Effective interventions for lowering HbA1C in African Americans with type 2 diabetes: A review

This synthesis of the literature provides descriptive analysis and outlines current self-management interventions for African Americans with type 2 diabetes. Specifically, this study describes and explores the design of those studies whose interventions have been shown to lower HbA1C levels in this population by at least 0.5% points, an improvement that provides approximately 10% reduction in long term complications from this disease.^ Results. In total, 37 articles were reviewed and 17 articles met inclusion criteria for analysis. Analysis of each study's methodology and results was performed and selected studies with interventions that resulted in improvements in HbA1C outcomes equal to 0.5% or greater for both group 1 and 2 were summarized by intervention type in table format. Descriptive analysis, outlining the number and characteristics of proximal and distal mediating components addressed in Group 1 studies, was performed in order to determine whether mediating components may have had some relation to effectiveness of intervention on outcome HbA1C. Descriptive analysis revealed that no particular design is substantially more effective than another among Behavioral studies although, there may be an advantage in using culturally sensitive, group interventions that address greater numbers of distal mediating components. Among Process studies, structured approaches (i.e. algorithm care and scheduled follow up), as well as utilization of specialty and group care are represented as effective for African American populations. ^ Conclusions. It may be summarized that by targeting behavior and addressing provider delivery (i.e. algorithm use, group care, home care, and provider follow up) in this population, a greater yield in outcome improvements may be accomplished. However, many gaps exist in a review process that stratifies results and focuses on identifying group specific intervention successes and failures. Further research in different populations will aid researchers and practitioners in discovering the best evidence, and identifying models that could be utilized in practice to achieve the best diabetes management for at risk groups.^

Goals, plans, and behavior changes: A relevant part of the post-treatment cancer experience

Background. Colorectal cancer (CRC) survivors have to manage treatment side effects, psychosocial issues, and co-morbidities, as well as modify their lifestyles to decrease risk of recurrence and prolong life. Identifying survivors’ goals and key factors that influence their goals will highlight the issues cancer survivors face post-treatment and the resources needed to help them engage in health-promoting behaviors.^ Objectives and methods. This dissertation examines the health-related goals of post-treatment CRC survivors using two studies: (1) a qualitative study to identify and describe the health goals of CRC survivors during the transition from active treatment to post-treatment survivorship and follow-up care; and (2) a cross-sectional survey to identify CRC survivors’ goals, and key factors that influence their goals.^ Results. (1) The 41 qualitative interviews indicated participants’ health-related goals were to be healthy, get back to normal, and not have a cancer recurrence. Most of the CRC survivors reported they maintained healthy behaviors, made healthy behavior changes, or had goals to change their behavior. Respondents were empowered to improve their health by maintaining follow-up care and regular health screenings, and many were managing treatment side effects in an effort to improve functional abilities. (2) The cross-sectional study found that CRC survivors’ most prevalent goals were related to healthy behaviors (i.e., eat a healthy diet and engage in physical activity), and cancer care or disease management (i.e., keep up with health screenings and monitor symptoms). Goals that survivors identified as important were similar to goals they perceived were important to their providers (i.e., goals related to cancer care, disease management). Certain goals were statistically associated with age, barriers to achieving goals, social support and health-related quality of life.^ Conclusions. CRC survivors have health-promoting goals post-treatment and are interested in making health behavior changes. Goals ranged from cancer care/surveillance and disease management to healthy lifestyle modifications. Patients may need help resolving or managing treatment side effects or co-morbidities prior to implementing health promoting behaviors. Healthcare providers’ recommendations may be a powerful resource to encourage survivors to engage in health-promoting behaviors. Self-management and goal setting support could be an appropriate strategy to assist patients with achieving their post-treatment health goals.^

Effects of a health advocacy program to promote physical activity and nutrition behaviors among adolescents: An evaluation of the Young Leaders for Healthy Change program

Background. This study was designed to evaluate the effects of the Young Leaders for Healthy Change program, an internet-delivered program in the school setting that emphasized health advocacy skills-development, on nutrition and physical activity behaviors among older adolescents (13–18 years). The program consisted of online curricular modules, training modules, social media, peer and parental support, and a community service project. Module content was developed based on Social Cognitive Theory and known determinants of behavior for older adolescents. ^ Methods. Of the 283 students who participated in the fall 2011 YL program, 38 students participated in at least ten of the 12 weeks and were eligible for this study. This study used a single group-only pretest/posttest evaluation design. Participants were 68% female, 58% white/Caucasian, 74% 10th or 11th graders, and 89% mostly A and/or B students. The primary behavioral outcomes for this analysis were participation in 60-minutes of physical activity per day, 20-minutes of vigorous- or moderate- intensity physical activity (MVPA) participation per day, television and computer time, fruit and vegetable (FV) intake, sugar-sweetened beverage intake, and consumption of breakfast, home-cooked meals, and fast food. Other outcomes included knowledge, beliefs, and attitudes related to healthy eating, physical activity, and advocacy skills. ^ Findings. Among the 38 participants, no significant changes in any variables were observed. However, among those who did not previously meet behavioral goals there was an 89% increase in students who participated in more than 20 minutes of MVPA per day and a 58% increase in students who ate home-cooked meals 5–7 days per week. The majority of participants met program goals related to knowledge, beliefs, and attitudes prior to the start of the program. Participants reported either maintaining or improving to the goal at posttest for all items except FV intake knowledge, taste and affordability of healthy foods, interest in teaching others about being healthy, and ease of finding ways to advocate in the community. ^ Conclusions. The results of this evaluation indicated that promoting healthy behaviors requires different strategies than maintaining healthy behaviors among high school students. In the school setting, programs need to target the promotion and maintenance of health behaviors to engage all students who participate in the program as part of a class or club activity. Tailoring the program using screening and modifying strategies to meet the needs of all students may increase the potential reach of the program. The Transtheoretical Model may provide information on how to develop a tailored program. Additional research on how to utilize the constructs of TTM effectively among high school students needs to be conducted. Further evaluation studies should employ a more expansive evaluation to assess the long-term effectiveness of health advocacy programming.^

Cost-effectiveness of intensified interventions to control healthcare-associated MRSA infections -- A systematic literature review

Methicillin Resistant Staphylococcus aureus healthcare-associated infections (MRSA HAIs) are a major cause of morbidity in hospitalized patients. They pose great economic burden to hospitals caring for these patients. Intensified Interventions aim to control MRSA HAIs. Cost-effectiveness of Intensified Interventions is largely unclear. We performed a review of cost-effectiveness literature on Intensified Interventions , and provide a summary of study findings, the status of economic research in the area, and information that will help decision-makers at regional level and guide future research.^ We conducted literature search using electronic database PubMed, EBSCO, and The Cochrane Library. We limited our search to English articles published after 1999. We reviewed a total of 1,356 titles, and after applying our inclusion and exclusion criteria selected seven articles for our final review. We modified the Economic Evaluation Abstraction Form provided by CDC, and used this form to abstract data from studies.^ Of the seven selected articles two were cohort studies and the remaining five were modeling studies. They were done in various countries, in different study settings, and with different variations of the Intensified Intervention . Overall, six of the seven studies reported that Intensified Interventions were dominant or at least cost-effective in their study setting. This effect persisted on sensitivity testing.^ We identified many gaps in research in this field. The cost-effectiveness research in the field is mostly composed of modeling studies. The studies do not always clearly describe the intervention. The intervention and infection costs and the sources for these costs are not always explicit or are missing. In modeling studies, there is uncertainty associated with some key model inputs, but these inputs are not always identified. The models utilized in the modeling studies are not always tested for internal consistency or validity. Studies usually test the short term cost-effectiveness of Intensified Interventions but not the long results.^ Our study limitation was the inability to adjust for differences in study settings, intervention costs, disease costs, or effectiveness measures. Our study strength is the presentation of a focused literature review of Intensified Interventions in hospital settings. Through this study we provide information that will help decision makers at regional level, help guide future research, and might change clinical care and policies. ^

Ethnic comparisons of adolescent sexual risk -taking and preventive behavior

For adolescents, unprotected sexual intercourse is the primary cause of sexually transmitted disease (STD), including Human Immunodeficiency Virus (HIV) infection (virus which causes Acquired Immunodeficiency Syndrome (AIDS)), and pregnancy. Although many studies on adolescent sexual behavior have addressed racial/ethnic differences, few studies have examined the relation between race/ethnicity while controlling for other sociocultural and psychosocial variables. The purpose of this study is to examine the relationship between racial/ethnic categories and selected sociocultural and psychosocial variables, with reported adolescent sexual risk-taking and preventive behavior.^ A self-administered questionnaire was used to collect information from 3132 students in a Texas school district (Section 3.5.2). The instrument contained approximately 100 questions on demographic characteristics, sexual behavior, and psychosocial determinants of sexual behavior. Based on the findings of this study, the following major conclusions are made: (1) There are differences in reported sexual risk-taking and preventive behavior among Black, Hispanic and White adolescents in this study. The stratified analysis by gender further suggests significant gender differences in reported sexual behavior among the three racial/ethnic groups. (2) Gender, living arrangement, academic grades, and language spoken at home modified the association between reported sexual risk-taking and preventive behavior and race/ethnicity in this study. This suggests that these sociocultural variables should be considered in future research and practice involving multicultural populations. (3) There are differences in selected psychosocial determinants among the three racial/ethnic groups and between males and females. These differences were consistent with the reported sexual risk-taking and preventive behaviors among race/ethnicity and gender for adolescents in this study. The findings support the consideration of psychosocial determinants in research and interventions addressing adolescent sexual behavior among different racial/ethnic groups.^ Based on the results of this study, two recommendations for practice are made. First, health professionals developing interventions for adolescents from different cultural backgrounds and gender need to be familiar with the specific sociocultural and psychosocial factors which will reduce risky sexual behavior, and promote protective behavior. Second, the need for immediate, realistic, and continuous HIV/STD and pregnancy prevention programs for children and adolescents should be considered. ^

Behavioral decision making and the levels of change: An application of the transtheoretical model to prenatal smoking in low -income women

Despite continued research and public health efforts to reduce smoking during pregnancy, prenatal cessation rates in the United States have decreased and the incidence of low birth weight has increased from 1985 to 1991. Lower socioeconomic status women who are at increased risk for poor pregnancy outcomes may be resistant to current intervention efforts during pregnancy. The purpose of this dissertation was to investigate the determinants of continued smoking and quitting among low-income pregnant women.^ Using data from cross-sectional surveys of 323 low-income pregnant smokers, the first study developed and tested measures of the pros and cons of smoking during pregnancy. The original decisional balance measure for smoking was compared with a new measure that added items thought to be more salient to the target population. Confirmatory factor analysis using structural equation modeling showed neither the original nor new measure fit the data adequately. Using behavioral science theory, content from interviews with the population, and statistical evidence, two 7-item scales representing the pros and cons were developed from a portion (n = 215) of the sample and successfully cross-validated on the remainder of the sample (n = 108). Logistic regression found only pros were significantly associated with continued smoking. In a discriminant function analysis, stage of change was significantly associated with pros and cons of smoking.^ The second study examined the structural relationships between psychosocial constructs representing some of the levels of and the pros and cons of smoking. The cross-sectional design mandates that statements made regarding prediction do not prove causation or directionality from the data or methods analysis. Structural equation modeling found the following: more stressors and family criticism were significantly more predictive of negative affect than social support; a bi-directional relationship was found between negative affect and current nicotine addiction; and negative affect, addiction, stressors, and family criticism were significant predictors of pros of smoking.^ The findings imply reversing the trend of decreasing smoking cessation during pregnancy may require supplementing current interventions for this population of pregnant smokers with programs addressing nicotine addiction, negative affect, and other psychosocial factors such as family functioning and stressors. ^

Seawater carbonate chemistry and auditory behavior of Orange clownfish (Amphiprion percula) during experiments, 2011

Ocean acidification is predicted to affect marine ecosystems in many ways, including modification of fish behaviour. Previous studies have identified effects of CO2-enriched conditions on the sensory behaviour of fishes, including the loss of natural responses to odours resulting in ecologically deleterious decisions. Many fishes also rely on hearing for orientation, habitat selection, predator avoidance and communication. We used an auditory choice chamber to study the influence of CO2-enriched conditions on directional responses of juvenile clownfish (Amphiprion percula) to daytime reef noise. Rearing and test conditions were based on Intergovernmental Panel on Climate Change predictions for the twenty-first century: current-day ambient, 600, 700 and 900 µatm pCO2. Juveniles from ambient CO2-conditions significantly avoided the reef noise, as expected, but this behaviour was absent in juveniles from CO2-enriched conditions. This study provides, to our knowledge, the first evidence that ocean acidification affects the auditory response of fishes, with potentially detrimental impacts on early survival.

Influence of cement properties in the reaction rate and mechanical behavior of concrete with high fl y ash content

The use of fly ash (FA) as an admixture to concrete is broadly extended for two main reasons: the reduction of costs that supposes the substitution of cement and the micro structural changes motivated by the mineral admixture. Regarding this second point, there is a consensus that considers that the ash generates a more compact concrete and a reduction in the size of the pore. However, the measure in which this contributes to the pozzolanic activity or as filler is not well defined. There is also no justification to the influence of the physical parameters, fineness of the grain and free water, in its behavior. This work studies the use of FA as a partial substitute of the cement in concretes of different workability (dry and wet) and the influence in the reactivity of the ash. The concrete of dry consistency which serves as reference uses a cement dose of 250 Kg/m 3 and the concrete of fluid consistency utilized a dose of cement of 350 Kg/m 3 . Two trademark of Portland Cement Type 1 were used. The first reached the resistant class for its fineness of grain and the second one for its composition. Moreover, three doses of FA have been used, and the water/binder ratio was constant in all the mixtures. We have studied the mechanical properties and the micro-structure of the concretes by means of compressive strength tests, mercury intrusion porosimetry (MIP) and thermal analysis (TA). The results of compressive strength tests allow us to observe that concrete mixtures with cements of the same classification and similar dosage of binder do not present the same mechanical behavior. These results show that the effective water/binder ratio has a major role in the development of the mechanical properties of concrete. The study of different dosages using TA, thermo-gravimetry and differential thermal analysis, revealed that the portlandite content is not restrictive in any of the dosages studied. Again, this proves that the rheology of the material influences the reaction rate and content of hydrated cement products. We conclude that the available free water is determinant in the efficiency of pozzolanic reaction. It is so that in accordance to the availability of free water, the ashes can react as an active admixture or simply change the porous distribution. The MIP shows concretes that do not exhibit significant changes in their mechanical behavior, but have suffered significant variation in their porous structure

Facing the climate change challenges in the mining and mineral industry as providers of a sustainable manufacturing process

A sustainable manufacturing process must rely on an also sustainable raw materials and energy supply. This paper is intended to show the results of the studies developed on sustainable business models for the minerals industry as a fundamental previous part of a sustainable manufacturing process. As it has happened in other economic activities, the mining and minerals industry has come under tremendous pressure to improve its social, developmental, and environmental performance. Mining, refining, and the use and disposal of minerals have in some instances led to significant local environmental and social damage. Nowadays, like in other parts of the corporate world, companies are more routinely expected to perform to ever higher standards of behavior, going well beyond achieving the best rate of return for shareholders. They are also increasingly being asked to be more transparent and subject to third-party audit or review, especially in environmental aspects. In terms of environment, there are three inter-related areas where innovation and new business models can make the biggest difference: carbon, water and biodiversity. The focus in these three areas is for two reasons. First, the industrial and energetic minerals industry has significant footprints in each of these areas. Second, these three areas are where the potential environmental impacts go beyond local stakeholders and communities, and can even have global impacts, like in the case of carbon. So prioritizing efforts in these areas will ultimately be a strategic differentiator as the industry businesses continues to grow. Over the next forty years, world?s population is predicted to rise from 6.300 million to 9.500 million people. This will mean a huge demand of natural resources. Indeed, consumption rates are such that current demand for raw materials will probably soon exceed the planet?s capacity. As awareness of the actual situation grows, the public is demanding goods and services that are even more environmentally sustainable. This means that massive efforts are required to reduce the amount of materials we use, including freshwater, minerals and oil, biodiversity, and marine resources. It?s clear that business as usual is no longer possible. Today, companies face not only the economic fallout of the financial crisis; they face the substantial challenge of transitioning to a low-carbon economy that is constrained by dwindling natural resources easily accessible. Innovative business models offer pioneering companies an early start toward the future. They can signal to consumers how to make sustainable choices and provide reward for both the consumer and the shareholder. Climate change and carbon remain major risk discontinuities that we need to better understand and deal with. In the absence of a global carbon solution, the principal objective of any individual country should be to reduce its global carbon emissions by encouraging conservation. The mineral industry internal response is to continue to focus on reducing the energy intensity of our existing operations through energy efficiency and the progressive introduction of new technology. Planning of the new projects must ensure that their energy footprint is minimal from the start. These actions will increase the long term resilience of the business to uncertain energy and carbon markets. This focus, combined with a strong demand for skills in this strategic area for the future requires an appropriate change in initial and continuing training of engineers and technicians and their awareness of the issue of eco-design. It will also need the development of measurement tools for consistent comparisons between companies and the assessments integration of the carbon footprint of mining equipments and services in a comprehensive impact study on the sustainable development of the Economy.

Numerical Simulation of the Aerodynamic Behavior of High Velocity Trains under Synthetic Crosswinds of Different Shear and Turbulence Characteristics

A numerical simulation of the aerodynamic behavior of high-speed trains under synthetic crosswinds at a 90º yaw angle is presented. The train geometry is the aerodynamic train model (ATM). Flow description based on numerical simulations is obtained using large eddy simulation (LES) and the commercial code ANSYSFluent V14.5. A crosswind whose averaged velocity and turbulence characteristics change with distance to the ground is imposed. Turbulent fluctuations that vary temporally and spatially are simulated with TurbSim code. The crosswind boundary condition is calculated for the distance the train runs during a simulation period. The inlet streamwise velocity boundary condition is generated using Taylor?s frozen turbulence hypothesis. The model gives a time history of the force and moments acting on the train; this includes averaged values, standard deviations and extreme values. Of particular interest are the spectra of the forces and moments, and the admittance spectra. For comparison, results obtained with LES and a uniform wind velocity fluctuating in time, and results obtained with Reynolds averaged Navier Stokes equations (RANS), and the averaged wind conditions, are also presented.

Estudio teórico-experimental sobre el deterioro en tableros de puentes de hormigón producido por la acción del hielo-deshielo con sales de fundentes

El deterioro del hormigón por ciclos de hielo-deshielo en presencia de sales fundentes es causa frecuente de problemas en los puentes e infraestructuras existentes en los países europeos. Los daños producidos por los ciclos de hielo-deshielo en el hormigón pueden ser internos, fundamentalmente la fisuración y/o externos como el descascarillamiento (desgaste superficial). La España peninsular presenta unas características geográficas y climáticas particulares. El 18% de la superficie tiene una altura superior a 1000mts y, además, la altura media geográfica con respecto al nivel del mar es de 660mts (siendo el segundo país más montañoso de toda Europa).Esto hace que la Red de Carreteras del Estado se vea afectada, durante determinados periodos, por fenómenos meteorológicos adversos, en particular por nevadas y heladas, que pueden comprometer las condiciones de vialidad para la circulación de vehículos. Por este motivo la Dirección General de Carreteras realiza trabajos anualmente (campañas de vialidad invernal, de 6 meses de duración) para el mantenimiento de la vialidad de las carreteras cuando éstas se ven afectadas por estos fenómenos. Existen protocolos y planes operativos que permiten sistematizar estos trabajos de mantenimiento que, además, se han intensificado en los últimos 10 años, y que se fundamentan en el empleo de sales fundentes, principalmente NaCl, con la misión de que no haya placas de hielo, ni nieve, en las carreteras. En zonas de fuerte oscilación térmica, que con frecuencia en España se localizan en la zona central del Pirineo, parte de la cornisa Cantábrica y Sistema Central, se producen importantes deterioros en las estructuras y paramentos de hormigón producidos por los ciclos de hielo- deshielo. Pero además el uso de fundentes de vialidad invernal acelera en gran medida la evolución de estos daños. Los tableros de hormigón de puentes de carretera de unos 40-50 años de antigüedad carecen, en general, de un sistema de impermeabilización, y están formados frecuentemente por un firme de mezcla asfáltica, una emulsión adherente y el hormigón de la losa. En la presente tesis se realiza una investigación que pretende reproducir en laboratorio los procesos que tienen lugar en el hormigón de tableros de puentes existentes de carreteras, de unos 40-50 años de antigüedad, que están expuestos durante largos periodos a sales fundentes, con objeto de facilitar la vialidad invernal, y a cambios drásticos de temperatura (hielo y deshielo). Por ello se realizaron cuatro campañas de investigación, teniendo en cuenta que, si bien nos basamos en la norma europea UNE-CEN/TS 12390-9 “Ensayos de hormigón endurecido. Resistencia al hielo-deshielo. Pérdida de masa”, se fabricaron probetas no estandarizadas para este ensayo, pensado en realidad para determinar la afección de los ciclos únicamente a la pérdida de masa. Las dimensiones de las probetas en nuestro caso fueron 150x300 mm, 75 x 150mm (cilíndricas normalizadas para roturas a compresión según la norma UNE-EN 12390-3) y 286x76x76 (prismáticas normalizadas para estudiar cambio de volumen según la norma ASTM C157), lo cual nos permitió realizar sobre las mismas probetas más ensayos, según se presentan en la tesis y, sobre todo, poder comparar los resultados con probetas extraídas de dimensiones similares en puentes existentes. En la primera campaña, por aplicación de la citada norma, se realizaron ciclos de H/D, con y sin contacto con sales de deshielo (NaCl en disolución del 3% según establece dicha norma). El hormigón fabricado en laboratorio, tratando de simular el de losas de tableros de puentes antiguos, presentó una fc de 22,6 MPa y relación agua/cemento de 0,65. Las probetas de hormigón fabricadas se sometieron a ciclos agresivos de hielo/deshielo (H/D), empleando una temperatura máxima de +20ºC y una temperatura mínima de -20ºC al objeto de poder determinar la sensibilidad de este ensayo tanto al tipo de hormigón elaborado como al tipo de probeta fabricado (cilíndrica y prismática). Esta campaña tuvo una segunda fase para profundizar más en el comportamiento de las probetas sometidas a ciclos H/D en presencia de sales. En la segunda campaña, realizada sobre probetas de hormigón fabricadas en laboratorio iguales a las anteriores, la temperaturas mínima del ensayo se subió a -14ºC, lo que nos permitió analizar el proceso de deterioro con más detalle. (Realizando una serie de ensayos de caracterización no destructivos y otros destructivos, y validando su aplicación a la detección de los deterioros causados tras los ensayos acelerados de hielodeshielo. También mediante aplicación de técnicas de microscopía electrónica.) La tercera campaña, se realizó sobre probetas de hormigón de laboratorio similares a las anteriores, fc de 29,3Mpa y relación a/c de 0,65, en las que se aplicó en una cara un revestimiento asfáltico de 2-4cms, según fueran prismáticas y cilíndricas respectivamente, compuesto por una mezcla asfáltica real (AC16), sobre una imprimación bituminosa. (Para simular el nivel de impermeabilización que produce un firme sobre el tablero de un puente) La cuarta campaña, se desarrolló tras una cuidadosa selección de dos puentes de hormigón de 40-50 años de antigüedad, expuestos y sensibles a deterioros de hielodeshielo, y en carreteras con aportación de fundentes. Una vez esto se extrajeron testigos de hormigón de zonas sanas (nervios del tablero), para realizar en laboratorio los mismos ensayos acelerados de hielo-deshielo y de caracterización, de la segunda campaña, basados en la misma norma. De los resultados obtenidos se concluye que cuando se emplean sales fundentes se acelera de forma significativa el deterioro, aumentando tanto el contenido de agua en los poros como el gradiente generado (mecanismo de deterioro físico). Las sales de deshielo aceleran claramente la aparición del daño, que se incrementa incluso en un factor de 5 según se constata en esta investigación para los hormigones ensayados. Pero además se produce un gradiente de cloruros que se ha detectado tanto en los hormigones diseñados en laboratorio como en los extraídos de puentes existentes. En casi todos los casos han aparecido cambios en la microestructura de la pasta de cemento (mecanismo de deterioro químico), confirmándose la formación de un compuesto en el gel CSH de la pasta de cemento, del tipo Ca2SiO3Cl2, que posiblemente está contribuyendo a la alteración de la pasta y a la aceleración de los daños en presencia de sales fundentes. Existe un periodo entre la aparición de fisuración y la pérdida de masa. Las fisuras progresan rápidamente desde la interfase de los áridos más pequeños y angulosos, facilitando así el deterioro del hormigón. Se puede deducir así que el tipo de árido afecta al deterioro. En el caso de los testigos con recubrimiento asfáltico, parece haberse demostrado que la precipitación de sales genera tensiones en las zonas de hormigón cercanas al recubrimiento, que terminan por fisurar el material. Y se constata que el mecanimo de deterioro químico, probablemente tenga más repercusión que el físico, por cuanto el recubrimiento asfáltico es capaz de retener suficiente agua, como para que el gradiente de contenido de agua en el hormigón sea mucho menor que sin el recubrimiento. Se constató, sin embargo, la importancia del gradiente de cloruros en el hormigon. Por lo que se deduce que si bien el recubrimiento asfáltico es ciertamente protector frente a los ciclos H/D, su protección disminuye en presencia de sales; es decir, los cloruros acabarán afectando al hormigón del tablero del puente. Finalmente, entre los hormigones recientes y los antiguos extraídos de puentes reales, se observa que existen diferencias significativas en cuanto a la resistencia a los ciclos H/D entre ellos. Los hormigones más recientes resultan, a igualdad de propiedades, más resistentes tanto a ciclos de H/D en agua como en sales. Posiblemente el hecho de que los hormigones de los puentes hayan estado expuestos a condiciones de temperaturas extremas durante largos periodos de tiempo les ha sensibilizado. La tesis realizada, junto con nuevos contrastes que se realicen en el futuro, nos permitirá implementar una metodología basada en la extracción de testigos de tableros de puente reales para someterlos a ensayos de hielo-deshielo, basados en la norma europea UNECEN/ TS 12390-9 aunque con probetas no normalizadas para el mismo, y, a su vez, realizar sobre estas probetas otros ensayos de caracterización destructivos, que posibilitarán evaluar los daños ocasionados por este fenómeno y su evolución temporal, para actuar consecuentemente priorizando intervenciones de impermeabilización y reparación en el parque de puentes de la RCE. Incluso será posible la elaboración de mapas de riesgo, en función de las zonas de climatología más desfavorable y de los tratamientos de vialidad invernal que se lleven a cabo. Concrete damage by freeze-thaw cycles in the presence of melting salts frequently causes problems on bridges and infrastructures in European countries. Damage caused by freeze-thaw cycles in the concrete can be internal, essentially cracking and / or external as flaking (surface weathering due to environmental action). The peninsular Spain presents specific climatic and geographical characteristics. 18% of the surface has a height greater than 1,000 m and the geographical average height from the sea level is 660 m (being the second most mountainous country in Europe). This makes the National Road Network affected during certain periods due to adverse weather, particularly snow and ice, which can compromise road conditions for vehicular traffic. For this reason the National Road Authority performs works annually (Winter Road Campaign, along 6 months) to maintain the viability of the roads when they are affected by these phenomena. There are protocols and operational plans that allow systematize these maintenance jobs, that also have intensified in the last 10 years, and which are based on the use of deicing salts, mainly NaCl, with the mission that no ice sheets, or snow appear on the roads. In areas of strong thermal cycling, which in Spain are located in the central area of the Pyrenees, part of the Cantabrian coast and Central System, significant deterioration take place in the structures and wall surfaces of concrete due to freeze-thaw. But also the use of deicing salts for winter maintenance greatly accelerated the development of such damages. The concrete decks for road bridges about 40-50 years old, lack generally a waterproofing system, and are often formed by a pavement of asphalt, an adhesive emulsion and concrete slab. In this thesis the research going on aims to reproduce in the laboratory the processes taking place in the concrete of an existing deck at road bridges, about 40-50 years old, they are exposed for long periods to icing salt, to be performed in order to facilitate winter maintenance, and drastic temperature changes (freezing and thawing). Therefore four campaigns of research were conducted, considering that while we rely on the European standard UNE-CEN/TS 12390-9 "Testing hardened concrete. Freezethaw resistance. Mass loss", nonstandard specimens were fabricated for this test, actually conceived to determine the affection of the cycles only to the mass loss. Dimensions of the samples were in our case 150x300 mm, 75 x 150mm (standard cylindrical specimens for compression fractures UNE-EN 12390-3) and 286x76x76 (standard prismatic specimens to study volume change ASTM C157), which allowed us to carry on same samples more trials, as presented in the thesis, and especially to compare the results with similar sized samples taken from real bridges. In the first campaign, by application of that European standard, freeze-thaw cycles, with and without contact with deicing salt (NaCl 3% solution in compliance with such standard) were performed. Concrete made in the laboratory, trying to simulate the old bridges, provided a compressive strength of 22.6 MPa and water/cement ratio of 0.65. In this activity, the concrete specimens produced were subjected to aggressive freeze/thaw using a maximum temperature of +20ºC and a minimum temperature of - 20°C in order to be able to determine the sensitivity of this test to the concrete and specimens fabricated. This campaign had a second phase to go deeper into the behavior of the specimens subjected to cycled freeze/thaw in the presence of salts. In the second campaign, conducted on similar concrete specimens manufactured in laboratory, temperatures of +20ºC and -14ºC were used in the tests, which allowed us to analyze the deterioration process in more detail (performing a series of non-destructive testing and other destructive characterization, validating its application to the detection of the damage caused after the accelerated freeze-thaw tests, and also by applying electron microscopy techniques). The third campaign was conducted on concrete specimens similar to the above manufactured in laboratory, both cylindrical and prismatic, which was applied on one side a 4 cm asphalt coating, consisting of a real asphalt mixture, on a bituminous primer (for simulate the level of waterproofing that produces a pavement on the bridge deck). The fourth campaign was developed after careful selection of two concrete bridges 40- 50 years old, exposed and sensitive to freeze-thaw damage, in roads with input of melting salts. Concrete cores were extracted from healthy areas, for the same accelerated laboratory freeze-thaw testing and characterization made for the second campaign, based on the same standard. From the results obtained it is concluded that when melting salts are employed deterioration accelerates significantly, thus increasing the water content in the pores, as the gradient. Besides, chloride gradient was detected both in the concrete designed in the laboratory and in the extracted in existing bridges. In all cases there have been changes in the microstructure of the cement paste, confirming the formation of a compound gel CSH of the cement paste, Ca2SiO3Cl2 type, which is possibly contributing to impair the cement paste and accelerating the damage in the presence of melting salts. The detailed study has demonstrated that the formation of new compounds can cause porosity at certain times of the cycles may decrease, paradoxically, as the new compound fills the pores, although this phenomenon does not stop the deterioration mechanism and impairments increase with the number of cycles. There is a period between the occurrence of cracking and mass loss. Cracks progress rapidly from the interface of the smallest and angular aggregate, thus facilitating the deterioration of concrete. It can be deduced so the aggregate type affects the deterioration. The presence of melting salts in the system clearly accelerates the onset of damage, which increases even by a factor of 5 as can be seen in this investigation for concrete tested. In the case of specimens with asphalt coating, it seems to have demonstrated that the precipitation of salts generate tensions in the areas close to the concrete coating that end up cracking the material. It follows that while the asphalt coating is certainly a protection against the freeze/thaw cycles, this protection decreases in the presence of salts; so the chlorides will finally affect the concrete bridge deck. Finally, among the recent concrete specimens and the old ones extracted from real bridges, it is observed that the mechanical strengths are very similar to each other, as well as the porosity values and the accumulation capacity after pore water saturation. However, there are significant differences in resistance to freeze/thaw cycles between them. More recent concrete are at equal properties more resistant both cycles freeze/thaw in water with or without salts. Possibly the fact that concrete bridges have been exposed to extreme temperatures for long periods of time has sensitized them. The study, along with new contrasts that occur in the future, allow us to implement a methodology based on the extraction of cores from the deck of real bridges for submission to freeze-thaw tests based on the European standard UNE-CEN/TS 12390-9 even with non-standard specimens for it, and in turn, performed on these samples other destructive characterization tests, which will enable to assess the damage caused by this phenomenon and its evolution, to act rightly prioritizing interventions improving the waterproofing and other repairs in the bridge stock of the National Road Network. It will even be possible to develop risk maps, depending on the worst weather areas and winter road treatments to be carried out.

Identifying effective behavioural components of Intervention and Comparison group support provided in SMOKing cEssation interventions (IC-SMOKE) : a systematic review protocol

Funding The research described in this paper is funded by Cancer Research UK, registered under application number C50862/A18446. The systematic review protocol reported in this paper was previously peer-reviewed by Cancer Research UK as part of the funding process. The funders had no role in protocol design, decision to publish, or preparation of the manuscript.

Nucleotide-dependent conformational change near the fulcrum region in Dictyostelium myosin II

In skeletal muscle myosin, the reactive thiols (SH1 and SH2) are close to a proposed fulcrum region that is thought to undergo a large conformational change. The reactive thiol region is thought to transmit the conformational changes induced by the actin–myosin–ATP interactions to the lever arm, which amplifies the power stroke. In skeletal muscle myosin, SH1 and SH2 can be chemically cross-linked in the presence of nucleotide, trapping the nucleotide in its pocket. Although the flexibility of the reactive thiol region has been well studied in skeletal muscle myosin, crystal structures of truncated nonmuscle myosin II from Dictyostelium in the presence of various ATP analogs do not show changes at the reactive thiol region that would be consistent with the SH1–SH2 cross-linking observed for muscle myosin. To examine the dynamics of the reactive thiol region in Dictyostelium myosin II, we have examined a modified myosin II that has cysteines at the muscle myosin SH1 and SH2 positions. This myosin is specifically cross-linked at SH1–SH2 by a chemical cross-linker in the presence of ADP, but not in its absence. Furthermore, the cross-linked species traps the nucleotide, as in the case of muscle myosin. Thus, the Dictyostelium myosin II shares the same dynamic behavior in the fulcrum region of the molecule as the skeletal muscle myosin. This result emphasizes the importance of nucleotide-dependent changes in this part of the molecule.

The Dynamic Behavior of Individual Microtubules Associated with Chromosomes In Vitro

Mitotic movements of chromosomes are usually coupled to the elongation and shortening of the microtubules to which they are bound. The lengths of kinetochore-associated microtubules change by incorporation or loss of tubulin subunits, principally at their chromosome-bound ends. We have reproduced aspects of this phenomenon in vitro, using a real-time assay that displays directly the movements of individual chromosome-associated microtubules as they elongate and shorten. Chromosomes isolated from cultured Chinese hamster ovary cells were adhered to coverslips and then allowed to bind labeled microtubules. In the presence of tubulin and GTP, these microtubules could grow at their chromosome-bound ends, causing the labeled segments to move away from the chromosomes, even in the absence of ATP. Sometimes a microtubule would switch to shortening, causing the direction of movement to change abruptly. The link between a microtubule and a chromosome was mechanically strong; 15 pN of tension was generally insufficient to detach a microtubule, even though it could add subunits at the kinetochore–microtubule junction. The behavior of the microtubules in vitro was regulated by the chromosomes to which they were bound; the frequency of transitions from polymerization to depolymerization was decreased, and the speed of depolymerization-coupled movement toward chromosomes was only one-fifth the rate of shortening for microtubules free in solution. Our results are consistent with a model in which each microtubule interacts with an increasing number of chromosome-associated binding sites as it approaches the kinetochore.

Induced intensification: Agricultural change in Bangladesh with implications for Malthus and Boserup

Bangladesh is dominated by a small-holder agrarian economy under extreme stress. Production shortfalls, increasing economic polarization, and chronic malnutrition are persistent, but major famine has been diverted in part by significant growth in agriculture. This recent history is open to both Malthusian and Boserupian interpretations—a history we explore here through a test of the induced intensification thesis of agricultural change. This thesis, framed by variations in the behavior of small-holders, has grown from a simple demand-production relationship to a consideration of the mediating influences on that relationship. The induced intensification thesis is reviewed and tested for 265 households in 6 villages in Bangladesh from 1950–1986. A time-series analysis of an induced intensification model provides relatively high levels of explained variance in cropping intensity (frequency and land productivity) and also indicates the relative impacts of household class, environment, and cropping strategies. On average, the small-holders in question kept pace with the demands on production, although important class and village variations were evident and the proportion of landless households increased. These results, coupled with evidence that agricultural growth involved intensification thresholds, provide clues about Malthusian and Boserupian interpretations of Bangladesh, and suggest that small-holder agriculture there is likely to continue on a “muted” path of growth.