Clarifying approaches to: health needs assessment, health impact assessment, integrated impact assessment, health equity audit, and race equality impact assessment

Planners, policy makers and practitioners across all sectors in England use a range of approaches to assess health needs, inform decisions and assess impact. Use of these approaches can lead to improved health outcomes and reduced inequalities through auditing provision, access and outcomes. Five main approaches are used by local, regional and national government, voluntary agencies and the NHS: ۢ Health needs assessment (HNA) ۢ Health impact assessment (HIA) ۢ Integrated impact assessment (IIA) ۢ Health equity audit (HEA) ۢ Race equality impact assessment (REIA)

Commissioning for equity. Equal access, equal care? Can London deliver the race equality action plan for mental health? Executive summary

This report has been produced by the London Health Observatory (LHO) for the London Development Centre to provide a London baseline for monitoring specific actions in the Delivering Race Equality (DRE) action plan. The report summarises the findings of an analysis of the information collected from all of London's nine Mental Health NHS providers, and 22 independent providers for the national census of inpatients in mental health hospitals and facilities in England and Wales on 31 March 2005 .

Exhumation history of eastern Ladakh revealed by 40Ar/39Ar and fission-track ages: the Indus River-Tso Morari transect, NW Himalaya

Fission-track and (40)Ar/(39)Ar ages place time constraints on the exhumation of the North Himalayan nappe stack, the Indus Suture Zone and Molasse, and the Transhimalayan Batholith in eastern Ladakh (NW India). Results from this and previous studies on a north-south transect passing near Tso Morari Lake suggest that the SW-directed North Himalayan nappe stack (comprising the Mata, Tetraogal and Tso Morari nappes) was emplaced and metamorphosed by c. 50-45 Ma, and exhumed to moderately shallow depths (c. 10 km) by c. 45-40 Ma. From the mid-Eocene to the present, exhumation continued at a steady and slow rate except for the root zone of the Tso Morari nappe, which cooled faster than the rest of the nappe stack. Rapid cooling occurred at c. 20 Ma and is linked to brittle deformation along the normal Ribil-Zildat Fault concomitant with extrusion of the Crystalline nappe in the south. Data from the Indus Molasse suggest that sediments were still being deposited during the Miocene.

A fast-track program reduces complications and length of hospital stay after open colonic surgery.

BACKGROUND & AIMS: A fast-track program is a multimodal approach for patients undergoing colonic surgery that combines stringent regimens of perioperative care (fluid restriction, optimized analgesia, forced mobilization, and early oral feeding) to reduce perioperative morbidity, hospital stay, and cost. We investigated the impact of a fast-track protocol on postoperative morbidity in patients after open colonic surgery. METHODS: A randomized trial of patients in 4 teaching hospitals in Switzerland included 156 patients undergoing elective open colonic surgery who were assigned to either a fast-track program or standard care. The primary end point was the 30-day complication rate. Secondary end points were severity of complications, hospital stay, and compliance with the fast-track protocol. RESULTS: The fast-track protocol significantly decreased the number of complications (16 of 76 in the fast-track group vs 37 of 75 in the standard care group; P = .0014), resulting in shorter hospital stays (median, 5 days; range, 2-30 vs 9 days, respectively; range, 6-30; P < .0001). There was a trend toward less severe complications in the fast-track group. A multiple logistic regression analysis revealed fluid administration greater than the restriction limits (odds ratio, 4.198; 95% confidence interval, 1.7-10.366; P = .002) and a nonfunctioning epidural analgesia (odds ratio, 3.365; 95% confidence interval, 1.367-8.283; P = .008) as independent predictors of postoperative complications. CONCLUSIONS: The fast-track program reduces the rate of postoperative complications and length of hospital stay and should be considered as standard care. Fluid restriction and an effective epidural analgesia are the key factors that determine outcome of the fast-track program.

Time processing in visual cortices: How the visual brain encodes and keeps track of time

Time is embedded in any sensory experience: the movements of a dance, the rhythm of a piece of music, the words of a speaker are all examples of temporally structured sensory events. In humans, if and how visual cortices perform temporal processing remains unclear. Here we show that both primary visual cortex (V1) and extrastriate area V5/MT are causally involved in encoding and keeping time in memory and that this involvement is independent from low-level visual processing. Most importantly we demonstrate that V1 and V5/MT are functionally linked and temporally synchronized during time encoding whereas they are functionally independent and operate serially (V1 followed by V5/MT) while maintaining temporal information in working memory. These data challenge the traditional view of V1 and V5/MT as visuo-spatial features detectors and highlight the functional contribution and the temporal dynamics of these brain regions in the processing of time in millisecond range. The present project resulted in the paper entitled: 'How the visual brain encodes and keeps track of time' by Paolo Salvioni, Lysiann Kalmbach, Micah Murray and Domenica Bueti that is now submitted for publication to the Journal of Neuroscience.

A 2D/3D image analysis system to track fluorescently labeled structures in rod-shaped cells: application to measure spindle pole asymmetry during mitosis.

BACKGROUND: The yeast Schizosaccharomyces pombe is frequently used as a model for studying the cell cycle. The cells are rod-shaped and divide by medial fission. The process of cell division, or cytokinesis, is controlled by a network of signaling proteins called the Septation Initiation Network (SIN); SIN proteins associate with the SPBs during nuclear division (mitosis). Some SIN proteins associate with both SPBs early in mitosis, and then display strongly asymmetric signal intensity at the SPBs in late mitosis, just before cytokinesis. This asymmetry is thought to be important for correct regulation of SIN signaling, and coordination of cytokinesis and mitosis. In order to study the dynamics of organelles or large protein complexes such as the spindle pole body (SPB), which have been labeled with a fluorescent protein tag in living cells, a number of the image analysis problems must be solved; the cell outline must be detected automatically, and the position and signal intensity associated with the structures of interest within the cell must be determined. RESULTS: We present a new 2D and 3D image analysis system that permits versatile and robust analysis of motile, fluorescently labeled structures in rod-shaped cells. We have designed an image analysis system that we have implemented as a user-friendly software package allowing the fast and robust image-analysis of large numbers of rod-shaped cells. We have developed new robust algorithms, which we combined with existing methodologies to facilitate fast and accurate analysis. Our software permits the detection and segmentation of rod-shaped cells in either static or dynamic (i.e. time lapse) multi-channel images. It enables tracking of two structures (for example SPBs) in two different image channels. For 2D or 3D static images, the locations of the structures are identified, and then intensity values are extracted together with several quantitative parameters, such as length, width, cell orientation, background fluorescence and the distance between the structures of interest. Furthermore, two kinds of kymographs of the tracked structures can be established, one representing the migration with respect to their relative position, the other representing their individual trajectories inside the cell. This software package, called "RodCellJ", allowed us to analyze a large number of S. pombe cells to understand the rules that govern SIN protein asymmetry. CONCLUSIONS: "RodCell" is freely available to the community as a package of several ImageJ plugins to simultaneously analyze the behavior of a large number of rod-shaped cells in an extensive manner. The integration of different image-processing techniques in a single package, as well as the development of novel algorithms does not only allow to speed up the analysis with respect to the usage of existing tools, but also accounts for higher accuracy. Its utility was demonstrated on both 2D and 3D static and dynamic images to study the septation initiation network of the yeast Schizosaccharomyces pombe. More generally, it can be used in any kind of biological context where fluorescent-protein labeled structures need to be analyzed in rod-shaped cells. AVAILABILITY: RodCellJ is freely available under http://bigwww.epfl.ch/algorithms.html, (after acceptance of the publication).

Exhumation history of the NW Indian Himalaya revealed by fission track and 40Ar/39Ar ages

New fission track and Ar/Ar geochronological data provide time constraints on the exhumation history of the Himalayan nappes in the Mandi (Beas valley) - Tso Monad transect of the NW Indian Himalaya. Results from this and previous studies suggest that the SW-directed North Himalayan nappes were emplaced by detachment from the underthrusted upper Indian crust by 55 Ma and metamorphosed by ca. 48-40 Ma. The nappe stack was subsequently exhumed to shallow upper crustal depths (<10 km) by 40-30 Ma in the Tso Monad dome (northern section of the transect) and by 30-20 Ma close to frontal thrusts in the Baralacha La region. From the Oligocene to the present, exhumation continued slowly.

Railroads are on Track to keep Iowa's Economy Healthy and Growing, 2005

Just as the railroad tracks guide trains toward their destination, Iowa’s railroads play a vital role in keeping our state’s economic health and growth “on track” for the future.

Phylogeographical structure, postglacial recolonization and barriers to gene flow in the distinctive Valais chromosome race of the common shrew (Sorex araneus).

Using one male-inherited and eight biparentally inherited microsatellite markers, we investigate the population genetic structure of the Valais chromosome race of the common shrew (Sorex araneus) in the Central Alps of Europe. Unexpectedly, the Y-chromosome microsatellite suggests nearly complete absence of male gene flow among populations from the St-Bernard and Simplon regions (Switzerland). Autosomal markers also show significant genetic structuring among these two geographical areas. Isolation by distance is significant and possible barriers to gene flow exist in the study area. Two different approaches are used to better understand the geographical patterns and the causes of this structuring. Using a principal component analysis for which testing procedure exists, and partial Mantel tests, we show that the St-Bernard pass does not represent a significant barrier to gene flow although it culminates at 2469 m, close to the highest altitudinal record for this species. Similar results are found for the Simplon pass, indicating that both passes represented potential postglacial recolonization routes into Switzerland from Italian refugia after the last Pleistocene glaciations. In contrast with the weak effect of these mountain passes, the Rhône valley lowlands significantly reduce gene flow in this species. Natural obstacles (the large Rhône river) and unsuitable habitats (dry slopes) are both present in the valley. Moreover, anthropogenic changes to landscape structures are likely to have strongly reduced available habitats for this shrew in the lowlands, thereby promoting genetic differentiation of populations found on opposite sides of the Rhône valley.

Track analysis of the Mexican species of Cerambycidae (Insecta, Coleoptera)

A track analysis of 221 species belonging to 68 genera of Mexican Cerambycidae was undertaken in order to identify their main distributional patterns. Based on the comparison of the individual tracks, fifteen generalized tracks were obtained: six are placed in the Neotropical region, seven are shared by the Neotropical region and the Mexican Transition Zone, one is situated in the Mexican Transition Zone, and one is shared by the Nearctic region and the Mexican Transition Zone. Eight nodes were found in the intersection of these generalized tracks, five of them located in the Neotropical region and three in the Mexican Transition Zone. Distributional patterns of Mexican Cerambycidae show two basic patterns: one mostly Neotropical, in the Mesoamerican dominion (Mexican Pacific Coast and Mexican Gulf biogeographic provinces) and another in the Mexican Transition Zone (Transmexican Volcanic Belt and Balsas Basin biogeographic provinces).