Practice and attitude differences in physician cigarette use: A study of prevalence, physicians' role, and smoking policy awareness in Dubai, UAE

The use of tobacco products ruins the health of millions of people around the world. On average, tobacco users die nearly seven years earlier than non-tobacco users. n1 Cigarette smoking is a particular concern in the developing countries of the Middle East and Gulf Cooperation Council (GCC) region where smoking prevalence is expected to increase. This is due to the tobacco industry's vigorous commercial and marketing activities. n3 Smoking prevalence among physicians is considered to be an effective indicator of a society's readiness to identify the smoking epidemic and its related health diseases. n4 There is a lack of detailed data on the smoking prevalence among healthcare professionals, particularly physicians, in the United Arab Emirates (UAE). This cross sectional study is the first to address smoking practices among physicians working at the Department of Health and Medical Services (DOHMS); in Dubai, UAE. ^ This study describes the cigarette smoking prevalence among DOHMS Physicians, physician attitudes towards tobacco use and tobacco bans; physician attitudes towards smoking cessation techniques (among smokers and non-smokers); and physician awareness of official anti-smoking policies. Data for the study was collected through the use of an adapted WHO standardized questionnaire, the Global Health Professionals Survey. The questionnaire was administered by the researcher to physicians (n=288) at their work place. Date was analyzed using the SPSS analytic software program. ^ Twelve percent of DOHMS physicians smoked cigarettes. Regardless of smoking status, the majority supported a tobacco ban in hospitals and public places, and a ban on tobacco advertising. There is a significant relationship between physician smoking status and discussing risks of tobacco use (p < 0.05). Non-smoking physicians reported spending more time with patients discussing hazards of smoking (p < 0.01). Non-smokers reported providing more counseling than their smoking colleagues. The majority of DOHMS physicians (63%) reported a lack of knowledge about 5As/ 5Rs. The majority of physicians also reported they are aware of hospital smoking policies that restrict smoking. Regardless of physician smoking status, DOHMS physicians are not very actively involved in smoking cessation activities. This cross sectional study is the first to address smoking programs, policies, and practices among physicians in Dubai, UAE. Findings support the need for increased physical smoking cessation training as well as the development of smoking cessation programs for tobacco control, and programs with a focus on physician participation in reducing tobacco and cigarette use among the general population.^

Future pandemic influenza control (FPIC) related strategic management plan based on the 2009 H1N1 pandemic influenza review of health policy decisions, their practice and implications

This cross-sectional study is based on the qualitative and quantitative research design to review health policy decisions, their practice and implications during 2009 H1N1 influenza pandemic in the United States and globally. The “Future Pandemic Influenza Control (FPIC) related Strategic Management Plan” was developed based on the incorporation of the “National Strategy for Pandemic Influenza (2005)” for the United States from the U.S. Homeland Security Council and “The Canadian Pandemic Influenza Plan for the Health Sector (2006)” from the Canadian Pandemic Influenza Committee for use by the public health agencies in the United States as well as globally. The “global influenza experts’ survey” was primarily designed and administered via email through the “Survey Monkey” system to the 2009 H1N1 influenza pandemic experts as the study respondents. The effectiveness of this plan was confirmed and the approach of the study questionnaire was validated to be convenient and the excellent quality of the questions provided an efficient opportunity to the study respondents to evaluate the effectiveness of predefined strategies/interventions for future pandemic influenza control.^ The quantitative analysis of the responses to the Likert-scale based questions in the survey about predefined strategies/interventions, addressing five strategic issues to control future pandemic influenza. The effectiveness of strategies defined as pertinent interventions in this plan was evaluated by targeting five strategic issues regarding pandemic influenza control. For the first strategic issue pertaining influenza prevention and pre pandemic planning; the confirmed effectiveness (agreement) for strategy (1a) 87.5%, strategy (1b) 91.7% and strategy (1c) 83.3%. The assessment of the priority level for strategies to address the strategic issue no. (1); (1b (High Priority) > 1a (Medium Priority) > 1c (Low Priority) based on the available resources of the developing and developed countries. For the second Strategic Issue encompassing the preparedness and communication regarding pandemic influenza control; the confirmed effectiveness (agreement) for the strategy (2a) 95.6%, strategy (2b) 82.6%, strategy (2c) 91.3% and Strategy (2d) 87.0%. The assessment of the priority level for these strategies to address the strategic issue no. (2); (2a (highest priority) > 2c (high priority) >2d (medium priority) > 2b (low priority). For the third strategic issue encompassing the surveillance and detection of pandemic influenza; the confirmed effectiveness (agreement) for the strategy (3a) 90.9% and strategy (3b) 77.3%. The assessment of the priority level for theses strategies to address the strategic Issue No. (3) (3a (high priority) > 3b (medium/low priority). For the fourth strategic issue pertaining the response and containment of pandemic influenza; the confirmed effectiveness (agreement) for the strategy (4a) 63.6%, strategy (4b) 81.8%, strategy (4c) 86.3%, and strategy (4d) 86.4%. The assessment of the priority level for these strategies to address the strategic issue no. (4); (4d (highest priority) > 4c (high priority) > 4b (medium priority) > 4a (low priority). The fifth strategic issue about recovery from influenza and post pandemic planning; the confirmed effectiveness (agreement) for the strategy (5a) 68.2%, strategy (5b) 36.3% and strategy (5c) 40.9%. The assessment of the priority level for strategies to address the strategic issue no. (5); (5a (high priority) > 5c (medium priority) > 5b (low priority).^ The qualitative analysis of responses to the open-ended questions in the study questionnaire was performed by means of thematic content analysis. The following recurrent or common “themes” were determined for the future implementation of various predefined strategies to address five strategic issues from the “FPIC related Strategic Management Plan” to control future influenza pandemics. (1) Pre Pandemic Influenza Prevention, (2) Seasonal Influenza Control, (3) Cost Effectiveness of Non Pharmaceutical Interventions (NPI), (4) Raising Global Public Awareness, (5) Global Influenza Vaccination Campaigns, (6)Priority for High Risk Population, (7) Prompt Accessibility and Distribution of Influenza Vaccines and Antiviral Drugs, (8) The Vital Role of Private Sector, (9) School Based Influenza Containment, (10) Efficient Global Risk Communication, (11) Global Research Collaboration, (12) The Critical Role of Global Public Health Organizations, (13) Global Syndromic Surveillance and Surge Capacity and (14) Post Pandemic Recovery and Lessons Learned. The future implementation of these strategies with confirmed effectiveness to primarily “reduce the overall response time’ in the process of ‘early detection’, ‘strategies (interventions) formulation’ and their ‘implementation’ to eventually ensure the following health outcomes: (a) reduced influenza transmission, (b) prompt and effective influenza treatment and control, (c) reduced influenza related morbidity and mortality.^

Global Ocean Colour for Carbon Cycle Research (full product set)

In 2005, the International Ocean Colour Coordinating Group (IOCCG) convened a working group to examine the state of the art in ocean colour data merging, which showed that the research techniques had matured sufficiently for creating long multi-sensor datasets (IOCCG, 2007). As a result, ESA initiated and funded the DUE GlobColour project (http://www.globcolour.info/) to develop a satellite based ocean colour data set to support global carbon-cycle research. It aims to satisfy the scientific requirement for a long (10+ year) time-series of consistently calibrated global ocean colour information with the best possible spatial coverage. This has been achieved by merging data from the three most capable sensors: SeaWiFS on GeoEye's Orbview-2 mission, MODIS on NASA's Aqua mission and MERIS on ESA's ENVISAT mission. In setting up the GlobColour project, three user organisations were invited to help. Their roles are to specify the detailed user requirements, act as a channel to the broader end user community and to provide feedback and assessment of the results. The International Ocean Carbon Coordination Project (IOCCP) based at UNESCO in Paris provides direct access to the carbon cycle modelling community's requirements and to the modellers themselves who will use the final products. The UK Met Office's National Centre for Ocean Forecasting (NCOF) in Exeter, UK, provides an understanding of the requirements of oceanography users, and the IOCCG bring their understanding of the global user needs and valuable advice on best practice within the ocean colour science community. The three year project kicked-off in November 2005 under the leadership of ACRI-ST (France). The first year was a feasibility demonstration phase that was successfully concluded at a user consultation workshop organised by the Laboratoire d'Océanographie de Villefranche, France, in December 2006. Error statistics and inter-sensor biases were quantified by comparison with insitu measurements from moored optical buoys and ship based campaigns, and used as an input to the merging. The second year was dedicated to the production of the time series. In total, more than 25 Tb of input (level 2) data have been ingested and 14 Tb of intermediate and output products created, with 4 Tb of data distributed to the user community. Quality control (QC) is provided through the Diagnostic Data Sets (DDS), which are extracted sub-areas covering locations of in-situ data collection or interesting oceanographic phenomena. This Full Product Set (FPS) covers global daily merged ocean colour products in the time period 1997-2006 and is also freely available for use by the worldwide science community at http://www.globcolour.info/data_access_full_prod_set.html. The GlobColour service distributes global daily, 8-day and monthly data sets at 4.6 km resolution for, chlorophyll-a concentration, normalised water-leaving radiances (412, 443, 490, 510, 531, 555 and 620 nm, 670, 681 and 709 nm), diffuse attenuation coefficient, coloured dissolved and detrital organic materials, total suspended matter or particulate backscattering coefficient, turbidity index, cloud fraction and quality indicators. Error statistics from the initial sensor characterisation are used as an input to the merging methods and propagate through the merging process to provide error estimates for the output merged products. These error estimates are a key component of GlobColour as they are invaluable to the users; particularly the modellers who need them in order to assimilate the ocean colour data into ocean simulations. An intensive phase of validation has been undertaken to assess the quality of the data set. In addition, inter-comparisons between the different merged datasets will help in further refining the techniques used. Both the final products and the quality assessment were presented at a second user consultation in Oslo on 20-22 November 2007 organised by the Norwegian Institute for Water Research (NIVA); presentations are available on the GlobColour WWW site. On request of the ESA Technical Officer for the GlobColour project, the FPS data set was mirrored in the PANGAEA data library.

Emergence of Asian GAPs and its relationship to global G.A.P.

Global G.A.P. is a one of the most influential private standards in the area of food safety and sustainability. With increasing impacts of Global G.A.P., many Asian countries have introduced the country versions of GAPs; China GAP, Japan GAP, Viet GAP, Thai GAP and ASEAN GAP. Each has been influenced by Global G.A.P. but ways of implementation, implementation bodies as well as focus differ from each other. This paper examines the development and motivation behind how the Asian GAPs have been introduced both from current situation and from historical perspectives. Then we compare current situation of different Asian GAPs.

Using global analysis, partial specifications, and an extensible assertion language for program validation and debugging

We present a framework for the application of abstract interpretation as an aid during program development, rather than in the more traditional application of program optimization. Program validation and detection of errors is first performed statically by comparing (partial) specifications written in terms of assertions against information obtained from static analysis of the program. The results of this process are expressed in the user assertion language. Assertions (or parts of assertions) which cannot be verified statically are translated into run-time tests. The framework allows the use of assertions to be optional. It also allows using very general properties in assertions, beyond the predefined set understandable by the static analyzer and including properties defined by means of user programs. We also report briefly on an implementation of the framework. The resulting tool generates and checks assertions for Prolog, CLP(R), and CHIP/CLP(fd) programs, and integrates compile-time and run-time checking in a uniform way. The tool allows using properties such as types, modes, non-failure, determinacy, and computational cost, and can treat modules separately, performing incremental analysis. In practice, this modularity allows detecting statically bugs in user programs even if they do not contain any assertions.

Global research alliance modelling platform (GRAMP): an open web platform for modelling greenhouse gas emissions from agro-ecosystems

Carbon (C) and nitrogen (N) process-based models are important tools for estimating and reporting greenhouse gas emissions and changes in soil C stocks. There is a need for continuous evaluation, development and adaptation of these models to improve scientific understanding, national inventories and assessment of mitigation options across the world. To date, much of the information needed to describe different processes like transpiration, photosynthesis, plant growth and maintenance, above and below ground carbon dynamics, decomposition and nitrogen mineralization. In ecosystem models remains inaccessible to the wider community, being stored within model computer source code, or held internally by modelling teams. Here we describe the Global Research Alliance Modelling Platform (GRAMP), a web-based modelling platform to link researchers with appropriate datasets, models and training material. It will provide access to model source code and an interactive platform for researchers to form a consensus on existing methods, and to synthesize new ideas, which will help to advance progress in this area. The platform will eventually support a variety of models, but to trial the platform and test the architecture and functionality, it was piloted with variants of the DNDC model. The intention is to form a worldwide collaborative network (a virtual laboratory) via an interactive website with access to models and best practice guidelines; appropriate datasets for testing, calibrating and evaluating models; on-line tutorials and links to modelling and data provider research groups, and their associated publications. A graphical user interface has been designed to view the model development tree and access all of the above functions.

Translating and Subtitling Humor Through Theory and Practice

This project assesses translating and subtitling humor in Italian and Spanish language films subtitled into English. Humor in film is problematic to translate when subtitling: visual humor may need no assistance to be delivered to a target audience, but verbal humor requires thorough analysis to be constructed effectively in the target language. To keep humor alive in target language translations, translators must understand the structure and function of humor. This project researches humor theory, translation and subtitling. It analyzes humor function through humor theory and applies this knowledge to translating audiovisual mediums. An understanding of joke structure and humor function can serve as a guide for translators to recognize, devise and evaluate equivalent translations of humor in film.

The Effect of the Farmer Assurance Provision of the Consolidated and Continuing Appropriations Act, 2013 on Biodiversity and Global Food Security

A rider to a US law, the Consolidated and Continuing Appropriations Act, 2013, known as the Farmer Assurance Provision, encourages the large-scale genetic modification and global distribution of agricultural crops, thereby undermining the Food and Agriculture Organization of the United Nations' determination that food security rests on biodiversity. The rider blocks the US Department of Agriculture's mandate to prohibit farmers from growing crops from biotechnological seeds where the courts have found that this farm practice may cause damage to human health and/or degrade the environment. Despite genetically modified organisms (GMOs) reducing unwanted traits in plants, the paper supports the UN's mission for biodiversity and that more long-term testing was (and is) needed for GMO products, developed from 1994 on, before a hasty piece of Congressional legislation as was made in this case.

The autonomy of the EU legal order and the law-making activities of international organizations. Some examples regarding the Council most recent practice. Research Papers in Law 03/2012

[Introduction.] It is generally believed that while the principle of the autonomy of the EU legal order, in the sense of constitutional and institutional autonomy that is to say what concerns the autonomous decision-making of the EU, has been clearly strengthened by the most recent jurisprudence of the Court of Justice (eg. Moxplant3, Intertanko or the Kadi/Al Baraakat judgements or the Opinion 1/2009 of the CJEU etc.) as well as, in my opinion, in many aspects by the Treaty of Lisbon, it is still valid to add that the principle of a favourable approach, stemming from the Court jurisprudence, for the enhanced openness of the EU legal order to international law has remained equally important for the EU4. On the other hand, it should be also seen that in a globalized world, and following the increased role of the EU as an international actor, its indispensable and crucial role concerning the creation of world (legal) order in many policy fields ( for example let's think about the G20 issues, the global economic and financial crisis, the role of the EU in promoting and protecting human rights worldwide, the implementation of the multilateral or regional conventional law, developed in the framework the UN (e.g. in the field of agriculture or environment etc) or what concerns the Kyoto process on climate change or the conservation of marine biological resources at international level etc), it seems reasonable and justified to submit that the influence, for example, of the law-making activities of the main stakeholder international organizations in the mentioned policy-areas on the EU (especially on the development of its constantly evolving legal order) or vice-versa the influence of the EU law-making practice on these international organizations is significant, in many aspects mutually interdependent and more and more remarkable. This tendency of the 21st century doesn't mean, however, in my view, that the notion of the autonomy of the EU legal order would have been weakened by this increasing interaction between international law and EU law over the passed years. This contribution is going to demonstrate and prove these departuring points by giving some concrete examples from the most recent practice of the Council (all occuring either in the second half of 2009 or after the entry into force of the Lisbon Treaty), and which relate to two very important policy areas in the EU, namely the protection of human rights and the Common Fishery Policy.

A Global Strategy for a soul-searching European Union. EPC Discussion Paper, 13 July 2016

On 28 June 2016, just a few days after the historic Brexit vote, High Representative of the Union for Foreign Affairs and Security Policy Federica Mogherini presented the paper on the new European Union Global Strategy (EUGS) at the European Council, outlining the strategic coordinates for the EU’s foreign and security policy. In this Discussion Paper, Giovanni Grevi takes a closer look at the EUGS and assesses its main rationale, features, added value and prospects against the backdrop of an ever more complex world. Not only is the EU dealing with increasingly contested and polarised politics at home, but the global theatre itself has become hugely disorienting, more integrated and yet more fragmented at the same time. The paper recalibrates the overall foreign policy posture of the EU and sketches out a more modest and concrete approach compared to earlier aspirations, and a more joined-up one compared to current practice. By doing so, the strategy seeks to square the circle between the need for Europe to be cohesive and purposeful in a harder strategic environment and the fact that domestic politics within the Union constrain its external action and drain its attractiveness. The EUGS calls on the EU and member states to fully take on their responsibility to underpin unity, prosperity and security at home by taking more effective and joined-up action abroad. The question is, of course, whether this call will be heeded.

Monitoring dendritic cells in clinical practice using a new whole blood single-platform TruCOUNT assay

Dendritic cells (DC) from distinct DC subsets are essential contributors to normal human immune responses. Despite this, reliable assays that enable DC to be counted precisely have been slow to evolve. We have now developed a new single-platform flow cytometric assay based on TruCOUN(TM) beads and the whole blood Lyse/No-Wash protocol that allows precise counting of the CD14(-) blood DC subsets: CD11c(+)CD16(-) DC, CD11c(+)CD16(+) DC, CD123(hi) DC, CD1c(+) DC and BDCA-3(+) DC. This assay requires 50 mul of whole blood; does not rely on a hematology blood analyser for the absolute DC counts; allows DC counting in EDTA samples 24 It after collection; and is suitable for cord blood and peripheral blood. The data is highly reproducible with intra-assay and inter-assay coefficients of variation less than 3% and 11%, respectively. This assay does not produce the DC-T lymphocyte conjugates that result in DC counting abnormalities in conventional gradient-density separation procedures. Using the TruCOUNT assay, we established that absolute blood DC counts reduce with age in healthy individuals. In preliminary studies, we found a significantly lower absolute blood CD11c(+)CD16(+) DC count in stage III/IV versus stage I/II breast carcinoma patients and a lower absolute blood CD123(hi) DC count in multiple myeloma patients, compared to age-matched controls. These data indicate that scientific progress in DC counting technology will lead to the global standardization of DC counting and allow clinically meaningful data to be obtained. (C) 2003 Elsevier B.V. All rights reserved.

Brand loyalties: rethinking content within global corporate media

Translating content from one media platform to another, a process here dubbed content streaming, is the leitmotif of contemporary globalized media. Yet widely divergent interpretations of the phenomenon have emerged. Academic political economy interprets content streaming as powerfully inimical to cultural diversity, media competition and freedom of speech. Mainstream business reporting, working from an opposing media economics schema, pillories ‘synergy’-based content strategies as oversold in theory and unworkable in practice. Challenging this established trend for the disciplines to develop in parallel, the article harnesses mainstream critique of content streaming to political economy’s traditionally circumspect view of corporate media. Examining first the commercial rationales for pursuing content streaming, before turning to the financial and managerial constraints on realizing these goals, the article positions content streaming as less all-pervasive than political economists have feared, but more commercially entrenched than the financial press currently allows.

Assessing professionalism: theory and practice

Professional attitudes and behaviours have only recently been explicitly recognized by medical educators as legitimate and necessary components of global competence, although the idea of Fitness to Practice has always presupposed acceptable professional behaviour. Medical schools have recently begun to introduce teaching and assessment of professionalism, including attitudes and behaviours. Partly as a result of the difficulty of assessment in this area, selection of students is receiving greater attention, in the pursuit of globally competent graduates. However, selection processes may be overrated for this purpose. Assessing actual attitudes and behaviour during the course is arguably a better way of ensuring that medical graduates are competent in these areas. I argue that judgments about attitudinal and behavioural competence are legitimate, and need be no more arbitrary than those made about scientific or clinical knowledge and skills, but also that these judgments should be restricted to what is agreed to be unacceptable behaviour, rather titan attempting to rate attitudes and behaviour positively. This model introduces students to the way in which their behaviours will be judged in their professional lives by registration authorities. These theoretical positions are illustrated by a recent case of academic failure based on inadequate attitudes and behaviours.

Global perspectives in Korean intercountry adoption

Policy and social work practice currently lack a theoretical framework that adequately explains the emergence, diffusion, and continuance of the intercountry adoption (ICA) phenomenon. Using South Korea as a case study and the application of actor network theory to the ICA phenomenon, this paper introduces a theoretical approach that allows an examination of the complex interrelationships between the global and local influences of a country's engagement in ICA. This theoretical approach provides a different way of understanding the phenomenon, which, in turn, can better inform policies and practice that affect children and families across the globe.