The evolution of the Global Burden of Disease framework for disease, injury and risk factor quantification: Developing the evidence base for national, regional and global public health action

Reliable, comparable information about the main causes of disease and injury in populations, and how these are changing, is a critical input for debates about priorities in the health sector. Traditional sources of information about the descriptive epidemiology of diseases, injuries and risk factors are generally incomplete, fragmented and of uncertain reliability and comparability. Lack of a standardized measurement framework to permit comparisons across diseases and injuries, as well as risk factors, and failure to systematically evaluate data quality have impeded comparative analyses of the true public health importance of various conditions and risk factors. As a consequence the impact of major conditions and hazards on population health has been poorly appreciated, often leading to a lack of public health investment. Global disease and risk factor quantification improved dramatically in the early 1990s with the completion of the first Global Burden of Disease Study. For the first time, the comparative importance of over 100 diseases and injuries, and ten major risk factors, for global and regional health status could be assessed using a common metric (Disability-Adjusted Life Years) which simultaneously accounted for both premature mortality and the prevalence, duration and severity of the non-fatal consequences of disease and injury. As a consequence, mental health conditions and injuries, for which non-fatal outcomes are of particular significance, were identified as being among the leading causes of disease/injury burden worldwide, with clear implications for policy, particularly prevention. A major achievement of the Study was the complete global descriptive epidemiology, including incidence, prevalence and mortality, by age, sex and Region, of over 100 diseases and injuries. National applications, further methodological research and an increase in data availability have led to improved national, regional and global estimates for 2000, but substantial uncertainty around the disease burden caused by major conditions, including, HIV, remains. The rapid implementation of cost-effective data collection systems in developing countries is a key priority if global public policy to promote health is to be more effectively informed.

Evaluating the properties of a stage-specific self-efficacy scale for physical activity using classical test theory, confirmatory factor analysis and item response modeling

The purpose of this paper was to evaluate the psychometric properties of a stage-specific selfefficacy scale for physical activity with classical test theory (CTT), confirmatory factor analysis (CFA) and item response modeling (IRM). Women who enrolled in the Women On The Move study completed a 20-item stage-specific self-efficacy scale developed for this study [n = 226, 51.1% African-American and 48.9% Hispanic women, mean age = 49.2 (67.0) years, mean body mass index = 29.7 (66.4)]. Three analyses were conducted: (i) a CTT item analysis, (ii) a CFA to validate the factor structure and (iii) an IRM analysis. The CTT item analysis and the CFA results showed that the scale had high internal consistency (ranging from 0.76 to 0.93) and a strong factor structure. Results also showed that the scale could be improved by modifying or eliminating some of the existing items without significantly altering the content of the scale. The IRM results also showed that the scale had few items that targeted high self-efficacy and the stage-specific assumption underlying the scale was rejected. In addition, the IRM analyses found that the five-point response format functioned more like a four-point response format. Overall, employing multiple methods to assess the psychometric properties of the stage-specific self-efficacy scale demonstrated the complimentary nature of these methods and it highlighted the strengths and weaknesses of this scale.

FATORES DETERMINANTES DA QUALIDADE DOS SERVIÇOS EM RESTAURANTES FAST FOOD

No mundo moderno, comodidade e conveniência têm sido fatores ligados diretamente às necessidades cotidianas das pessoas, onde o tempo é cada vez mais escasso e a busca por facilidades se torna uma constante. Tendo em vista esse cenário, na mesma medida crescente do número de frequentadores em praça de alimentação, há uma concorrência intensa travada pelas empresas de fast food estabelecidas nesses centros de compras. Nesse contexto, esse trabalho identifica e analisa fatores determinantes da qualidade dos serviços de restaurantes fast food, sob a ótica dos consumidores. O setor de fast food foi dividido em três categorias: temáticos, por quilo e lanchonetes, visando identificar possíveis diferenças nesses segmentos. O universo da pesquisa concentra-se nos consumidores dos restaurantes fast food situados no principal shopping center da cidade de Mauá. A pesquisa é de caráter descritivo e exploratório, cujos dados foram coletados por meio de questionário, baseado no instrumento de análise SERVQUAL, aplicado junto a uma amostra não probabilística de 390 usuários da praça de alimentação. Foi realizada análise fatorial por meio do software estatístico SPSS v19, extraindo cinco fatores determinantes da qualidade dos serviços de restaurantes fast food. Dentre os fatores extraidos, ressaltam-se os que estão ligados à Excelência e à Personalização dos serviços. Os segmentos analisados apresentaram convergências em seus resultados, como a elevada expectativa por parte dos consumidores, além do déficit na qualidade percebida de serviços dos restaurantes fast food, assim como apresentaram divergências em suas análises individuais, evidenciando peculiaridades a cada um desses.

Impacto do contexto de trabalho e da resiliência sobre o bem-estar no trabalho de profissionais dos Centros de Atenção Psicossocial

Este estudo teve como intuito investigar o impacto do contexto de trabalho e da resiliência sobre o bem-estar no trabalho em profissionais dos Centros de Atenção Psicossocial (CAPS). Os CAPS são serviços públicos substitutivos ao modelo asilar para tratamento de pessoas em sofrimento psíquico, preconizado e fundamentado na Política Nacional de Saúde Mental (PNSM). Para medir o contexto de trabalho utilizou-se a Escala de Avaliação do Contexto de Trabalho (EACT) que investiga as condições de trabalho, a organização do trabalho e as relações sócio profissionais. Já o instrumento utilizado para medir a capacidade dos trabalhadores em manter o nível de desempenho no trabalho mesmo em situações complexas e desgastantes foi a Escala de Avaliação de Resiliência no Trabalho (EART). Por último, investigou-se o nível de bem-estar do público pesquisado através do Inventário de Bem- Estar no Trabalho (IBET-13). O bem-estar no trabalho tem sido considerado como um construto psicológico resultado de vínculos positivos com o trabalho e com a organização. Participaram 81 profissionais dos CAPS das cidades de Petrolina PE e São Bernardo do Campo SP, com idade média de 37 anos (DP= 10,45), em sua maioria do sexo feminino (65,4%), com níveis de escolaridade acima do ensino superior e pós-graduação completa (ambos com 29%), que se declararam casados ou em união estável (39%). Neste estudo, considerou-se bem-estar no trabalho como variável critério e resiliência no trabalho e contexto de trabalho como preditores. Foram realizadas análises estatísticas exploratórias e descritivas, análises de regressão e análises de variância (ANOVA) para descrever participantes, variáveis e testar o modelo. Os resultados apoiaram parcialmente o modelo de predição, pois apenas o fator relações sócio profissionais se confirmou como preditor significativo de Bem-estar no Trabalho, e não houve predição significativa com as demais variáveis (Condições de Trabalho, Organização do Trabalho e Resiliência no Trabalho). Estes dados podem revelar que boas relações sócio profissionais tendem a aumentar o nível de satisfação e comprometimento organizacional afetivo com a instituição, bem como o aumento do nível de envolvimento desses profissionais com seu trabalho.

Precolonial agricultural terracing in Bokoni, South Africa : Typology and an exploratory excavation

Earlier work on the terraced settlements of the Bokoni area (16th to 19th century, Mpumalanga province, South Africa) focussed on the homesteads, their contents, layout and chronology. This paper suggests a terminology and typology of agrarian structures in Bokoni in order to improve comparative approaches in Africa and beyond. The typology and an excavation of the terracing have made possible preliminary conclusions relevant for the further analysis of the terracing and stone-walling in Bokoni. The terracing developed incrementally, whereby cultivation, stone-clearing and terracing were intermixed processes. This is supported both by the organic content in a section of a terrace and by a phytolith analysis. The phytolith analysis furthermore indicated that maize was cultivated on the terraces, but this should be seen as a pilot study only, and presence of maize in Bokoni must be tested with other archaeobotanical methods.

Role of fibroblast growth factor receptor in regulation of membrane traffic

Several studies show that membrane transport mechanisms are regulated by signalling molecules. Recently, genome-wide screen analyses in C.elegans have enabled scientists to identify novel regulators in membrane trafficking and also signalling molecules which are found to couple with this machinery. Fibroblast growth factor (FGF) via binding to fibroblast growth factor receptor (FGFR) mediate signals which are essential in the development of an organism, patterning, cell migration and tissue homeostasis. Impaired FGFR-mediated signalling has been associated with various developmental, neoplastic, metabolic and neurological diseases and cancer. In this study, the potential role of FGFR-mediated signalling pathway as a regulator of membrane trafficking was investigated. The GFP-tagged yolk protein YP170-GFP trafficking was analysed in worms where 1) FGFR signalling cascade components were depleted by RNAi and 2) in mutant animals. From these results, it was found that the disruption of the genes egl-15 (FGFR), egl-17(FGF), let-756(FGF), sem-5, let-60, lin-45, mek-2, mpk-1 and plc-3 lead to abnormal localization of YP170-GFP, suggesting that signalling downstream of FGFR via activation of MAPK and PLC-γ pathway is regulating membrane transport. The route of trafficking was further investigated, to pinpoint which membrane step is regulated by worm FGFR, by analysing a number of GFP-tagged intracellular membrane markers in the intestine of Wild Type (WT) and FGFR mutant worms. FGFR mutant worms showed a significant difference in the localisation of several endosomal membrane markers, suggesting its regulatory role in early and recycling steps of endocytosis. Finally, the trafficking of transferrin in a mammalian NIH/3T3 cell line was investigated to identify the conservation of these membrane trafficking regulatory mechanisms between organisms. Results showed no significant changes in transferrin trafficking upon FGFR stimulation or inhibition.

Public capital and total factor productivity:new evidence from the Italian regions, 1970-98

This paper analyses the relationship between industrial total factor productivity and public capital across the 20 Italian administrative regions. It adds upon the existing literature in a number of ways: it analyses a longer period (1970-98); it allows for the role of human capital accumulation; it tests for the existence of a long-run relationship between total factor productivity and public capital (through previously suggested panel techniques) and for weak exogeneity of public capital; and it assesses the significance of public capital within a non-parametric set-up based on the Free Disposal Hull. The results confirm that public capital has a significant impact on the evolution of total factor productivity, particularly in the Southern regions. This impact is mainly ascribed to the core infrastructures (road and airports, harbours, railroads, water and electricity, telecommunications). Also, core infrastructures are weakly exogenous. © 2005 Regional Studies Association.

The development of a short scale measuring aggressiveness and anger in competitive athletes

Objectives: The study of aggression and anger in competitive sport relies on accurate and economical measurement via observation, interview and questionnaire. Unfortunately, extant questionnaires have been criticised for having poor validity, are not sport specific, or reflect mood states rather than trait qualities. Therefore, a measure of trait anger and aggressiveness in competitive athletes was developed. Method: A list of statements representing aggressiveness and anger was generated and distributed to competitive athletes from diverse sports. Exploratory and confirmatory analyses were used to verify the theoretically predicted factor structure. Correlations with an extant measure of aggression and anger were used to ascertain concurrent validity. Discriminant validity was tested by comparing males with females, and aggressive with non-aggressive footballers. Results: A 12-item scale (Competitive Aggressiveness and Anger Scale, CAAS) consisting of two subscales was derived using principal component factor analysis with oblimin rotation. Confirmatory factor analysis using structural equation modelling confirmed the overall structure. Test-retest correlation, construct and discriminant validities were good, supporting the utility of the scale as a measure of athlete trait aggressiveness and anger. Conclusions: The CAAS appears to be a useful measure of athletic anger and aggressiveness. Its brevity and ability to discriminate aggressive from non-aggressive athletes should prove useful for future research concerning aggressive behaviour in competitive athletes. © 2006 Elsevier Ltd. All rights reserved.

Parent-child interaction and road behaviour:An exploratory study

The relationship between parent-child interaction and child pedestrian behaviour was investigated by comparing parent-child communication to road-crossing behaviour. Forty-four children and their parents were observed carrying out a communication task (the Map Task), and were covertly filmed crossing roads around a university campus. The Map Task provided measures of task focus and sensitivity to another's current knowledge, which we predicted would be reflected in road-crossing behaviour. We modelled indices of road behaviour with factor scores derived from a principal-component analysis of communication features, and background variables including the age, sex and traffic experience of the child, and parental education. A number of variables were significantly related to road crossing, including the age and sex of the child, the length of the conversation, and specific conversational features such as the checking and clarification of uncertain information by both parent and child. The theoretical and practical implications of the findings are discussed.

Exploratory database visualisation: the application and assessment of data and dimensionality reduction

This thesis describes the development of a complete data visualisation system for large tabular databases, such as those commonly found in a business environment. A state-of-the-art 'cyberspace cell' data visualisation technique was investigated and a powerful visualisation system using it was implemented. Although allowing databases to be explored and conclusions drawn, it had several drawbacks, the majority of which were due to the three-dimensional nature of the visualisation. A novel two-dimensional generic visualisation system, known as MADEN, was then developed and implemented, based upon a 2-D matrix of 'density plots'. MADEN allows an entire high-dimensional database to be visualised in one window, while permitting close analysis in 'enlargement' windows. Selections of records can be made and examined, and dependencies between fields can be investigated in detail. MADEN was used as a tool for investigating and assessing many data processing algorithms, firstly data-reducing (clustering) methods, then dimensionality-reducing techniques. These included a new 'directed' form of principal components analysis, several novel applications of artificial neural networks, and discriminant analysis techniques which illustrated how groups within a database can be separated. To illustrate the power of the system, MADEN was used to explore customer databases from two financial institutions, resulting in a number of discoveries which would be of interest to a marketing manager. Finally, the database of results from the 1992 UK Research Assessment Exercise was analysed. Using MADEN allowed both universities and disciplines to be graphically compared, and supplied some startling revelations, including empirical evidence of the 'Oxbridge factor'.

Evaluation of public housing strategies in Mexico City : an exploratory goal programming approach

This thesis describes the development and use of a goal programming methodology for the evaluation of public housjng strategies in Mexico City, The methodology responds to the need to incorporate the location, size and densities of housing projects on the one hand, and "external" constraints such as the ability of low income families to pay for housing, and the amounts of capital and land available, on the other. The provision of low cost housing by public housing agencies in Mexico City is becoming increasingly difficult because there are so many constraints to be met and overcome, the most important of which is the ability of families to pay for housing. Other important limiting factors are the availability of capital and of land plots of the right size in desired locations. The location of public housing projects is significant because it determines the cost and pattern of work trips, which in a metropolitan area such as Mexico City are of considerable importance to both planners and potential. house owners. In addition, since the price of land is closely related to its location, the last factor is also significant in determining the price of the total housing package. Consequently there is a major trade-off between a housing strategy based on the provision of housing at locations close to employment, and the opposite one based on the provjsion of housjng at locations where employment accessibility is poorer but housing can be provided at a lower price. The goal programming evaluation methodology presented in this thesis was developed to aid housing planners to evaluate housing strategies which incorporate the issues raised above,

Identifying a novel functional domain within the p115 tethering factor required for Golgi ribbon assembly and membrane trafficking

The tethering factor p115 has been shown to facilitate Golgi biogenesis and membrane traffic in cells in culture. However, the role of p115 within an intact animal is largely unknown. Here, we document that RNAi-mediated depletion of p115 in C. elegans causes accumulation of the yolk protein (YP170) in body cavity and the retention of the yolk receptor RME-2 in the ER and the Golgi within oocytes.Structure-function analyses of p115 have identified two homology (H1-2) regions within the N-terminal globular head and the coiled-coil 1 (CC1) domain as essential for p115 function. We identify a novel C-terminal domain of p115 as necessary for Golgi ribbon formation and cargo trafficking. We show that p115 mutants lacking the fourth CC domain (CC4) act in a dominant negative manner to disrupt Golgi and prevent cargo trafficking in cells containing endogenous p115. Furthermore, using RNAi-mediated "replacement" strategy we show that CC4 is necessary for Golgi ribbon formation and membrane trafficking in cells depleted of endogenous p115.p115 has been shown to bind a subset of ER-Golgi SNAREs through CC1 and CC4 domains (Shorter et al., 2002). Our findings show that CC4 is required for p115 function and suggest that both the CC1 and the CC4 SNARE-binding motifs may participate in p115-mediated membrane tethering.

Knowledge-based development in leading regions across the globe:an exploratory analysis of the co-evolution of resources, capabilities, and outputs

It is widely observed that the global geography of innovation is rapidly evolving. This paper presents evidence concerning the contemporary evolution of the globe's most productive regions. The paper uncovers the underlying structure and co-evolution of knowledge-based resources, capabilities and outputs across these regions. The analysis identifies two key trends by which the economic evolution and growth patterns of these regions are differentiated-namely, knowledge-based growth and labour market growth. The knowledge-based growth factor represents the underlying commonality found between the growth of economic output, earnings and a range of knowledge-based resources. The labour market growth factor represents the capability of regions to draw on their human capital. Overall, spectacular knowledge-based growth of leading Chinese regions is evident, highlighting a continued shift of knowledge-based resources to Asia. It is concluded that regional growth in knowledge production investment and the capacity to draw on regional human capital reserves are neither necessarily traded-off nor complementary to each other. © 2012 Urban Studies Journal Limited.

Efficiency and total factor productivity changes of Malaysian commercial banks

This paper analyses the efficiency of Malaysian commercial banks between 1996 and 2002 and finds that while the East Asian financial crisis caused a short-term increase in efficiency in 1998 primarily due to cost-cutting, increases in non-performing loans after the crisis caused a more sustained decline in bank efficiency. It is also found that mergers, fully Islamic banks, and conventional banks operating Islamic banking windows are all associated with lower efficiency. The paper estimates suggest mild decreasing returns to scale, and an average productivity change of 2.37% that is primarily attributable to technical change, which has nonetheless declined over time. Finally, while Islamic banks have been moderately successful in developing new products and technologies, the results suggest that the potential for Islamic banks to overcome their relative inefficiency is limited.

The development of an objective methodology to measure medication adherence to oral thiopurines in paediatric patients with acute lymphoblastic leukaemia - an exploratory study

Aims - To develop a method that prospectively assesses adherence rates in paediatric patients with acute lymphoblastic leukaemia (ALL) who are receiving the oral thiopurine treatment 6-mercaptopurine (6-MP). Methods - A total of 19 paediatric patients with ALL who were receiving 6-MP therapy were enrolled in this study. A new objective tool (hierarchical cluster analysis of drug metabolite concentrations) was explored as a novel approach to assess non-adherence to oral thiopurines, in combination with other objective measures (the pattern of variability in 6-thioguanine nucleotide erythrocyte concentrations and 6-thiouric acid plasma levels) and the subjective measure of self-reported adherence questionnaire. Results - Parents of five ALL patients (26.3%) reported at least one aspect of non-adherence, with the majority (80%) citing “carelessness at times about taking medication” as the primary reason for non-adherence followed by “forgetting to take the medication” (60%). Of these patients, three (15.8%) were considered non-adherent to medication according to the self-reported adherence questionnaire (scored ≥ 2). Four ALL patients (21.1%) had metabolite profiles indicative of non-adherence (persistently low levels of metabolites and/or metabolite levels clustered variably with time). Out of these four patients, two (50%) admitted non-adherence to therapy. Overall, when both methods were combined, five patients (26.3%) were considered non-adherent to medication, with higher age representing a risk factor for non-adherence (P < 0.05). Conclusions - The present study explored various ways to assess adherence rates to thiopurine medication in ALL patients and highlighted the importance of combining both objective and subjective measures as a better way to assess adherence to oral thiopurines.