832 resultados para Collaborative bibliographic revision


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von Ignaz Zollschan

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The central assumption in the literature on collaborative networks and policy networks is that political outcomes are affected by a variety of state and nonstate actors. Some of these actors are more powerful than others and can therefore have a considerable effect on decision making. In this article, we seek to provide a structural and institutional explanation for these power differentials in policy networks and support the explanation with empirical evidence. We use a dyadic measure of influence reputation as a proxy for power, and posit that influence reputation over the political outcome is related to vertical integration into the political system by means of formal decision-making authority, and to horizontal integration by means of being well embedded into the policy network. Hence, we argue that actors are perceived as influential because of two complementary factors: (a) their institutional roles and (b) their structural positions in the policy network. Based on temporal and cross-sectional exponential random graph models, we compare five cases about climate, telecommunications, flood prevention, and toxic chemicals politics in Switzerland and Germany. The five networks cover national and local networks at different stages of the policy cycle. The results confirm that institutional and structural drivers seem to have a crucial impact on how an actor is perceived in decision making and implementation and, therefore, their ability to significantly shape outputs and service delivery.

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von Ignaz Zollschan

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BACKGROUND High early mortality in patients with HIV-1 starting antiretroviral therapy (ART) in sub-Saharan Africa, compared to Europe and North America, is well documented. Longer-term comparisons between settings have been limited by poor ascertainment of mortality in high burden African settings. This study aimed to compare mortality up to four years on ART between South Africa, Europe, and North America. METHODS AND FINDINGS Data from four South African cohorts in which patients lost to follow-up (LTF) could be linked to the national population register to determine vital status were combined with data from Europe and North America. Cumulative mortality, crude and adjusted (for characteristics at ART initiation) mortality rate ratios (relative to South Africa), and predicted mortality rates were described by region at 0-3, 3-6, 6-12, 12-24, and 24-48 months on ART for the period 2001-2010. Of the adults included (30,467 [South Africa], 29,727 [Europe], and 7,160 [North America]), 20,306 (67%), 9,961 (34%), and 824 (12%) were women. Patients began treatment with markedly more advanced disease in South Africa (median CD4 count 102, 213, and 172 cells/µl in South Africa, Europe, and North America, respectively). High early mortality after starting ART in South Africa occurred mainly in patients starting ART with CD4 count <50 cells/µl. Cumulative mortality at 4 years was 16.6%, 4.7%, and 15.3% in South Africa, Europe, and North America, respectively. Mortality was initially much lower in Europe and North America than South Africa, but the differences were reduced or reversed (North America) at longer durations on ART (adjusted rate ratios 0.46, 95% CI 0.37-0.58, and 1.62, 95% CI 1.27-2.05 between 24 and 48 months on ART comparing Europe and North America to South Africa). While bias due to under-ascertainment of mortality was minimised through death registry linkage, residual bias could still be present due to differing approaches to and frequency of linkage. CONCLUSIONS After accounting for under-ascertainment of mortality, with increasing duration on ART, the mortality rate on HIV treatment in South Africa declines to levels comparable to or below those described in participating North American cohorts, while substantially narrowing the differential with the European cohorts. Please see later in the article for the Editors' Summary.

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BACKGROUND The Journey bicruciate substituting (BCS) total knee replacement (TKR) is intended to improve knee kinematics by more closely approximating the surfaces of a normal knee. The purpose of this analysis was to address the safety of Journey BCS knees by studying early complication and revision rates in a consecutive case series. METHODS Between December 2006 and May 2011, a single surgeon implanted 226 Journey BCS total knee prostheses in 191 patients (124 women, 67 men) who were eligible for study. Mean age at surgery was 68 years (41-85 years).Outcome measures were early complications and minor and major revision rates. All complications were considered, irrespective of whether conservative treatment or revision was required. RESULTS The average implantation time was 3.5 years (range 1.3-5.8 years). Thirty-three complications (14.6% of 226 knees) required minor or major revision surgery in 25 patients. The remaining eight patients were treated conservatively. Sixteen minor revisions were performed in 12 patients. Thirteen major revisions were required in 13 patients, which results in a rate of 1.65 major revisions per 100 component years. The linear trend of the early complication rate by treatment year was not significant (p = .22).Multivariate logistic regression showed no significant predictors for the occurrence of a complication or for revision surgery. A tendency towards higher complication rates was observed in female patients, although it was not significant (p = .066). CONCLUSIONS The complication and revision rates of the Journey BCS knee implant are high in comparison with those reported for other established total knee systems. Caution is advised when using this implant, particularly for less experienced knee surgeons.

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Fragestellung/Einleitung: Bisher existieren kaum Daten für den deutschsprachigen Raum, welche Fehler häufig bei der Erstellung von schriftlichen Prüfungsfragen gemacht werden. Diese Erkenntnisse könnten hilfreich sein, um Autoren in Schulungsworkshops mit dem Fokus auf die häufigsten Fehler zu schulen. Im vorliegenden Projekt wird der Frage nachgegangen, welche Fehler am häufigsten bei der Erstellung von schriftlichen Prüfungsfragen gemacht werden, und welche Schlussfolgerungen daraus für Autorenschulungen gezogen werden können. Methoden: Am Institut für Medizinische Lehre Bern werden die mit der inhaltlichen und/oder formalen Fragenrevision befassten MitarbeiterInnen (N=14) anhand von semi-strukturierten Interviews befragt, mit welcher Art von Mängeln sie bei den Fragen der von ihnen betreuten schriftlichen Prüfungen am häufigsten umgehen. Weiter wird erhoben, wie dem Revisionsbedarf aus ihrer Sicht in Schulungen am besten begegnet werden kann. Ergebnisse: Die vorläufigen Ergebnisse weisen darauf hin, dass in folgenden Bereichen am häufigsten Revisionsbedarf besteht: eindeutiger Focus auf ein konkretes Lernziel authentische und relevante Vignette für den Ausbildungsstand angemessener Schwierigkeitsgrad eindeutige Lösung formale und sprachliche Korrektheit Dementsprechend sollte auf diese Themenbereiche ein besonderer Schwerpunkt bei Schulungen gelegt werden. Diskussion/Schlussfolgerung: Die vorläufigen Ergebnisse weisen darauf hin, dass Mängel von schriftlichen Prüfungsfragen häufig in den Bereichen Focus, Vignette, Schwierigkeitsgrad, Eindeutigkeit und formal-sprachlichen Aspekten liegen. Autorenschulungen sollten diese Aspekte in den Vordergrund stellen. Unsere zum Zeitpunkt der GMA-Tagung vorliegenden definitiven Ergebnisse können dazu beitragen, Workshops zur Fragenerstellung noch besser am Schulungsbedarf auszurichten.

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Two batches of excretory/secretory (E/S) antigens from second stage larvae of Toxocara canis maintained in vitro were prepared independently in two different laboratories (Zürich and Basel) and analysed in order to obtain information for future efforts to standardize the enzyme-linked immunosorbent assay (ELISA) used for the serodiagnosis of human toxocariasis. SDS-PAGE and "Western-blotting" revealed at least 10 different antigenic components common to the two antigen preparations. However, distinct qualitative and quantitative differences among the two E/S-antigens were observed, since one antigen had a more complex composition than the other. Despite these differences, an accordance of serodiagnosis was obtained in 80% of 25 sera from patients with suspected Toxocara infection tested independently in two different ELISA systems (Basel and Zürich) with the corresponding E/S-antigens. The specificity was 93% as determined (BS-antigen, BS-ELISA) by testing 46 out of 3396 sera from patients with parasitologically proven extra-intestinal helminthic infections. Cross-reactions occurred mainly with sera from patients infected with filariae (5 from 13 cases) exhibiting very high extinction values in their homologous ELISA-system. The reproducibility (intra- and inter-test variations) of two ELISA systems using the corresponding E/S-antigens varied from 5-15%. The results demonstrate that T. canis E/S-antigens may well be applicable for standardization of the ELISA used for the serodiagnosis of human toxocariasis.

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BACKGROUND HIV-1 viral load (VL) testing is recommended to monitor antiretroviral therapy (ART) but not universally available. We examined monitoring of first-line and switching to second-line ART in sub-Saharan Africa, 2004-2013. METHODS Adult HIV-1 infected patients starting combination ART in 16 countries were included. Switching was defined as a change from a non-nucleoside reverse-transcriptase inhibitor (NNRTI)-based regimen to a protease inhibitor (PI)-based regimen, with a change of ≥1 NRTI. Virological and immunological failures were defined per World Health Organization criteria. We calculated cumulative probabilities of switching and hazard ratios with 95% confidence intervals (CI) comparing routine VL monitoring, targeted VL monitoring, CD4 cell monitoring and clinical monitoring, adjusted for programme and individual characteristics. FINDINGS Of 297,825 eligible patients, 10,352 patients (3·5%) switched during 782,412 person-years of follow-up. Compared to CD4 monitoring hazard ratios for switching were 3·15 (95% CI 2·92-3·40) for routine VL, 1·21 (1·13-1·30) for targeted VL and 0·49 (0·43-0·56) for clinical monitoring. Overall 58.0% of patients with confirmed virological and 19·3% of patients with confirmed immunological failure switched within 2 years. Among patients who switched the percentage with evidence of treatment failure based on a single CD4 or VL measurement ranged from 32·1% with clinical to 84.3% with targeted VL monitoring. Median CD4 counts at switching were 215 cells/µl under routine VL monitoring but lower with other monitoring (114-133 cells/µl). INTERPRETATION Overall few patients switched to second-line ART and switching occurred late in the absence of routine viral load monitoring. Switching was more common and occurred earlier with targeted or routine viral load testing.

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Indigenous media as a phenomenon cannot be reduced to a reaction to western hegemony and colonial legacies, but is often rooted in the context of resistance, empowerment, self-determination and the reclaiming of symbolic representation. Therefore I would like to reflect on different cases of indigenous film and participatory video work in an attempt to highlight the multiple dynamics that arise due to the desideratum of self-representation and to finally locate us as anthropologists in that context.

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Boberach: Nachdem die Grundzüge der Frankfurter Reichsverfassung ins Dreikönigsbündnis eingegangen sind, bieten sich zwei Wege: Entweder wird die Idee des Bundesstaates ganz aufgegeben und die Bundesakte verbessert, oder anstelle des "Reichs" bilden sich als neue Großmacht die Vereinten Staaten Deutschlands, die einen Unionsvertrag mit den übrigen Staaten schließen, denen aber der Beitritt zum Dreikönigsbündnis offen stehen muß. Die Union ließe sich aber auch durch Einführung von Mehrheitsbeschlüssen und Anschluß der Küstenstaaten an den Deutschen Zollverein herstellen