Market reforms and privatisation in the English National Health Service

The article examines developments in the marketisation and privatisation of the English National Health Service, primarily since 1997. It explores the use of competition and contracting out in ancillary services and the levering into public services of private finance for capital developments through the Private Finance Initiative. A substantial part of the article examines the repeated restructuring of the health service as a market in clinical services, initially as an internal market but subsequently as a market increasing opened up to private sector involvement. Some of the implications of market processes for NHS staff and for increased privatisation are discussed. The article examines one episode of popular resistance to these developments, namely the movement of opposition to the 2011 health and social care legislative proposals. The article concludes with a discussion of the implications of these system reforms for the founding principles of the NHS and the sustainability of the service.

Plasticity varies with boldness in a weakly-electric fish

The expression of animal personality is indicated by patterns of consistency in  individual behaviour. Often, the differences exhibited between individuals are consistent across situations. However, between some situations, this can be biased by variable levels of individual plasticity. The interaction between individual plasticity and animal personality can be illustrated by examining situation-sensitive personality traits such as boldness (i.e. risk-taking and exploration tendency). For the weakly electric fish Gnathonemus petersii, light condition is a major factor influencing behaviour. Adapted to navigate in low-light conditions, this species chooses to be more active in dark environments where risk from visual predators is lower. However, G. petersii also exhibit individual differences in their degree of behavioural change from light to dark. The present study, therefore, aims to  examine if an increase of motivation to explore in the safety of the dark, not only affects mean levels of boldness, but also the variation between individuals, as a result of differences  in individual plasticity.  Results: Boldness was consistent between a novel-object and a novel-environment situation in bright light. However, no consistency in boldness was noted between a bright (risky) and a  dark (safe) novel environment. Furthermore, there was a negative association between boldness and the degree of change across novel environments, with shier individuals  exhibiting greater behavioural plasticity.  Conclusions: This study highlights that individual plasticity can vary with personality. In  addition, the effect of light suggests that variation in boldness is situation specific. Finally,  there appears to be a trade-off between personality and individual plasticity with shy but  plastic individuals minimizing costs when perceiving risk and bold but stable individuals  consistently maximizing rewards, which can be maladaptive.

Actual status of preoperative diagnosis of thyroid cancer in Albania

Introduction. Thyroid cancer is the most common endocrine malignancy and accounts for almost 1% of human cancer. It is well known that the majority of cases occur in women in the middle decades of life. Thyroid cancer is a relatively rare disease; on the other hand clinically apparent thyroid nodules are present in 4-7% of the adult population. Most thyroid nodules are not malignant, with reported malignancy rates from 3-12%. It is important for the surgeon to know beforehand the diagnosis of malignancy, in order to perform a more radical operation on the thyroid gland. Patients and Methods. In our study we have analyzed the preoperative clinical data of 84 patients operated in the First Clinic of General Surgery, UHC “Mother Theresa” in Tirana; all with a positive histopathologic diagnosis of thyroid cancer. The data comprised age, sex, age distribution, blood group, time-lapse from the first endocrinologic visit, clinical examination, signs and symptoms, imaging, functional tests, preoperative FNA, admission diagnosis, associated diseases and preoperative treatment. Results. From the study emerged that only 9,3% of these patients were diagnosed preoperatively as thyroid cancer. Another related problem is the low percentage of preoperative FNA – only 22%. Among the signs and symptoms related to thyroid cancer we found that 40 and 33% of these patient presented dyspnea and dysphagia, respectively. The physical examination revealed apparent nodular growth of the thyroid gland in 81% and nodular hard consistency in 79% of cases. The proper endocrinologist consultation lacked in 23% of cases. Conclusion. In our opinion, close collaboration between endocrinologists and surgeons in a multidisciplinary frame is the key to correct preoperative thyroid cancer diagnosis and optimal treatment.

Comparison of different methods to detect genetic barriers in a small mammal population

Habitat fragmentation and the consequently the loss of connectivity between populations can reduce the individuals interchange and gene flow, increasing the chances of inbreeding, and the increase the risk of local extinction. Landscape genetics is providing more and better tools to identify genetic barriers.. To our knowledge, no comparison of methods in terms of consistency has been made with observed data and species with low dispersal ability. The aim of this study is to examine the consistency of the results of five methods to detect barriers to gene flow in a Mediterranean pine vole population Microtus duodecimcostatus: F-statistics estimations, Non-Bayesian clustering, Bayesian clustering, Boundary detection and Simple/Partial Mantel tests. All methods were consistent in detecting the stream as a non-genetic barrier. However, no consistency in results among the methods were found regarding the role of the highway as a genetic barrier. Fst, Bayesian clustering assignment test and Partial Mantel test identifyed the highway as a filter to individual interchange. The Mantel tests were the most sensitive method. Boundary detection method (Monmonier’s Algorithm) and Non-Bayesian approaches did not detect any genetic differentiation of the pine vole due to the highway. Based on our findings we recommend that the genetic barrier detection in low dispersal ability populations should be analyzed with multiple methods such as Mantel tests, Bayesian clustering approaches because they show more sensibility in those scenarios and with boundary detection methods by having the aim of detect drastic changes in a variable of interest between the closest individuals. Although simulation studies highlight the weaknesses and the strengths of each method and the factors that promote some results, tests with real data are needed to increase the effectiveness of genetic barrier detection.

Orthographic regularization in Early Modern English: Grapheme distribution and vowel length indication

The present study is an attempt at assessing the level of consistency in the orthographic systems of selected sixteenth and seventeenth-century printers and at tracing the influence that normative writings could have potentially exerted on them. The approach taken here draws upon the philological tradition of examining and comparing several texts written in the same language, but produced at different times. The study discusses the orthography of the editions of The Schoole of Vertue, a manual of good conduct for children, published between 1557 and 1687. The orthographic variables taken into account fall into two criteria: the distribution and functional load of the selected graphemes and the indication of vowel length.

Social Tagging and the Next Steps for Indexing: Fordist Relexivity and Intertextuality

Social tagging, as a particular type of indexing, has thrown into question the nature of indexing. Is it a democratic process? Can we all benefit from user-created tags? What about the value added by professionals? Employing an evolving framework analysis, this paper addresses the question: what is next for indexing? Comparing social tagging and subject cataloguing; this paper identifies the points of similarity and difference that obtain between these two kinds of information organization frameworks. The subsequent comparative analysis of the parts of these frameworks points to the nature of indexing as an authored, personal, situational, and referential act, where differences in discursive placement divide these two species. Furthermore, this act is contingent on implicit and explicit understanding of purpose and tools available. This analysis allows us to outline desiderata for the next steps in indexing.

Collocative Integrity and Our Many Varied Subjects: What the Metric of Alignment between Classification Scheme and Indexer Tells Us About Langridge’s Theory of Indexing

As the universe of knowledge and subjects change over time, indexing languages like classification schemes, accommodate that change by restructuring. Restructuring indexing languages affects indexer and cataloguer work. Subjects may split or lump together. They may disappear only to reappear later. And new subjects may emerge that were assumed to be already present, but not clearly articulated (Miksa, 1998). In this context we have the complex relationship between the indexing language, the text being described, and the already described collection (Tennis, 2007). It is possible to imagine indexers placing a document into an outdated class, because it is the one they have already used for their collection. However, doing this erases the semantics in the present indexing language. Given this range of choice in the context of indexing language change, the question arises, what does this look like in practice? How often does this occur? Further, what does this phenomenon tell us about subjects in indexing languages? Does the practice we observe in the reaction to indexing language change provide us evidence of conceptual models of subjects and subject creation? If it is incomplete, but gets us close, what evidence do we still require?

Mensuração da potência mecânica em esforços de alta intensidade na condição laboratorial de corrida atada e na condição de campo em corrida semi-atada e livre

Universidade Estadual de Campinas . Faculdade de Educação Física

Construção e validação da Escala de Crenças Parentais e Práticas de Cuidado (E-CPPC) na primeira infância

O presente estudo teve como objetivo construir e validar uma escala de crenças parentais e práticas de cuidado na primeira infância para o contexto brasileiro. Após a construção teórica dos itens, a versão final da escala foi aplicada em dois estudos com populações distintas (estudo preliminar - 250 mães; estudo final - 600 mães), visando avaliar a frequência de comportamento e o grau de importância atribuído às práticas. Para as análises psicométricas, foram realizadas: análise fatorial e o cálculo da consistência interna. Em ambos os estudos a análise fatorial resultou em dois fatores, sendo o primeiro denominado "cuidados primários" e o segundo "estimulação". Os alfas de Cronbach apresentaram-se satisfatórios, variando de 0,68 a 0,83. Os resultados do estudo demonstraram a validade e precisão da escala, a qual poderá ser utilizada em futuras pesquisas, bem como em práticas de intervenção familiar, principalmente durante os primeiros anos de vida das crianças.

Validação e reprodutibilidade da Escala de Evaluación de Insatisfación Corporal para Adolescentes

OBJETIVO:Validar escala de insatisfação corporal para adolescentes. MÉTODOS: Participaram do estudo 386 adolescentes, de ambos os sexos, entre dez e 17 anos de idade, de uma escola particular de ensino fundamental e médio, de São Bernardo do Campo, SP, em 2006. Foram realizadas tradução e adaptação cultural da "Escala de Evaluación de Insatisfación Corporal para Adolescentes" para o português. Foram avaliadas consistência interna por meio do coeficiente alfa de Cronbach, análise fatorial pelo método Varimax e validade discriminante pelas diferenças entre médias de estado nutricional, utilizando-se o teste de Kruskal-Wallis. Na validação concorrente, calculou-se o coeficiente de correlação de Spearman entre a escala e o índice de massa corporal, a razão circunferência quadril e a circunferência da cintura. Para reprodutibilidade, foram utilizados o teste de Wilcoxon, o coeficiente de correlação intra-classe. RESULTADOS: A escala traduzida não apresentou discordâncias significativas com a original. A escala apresentou consistência interna satisfatória para todos os subgrupos estudados (fases inicial e intermediária de adolescência, ambos os sexos) e foi capaz de discriminar os adolescentes segundo o estado nutricional. Na análise concorrente, as três medidas corporais foram correlacionadas, exceto adolescentes do sexo masculino em fase inicial, e sua reprodutibilidade foi confirmada. CONCLUSÕES: A Escala de Avaliação da Insatisfação Corporal para Adolescentes está traduzida e adaptada para o português e apresentou resultados satisfatórios, sendo recomendada para avaliação do aspecto atitudinal da imagem corporal de adolescentes.

The notion of structure and the information records of the documentary systems

Assuming as a starting point the acknowledge that the principles and methods used to build and manage the documentary systems are disperse and lack systematization, this study hypothesizes that the notion of structure, when assuming mutual relationships among its elements, promotes more organical systems and assures better quality and consistency in the retrieval of information concerning users` matters. Accordingly, it aims to explore the fundamentals about the records of information and documentary systems, starting from the notion of structure. In order to achieve that, it presents basic concepts and relative matters to documentary systems and information records. Next to this, it lists the theoretical subsides over the notion of structure, studied by Benveniste, Ferrater Mora, Levi-Strauss, Lopes, Penalver Simo, Saussure, apart from Ducrot, Favero and Koch. Appropriations that have already been done by Paul Otlet, Garcia Gutierrez and Moreiro Gonzalez. In Documentation come as a further topic. It concludes that the adopted notion of structure to make explicit a hypothesis of real systematization achieves more organical systems, as well as it grants pedagogical reference to the documentary tasks.

Interesterification of milkfat with soybean oil catalysed by Rhizopus oryzae lipase immobilised on SiO(2)-PVA on packed bed reactor

The potential of the lipase from Rhizopus oryzae immobilised on SiO(2)-PVA to catalyse the interesterification of the milkfat with soybean oil in a packed bed reactor running on continuous mode was evaluated. The reactor operated continuously for 35 days at 45 degrees C, and during 12 days, no significant decrease in the initial lipase activity was verified. Interesterification yields were in the range from 35 to 38% wt, which gave an interesterified product having 59% lower consistency in relation to non-interesterified blend. Results showed the potential of the lipase from Rhizopus oryzae to mediate the interesterification of milkfat with soybean oil in packed bed reactor, attaining a more spreadable product under a cool temperature. The biocatalyst operational stability was assessed and an inactivation profile was found to follow the Arrhenius model, revealing values of 34 days and 0.034 day(-1), for half-life and a deactivation coefficient, respectively.

Performance of a multi-level TDR system exposed to tropical field conditions - A time-space comparison with tensiometry

Time-domain reflectometry (TDR) is an important technique to obtain series of soil water content measurements in the field. Diode-segmented probes represent an improvement in TDR applicability, allowing measurements of the soil water content profile with a single probe. In this paper we explore an extensive soil water content dataset obtained by tensiometry and TDR from internal drainage experiments in two consecutive years in a tropical soil in Brazil. Comparisons between the variation patterns of the water content estimated by both methods exhibited evidences of deterioration of the TDR system during this two year period at field conditions. The results showed consistency in the variation pattern for the tensiometry data, whereas TDR estimates were inconsistent, with sensitivity decreasing over time. This suggests that difficulties may arise for the long-term use of this TDR system under tropical field conditions. (c) 2008 Elsevier B.V. All rights reserved.

Micromanipulation of chloroplasts using optical tweezers

This paper describes experiments using optical tweezers to probe chloroplast arrangement, shape and consistency in cells of living leaf tissue and in suspension. Dual optical tweezers provided two-point contact on a single chloroplast or two-point contact on two adhered chloroplasts for manipulation in suspension. Alternatively, a microstirrer consisting of a birefringent particle trapped in an elliptically polarized laser trap was used to induce motion and tumbling of a selected chloroplast suspended in a solution. We demonstrate that displacement of chloroplasts inside the cell is extremely difficult, presumably due to chloroplast adhesion to the cytoskeleton and connections between organelles. The study also confirms that the chloroplasts are very thin and extremely cup-shaped with a concave inner surface and a convex outer surface.

Prejudiced attitudes, group norms, and discriminatory behaviour

Most current attitude research focuses on range of non-social attitudinal targets, including health-related and consumer outcomes. In this paper, a program of research that considers the relations among intergroup attitudes, group norms, and behavior will be described. The first study examined the effect of ingroup norms relating to multiculturalism on the extent to wich participants hehaviourally enacted their attitudes. Consistent with social identity theory, attitudebehaviour consistency in relation was influenced by ingroup norms, particularly when national identity was salient. The results of a large scale field study that essential replicated this pattern of results will also be discussed.