzo non clinico del simulatore d’alba (un dispositivo che emette luce in graduale aumento prima del risveglio), basato su specifiche conoscenze cronobiologiche, potesse ridurre alcune delle conseguenze del social jetlag, in studenti di scuola secondaria di secondo grado. A tal fine, sono stati valutati gli effetti del simulatore d’alba su tono dell’umore (valutato soggettivamente tramite la Global and Vigor Affect Scale-GVA), livelli di attivazione (valutati soggettivamente tramite la GVA), qualità/quantità di sonno (valutate oggettivamente e soggettivamente tramite attigrafia e Mini Sleep Questionnaire-MSQ), architettura del sonno (valutata oggettivamente tramite Zeo®) ed efficienza dei tre network attentivi (alerting, orienting ed executive), valutata oggettivamente tramite l’Attention Network Test (ANT). In totale, hanno preso parte alla ricerca 56 adolescenti (24 femmine e 32 maschi), frequentanti due istituti di scuola secondaria di secondo grado nella città di Cesena, la cui età media era di 17.68 anni (range d’età 15-20 anni). Ad ogni studente è stata richiesta una partecipazione di 5 settimane consecutive ed il disegno di ricerca prevedeva 3 condizioni sperimentali: baseline, simulatore d’alba e controllo. All’MSQ, in seguito all’utilizzo del simulatore d’alba, sono state osservate una minore percezione di sonnolenza diurna, una frequenza inferiore di risvegli notturni ed una riduzione del numero di partecipanti che presentavano una cattiva qualità della veglia. All’ANT, è stato documentato un significativo miglioramento dell’efficienza del network attentivo dell’alerting, successivo all’impiego del simulatore d’alba, dovuto ad una maggiore reattività dei partecipanti in seguito alla comparsa del double cue, che anticipava la presentazione del target (freccia centrale di cui i partecipanti dovevano giudicare la direzione). Tali risultati convergono nell’evidenziare la capacità del simulatore d’alba di esercitare un effetto attivante/stimolante, mostrando dunque come esso possa essere considerato uno strumento potenzialmente utilizzabile quale contromisura al social jetlag in adolescenza.

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One important metaphor, referred to biological theories, used to investigate on organizational and business strategy issues is the metaphor about heredity; an area requiring further investigation is the extent to which the characteristics of blueprints inherited from the parent, helps in explaining subsequent development of the spawned ventures. In order to shed a light on the tension between inherited patterns and the new trajectory that may characterize spawned ventures’ development we propose a model aimed at investigating which blueprints elements might exert an effect on business model design choices and to which extent their persistence (or abandonment) determines subsequent business model innovation. Under the assumption that academic and corporate institutions transmit different genes to their spin-offs, we hence expect to have heterogeneity in elements that affect business model design choices and its subsequent evolution. This is the reason why we carry on a twofold analysis in the biotech (meta)industry: under a multiple-case research design, business model and especially its fundamental design elements and themes scholars individuated to decompose the construct, have been thoroughly analysed. Our purpose is to isolate the dimensions of business model that may have been the object of legacy and the ones along which an experimentation and learning process is more likely to happen, bearing in mind that differences between academic and corporate might not be that evident as expected, especially considering that business model innovation may occur.

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The development of next generation microwave technology for backhauling systems is driven by an increasing capacity demand. In order to provide higher data rates and throughputs over a point-to-point link, a cost-effective performance improvement is enabled by an enhanced energy-efficiency of the transmit power amplification stage, whereas a combination of spectrally efficient modulation formats and wider bandwidths is supported by amplifiers that fulfil strict constraints in terms of linearity. An optimal trade-off between these conflicting requirements can be achieved by resorting to flexible digital signal processing techniques at baseband. In such a scenario, the adaptive digital pre-distortion is a well-known linearization method, that comes up to be a potentially widely-used solution since it can be easily integrated into base stations. Its operation can effectively compensate for the inter-modulation distortion introduced by the power amplifier, keeping up with the frequency-dependent time-varying behaviour of the relative nonlinear characteristic. In particular, the impact of the memory effects become more relevant and their equalisation become more challenging as the input discrete signal feature a wider bandwidth and a faster envelope to pre-distort. This thesis project involves the research, design and simulation a pre-distorter implementation at RTL based on a novel polyphase architecture, which makes it capable of operating over very wideband signals at a sampling rate that complies with the actual available clock speed of current digital devices. The motivation behind this structure is to carry out a feasible pre-distortion for the multi-band spectrally efficient complex signals carrying multiple channels that are going to be transmitted in near future high capacity and reliability microwave backhaul links.

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Die Regulierung und Steuerung von Hochschulen unterliegt spätestens seit der Liberalisierung des Hochschulrahmengesetzes im Jahr 1998 einer erheblichen Reformdynamik. Hochschulautonomie, New Public Management, Profilbildung, Exzellenz und Wettbewerb sind zentrale Stichworte im Rahmen der durchgeführten politischen Reformen und Programme.rnDer politisch intendierte Ausbau einer organisationalen Selbststeuerung von Universitäten stellt die Hochschulen vor beachtliche Herausforderungen und kann als Paradigmenwechsel im Bereich der Hochschul-Governance betrachtet werden. In der Fachdiskussion wird der entsprechende Wandel auch als Stärkung der „managerial governance“ (bspw. de Boer et al. 2007) oder als Wandel von Universitäten hin zu „more complete organizations“ (Brunsson/ Sahlin-Andersson 2000) bzw. „organisational actors“ (Krücken/Meier 2006) beschrieben. rnGleichzeitig liegt bislang eher fragmentarisches Wissen darüber vor, wie der veränderte Re-gulierungskontext von den Steuerungsakteuren in deutschen Hochschulen aufgegriffen wird, d.h. ob auf Organisationsebene tatsächlich ein Ausbau der organisationalen Selbststeuerung stattfindet, welche Steuerungsinitiativen und -instrumente sich bewähren und warum dies der Fall ist. Die vorliegende Arbeit geht diesen Fragen im Rahmen einer vergleichenden Fallstudie an sechs Universitäten nach. rnIm Zentrum der empirischen Erhebung stehen 60 qualitative sozialwissenschaftliche Interviews mit Leitungsakteuren auf Hochschul- und Fachbereichsebene. Diese Daten werden ergänzt durch umfangreiche Dokumentenanalysen, insbesondere von Jahresberichten, Grundordnungen, Strategie- und Planungsdokumenten sowie durch Daten der amtlichen Hochschul-statistik. Das Untersuchungsdesign erlaubt überdies eine Gegenüberstellung von großen und kleinen Universitäten sowie von Hochschulen mit einer technisch-naturwissenschaftlichen Ausrichtung gegenüber solchen mit einem kultur- und sozialwissenschaftlichen Schwerpunkt. Die Untersuchung zeigt, dass an fünf der sechs untersuchten Hochschulen ein zum Teil deutlicher Ausbau der organisationalen Selbststeuerung festzustellen ist, wenngleich der spezifische organisationale Charakter von Universitäten, d.h. eine weitgehend lose Kopplung mit autonomen Professionals, im Wesentlichen erhalten bleibt. Die Zusammenschau der Veränderungen ergibt ein idealtypisches Modell des Wandels von Strategie, Struktur und Kultur der Hochschulen. Auf Basis der empirischen Ergebnisse werden weiterhin zentrale externe und interne Einflussfaktoren auf den spezifischen organisationalen Wandel analysiert. Schließlich werden Kosten und Nutzen sowie Risiken und Chancen der Governance-Reformen im Hoch-schulbereich gegenübergestellt.

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Excessive cantilever lengths of fixed implant-supported prostheses may have functional and biomechanical disadvantages. This study reports the clinical outcomes of unconventional implants placed for distal support of a fixed implant-supported prostheses. Seven extraoral implants with intraosseous lengths of 2.5 to 4.0 mm were placed in four patients. Distal cantilevers had a mean length of 29.8 mm (range, 18.6 to 39.3 mm). No bone loss or other adverse events were found. The prosthetic plan was maintained in all patients. Within the limits of the employed research design, this concept seems to be a successful option for fixed complete implant-supported prosthesis treatment.

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Using data from a large European collaborative study, we aimed to identify the circumstances in which treated HIV-infected individuals will experience similar mortality rates to those of the general population.

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Area-based measures of socioeconomic position (SEP) suitable for epidemiological research are lacking in Switzerland. The authors developed the Swiss neighbourhood index of SEP (Swiss-SEP).

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Indoor radon is regularly measured in Switzerland. However, a nationwide model to predict residential radon levels has not been developed. The aim of this study was to develop a prediction model to assess indoor radon concentrations in Switzerland. The model was based on 44,631 measurements from the nationwide Swiss radon database collected between 1994 and 2004. Of these, 80% randomly selected measurements were used for model development and the remaining 20% for an independent model validation. A multivariable log-linear regression model was fitted and relevant predictors selected according to evidence from the literature, the adjusted R², the Akaike's information criterion (AIC), and the Bayesian information criterion (BIC). The prediction model was evaluated by calculating Spearman rank correlation between measured and predicted values. Additionally, the predicted values were categorised into three categories (50th, 50th-90th and 90th percentile) and compared with measured categories using a weighted Kappa statistic. The most relevant predictors for indoor radon levels were tectonic units and year of construction of the building, followed by soil texture, degree of urbanisation, floor of the building where the measurement was taken and housing type (P-values <0.001 for all). Mean predicted radon values (geometric mean) were 66 Bq/m³ (interquartile range 40-111 Bq/m³) in the lowest exposure category, 126 Bq/m³ (69-215 Bq/m³) in the medium category, and 219 Bq/m³ (108-427 Bq/m³) in the highest category. Spearman correlation between predictions and measurements was 0.45 (95%-CI: 0.44; 0.46) for the development dataset and 0.44 (95%-CI: 0.42; 0.46) for the validation dataset. Kappa coefficients were 0.31 for the development and 0.30 for the validation dataset, respectively. The model explained 20% overall variability (adjusted R²). In conclusion, this residential radon prediction model, based on a large number of measurements, was demonstrated to be robust through validation with an independent dataset. The model is appropriate for predicting radon level exposure of the Swiss population in epidemiological research. Nevertheless, some exposure misclassification and regression to the mean is unavoidable and should be taken into account in future applications of the model.

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Background Most adults infected with HIV achieve viral suppression within a year of starting combination antiretroviral therapy (cART). It is important to understand the risk of AIDS events or death for patients with a suppressed viral load. Methods and Findings Using data from the Collaboration of Observational HIV Epidemiological Research Europe (2010 merger), we assessed the risk of a new AIDS-defining event or death in successfully treated patients. We accumulated episodes of viral suppression for each patient while on cART, each episode beginning with the second of two consecutive plasma viral load measurements <50 copies/µl and ending with either a measurement >500 copies/µl, the first of two consecutive measurements between 50–500 copies/µl, cART interruption or administrative censoring. We used stratified multivariate Cox models to estimate the association between time updated CD4 cell count and a new AIDS event or death or death alone. 75,336 patients contributed 104,265 suppression episodes and were suppressed while on cART for a median 2.7 years. The mortality rate was 4.8 per 1,000 years of viral suppression. A higher CD4 cell count was always associated with a reduced risk of a new AIDS event or death; with a hazard ratio per 100 cells/µl (95% CI) of: 0.35 (0.30–0.40) for counts <200 cells/µl, 0.81 (0.71–0.92) for counts 200 to <350 cells/µl, 0.74 (0.66–0.83) for counts 350 to <500 cells/µl, and 0.96 (0.92–0.99) for counts ≥500 cells/µl. A higher CD4 cell count became even more beneficial over time for patients with CD4 cell counts <200 cells/µl. Conclusions Despite the low mortality rate, the risk of a new AIDS event or death follows a CD4 cell count gradient in patients with viral suppression. A higher CD4 cell count was associated with the greatest benefit for patients with a CD4 cell count <200 cells/µl but still some slight benefit for those with a CD4 cell count ≥500 cells/µl.

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We developed a geospatial model that calculates ambient high-frequency electromagnetic field (HF-EMF) strengths of stationary transmission installations such as mobile phone base stations and broadcast transmitters with high spatial resolution in the order of 1 m. The model considers the location and transmission patterns of the transmitters, the three-dimensional topography, and shielding effects by buildings. The aim of the present study was to assess the suitability of the model for exposure monitoring and for epidemiological research. We modeled time-averaged HF-EMF strengths for an urban area in the city of Basel as well as for a rural area (Bubendorf). To compare modeling with measurements, we selected 20 outdoor measurement sites in Basel and 18 sites in Bubendorf. We calculated Pearson's correlation coefficients between modeling and measurements. Chance-corrected agreement was evaluated by weighted Cohen's kappa statistics for three exposure categories. Correlation between measurements and modeling of the total HF-EMF strength was 0.67 (95% confidence interval (CI): 0.33-0.86) in the city of Basel and 0.77 (95% CI: 0.46-0.91) in the rural area. In both regions, kappa coefficients between measurements and modeling were 0.63 and 0.77 for the total HF-EMF strengths and for all mobile phone frequency bands. First evaluation of our geospatial model yielded substantial agreement between modeling and measurements. However, before the model can be applied for future epidemiologic research, additional validation studies focusing on indoor values are needed to improve model validity.Journal of Exposure Science and Environmental Epidemiology (2008) 18, 183-191; doi:10.1038/sj.jes.7500575; published online 4 April 2007.

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OBJECTIVE: Adiponectin has anti-atherogenic properties and low circulating adiponectin has been linked to coronary atherosclerosis. Yet, there is considerable evidence that the high-molecular weight (HMW) complex of adiponectin is the major active form of this adipokine. We therefore investigated whether HMW adiponectin is associated with the extent of coronary artery disease (CAD) in men. RESEARCH DESIGN AND METHODS: Associations among CAD, HMW adiponectin and the HMW/total-adiponectin ratio were assessed in 240 male patients undergoing elective coronary angiography. Total adiponectin and HMW adiponectin was measured by enzyme-linked immunosorbent assay and serum levels were correlated with defined coronary scores and established cardiovascular risk factors. RESULTS: We found significant inverse correlations between angiographic scores and HMW adiponectin [Extent Score (ES): r=-0.39; Gensini Score (GS): r=-0.35; and Severity Score (SS): r=-0.40, all P<0.001], and the HMW/total-adiponectin ratio (ES: r=-0.49; GS: r=-0.46; SS: r=-0.46; all P<0.001). Multivariable regression analyses revealed that HMW adiponectin and the HMW/total-adiponectin ratio were significantly associated with the extent of CAD (both P<0.001). ROC analyses demonstrated that the predictive value of HMW adiponectin and the HMW/total-adiponectin ratio for the extent of coronary atherosclerosis significantly exceeded that of total adiponectin (P<0.001, P=0.010, respectively). CONCLUSIONS: HMW adiponectin and the HMW/total-adiponectin ratio inversely correlate with the extent of CAD. HMW adiponectin in particular seems to be a better marker for CAD extent than total adiponectin.

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OBJECTIVE: To assess the effect of a possible interaction between dietary fat and physical inactivity on whole-body insulin sensitivity and intramyocellular lipids (IMCLs). RESEARCH DESIGN AND METHODS: Eight healthy male volunteers were studied on two occasions. After 2 days of an equilibrated diet and moderate physical activity, participants remained inactive (bed rest) for 60 h and consumed either a high-saturated fat (45% fat, of which approximately 60% was saturated fat [BR-HF]) or a high-carbohydrate (70% carbohydrate [BR-HCHO]) diet. To evaluate the effect of a high-fat diet alone, six of the eight volunteers were restudied after a 2-day equilibrated diet followed by 60 h on a high-saturated fat diet and controlled physical activity (PA-HF). Insulin sensitivity was measured by hyperinsulinemic-euglycemic clamp and IMCL concentrations by (1)H-magnetic resonance spectroscopy. RESULTS: Insulin-mediated glucose disposal was decreased by BR-HF condition (-24 +/- 6%, P < 0.05) but did not change with BR-HCHO (+19 +/- 10%, NS). BR-HF and BR-HCHO increased IMCL levels (+32 +/- 7%, P < 0.05 and +17 +/- 8%, P < 0.0011, respectively). Although the increase in IMCL levels with PA-HF (+31 +/- 19%, P = 0.12) was similar to that during BR-HF, insulin-mediated glucose disposal (-7 +/- 9%, NS) was not decreased. CONCLUSIONS: These data indicate that physical inactivity and a high-saturated fat diet may interact to reduce whole-body insulin sensitivity. IMCL content was influenced by dietary lipid and physical inactivity but was not directly associated with insulin resistance.

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OBJECTIVE: Apoptosis of pancreatic beta-cells is critical in both diabetes development and failure of islet transplantation. The role in these processes of pro- and antiapoptotic Bcl-2 family proteins, which regulate apoptosis by controlling mitochondrial integrity, remains poorly understood. We investigated the role of the BH3-only protein Bid and the multi-BH domain proapoptotic Bax and Bak, as well as prosurvival Bcl-2, in beta-cell apoptosis. RESEARCH DESIGN AND METHODS: We isolated islets from mice lacking Bid, Bax, or Bak and those overexpressing Bcl-2 and exposed them to Fas ligand, tumor necrosis factor (TNF)-alpha, and proinflammatory cytokines or cytotoxic stimuli that activate the mitochondrial apoptotic pathway (staurosporine, etoposide, gamma-radiation, tunicamycin, and thapsigargin). Nuclear fragmentation was measured by flow cytometry. RESULTS: Development and function of islets were not affected by loss of Bid, and Bid-deficient islets were as susceptible as wild-type islets to cytotoxic stimuli that cause apoptosis via the mitochondrial pathway. In contrast, Bid-deficient islets and those overexpressing antiapoptotic Bcl-2 were protected from Fas ligand-induced apoptosis. Bid-deficient islets were also resistant to apoptosis induced by TNF-alpha plus cycloheximide and were partially resistant to proinflammatory cytokine-induced death. Loss of the multi-BH domain proapoptotic Bax or Bak protected islets partially from death receptor-induced apoptosis. CONCLUSIONS: These results demonstrate that Bid is essential for death receptor-induced apoptosis of islets, similar to its demonstrated role in hepatocytes. This indicates that blocking Bid activity may be useful for protection of islets from immune-mediated attack and possibly also in other pathological states in which beta-cells are destroyed.