2005 ACIP recommendations effect on newborn hepatitis B vaccination rates and the factors affecting the successful implementation of the recommendations in the US

Background. Hepatitis B virus infection is one of major causes of acute and chronic hepatitis, cirrhosis of the liver, and primary hepatocellular carcinoma. Hepatitis B and its long term consequences are major health problems in the United States. Hepatitis B virus can be vertically transmitted from mother to infant during birth. Hepatitis B vaccination at birth is the most effective measure to prevent the newborn from HBV infection and its consequences, and is part of any robust perinatal hepatitis B prevention program following ACIP recommendations. Universal vaccination of the new born will prevent HBV infection during early childhood and, assuming that children receive the three dosages of the vaccine, it will also prevent adolescent and adult infections. Hepatitis B vaccination is now recommended as part of a comprehensive strategy to eliminate HBV transmission in the United States. ^ Objective. (1)To assess if the hepatitis B vaccination rates of newborn babies have improved after the 2005 ACIP recommendations. (2) To identify factors that affects the implementation of ACIP recommendation for hepatitis B vaccination in newborn babies. These factors will encourage ongoing improvement by identifying successful efforts and pinpointing areas that fall short and need attention. Additional focus areas may be identified to accelerate progress in eliminating perinatal HBV transmission.^ Methods. This review includes information from all pertinent articles, reviews, National immunization survey (NIS) surveys, reports, peer reviewed literature and web sources that were published after 1991.The key words to be used for selecting the articles are: "Perinatal Hepatitis B Prevention program", "Universal Hepatitis B vaccination of newborn babies", "ACIP Recommendations." The data gathered will be supplemented with an analysis of vaccination rates using the National Immunization Survey (NIS) birth dose coverage data.^ Results. The data collected in the NIS of 2009 reveals that the national coverage for birth dose of HepB increased to 60.8% from 50.1% in 2006. The largest increase observed for the birth dose in the past 5 years is from 2008 which increased from 55.3 % to 60.8% in 2009. By state, coverage ranged from 22.8% in Vermont to 80.7% in Michigan. %. Overall, in 2009 the estimated vaccination rates are in higher ranges for most states compared to the estimated vaccination rates in 2006. States vary widely in hepatitis B vaccination rates and in their compliance with the 2005 ACIP recommendation. There are many factors at various stages that might affect the successful implementation of the new ACIP recommendation as revealed in literature review. ^ Conclusions. HBV perinatal transmission can be eliminated, but it requires identifying the gaps and measures taken to increase the current vaccination coverage, ensuring timely administration of post exposure immunoprophylaxis and continued evaluations of the impact of immunization recommendations.^

Recommendations for dementia caregiver stress interventions based on Intervention Mapping guidelines

Stress can affect a person's psychological and physical health and cause a variety of conditions including depression, immune system changes, and hypertension (Alzheimer's Association, 2010; Aschbacher et al., 2009; Fredman et al., 2010; Long et al., 2004; Mills et al., 2009; von Känel et al., 2008). The severity and consequences of these conditions can vary based on the duration, amount, and sources of stress experienced by the individual (Black & Hyer, 2010; Coen et al., 1997; Conde-Sala et al., 2010; Pinquart & Sörensen, 2007). Caregivers of people with dementia have an elevated risk for stress and its related health problems because they experience more negative interactions with, and provide more emotional support for, their care recipients than other caregivers. ^ This paper uses a systematic program planning process of Intervention Mapping to organize evidence from literature, qualitative research and theory to develop recommendations for a theory- and evidence-based intervention to improve outcomes for caregivers of people with dementia. A needs assessment was conducted to identify specific dementia caregiver stress influences and a logic model of dementia caregiver stress was developed using the PRECEDE Model. Necessary behavior and environmental outcomes are identified for dementia caregiver stress reduction and performance objectives for each were combined with selected determinants to produce change objectives. Planning matrices were then designed to inform effective theory-based methods and practical applications for recommended intervention delivery. Recommendations for program components, their scope and sequence, the completed program materials, and the program protocols are delineated along with ways to insure that the program is adopted and implemented after it is shown to be effective.^

Sudden Infant Death disparities: A systematic review on health education and policy recommendations for decreasing Sudden Infant Death in the African-American community

Objective: To perform a systematic review of the literature on SIDS and SUID deaths concentrated in the African-American community, describe health education and policy recommendations and recommend a new approach that may aid in decreasing the disparity of infant mortality in the African-American community. ^ Methods: The PubMed database was systematically searched to identify relevant articles for final review and analysis. Using the CASP 2006 system to critique literature, twelve articles were found that met inclusion and exclusion criteria. ^ Results: Evidence in the literature confirmed there was a current disparity among African Americans' infant mortality rates in comparison to other US ethnic groups. The underlying reasons for these disparities included the following maternal and infant characteristics: mothers younger than eighteen, having more than one live infant, having a high school education or less, never been married, and have infants born preterm or with low birth weight. Maternal smoking, substance abuse, and breastfeeding did not have a significant impact on infant sleep environments among African Americans. ^ Conclusion: Tailored health education programs at the community level, better access to pre-pregnancy and prenatal care, and increased maternal perception of risk that is relevant to the infants sleeping environment are all possible solutions that may decrease African American infant mortality rates.^

Climate change technology transfer to developing countries: evidence analysis and policy recommendations

Developing countries are experiencing unprecedented levels of economic growth. As a result, they will be responsible for most of the future growth in energy demand and greenhouse gas (GHG) emissions. Curbing GHG emissions in developing countries has become one of the cornerstones of a future international agreement under the United Nations Framework Convention for Climate Change (UNFCCC). However, setting caps for developing countries’ GHG emissions has encountered strong resistance in the current round of negotiations. Continued economic growth that allows poverty eradication is still the main priority for most developing countries, and caps are perceived as a constraint to future growth prospects. The development, transfer and use of low-carbon technologies have more positive connotations, and are seen as the potential path towards low-carbon development. So far, the success of the UNFCCC process in improving the levels of technology transfer (TT) to developing countries has been limited. This thesis analyses the causes for such limited success and seeks to improve on the understanding about what constitutes TT in the field of climate change, establish the factors that enable them in developing countries and determine which policies could be implemented to reinforce these factors. Despite the wide recognition of the importance of technology and knowledge transfer to developing countries in the climate change mitigation policy agenda, this issue has not received sufficient attention in academic research. Current definitions of climate change TT barely take into account the perspective of actors involved in actual climate change TT activities, while respective measurements do not bear in mind the diversity of channels through which these happen and the outputs and effects that they convey. Furthermore, the enabling factors for TT in non-BRIC (Brazil, Russia, India, China) developing countries have been seldom investigated, and policy recommendations to improve the level and quality of TTs to developing countries have not been adapted to the specific needs of highly heterogeneous countries, commonly denominated as “developing countries”. This thesis contributes to enriching the climate change TT debate from the perspective of a smaller emerging economy (Chile) and by undertaking a quantitative analysis of enabling factors for TT in a large sample of developing countries. Two methodological approaches are used to study climate change TT: comparative case study analysis and quantitative analysis. Comparative case studies analyse TT processes in ten cases based in Chile, all of which share the same economic, technological and policy frameworks, thus enabling us to draw conclusions on the enabling factors and obstacles operating in TT processes. The quantitative analysis uses three methodologies – principal component analysis, multiple regression analysis and cluster analysis – to assess the performance of developing countries in a number of enabling factors and the relationship between these factors and indicators of TT, as well as to create groups of developing countries with similar performances. The findings of this thesis are structured to provide responses to four main research questions: What constitutes technology transfer and how does it happen? Is it possible to measure technology transfer, and what are the main challenges in doing so? Which factors enable climate change technology transfer to developing countries? And how do different developing countries perform in these enabling factors, and how can differentiated policy priorities be defined accordingly? vi Resumen Los paises en desarrollo estan experimentando niveles de crecimiento economico sin precedentes. Como consecuencia, se espera que sean responsables de la mayor parte del futuro crecimiento global en demanda energetica y emisiones de Gases de Efecto de Invernadero (GEI). Reducir las emisiones de GEI en los paises en desarrollo es por tanto uno de los pilares de un futuro acuerdo internacional en el marco de la Convencion Marco de las Naciones Unidas para el Cambio Climatico (UNFCCC). La posibilidad de compromisos vinculantes de reduccion de emisiones de GEI ha sido rechazada por los paises en desarrollo, que perciben estos limites como frenos a su desarrollo economico y a su prioridad principal de erradicacion de la pobreza. El desarrollo, transferencia y uso de tecnologias bajas en carbono tiene connotaciones mas positivas y se percibe como la via hacia un crecimiento bajo en carbono. Hasta el momento, la UNFCCC ha tenido un exito limitado en la promocion de transferencias de tecnologia (TT) a paises en desarrollo. Esta tesis analiza las causas de este resultado y busca mejorar la comprension sobre que constituye transferencia de tecnologia en el area de cambio climatico, cuales son los factores que la facilitan en paises en desarrollo y que politicas podrian implementarse para reforzar dichos factores. A pesar del extendido reconocimiento sobre la importancia de la transferencia de tecnologia a paises en desarrollo en la agenda politica de cambio climatico, esta cuestion no ha sido suficientemente atendida por la investigacion existente. Las definiciones actuales de transferencia de tecnologia relacionada con la mitigacion del cambio climatico no tienen en cuenta la diversidad de canales por las que se manifiestan o los efectos que consiguen. Los factores facilitadores de TT en paises en desarrollo no BRIC (Brasil, Rusia, India y China) apenas han sido investigados, y las recomendaciones politicas para aumentar el nivel y la calidad de la TT no se han adaptado a las necesidades especificas de paises muy heterogeneos aglutinados bajo el denominado grupo de "paises en desarrollo". Esta tesis contribuye a enriquecer el debate sobre la TT de cambio climatico con la perspectiva de una economia emergente de pequeno tamano (Chile) y el analisis cuantitativo de factores que facilitan la TT en una amplia muestra de paises en desarrollo. Se utilizan dos metodologias para el estudio de la TT a paises en desarrollo: analisis comparativo de casos de estudio y analisis cuantitativo basado en metodos multivariantes. Los casos de estudio analizan procesos de TT en diez casos basados en Chile, para derivar conclusiones sobre los factores que facilitan u obstaculizan el proceso de transferencia. El analisis cuantitativo multivariante utiliza tres metodologias: regresion multiple, analisis de componentes principales y analisis cluster. Con dichas metodologias se busca analizar el posicionamiento de diversos paises en cuanto a factores que facilitan la TT; las relaciones entre dichos factores e indicadores de transferencia tecnologica; y crear grupos de paises con caracteristicas similares que podrian beneficiarse de politicas similares para la promocion de la transferencia de tecnologia. Los resultados de la tesis se estructuran en torno a cuatro preguntas de investigacion: .Que es la transferencia de tecnologia y como ocurre?; .Es posible medir la transferencia de tecnologias de bajo carbono?; .Que factores facilitan la transferencia de tecnologias de bajo carbono a paises en desarrollo? y .Como se puede agrupar a los paises en desarrollo en funcion de sus necesidades politicas para la promocion de la transferencia de tecnologias de bajo carbono?

Usability Planner: A Tool to Support the Process of Selecting Usability Methods

There is increasing pressure on developers to produce usable systems, which requires the use of appropriate methods to support user centred design during development. There is currently no consistent advice on which methods are appropriate in which circumstances, so the selection of methods relies on individual experience and expertise. Considerable effort is required to collate information from various sources and to understand the applicability of each method in a particular situation. Usability Planner is a tool aimed to support the selection of the most appropriate methods depending on project and organizational constraints. Many of the rules employed are derived from ISO standards, complemented with rules from the authors’ experience.

Recommendations on seismic actions on bridges

The paper describes the main features of a technical Recommendation first draft on Seismic Actions on Bridges, promoted by the Spanish Ministry of Public Works (MOPT). Although much more research is needed to clarify the seismic behaviour of the vast class of problems present in port structures the current state of the art allows at least a classificaton of subjects and the establishment of minimum requirements to guide the design. Also the use of more refined methods for specially dangerous situations needs some general guidelines that contribute to mantein the design under reasonable safety margins. The Recommendations of the Spanish MOPT are a first try in those directions.

Recommendations on seismic actions on port structures

The paper describes the main features of a Technical Recommendation first draft on Seismic Action on port structures promoted recently by the Spanish Ministry of Public Works (MOPT). Although much more research is needed to clarify the seismic behaviour of the vast class of problems present in port structures the current state of the art allows at least a classification of subjects and the establishment of minimum requirements to guide the design. Also the use of more refined methods for specially dangerous situations needs some general guidelines that contribute to mantein the design under reasonable safety margins. The Recommendations of the Spanish MOPT are a first try in those directions.

Effects of dietary restriction combined with different exercise programs or physical activity recommendations on blood lipids in overweight adults

Background and aim: Many exercise studies, although generally showing the beneficial effects of supervised aerobic, resistance or combined exercise on blood lipids, have sometimes reached equivocal conclusions. The aim of this study is to evaluate the impact of different programs that combined exercise and dietary restriction on blood lipids versus a clinical practice intervention for weight loss, in overweight adults. Methods: For this study 66 subjects participated in a supervised 22 weeks training program, composed of three sessions per week and they were randomized in three groups: strength training (S; n = 19), endurance training (E; n = 25), a combination of E and S (SE; n = 22). Eighteen subjects served as physical activity group (PA) that followed a clinical intervention consisted of physical activity recommendations. All groups followed the same dietary treatment, and blood samples were obtained for lipids measurements, at the beginning and end of the study. Results: Lipid profile improved in all groups. No significant differences for baseline and post-training values were observed between groups. In general, SE and PA decreased low-density lipoprotein cholesterol (LDL-C) values (p menor que 0.01). S decreased triglyceride levels (p menor que 0.01) and E, SE, and PA decreased total cholesterol levels (p menor que 0.05, p menor que 0.01 and p menor que 0.01, respectively). Conclusions: These results suggest that an intervention program of supervised exercise combined with diet restriction did not achieved further improvements in blood lipid profile than diet restriction and physical activity recommendations, in overweight adults. (Clinical Trials gov number: NCT01116856).

Generating context-aware recommendations using banking data in a mobile recommender system

The increasing adoption of smartphones by the society has created a new area of research in recommender systems. This new domain is based on using location and context-awareness to provide personalization. This paper describes a model to generate context-aware recommendations for mobile recommender systems using banking data in order to recommend places where the bank customers have previously spent their money. In this work we have used real data provided by a well know Spanish bank. The mobile prototype deployed in the bank Labs environment was evaluated in a survey among 100 users with good results regarding usefulness and effectiveness. The results also showed that test users had a high confidence in a recommender system based on real banking data.

The dicode workbench: A flexible framework for the integration of information and web services

Aiming to address requirements concerning integration of services in the context of ?big data?, this paper presents an innovative approach that (i) ensures a flexible, adaptable and scalable information and computation infrastructure, and (ii) exploits the competences of stakeholders and information workers to meaningfully confront information management issues such as information characterization, classification and interpretation, thus incorporating the underlying collective intelligence. Our approach pays much attention to the issues of usability and ease-of-use, not requiring any particular programming expertise from the end users. We report on a series of technical issues concerning the desired flexibility of the proposed integration framework and we provide related recommendations to developers of such solutions. Evaluation results are also discussed.

3-dimensional binaural sound rendering using acoustic measurements stored in the SOFA format

Several groups all over the world are researching in several ways to render 3D sounds. One way to achieve this is to use Head Related Transfer Functions (HRTFs). These measurements contain the Frequency Response of the human head and torso for each angle. Some years ago, was only possible to measure these Frequency Responses only in the horizontal plane. Nowadays, several improvements have made possible to measure and use 3D data for this purpose. The problem was that the groups didn't have a standard format file to store the data. That was a problem when a third part wanted to use some different HRTFs for 3D audio rendering. Every of them have different ways to store the data. The Spatially Oriented Format for Acoustics or SOFA was created to provide a solution to this problem. It is a format definition to unify all the previous different ways of storing any kind of acoustics data. At the moment of this project they have defined some basis for the format and some recommendations to store HRTFs. It is actually under development, so several changes could come. The SOFA[1] file format uses a numeric container called netCDF[2], specifically the Enhaced data model described in netCDF 4 that is based on HDF5[3]. The SoundScape Renderer (SSR) is a tool for real-time spatial audio reproduction providing a variety of rendering algorithms. The SSR was developed at the Quality and Usability Lab at TU Berlin and is now further developed at the Institut für Nachrichtentechnik at Universität Rostock [4]. This project is intended to be an introduction to the use of SOFA files, providing a C++ API to manipulate them and adapt the binaural renderer of the SSR for working with the SOFA format. RESUMEN. El SSR (SoundScape Renderer) es un programa que está siendo desarrollado actualmente por la Universität Rostock, y previamente por la Technische Universität Berlin. El SSR es una herramienta diseñada para la reproducción y renderización de audio 2D en tiempo real. Para ello utiliza diversos algoritmos, algunos orientados a sistemas formados por arrays de altavoces en diferentes configuraciones y otros algoritmos diseñados para cascos. El principal objetivo de este proyecto es dotar al SSR de la capacidad de renderizar sonidos binaurales en 3D. Este proyecto está centrado en el binaural renderer del SSR. Este algoritmo se basa en el uso de HRTFs (Head Related Transfer Function). Las HRTFs representan la función de transferencia del sistema formado por la cabeza y el torso del oyente. Esta función es medida desde diferentes ángulos. Con estos datos el binaural renderer puede generar audio en tiempo real simulando la posición de diferentes fuentes. Para poder incluir una base de datos con HRTFs en 3D se ha hecho uso del nuevo formato SOFA (Spatially Oriented Format for Acoustics). Este nuevo formato se encuentra en una fase bastante temprana de su desarrollo. Está pensado para servir como formato estándar para almacenar HRTFs y cualquier otro tipo de medidas acústicas, ya que actualmente cada laboratorio cuenta con su propio formato de almacenamiento y esto hace bastante difícil usar varias bases de datos diferentes en un mismo proyecto. El formato SOFA hace uso del contenedor numérico netCDF, que a su vez esta basado en un contenedor más básico llamado HRTF-5. Para poder incluir el formato SOFA en el binaural renderer del SSR se ha desarrollado una API en C++ para poder crear y leer archivos SOFA con el fin de utilizar los datos contenidos en ellos dentro del SSR.

Usability Planner: Herramienta para la planificación de técnicas de usabilidad en el ciclo de vida del software

A pesar del creciente interés de las organizaciones por la aplicación de métodos y técnicas de usabilidad en el proceso de desarrollo de software, seleccionar y poner en práctica aquellas técnicas que más se adecuan a las características de un determinado proyecto es una tarea compleja y con un soporte bajo. La diversidad de métodos de usabilidad, su desconocimiento en el mundo profesional y la falta de unas pautas claras para su aplicación en un determinado proyecto están causando que la introducción del Diseño Centrado en el Usuario (UCD, del inglés User Centred Design o DCU en español) en las compañías sea una tarea costosa y compleja. No obstante, las empresas que apuestan por la usabilidad de sus productos se están posicionando por encima del resto al crear sistemas que los usuarios valoran notablemente y por ver incrementadas sus ventas. Jefes de proyecto y consultores, que ven atractivo el desarrollo de sistemas usables, se hallan en un escenario en el que no encuentran un mecanismo sencillo e inmediato para seleccionar y aplicar las técnicas de usabilidad en sus proyectos de forma ágil y estructurada. El criterio para la selección de técnicas y métodos que manejan se basa únicamente en su experiencia profesional y en la bibliografía de numerosos autores. Usability Planner es una aplicación web dirigida a profesionales, estudiantes e investigadores involucrados en el desarrollo de software para ayudar a cambiar este escenario. Su objetivo es dar soporte a la selección de técnicas y métodos de usabilidad en el proceso de desarrollo de software minimizando riesgos y maximizando beneficios.

Development of a Model for Security and Usability

This research addressed the development of a consolidated model designed especially to cover the security and usability attributes of a software product. As a starting point, we built a new usability model on the basis of well-known quality standards and models. We then used an existing security model to analyse the relationship between these two approaches. This analysis consisted of a systematic mapping study of the relationship between security and usability as global quality factors. We identified five relationship types: inverse, direct, relative, one-way inverse, and no relationship. Most authors agree that there is an inverse relationship between security and usability. However, this is not a unanimous finding, and this study unveils a number of open questions, like application domain dependency and the need to explore lower-level relationships between attribute subcharacteristics. In order to clarify the questions raised during the research, we conducted a second systematic mapping to further analyse the finer-grained structure of these factors, such as authentication as a subset of security and user efficiency as a subset of usability. The most relevant finding is that efficiency does not depend on the security level during the authentication process. There are other subfactors that require analysis. Accordingly, this research is the first part of a larger project to develop a full-blown consolidated model for security and usability.

Adding Usability Mechanisms into Agile Requirements: Tool Support with U-Kunagi

The growing interest for integrating agile methodologies and usability has brought various challenges to practitioners. This research focuses on a specific part of these challenges that is related to the integration of usability mechanisms (features such as cancel, undo, warning, etc.) into agile requirements, usually written in the form of user stories. For this aim, a framework has been developed, conformed first by a well-defined modeling language that aims to formalize previous empirical research in the field, models of the impact of usability mechanisms into user stories, and a tool to help practitioners applying them to user stories. Results show that the use of this framework helps agile developers to think about usability from the beginning of the development process, without needing to be an expert in the subject. Our proposal can therefore complement other usability practices to improve the quality of use of software developed using agile methodologies.

Enhanced recommendations for e-learning authoring tools based on a proactive context-aware recommender

Authoring tools are powerful systems in the area of e-Learning that make easier for teachers to create new learning objects by reusing or editing existing educational resources coming from learning repositories or content providers. However, due to the overwhelming number of resources these tools can access, sometimes it is difficult for teachers to find the most suitable resources taking into account their needs in terms of content (e.g. topic) or pedagogical aspects (e.g. target level associated to their students). Recommender systems can take an important role trying to mitigate this problem. In this paper we propose a new model to generate proactive context-aware recommendations on resources during the creation process of a new learning object that a teacher carries out by using an authoring tool. The common use cases covered by the model for having recommendations in online authoring tools and details about the recommender model itself are presented.