Applying the WHO recommendations on health-sector response to violence against women to assess the Spanish health system. A mixed methods approach

This methodological note describes the development and application of a mixed-methods protocol to assess the responsiveness of Spanish health systems to violence against women in Spain, based on the World Health Organization (WHO) recommendations. Five areas for exploration were identified based on the WHO recommendations: policy environment, protocols, training, accountability/monitoring, and prevention/promotion. Two data collection instruments were developed to assess the situation of 17 Spanish regional health systems (RHS) with respect to these areas: 1) a set of indicators to guide a systematic review of secondary sources, and 2) an interview guide to be used with 26 key informants at the regional and national levels. We found differences between RHSs in the five areas assessed. The progress of RHSs on the WHO recommendations was notable at the level of policies, moderate in terms of health service delivery, and very limited in terms of preventive actions. Using a mixed-methods approach was useful for triangulation and complementarity during instrument design, data collection and interpretation.

Health-Sector Responses to Intimate Partner Violence Fitting the Response Into the Biomedical Health System or Adapting the System to Meet the Response?

This study aims to analyze how middle-level health systems’ managers understand the integration of a health care response to intimate partner violence (IPV) within the Spanish health system. Data were obtained through 26 individual interviews with professionals in charge of coordinating the health care response to IPV within the 17 regional health systems in Spain. The transcripts were analyzed following grounded theory in accordance with the constructivist approach described by Charmaz. Three categories emerged, showing the efforts and challenges to integrate a health care response to IPV within the Spanish health system: “IPV is a complex issue that generates activism and/or resistance,” “The mandate to integrate a health sector response to IPV: a priority not always prioritized,” and “The Spanish health system: respectful with professionals’ autonomy and firmly biomedical.” The core category, “Developing diverse responses to IPV integration,” crosscut the three categories and encompassed the range of different responses that emerge when a strong mandate to integrate a health care response to IPV is enacted. Such responses ranged from refraining to deal with the issue to offering a women-centered response. Attempting to integrate a response to nonbiomedical health problems as IPV into health systems that remain strongly biomedicalized is challenging and strongly dependent both on the motivation of professionals and on organizational factors. Implementing and sustaining changes in the structure and culture of the health care system are needed if a health care response to IPV that fulfills the World Health Organization guidelines is to be ensured.

A gas-exchange system for assessing plant performance in response to environmental stress /

Mode of access: Internet.

Development of Chemical Hazards Response Information System (CHRIS) /

Performed by Arthur D. Little, Inc. for the Coast Guard under contract no. DOT-CG-24,655-A.

CERCLIS (Comprehensive environmental response, compensation, and liability information system) site location extract data element dictionary.

PB90-215120

A staff response to the report, An assessment of the Michigan accountability system.

Cover title.

Effector ExoU from the type III secretion system is an important modulator of gene expression in lung epithelial cells in response to Pseudomonas aeruginosa infection

Pseudomonas aeruginosa is an important pathogen in immunocompromised patients and secretes a diverse set of virulence factors that aid colonization and influence host cell defenses. An important early step in the establishment of infection is the production of type III-secreted effectors translocated into host cells by the bacteria. We used cDNA microarrays to compare the transcriptomic response of lung epithelial cells to P. aeruginosa mutants defective in type IV pili, the type III secretion apparatus, or in the production of specific type III-secreted effectors. Of the 18,000 cDNA clones analyzed, 55 were induced or repressed after 4 It of infection and could be classified into four different expression patterns. These include (i) host genes that are induced or repressed in a type III secretion-independent manner (32 clones), (ii) host genes induced specifically by ExoU (20 clones), and (iii) host genes induced in an ExoU-independent but type III secretion dependent manner (3 clones). In particular, ExoU was essential for the expression of immediate-early response genes, including the transcription factor c-Fos. ExoU-dependent gene expression was mediated in part by early and transient activation of the AN transcription factor complex. In conclusion, the present study provides a detailed insight into the response of epithelial cells to infection and indicates the significant role played by the type III virulence mechanism in the initial host response.

Fast response static var generator for improving the power system performance of an electric arc furnace (EAF)

Cascaded multilevel inverters-based Static Var Generators (SVGs) are FACTS equipment introduced for active and reactive power flow control. They eliminate the need for zigzag transformers and give a fast response. However, with regard to their application for flicker reduction in using Electric Arc Furnace (EAF), the existing multilevel inverter-based SVGs suffer from the following disadvantages. (1) To control the reactive power, an off-line calculation of Modulation Index (MI) is required to adjust the SVG output voltage. This slows down the transient response to the changes of reactive power; and (2) Random active power exchange may cause unbalance to the voltage of the d.c. link (HBI) capacitor when the reactive power control is done by adjusting the power angle d alone. To resolve these problems, a mathematical model of 11-level cascaded SVG, was developed. A new control strategy involving both MI (modulation index) and power angle (d) is proposed. A selected harmonics elimination method (SHEM) is taken for switching pattern calculations. To shorten the response time and simplify the controls system, feed forward neural networks are used for on-line computation of the switching patterns instead of using look-up tables. The proposed controller updates the MI and switching patterns once each line-cycle according to the sampled reactive power Qs. Meanwhile, the remainder reactive power (compensated by the MI) and the reactive power variations during the line-cycle will be continuously compensated by adjusting the power angles, d. The scheme senses both variables MI and d, and takes action through the inverter switching angle, qi. As a result, the proposed SVG is expected to give a faster and more accurate response than present designs allow. In support of the proposal there is a mathematical model for reactive powered distribution and a sensitivity matrix for voltage regulation assessment, MATLAB simulation results are provided to validate the proposed schemes. The performance with non-linear time varying loads is analysed and refers to a general review of flicker, of methods for measuring flickers due to arc furnace and means for mitigation.

Sustained insulin secretory response in human islets co-cultured with pancreatic duct-derived epithelial cells within a rotational cell culture system

Aims/hypothesis - Loss of the trophic support provided by surrounding non-endocrine pancreatic cell populations underlies the decline in beta cell mass and insulin secretory function observed in human islets following isolation and culture. This study sought to determine whether restoration of regulatory influences mediated by ductal epithelial cells promotes sustained beta cell function in vitro. Methods - Human islets were isolated according to existing protocols. Ductal epithelial cells were harvested from the exocrine tissue remaining after islet isolation, expanded in monolayer culture and characterised using fluorescence immunocytochemistry. The two cell types were co-cultured under conventional static culture conditions or within a rotational cell culture system. The effect of co-culture on islet structural integrity, beta cell mass and insulin secretory capacity was observed for 10 days following isolation. Results - Human islets maintained under conventional culture conditions exhibited a characteristic loss in structural integrity and functional viability as indicated by a diminution of glucose responsiveness. By contrast, co-culture of islets with ductal epithelial cells led to preserved islet morphology and sustained beta cell function, most evident in co-cultures held within the rotational cell culture system, which showed a significantly (p<0.05) greater insulin secretory response to elevated glucose compared with control islets. Similarly, insulin/protein ratio data suggested that the presence of ductal epithelial cells is beneficial for the maintenance of beta cell mass. Conclusions/interpretation - The data indicate a supportive role for ductal epithelial cells in islet viability. Further characterisation of the regulatory influences may lead to novel strategies to improve long-term beta cell function both in vitro and following islet transplantation.

Automated Response to Query System

SMS (Short Message Service) is now a hugely popular and a very powerful business communication technology for mobile phones. In order to respond correctly to a free form factual question given a large collection of texts, one needs to understand the question at a level that allows determining some of constraints the question imposes on a possible answer. These constraints may include a semantic classification of the sought after answer and may even suggest using different strategies when looking for and verifying a candidate answer. In this paper we focus on various attempts to overcome the major contradiction: the technical limitations of the SMS standard, and the huge number of found information for a possible answer.

Reliability estimation of second life battery system power electronic topologies for grid frequency response applications

This paper is part of a project which aims to research the opportunities for the re-use of batteries after their primary use in low and ultra low carbon vehicles on the electricity grid system. One potential revenue stream is to provide primary/secondary/high frequency response to National Grid through market mechanisms via DNO's or Energy service providers. Some commercial battery energy storage systems (BESS) already exist on the grid system, but these tend to use costly new or high performance batteries. Second life batteries should be available at lower cost than new batteries but reliability becomes an important issue as individual batteries may suffer from degraded performance or failure. Therefore converter topology design could be used to influence the overall system reliability. A detailed reliability calculation of different single phase battery-to-grid converter interfacing schemes is presented. A suitable converter topology for robust and reliable BESS is recommended.

The response to an ESL population boom in the Beaufort County, South Carolina school system: A case study

The purpose of this case study was to examine the why the English language learners (ELLs) in the Beaufort County, South Carolina school system have been so successful. This school system has recently experienced a boom in its ESL student population, and this population has performed very well on standardized tests. This study used critical theory as its theoretical framework and examined why the students have been successful rather than marginalized in Beaufort County schools. This phenomenon was investigated using semi-structured interviews with the ESOL Coordinator for Beaufort County, 4 ESL-lead teachers, and 6 mainstream teachers.^ Data were collected using semi-structured interviews with Sarah Owen, the Beaufort County ESOL, Gifted and Talented, and World Languages coordinator. Based on the results of her interview, 4 themes emerged that were used for the semi-structured interviews with ESOL and mainstream teachers. The interviews centered on the themes of ESL policy, ESL leadership, and teacher training. The ESL and mainstream teacher interviews also revealed several subthemes that included teacher attitude, why Beaufort County has been successful with the ELLs, and the teachers' recommendations for other schools systems trying to successfully accommodate a large ESL student population in mainstream classrooms. ^ The findings from the teachers' interviews revealed that additional training for the teachers without ESL experience helped them become comfortable instructing ELLs. This training should be conducted by the ESOL teachers for those without ESOL certification or endorsement. As the teachers had more training, they had better attitudes about teaching ESOL students in their classes. Finally, those who utilized the additional ESOL training and ESOL accommodations saw better student achievement in their classes.^ Based on the finding of this study, the researcher proposed a model for other school systems to follow in order to replicate the success of Beaufort County's ELLs. The implications of this study focus on other schools systems and why ELLs are not obtaining the same level of success as those in Beaufort County's schools. Finally, recommendations for further research are provided.^