978 resultados para Voter registration.
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Current methods for the control of the cattle tick Boophils microplus and the agent of bovine babesiosis, Babesia bovis are unsatisfactory. Effective immunological control of both parasites would have great advantages. However, naturally acquired immunity to the tick is generally unable to prevent serious production losses. A vaccine against the tick, based on a novel form of immunization, is being developed. A protective antigen has been isolated from the tick, characterized and produced as an effective, recombinant protein. A vaccine incorporating this antigen is currently undergoing field trials. In the Australian situation, improved tick control will probably increase endemic instability with respect to B. bovis. Fortunately, a trivalent, recombinant B. bovis vaccine has also been developed. This too is now undergoing pre-registration field trials.
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Aquest projecte realitza una auditoria ambiental de l’edifici de l’Àrea de Territori, Medi Ambient, Paisatge i Espai Urbà de l’Ajuntament de Sitges, com a primer pas per a la implantació d’un sistema de gestió ambiental (SGA), en acord amb el Reglament (CE) nº 761/2001, i la posterior obtenció d’un certificat de gestió i auditories ambientals (EMAS). L’auditoria s’inicia amb la identificació dels aspectes ambientals de l’edifici, mitjançant la recopilació de dades sobre consums energètics i hídrics, la estimació de la generació de residus i enquestes de mobilitat als treballadors. Aquestes dades són utilitzades per determinar els aspectes ambientals significatius i posteriorment, exposar una sèrie de propostes de millora per tal de corregir-los o minimitzar-los, com ara sistemes d’estalvi d’aigua, d’enllumenat, de producció d’electricitat i l’educació ambiental dels treballadors. Per a la implantació d’un SGA en la situació actual de l’edifici, es necessària, entre altres coses, la implantació d’un sistema de registre que arxivi els consums d’aigua, energia i generació de residus, per tal de dur un control de les despeses de cadascun dels vectors. A més, caldrà implementar un Programa de bones pràctiques ambientals en l’oficina per tal de reduir el consum elèctric, d’aigua i generació de residus, i la seva classificació per part dels treballadors.
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We characterize the class of strategy-proof social choice functions on the domain of symmetric single-peaked preferences. This class is strictly larger than the set of generalized median voter schemes (the class of strategy-proof and tops-only social choice functions on the domain of single-peaked preferences characterized by Moulin (1980)) since, under the domain of symmetric single-peaked preferences, generalized median voter schemes can be disturbed by discontinuity points and remain strategy-proof on the smaller domain. Our result identifies the specific nature of these discontinuities which allow to design non-onto social choice functions to deal with feasibility constraints.
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OBJECTIVE: To calculate the variable costs involved with the process of delivering erythropoiesis stimulating agents (ESA) in European dialysis practices. METHODS: A conceptual model was developed to classify the processes and sub-processes followed in the pharmacy (ordering from supplier, receiving/storing/delivering ESA to the dialysis unit), dialysis unit (dose determination, ordering, receipt, registration, storage, administration, registration) and waste disposal unit. Time and material costs were recorded. Labour costs were derived from actual local wages while material costs came from the facilities' accounting records. Activities associated with ESA administration were listed and each activity evaluated to determine if dosing frequency affected the amount of resources required. RESULTS: A total of 21 centres in 8 European countries supplied data for 142 patients (mean) per hospital (range 42-648). Patients received various ESA regimens (thrice-weekly, twice-weekly, once-weekly, once every 2 weeks and once-monthly). Administering ESA every 2 weeks, the mean costs per patient per year for each process and the estimates of the percentage reduction in costs obtainable, respectively, were: pharmacy labour (10.1 euro, 39%); dialysis unit labour (66.0 euro, 65%); dialysis unit materials (4.11 euro, 61%) and waste unit materials (0.43 euro, 49%). LIMITATION: Impact on financial costs was not measured. CONCLUSION: ESA administration has quantifiable labour and material costs which are affected by dosing frequency.
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Brain deformations induced by space-occupying lesions may result in unpredictable position and shape of functionally important brain structures. The aim of this study is to propose a method for segmentation of brain structures by deformation of a segmented brain atlas in presence of a space-occupying lesion. Our approach is based on an a priori model of lesion growth (MLG) that assumes radial expansion from a seeding point and involves three steps: first, an affine registration bringing the atlas and the patient into global correspondence; then, the seeding of a synthetic tumor into the brain atlas providing a template for the lesion; finally, the deformation of the seeded atlas, combining a method derived from optical flow principles and a model of lesion growth. The method was applied on two meningiomas inducing a pure displacement of the underlying brain structures, and segmentation accuracy of ventricles and basal ganglia was assessed. Results show that the segmented structures were consistent with the patient's anatomy and that the deformation accuracy of surrounding brain structures was highly dependent on the accurate placement of the tumor seeding point. Further improvements of the method will optimize the segmentation accuracy. Visualization of brain structures provides useful information for therapeutic consideration of space-occupying lesions, including surgical, radiosurgical, and radiotherapeutic planning, in order to increase treatment efficiency and prevent neurological damage.
Systemic effects of epidural Methylprednisolone injection on glucose tolerance in diabetic patients.
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ABSTRACT: BACKGROUND: Several studies have shown that in diabetic patients, the glycemic profile was disturbed after intra-articular injection of corticosteroids. Little is known about the impact of epidural injection in such patients. The goal of this study was double, at first comparing the glycaemic profile in diabetic patients after a unique injection of 80 mg of acetate methylprednisolone either intra-articular or epidural and secondly to compare the amount of systemic diffusion of the drug after both procedures. METHODS: Seventeen patients were included. Glycemic changes were compared in 9 diabetic patients following intra-articular (4 patients) and epidural injections (5 patients). Epidural injections were performed using the sacral route under fluoroscopic control in patients with lumbar spinal stenosis. Diabetes control had to stable for more than 10 days and the renal function to be preserved. Blood glucose was monitored using a validated continuous measuring device (GMS, Medtronic) the day before and for two days following the injection. Results were expressed in the form of daily glycemic profiles and as by mean, peak and minimal values +/ SD. The urinary excretion of methylprednisolone after the 2 routes of injection was analyzed in 8 patients (4 in each group). Urine samples were cropped one hour before the injections, then 4 times during the first day and 3 times a week for 2 weeks. The measurements included the free and conjugated fraction RESULTS: The glycaemic profile remains unchanged with no significant changes in the group of the 5 diabetic patients receiving epidural injections. On the other end, the average peak and mean values were enhanced up to 3 mmol/l above baseline two days after the infiltration in the groups of the 4 diabetic patients infiltrated intra-articular. The mean urinary excretion of the steroid was about ten times higher in the intra-articular versus epidural group: 7000 ng/ml versus 700 ng/ml. Looking at each individual there were marked differences especially after intra-articular injections. CONCLUSION: This is the first study to show that a single epidural steroid injection of 80 mg depot methylprednisolone had no effect on the glycemic control in diabetic patients. The absence of glycemic control changes correlated well with the very low urinary excretion of the drug after epidural injection. Trial registration NCT01420497.
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BACKGROUND: The debate about a possible relationship between aerobic fitness and motor skills with cognitive development in children has recently re-emerged, because of the decrease in children's aerobic fitness and the concomitant pressure of schools to enhance cognitive performance. As the literature in young children is scarce, we examined the cross-sectional and longitudinal relationship of aerobic fitness and motor skills with spatial working memory and attention in preschool children. METHODS: Data from 245 ethnically diverse preschool children (mean age: 5.2 (0.6) years, girls: 49.4%) analyzed at baseline and 9 months later. Assessments included aerobic fitness (20 m shuttle run) and motor skills with agility (obstacle course) and dynamic balance (balance beam). Cognitive parameters included spatial working memory (IDS) and attention (KHV-VK). All analyses were adjusted for age, sex, BMI, migration status, parental education, native language and linguistic region. Longitudinal analyses were additionally adjusted for the respective baseline value. RESULTS: In the cross-sectional analysis, aerobic fitness was associated with better attention (r=0.16, p=0.03). A shorter time in the agility test was independently associated with a better performance both in working memory (r=-0.17, p=0.01) and in attention (r=-0.20, p=0.01). In the longitudinal analyses, baseline aerobic fitness was independently related to improvements in attention (r=0.16, p=0.03), while baseline dynamic balance was associated with improvements in working memory (r=0.15, p=0.04). CONCLUSIONS: In young children, higher baseline aerobic fitness and motor skills were related to a better spatial working memory and/or attention at baseline, and to some extent also to their future improvements over the following 9 months. TRIAL REGISTRATION: clinicaltrials.gov NCT00674544.
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BACKGROUND: Chest pain is a common complaint in primary care, with coronary heart disease (CHD) being the most concerning of many potential causes. Systematic reviews on the sensitivity and specificity of symptoms and signs summarize the evidence about which of them are most useful in making a diagnosis. Previous meta-analyses are dominated by studies of patients referred to specialists. Moreover, as the analysis is typically based on study-level data, the statistical analyses in these reviews are limited while meta-analyses based on individual patient data can provide additional information. Our patient-level meta-analysis has three unique aims. First, we strive to determine the diagnostic accuracy of symptoms and signs for myocardial ischemia in primary care. Second, we investigate associations between study- or patient-level characteristics and measures of diagnostic accuracy. Third, we aim to validate existing clinical prediction rules for diagnosing myocardial ischemia in primary care. This article describes the methods of our study and six prospective studies of primary care patients with chest pain. Later articles will describe the main results. METHODS/DESIGN: We will conduct a systematic review and IPD meta-analysis of studies evaluating the diagnostic accuracy of symptoms and signs for diagnosing coronary heart disease in primary care. We will perform bivariate analyses to determine the sensitivity, specificity and likelihood ratios of individual symptoms and signs and multivariate analyses to explore the diagnostic value of an optimal combination of all symptoms and signs based on all data of all studies. We will validate existing clinical prediction rules from each of the included studies by calculating measures of diagnostic accuracy separately by study. DISCUSSION: Our study will face several methodological challenges. First, the number of studies will be limited. Second, the investigators of original studies defined some outcomes and predictors differently. Third, the studies did not collect the same standard clinical data set. Fourth, missing data, varying from partly missing to fully missing, will have to be dealt with.Despite these limitations, we aim to summarize the available evidence regarding the diagnostic accuracy of symptoms and signs for diagnosing CHD in patients presenting with chest pain in primary care. REVIEW REGISTRATION: Centre for Reviews and Dissemination (University of York): CRD42011001170.
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El procés de fusió de dues o més imatges de la mateixa escena en una d'única i més gran és conegut com a Image Mosaicing. Un cop finalitzat el procés de construcció d'un mosaic, els límits entre les imatges són habitualment visibles, degut a imprecisions en els registres fotomètric i geomètric. L'Image Blending és l'etapa del procediment de mosaicing a la que aquests artefactes són minimitzats o suprimits. Existeixen diverses metodologies a la literatura que tracten aquests problemes, però la majoria es troben orientades a la creació de panorames terrestres, imatges artístiques d'alta resolució o altres aplicacions a les quals el posicionament de la càmera o l'adquisició de les imatges no són etapes rellevants. El treball amb imatges subaquàtiques presenta desafiaments importants, degut a la presència d'scattering (reflexions de partícules en suspensió) i atenuació de la llum i a condicions físiques extremes a milers de metres de profunditat, amb control limitat dels sistemes d'adquisició i la utilització de tecnologia d'alt cost. Imatges amb il·luminació artificial similar, sense llum global com la oferta pel sol, han de ser unides sense mostrar una unió perceptible. Les imatges adquirides a gran profunditat presenten una qualitat altament depenent de la profunditat, i la seva degradació amb aquest factor és molt rellevant. El principal objectiu del treball és presentar dels principals problemes de la imatge subaquàtica, seleccionar les estratègies més adequades i tractar tota la seqüència adquisició-procesament-visualització del procés. Els resultats obtinguts demostren que la solució desenvolupada, basada en una Estratègia de Selecció de Límit Òptim, Fusió en el Domini del Gradient a les regions comunes i Emfatització Adaptativa d'Imatges amb baix nivell de detall permet obtenir uns resultats amb una alta qualitat. També s'ha proposat una estratègia, amb possibilitat d'implementació paral·lela, que permet processar mosaics de kilòmetres d'extensió amb resolució de centímetres per píxel.
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To assess the effectiveness of a school based physical activity programme during one school year on physical and psychological health in young schoolchildren. Cluster randomised controlled trial. 28 classes from 15 elementary schools in Switzerland randomly selected and assigned in a 4:3 ratio to an intervention (n=16) or control arm (n=12) after stratification for grade (first and fifth grade), from August 2005 to June 2006. 540 children, of whom 502 consented and presented at baseline. Children in the intervention arm (n=297) received a multi-component physical activity programme that included structuring the three existing physical education lessons each week and adding two additional lessons a week, daily short activity breaks, and physical activity homework. Children (n=205) and parents in the control group were not informed of an intervention group. For most outcome measures, the assessors were blinded. Primary outcome measures included body fat (sum of four skinfolds), aerobic fitness (shuttle run test), physical activity (accelerometry), and quality of life (questionnaires). Secondary outcome measures included body mass index and cardiovascular risk score (average z score of waist circumference, mean blood pressure, blood glucose, inverted high density lipoprotein cholesterol, and triglycerides). 498 children completed the baseline and follow-up assessments (mean age 6.9 (SD 0.3) years for first grade, 11.1 (0.5) years for fifth grade). After adjustment for grade, sex, baseline values, and clustering within classes, children in the intervention arm compared with controls showed more negative changes in the z score of the sum of four skinfolds (-0.12, 95 % confidence interval -0.21 to -0.03; P=0.009). Likewise, their z scores for aerobic fitness increased more favourably (0.17, 0.01 to 0.32; P=0.04), as did those for moderate-vigorous physical activity in school (1.19, 0.78 to 1.60; P<0.001), all day moderate-vigorous physical activity (0.44, 0.05 to 0.82; P=0.03), and total physical activity in school (0.92, 0.35 to 1.50; P=0.003). Z scores for overall daily physical activity (0.21, -0.21 to 0.63) and physical quality of life (0.42, -1.23 to 2.06) as well as psychological quality of life (0.59, -0.85 to 2.03) did not change significantly. A school based multi-component physical activity intervention including compulsory elements improved physical activity and fitness and reduced adiposity in children. Trial registration Current Controlled Trials ISRCTN15360785.
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El projecte "Programa d'introducció al dret espanyol per a estudiants d'intercanvi" s'ha dut a terme a la Facultat de dret de la Universitat de Barcelona des del mes de juny de 2007 al mes de setembre de 2008. Ha consistit en iniciar l’esmentat programa que suposava, pels estudiants d’intercanvi sol·licitants, la consecució d’un Diploma d’Introducció al Dret espanyol, expedit per la Facultat de Dret de la UB, a banda del reconeixement dels crèdits cursats a Barcelona. L’objectiu va ser proposar canvis en el plantejament curricular, en concret la posada en marxa de les assignatures del Diploma: Introducció al Dret Privat, Introducció al Dret públic, Introducció al sistema processal espanyol, i Bases del sistema legal espanyol. Com a tasca prèvia que havia de garnatir l’èxit es va fer una difusió del programa a les universitats d’origen i es va articular un sistema d’acollida als estudiants que es va demostrar molt útil al principi de curs per a informacions diverses, però que després va ser infrautilitzat. Pel que fa a les assignatures, es van plantejar com un anàlisi dels trets fonamentals i diferencials del nostre dret, utilitzant elements de comparació amb els ordenaments dels països dels alumnes, però sense fer un exercici estricte de dret comparat. La taxa de rediment va ser alta – 75% - però es va detectar un problema, la insuficient preparació idomàtica, que depassa l’organització del programa. També es va considerar un repte pedagògic important: la heterogeneïtat dels estudiants tant en la seva formació jurídica prèvia –assignatures cursades en la seva Universitat-, com en relació al sistema legal del país del qual provenien, en relació al sistema espanyol. Per aquest motiu, el plantejament del curs i els materials a utilitzar va dependre en bona mesura del conjunt del grup al qual es va dirigr cada assignatura en concret.
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BACKGROUND: Adherence to guidelines is associated with improved outcomes of patients with acute coronary syndrome (ACS). Clinical registries developed to assess quality of care at discharge often do not collect the reasons for non-prescription for proven efficacious preventive medication in Continental Europe. In a prospective cohort of patients hospitalized for an ACS, we aimed at measuring the rate of recommended treatment at discharge, using pre-specified quality indicators recommended in cardiologic guidelines and including systematic collection of reasons for non-prescription for preventive medications. METHODS: In a prospective cohort with 1260 patients hospitalized for ACS, we measured the rate of recommended treatment at discharge in 4 academic centers in Switzerland. Performance measures for medication at discharge were pre-specified according to guidelines, systematically collected for all patients and included in a centralized database. RESULTS: Six hundred and eighty eight patients(54.6%) were discharged with a main diagnosis of STEMI, 491(39%) of NSTEMI and 81(6.4%) of unstable angina. Mean age was 64 years and 21.3% were women. 94.6% were prescribed angiotensin converting enzyme inhibitors/angiotensin II receptor blockers at discharge when only considering raw prescription rates, but increased to 99.5% when including reasons non-prescription. For statins, rates increased from 98% to 98.6% when including reasons for non-prescription and for beta-blockers, from 82% to 93%. For aspirin, rates further increased from 99.4% to 100% and from to 99.8% to 100% for P2Y12 inhibitors. CONCLUSIONS: We found a very high adherence to ACS guidelines for drug prescriptions at discharge when including reasons for non-prescription to drug therapy. For beta-blockers, prescription rates were suboptimal, even after taking into account reason for non-prescription. In an era of improving quality of care to achieve 100% prescription rates at discharge unless contra-indicated, pre-specification of reasons for non-prescription for cardiovascular preventive medication permits to identify remaining gaps in quality of care at discharge. TRIAL REGISTRATION: ClinicalTrials.gov NCT01000701.
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Whilst scholars have long recognised that processes of decentralisation create new regional arenas where distinct patterns of party competition are likely to emerge, there has been little systematic analysis of the dynamics of such competition. This working paper thus proposes a framework for analysing party competition between regional branches of state-wide parties, and autonomist parties, in regional arenas. Firstly, the different strategies political parties may adopt in response to their perceptions of voter preferences and to the strategies pursued by their competitors are identified. Secondly, different factors that impact on parties' strategic choices, and which may constrain a party's ability to select electorally optimal strategies in a given political context, are proposed.
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In this paper, I provide a formal justi cation for a well-established coattail effect, when a popular candidate at one branch of government attracts votes to candidates from the same political party for other branches of government. A political agency frame- work with moral hazard is applied to analyze coattails in simultaneous presidential and congressional elections. I show that coattail voting is a natural outcome of the optimal reelection scheme adopted by a representative voter to motivate politicians' efforts in a retrospective voting environment. I assume that an office-motivated politician (executive or congressman) prefers her counterpart to be affiliated with the same political party. This correlation of incentives leads the voter to adopt a joint performance evaluation rule, which is conditioned on the politicians belonging to the same party or different parties. The two-sided coattail effects then arise. On the one hand, the executive's suc- cess/failure props up/drags down her partisan ally in congressional election, which implies presidential coattails. On the other hand, the executive's reelection itself is affected by the congressman's performance, which results in reverse coattails. JEL classi fication: D72, D86. Keywords: Coattail voting; Presidential coattails; Reverse coattails; Simultaneous elections; Political Agency; Retrospective voting.
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This paper studies party discipline in a congress within a political agency framework with retrospective voting. Party discipline serves as an incentive device to induce office- motivated congress members to perform in line with the party leadership's objective of controlling both the executive and the legislative branches of government. I show fi rst that the same party is more likely to control both branches of government (i.e., uni ed government) the stronger the party discipline in the congress is. Second, the leader of the governing party imposes more party discipline under uni ed government than does the opposition leader under divided government. Moreover, the incumbents' aggregate performance increases with party discipline, so a representative voter becomes better off. JEL classi cation: D72. Keywords: Party discipline; Political agency; Retrospective voting; Office-motivated politicians.