bluuebunny/crossref_metadata_2025 huggingface dataset:
A case report of evaluating a large-scale health systems improvement project in an uncontrolled setting: a quality improvement initiative in KwaZulu-Natal, South Africa
Authors: Mate Kedar S , Ngidi Wilbroda Hlolisile , Reddy Jennifer , Mphatswe Wendy , Rollins Nigel , Barker Pierre
Published: December 2012

Objective

New approaches are needed to evaluate quality improvement (QI) within large-scale public health efforts. This case report details challenges to large-scale QI evaluation, and proposes solutions relying on adaptive study design.

Study design

We used two sequential evaluative methods to study a QI effort to improve delivery of HIV preventive care in public health facilities in three districts in KwaZulu-Natal, South Africa, over a 3-year period. We initially used a cluster randomised controlled trial (RCT) design.

Principal findings

During the RCT study period, tensions arose between intervention implementation and evaluation design due to loss of integrity of the randomisation unit over time, pressure to implement changes across the randomisation unit boundaries, and use of administrative rather than functional structures for the randomisation. In response to this loss of design integrity, we switched to a more flexible intervention design and a mixed-methods quasiexperimental evaluation relying on both a qualitative analysis and an interrupted time series quantitative analysis.

Conclusions

Cluster RCT designs may not be optimal for evaluating complex interventions to improve implementation in uncontrolled ‘real world’ settings. More flexible, context-sensitive evaluation designs offer a better balance of the need to adjust the intervention during the evaluation to meet implementation challenges while providing the data required to evaluate effectiveness. Our case study involved HIV care in a resource-limited setting, but these issues likely apply to complex improvement interventions in other settings.
Urethral caruncle: a lesion related to IgG4-associated sclerosing disease?
Authors: Williamson Sean R , Scarpelli Marina , Lopez-Beltran Antonio , Montironi Rodolfo , Conces Miriam R , Cheng Liang
Published: December 2012

Aims

Urethral caruncle is a benign, polypoid urethral mass that occurs almost exclusively in postmenopausal women. Despite that these lesions are routinely managed with topical medications or excision, their pathogenesis is not well understood. We investigated the possibilities of autoimmune, viral and inflammatory myofibroblastic proliferations as possible aetiologies.

Methods

In 38 patients with urethral caruncle, we utilised immunohistochemistry for immunoglobulin G (IgG) and IgG4 to assess for a potential autoimmune aetiology. Immunohistochemistry was performed in nine patients for Epstein–Barr virus, BK virus, human herpesvirus 8, human papillomavirus, adenovirus and anaplastic lymphoma kinase.

Results

Four patients (11%) showed infiltrates of ≥50 IgG4-positive plasma cells per high power field, of which all showed an IgG4 to IgG ratio greater than 40%. A statistically significant difference (p<0.01) was detected in the mean number of IgG4-positive cells (14.73 per high power field) compared with control benign urethral specimens (mean, 1.19). One patient with increased counts below this threshold had rheumatoid arthritis; none had documented autoimmune pancreatitis or other known manifestations of systemic IgG4-related sclerosing disease. All lesions showed negative reactions for the viral and inflammatory myofibroblastic markers.

Conclusions

Urethral caruncle is a benign inflammatory and fibrous polypoid urethral mass of unclear aetiology. It appears unrelated to viral infection and lacks the abnormal expression of anaplastic lymphoma kinase protein, as seen in inflammatory myofibroblastic tumours. Increased numbers of IgG4-positive plasma cells in a subset of lesions raise the possibility that some cases may be related to the autoimmune phenomena of IgG4-associated disease.
The changing contribution of smoking to educational differences in life expectancy: indirect estimates for Finnish men and women from 1971 to 2010
Authors: Martikainen Pekka , Ho Jessica Y , Preston Samuel , Elo Irma T
Published: December 2012

Background

We estimated the contribution of smoking to educational differences in mortality and life expectancy between 1971 and 2010 in Finland.

Methods

Eight prospective datasets with baseline in 1970, 1975, 1980, 1985, 1990, 1995, 2000 and 2005 and each linked to a 5-year mortality follow-up were used. We calculated life expectancy at age 50 years with and without smoking-attributable mortality by education and gender. Estimates of smoking-attributable mortality were based on an indirect method that used lung cancer mortality as a proxy for the impact of smoking on mortality from all other causes.

Results

Smoking-attributable deaths constituted about 27% of all male deaths above age 50 years in the early 1970s and 17% in the period 2006–2010; these figures were 1% and 4% among women, respectively. The life expectancy differential between men with basic versus high education increased from 3.4 to 4.7 years between 1971–1975 and 2006–2010. In the absence of smoking, these differences would have been 1.5 and 3.4 years, 1.9 years (55%) and 1.3 years (29%) less than those observed. Among women, educational differentials in life expectancy between the most and least educated increased from 2.5 to 3.0 years. This widening was nearly entirely accounted for by the increasing impact of smoking. Among women the contribution of smoking to educational differences had increased from being negligible in 1971–1975 to 16% in 2006–2010.

Conclusions

Among men, the increase in educational differences in mortality in the past decades was driven by factors other than smoking. However, smoking continues to have a major influence on educational differences in mortality among men and its contribution is increasing among women.
Synthesis, characterization, and solid-state polymerization of cross-conjugated octatetraynes
Authors: Zhao Yuming , Luu Thanh , Bernard Guy M. , Taerum Tyler , McDonald Robert , Wasylishen Roderick E. , Tykwinski Rik R.
Published: December 2012

Two series of cross-conjugated 1,3,5,7-octatetraynes (1a–1l and 6a–6d) have been synthesized. UV–vis spectroscopic analysis shows that pendent groups connected to the cross-conjugated skeleton have little effect on the λmax energies, irrespective of whether the groups are electron withdrawing or donating. A number of the isolated products readily give crystals suitable for X-ray crystallography, and the solid-state structural properties of five derivatives (1k, 1l, 6a, 6c, and 6d) have been examined by X-ray crystallographic analysis. Parallel packing of the polyynes in the solid state indicates that four of the five samples are potentially suitable for topochemical polymerization, based on solid-state packing parameters θ, R, and d. Attempts to effect a solid-state reaction have been explored through UV–vis and γ-ray irradiation as well as thermal heating. The course of these reactions was monitored by differential scanning calorimetry (DSC) analysis, as well as UV–vis and solid-state 13C NMR spectroscopy (for 1d, 1j, 1k, and 6d), which offered evidence of polymer formation from these reactions. Structural determination of the product(s), however, remains elusive.
Biomechanical modeling and morphology analysis indicates plaque rupture due to mechanical failure unlikely in atherosclerosis-prone mice
Authors: Campbell Ian C. , Weiss Daiana , Suever Jonathan D. , Virmani Renu , Veneziani Alessandro , Vito Raymond P. , Oshinski John N. , Taylor W. Robert
Published: December 2012

Spontaneous plaque rupture in mouse models of atherosclerosis is controversial, although numerous studies have discussed so-called “vulnerable plaque” phenotypes in mice. We compared the morphology and biomechanics of two acute and one chronic murine model of atherosclerosis to human coronaries of the thin-cap fibroatheroma (TCFA) phenotype. Our acute models were apolipoprotein E-deficient (ApoE−/−) and LDL receptor-deficient (LDLr−/−) mice, both fed a high-fat diet for 8 wk with simultaneous infusion of angiotensin II (ANG II), and our chronic mouse model was the apolipoprotein E-deficient strain fed a regular chow diet for 1 yr. We found that the mouse plaques from all three models exhibited significant morphological differences from human TCFA plaques, including the plaque burden, plaque thickness, eccentricity, and amount of the vessel wall covered by lesion as well as significant differences in the relative composition of plaques. These morphological differences suggested that the distribution of solid mechanical stresses in the walls may differ as well. Using a finite-element analysis computational solid mechanics model, we computed the relative distribution of stresses in the walls of murine and human plaques and found that although human TCFA plaques have the highest stresses in the thin fibrous cap, murine lesions do not have such stress distributions. Instead, local maxima of stresses were on the media and adventitia, away from the plaque. Our results suggest that if plaque rupture is possible in mice, it may be driven by a different mechanism than mechanics.
Mucociliary transport in porcine trachea: differential effects of inhibiting chloride and bicarbonate secretion
Authors: Cooper Jeffrey L. , Quinton Paul M. , Ballard Stephen T.
Published: December 2012

This study was designed to assess the relative importance of Cl− and HCO3− secretion to mucociliary transport rate (MCT) in ex vivo porcine tracheas. MCT was measured in one group of tissues that was exposed to adventitial HCO3−-free solution while a parallel group was exposed to adventitial HCO3−-replete solution. After measurement of baseline MCT rates, acetylcholine (ACh) was added to stimulate submucosal gland mucous liquid secretion, and MCT rates were again measured. Before ACh addition, the mean MCT was higher in the HCO3−-free group (4.2 ± 0.9 mm/min) than in the HCO3−-replete group (2.3 ± 0.3 mm/min), but this difference was not statistically significant. ACh addition significantly increased MCT in both groups, but ACh-stimulated MCT was significantly lower in the HCO3−-free group (11.0 ± 1.5 mm/min) than in the HCO3−-replete group (17.0 ± 2.0 mm/min). A second series of experiments examined the effect on MCT of blocking Cl− secretion with 100 μM bumetanide. Before adding ACh, MCT in the bumetanide-treated group (1.0 ± 0.2 mm/min) was significantly lower than in the control group (3.8 ± 1.1 mm/min). ACh addition significantly increased MCT in both groups, but there was no significant difference between the bumetanide-treated group (21.4 ± 1.7 mm/min) and control group (19.5 ± 3.4 mm/min). These results indicate that ACh-stimulated MCT has greater dependence on HCO3− secretion, whereas the basal MCT rate has greater dependence on Cl− secretion.
A Transcontinental Pilot Study for Acupuncture Lifting-Thrusting and Twisting-Rotating Manipulations
Authors: Huang Tao , Zhang Weibo , Jia Shuyong , Tian Yuying , Wang Guangjun , Yang Lijian , Gaischek Ingrid , Wang Lu , Litscher Gerhard
Published: December 2012

The goal of this study was to observe possible changes of the skin microvascular perfusion on the acupoints and related areas and to quantify influences of acupuncture stimulation on the volunteers' blood pressure, heart rate, and heart rate variability (HRV). During the measurement, the needling sensations of volunteers were enquired and recorded. Ten healthy volunteers with a mean age ± SD of 25.4 ± 2.6 years were enrolled, and acupuncture stimulation was performed on ST36 (Zusanli, right side), in pure lifting-thrusting or twisting-rotating manipulation. During needling, we observed the changing of microvascular perfusion on ST36, 37, 38, and a control point using MOOR speckle laser blood flow scanning. Electrocardiogram and blood pressure were registered before, during, and after needling. Both lifting-thrusting and twisting-rotating needle manipulations could decrease blood pressure and heart rate while improving HRV significantly. There were significant differences in microvascular perfusion on acupoints ST36, 37, 38, and the control point following these two kinds of needle manipulation. The needling sensation caused by lifting-thrusting is stronger than that of twisting-rotating manipulation. Significant differences between lifting-thrusting and twisting-rotating acupuncture stimulation methods show that the mechanisms may be different and need to be researched thoroughly in the future.
Male Breast Cancer Originating in an Accessory Mammary Gland in the Axilla: A Case Report
Authors: Yamamura Jun , Masuda Norikazu , Kodama Yoshinori , Yasojima Hiroyuki , Mizutani Makiko , Kuriyama Keiko , Mano Masayuki , Nakamori Shoji , Sekimoto Mitsugu
Published: December 2012

Carcinoma of an accessory mammary gland is an extremely rare tumor. A 61-year-old male patient presented with a hard mass measuring 85 mm × 51 mm in the left axilla. Incisional biopsy histopathologically showed an adenocarcinoma compatible with breast carcinoma originating in an accessory mammary gland. Systemic examinations revealed no evidence of malignant or occult primary lesion in the bilateral mammary glands or in other organs. Neoadjuvant chemotherapy was performed for the locally advanced axillary tumor and reduced the tumor to 55 mm in size, and, then, he could undergo complete resection with a negative surgical margin in combination with reconstructive surgery to fill the resulting skin defect with a local flap of the latissimus dorsi muscle. The patient has presented with no metastatic lesion in four years since the operation. This unusual case shows that neoadjuvant chemotherapy is an effective and tolerated therapy for advanced accessory breast cancer in the axilla.
Stomach Metastasis in a Patient with Prostate Cancer 4 Years after the Initial Diagnosis: A Case Report and a Literature Review
Authors: Bilici Ahmet , Dikilitas Mustafa , Eryilmaz Ozlem Ton , Bagli Bekir Selim , Selcukbiricik Fatih
Published: December 2012

Prostate cancer commonly metastasizes bones and lymph nodes, but it very rarely spreads to the gastrointestinal tract. However, only five cases of prostate cancer metastatic to the stomach have been previously reported in the literature. We report a case of a 69-year-old man with metastatic prostate cancer who presented with upper gastrointestinal bleeding (UGB) 4 years after the diagnosis. Esophagogastroscopy revealed multiple ulcerations in the gastric body and histopathological examination confirmed gastric metastasis that originated from prostate cancer. Chemotherapy could not be given because of patient's refusal. He was treated with LHRH agonist. We suggest that for a man with prostate cancer diagnosed with UGB, stomach metastasis should be considered in the differential diagnosis of UGB.
Small Bowel Adenocarcinoma Complicating Coeliac Disease: A Report of Three Cases and the Literature Review
Authors: Benhammane Hafida , El M'rabet Fatima Zahra , Idrissi Serhouchni Karima , El yousfi Mounia , Charif Ilias , Toughray Imane , Mellas Naoufal , Riffi Amarti Afaf , Maazaz khalid , Ibrahimi Sidi Adil , El mesbahi Omar
Published: December 2012

Coeliac disease is associated with an increased risk of malignancy, not only of intestinal lymphoma but also of small intestinal adenocarcinoma which is 82 times more common in patients with celiac disease than in the normal population. We report three additional cases of a small bowel adenocarcinoma in the setting of coeliac disease in order to underline the epidemiological features, clinicopathological findings, and therapeutic approaches of this entity based on a review of the literature. The three patients underwent a surgical treatment followed by adjuvant chemotherapy based on capecitabine/oxaliplatin regimen, and they have well recovered.
Mowat-Wilson Syndrome: The First Clinical and Molecular Report of an Indonesian Patient
Authors: Mundhofir Farmaditya E. P. , Yntema Helger G. , van der Burgt Ineke , Hamel Ben C. J. , Faradz Sultana M. H. , van Bon Bregje W. M.
Published: December 2012

Mowat-Wilson syndrome (OMIM 235730) is a genetic condition characterized by moderate-to-severe intellectual disability, a recognizable facial phenotype, and multiple congenital anomalies. The striking facial phenotype in addition to other features such as severely impaired speech, hypotonia, microcephaly, short stature, seizures, corpus callosum agenesis, congenital heart defects, hypospadias, and Hirschsprung disease are particularly important clues for the initial clinical diagnosis. All molecularly confirmed cases with typical MWS have a heterozygous loss-of-function mutation in the zinc finger E-box protein 2 (ZEB2) gene, also calledSIP1(Smad-interacting protein 1) andZFHX1B, suggesting that haploinsufficiency is the main pathological mechanism. Approximately 80% of mutations are nonsense and frameshift mutations (small insertions or deletions). About half of these mutations are located in exon eight. Here, we report the first Indonesian patient with Mowat-Wilson syndrome confirmed by molecular analysis.
The Relationship between Endorsing Gambling as an Escape and the Display of Gambling Problems
Authors: Weatherly Jeffrey N.
Published: December 2012

Previous research has reported a strong relationship between endorsing gambling as an escape and problem/pathological gambling as measured by the South Oaks Gambling Screen (SOGS). The present study recruited 249 university students to complete the Gambling Functional Assessment-Revised (GFA-R), which measures the function of the respondent’s gambling, as well as the SOGS and the Problem Gambling Severity Index (PGSI), which was designed to identify gambling problems in the general population. Endorsing gambling as an escape on the GFA-R was again predictive of SOGS scores. The function of one’s gambling was also predictive of the respondents’ PGSI scores, but whether gambling for positive reinforcement or as an escape was the significant predictor differed between male and female respondents. Scores on the GFA-R subscales also accounted for a significant amount of variance in PGSI scores above and beyond that accounted for by SOGS scores. The present results support the idea that both practitioners and researchers should be interested in the function of an individual’s gambling as well as the presence or the absence of pathology. They also suggest that differences in the function of gambling might also exist between the sexes.
Depression, Depressive Somatic or Nonsomatic Symptoms, and Function in a Primarily Hispanic Chronic Pain Population
Authors: Robinson Kristynia M. , Monsivais Jose J.
Published: December 2012

Chronic pain and depression are two major causes of disability. Comorbidity decreases psychosocial and physical functioning while increasing economic burden. The prevailing belief that Hispanics somaticize depression may hinder the diagnostic process and, thus, may impact outcomes. The purpose of this study was to explore the relationships among depression and depressive symptoms (somatic or nonsomatic) and function in chronic pain sufferers residing along the USA-Mexico border. Like other studies, as level of depression increased, level of pain increased and level of functioning decreased. So much so that almost a quarter of the participants reported moderate-to-severe depression, and another quarter of the participants reported suicidal ideation independent of depression or treatment. Unlike other published reports, we used a sample of chronic pain patients who received individualized, multimodal pain treatment. Compared to our previous work in a similar population, pain intensity and suicidal ideation were lower in this study. A plausible explanation is the use of antidepressants as adjuvant treatment for pain. Regardless of gender or ethnicity, persons with chronic pain will disclose symptoms of depression when appropriate tools are used to collect the data. Implications for future research and clinical practice are discussed.
Duck-Rabbits in Social Analysis
Authors: Elman Colin
Published: December 2012

This article differentiates between three approaches to methodological diversity: monism, pluralism, and eclecticism. It suggests that in advancing a set-theoretic understanding of qualitative research, A Tale of Two Cultures makes an unusually strong argument for robust pluralism. The article anticipates three types of critiques that are likely to be made of the book: Monists will argue that pluralism is an illusion; quantitative researchers will suggest that Goertz and Mahoney inaccurately describe quantitative methods; and qualitative researchers will express doubts as to whether their tradition can be best understood using set theory. The article mainly focuses on the third of these responses, and suggests that even if A Tale of Two Cultures is not always convincing as a descriptive account of current practices, it holds considerable promise as a prescriptive agenda.
Do Parole Technical Violators Pose a Safety Threat? An Analysis of Prison Misconduct
Authors: Orrick Erin A. , Morris Robert G.
Published: December 2012

We examined records of males incarcerated in a large southern state to assess the risk technical violators would pose to public safety by exploring their likelihood of engaging in prison misconduct. Data from official prison records provided by a large southern state’s primary corrections agency were examined using multiple counterfactual analytic techniques. Based on the official disciplinary records from male inmates readmitted to prison for technical violations and new offenses, technical violators were found to be significantly less likely to engage in any form of prison misconduct. Implications for research and policy are discussed, including the potential for recidivism research and prison reduction policies.
Does the Presence of Sexually Oriented Businesses Relate to Increased Levels of Crime? An Examination Using Spatial Analyses
Authors: McCord Eric S. , Tewksbury Richard
Published: December 2012

Scholarly debate about whether the presence of sexually oriented businesses in a community is related to increased levels of crime has been present for several decades. This argument about the “secondary effects” of such businesses shows support for the link to increased crime as well as evidence of a lack of relationship. This article addresses this debate, presenting findings from three spatial analyses using varying-sized buffer zones of rates of violent, property, and public order offenses in the vicinity of sexually oriented businesses in Louisville, Kentucky. Results show that sexually oriented businesses are associated with much higher rates of all types of offenses in the immediate vicinity of the business and continue to have significant effects on crime levels as one moves further from the business. At the site of the sexually oriented business, community, social and economic characteristics are outweighed by the effect of the business; in farther-reaching buffer zones, community characteristics become more important, although the effects of the business remain significant.
The Relationship Between Social Support and Intimate Partner Violence in Neighborhood Context
Authors: Wright Emily M.
Published: December 2012

Social support has been recognized as a protective factor associated with reduced intimate partner violence (IPV). A question that few studies have examined, however, is whether the effectiveness of social support on IPV is conditioned by the neighborhood in which it occurs. This study investigated whether the separate effects of support from friends and family members on partner violence were conditioned by neighborhood disadvantage. Results indicated that social support from family significantly reduced the prevalence and frequency of IPV, whereas support from friends was associated with higher frequencies of partner violence. Importantly, the effects of social support were contextualized by neighborhood disadvantage, with the impact of both forms of social support on IPV being diminished in neighborhoods characterized by higher levels of disadvantage.
Numerical Differentiation Methods for Computing Error Covariance Matrices in Item Response Theory Modeling
Authors: Tian Wei , Cai Li , Thissen David , Xin Tao
Published: December 2012

In item response theory (IRT) modeling, the item parameter error covariance matrix plays a critical role define? in statistical inference procedures. When item parameters are estimated using the EM algorithm, the parameter error covariance matrix is not an automatic by-product of item calibration. Cai proposed the use of Supplemented EM algorithm for computing the item parameter error covariance matrix. This method has been subsequently implemented in commercial IRT software programs such as IRTPRO and flexMIRT. Jamshidian and Jennrich noted that Supplemented EM is among a class of methods based on numerically differentiating the EM map, and they proposed noniterative alternatives, such as forward difference and Richardson extrapolation, that are mathematically simpler and may lead to a reduction in computational burden when compared with Supplemented EM. However, the relative merits of the various numerical differentiation methods have not been evaluated in the context of IRT modeling. We perform such an evaluation, using both simulated and empirical data. It is found that the accuracy of the simpler noniterative alternatives is heavily dependent on the choice of the numerical differentiation perturbation constants. On the other hand, Supplemented EM consistently maintains accuracy and does not require the selection of perturbation constants. Furthermore, when implemented with an adaptive iteration scheme, an updated Supplemented EM algorithm can be as computationally efficient as the alternatives. The expected (Fisher) information matrix, while accurate, requires too heavy computation for realistic test lengths. Therefore, we recommend the routine use of the updated Supplemented EM algorithm in IRT applications.
Anthropometric Procedures for Protective Equipment Sizing and Design
Authors: Hsiao Hongwei
Published: December 2012

Objectives:

This article presented four anthropometric theories (univariate, bivariate/probability distribution, multivariate, and shape-based methods) for protective equipment design decisions.

Background:

While the significance of anthropometric information for product design is well recognized, designers continue to face challenges in selecting efficient anthropometric data processing methods and translating the acquired information into effective product designs.

Methods:

For this study, 100 farm tractor operators, 3,718 respirator users, 951 firefighters, and 816 civilian workers participated in four studies on the design of tractor roll-over protective structures (ROPS), respirator test panels, fire truck cabs, and fall-arrest harnesses, respectively. Their anthropometry and participant-equipment interfaces were evaluated.

Results:

Study 1 showed a need to extend the 90-cm vertical clearance for tractor ROPS in the current industrial standards to 98.3 to 101.3 cm. Study 2 indicated that current respirator test panel would have excluded 10% of the male firefighter population; a systematic adjustment to the boundaries of test panel cells was suggested. Study 3 provided 24 principal component analysis-based firefighter body models to facilitate fire truck cab design. Study 4 developed an improved gender-based fall-arrest harness sizing scheme to supplant the current unisex system.

Conclusions:

This article presented four anthropometric approaches and a six-step design paradigm for ROPS, respirator test panel, fire truck cab, and fall-arrest harness applications, which demonstrated anthropometric theories and practices for defining protective equipment fit and sizing schemes.

Applications:

The study provided a basis for equipment designers, standards writers, and industry manufacturers to advance anthropometric applications for product design and improve product efficacy.
Playing with Power
Authors: Lerner Josh
Published: December 2012

In recent decades, progressive city administrations and urban shantytowns have both proliferated across Latin America. Many leftist local governments have tried to improve shantytown conditions, but ineffective engagement of residents has often undermined these efforts. Games and game techniques can enhance participation in these urban development programs as they already have for broader Latin American movements for participatory democracy such as Freire’s popular education, Boal’s Theater of the Oppressed, and participatory budgeting in Brazil. A case study of the Argentine development program Rosario Hábitat shows how games can animate people, challenge their assumptions, and establish collaborative social ties. The program also illustrates how the lessons of game design can be extended even deeper by redesigning the entire participatory process to be more gamelike. This game approach has enabled Rosario Hábitat to forge fairer and more informed community agreements and to spark more active and meaningful participation.

En las décadas recientes se ha visto la proliferación de ambos, los gobiernos urbanos de ende progresista y los asentamientos informales de la urbe. Muchos gobiernos locales de izquierda han intentado mejorar las condiciones de las villas miserias, pero estos esfuerzos quedan socavados por la falta de compromiso con los residentes. Los juegos y las técnicas del juego pueden aumentar la participación en los programas de desarrollo urbano como ya se ha hecho en los movimientos latinoamericanos de democracia participativa, como son las de educación popular de Paolo Freire, el Teatro del Oprimido de Boal, y el presupuesto participativo de Brasil. Un caso de desarrollo urbano en Argentina, Rosario Hábitat, demuestra en como los juegos animan a la gente, le dan reto a sus suposiciones, y establecen lazos de colaboración social, y en como pueden, a partir del diseño del juego, extenderse hasta volver a diseñar el proceso participativo entero. Este acercamiento por vía de los juegos permitió que Rosario Hábitat forjara acuerdos comunitarios mas justos y mejor informados, dándole chispa a una mayor y significativa participación.
A Struggle Larger Than a House
Authors: Cortés Morales Alexis
Published: December 2012

During the twentieth century, the political action of the urban poor in Santiago de Chile and Rio de Janeiro was a focal point of research in the social sciences. A critical reading of the major theories that were proposed begins with an analysis of marginality theory, which represented the first (negative) interpretation of the political potential of the marginalized. Subsequently, Santiago and Rio witnessed a series of urban popular experiences that elicited two opposing schools of thought: the urban-social-movement school and the utilitarian perspective. Chilean and Brazilian social scientists grappled with the way the popular sectors reacted to each country’s military dictatorship, and their interpretations reflected a certain indeterminacy, ranging from rediscovery to eulogy to denial. Urban popular struggle must be rethought in order to move beyond this theoretical ambivalence.

Durante el siglo veinte, la acción política de parte de los pobres urbanos de Santiago de Chile y Rio de Janeiro fue un foco investigativo en las ciencias sociales. Esta lectura crítica de las principales teorías propone, en primer lugar, un análisis de la teoría de la marginalidad, la cual representó la primera interpretación (negativa) del potencial político de los marginados. Posteriormente, Santiago y Rio de Janeiro fueron testigos de una serie de experiencias populares urbanas, las cuales configuraron dos modos de pensamiento opuestos: la escuela de los movimientos sociales urbanos y la perspectiva utilitaria. Los cientistas sociales chilenos y brasileños, al enfrentar la forma en la cual los sectores populares reaccionaron frente a las dictaduras militares en cada país, reflejaron en sus interpretaciones una cierta indeterminación, fluctuando entre el redescubrimiento, la exaltación, hasta la negación. La lucha popular urbana tiene que volver a pensarse para superar esta ambivalencia teórica.
Mining and Tourism
Authors: Steel Griet
Published: December 2012

In recent decades, the exponential growth of tourism and mining in Cusco and Cajamarca has made these two intermediate cities in the Peruvian Andes important on the global economic scene. Foreign direct investment in these industries has attracted internal and transnational migrants who now dominate the lucrative real estate and labor markets in these cities. Residents have been driven to the peripheries, and there is a sharp contrast between those who have access to the benefits of mining and tourism and those who do not. The article shows that these intermediate cities can no longer escape the spatial segregation, economic exploitation, and inequality that used to be associated almost exclusively with metropolitan centers. These supposedly livable and harmonious urban environments are increasingly jeopardized by the growing imbalance between the livelihoods of local residents and those of transnational elites.

En las décadas recientes, el crecimiento exponencial del turismo y la minería en Cusco y Cajamarca ha hecho de estas dos ciudades medianas de los Andes peruanos importantes urbes en el escenario económico global. La inversión extranjera directa en estas industrias ha atraído a migrantes internos y trasnacionales quienes ahora dominan los mercados lucrativos de bienes raíces y labor en estas ciudades. Los residentes han sido empujados a la periferia, y existe un marcado contraste entre quienes tienen acceso a los beneficios de la minería y el turismo, y quienes no. El artículo demuestra que estas ciudades medianas no pueden más escaparse de la segregación espacial, la explotación económica, y la desigualdad que antes se asociaba exclusivamente con los centros metropolitanos. Estos supuestamente habitables y armoniosos ambientes urbanos se encuentran cada vez mas perjudicados por la creciente falta de balance entre el sustento de los residentes y el de las élites trasnacionales.
Experiential knowledge types and profiles of internationalising small and medium-sized enterprises
Authors: Hilmersson Mikael
Published: December 2012

Although experiential knowledge is a well-documented construct in the internationalisation literature, research on the multidimensionality of the construct remains limited and we do not know how different knowledge combinations among internationalising SMEs are composed. This article answers the research questions: is experiential knowledge in the internationalisation process a multidimensional construct, and is there a pattern to be found among the experiential knowledge profiles of internationalising SMEs? In the article, the multidimensionality of the concept is established and four experience-based knowledge profiles of internationalising firms are identified. First, four types of experiential knowledge are extracted: internationalisation, institutional, business network and social network knowledge. Second, four experiential knowledge profiles are identified: masters, institutional experts, social networkers and learners. The article concludes that experiential knowledge is a multidimensional construct and that internationalising SMEs develop heterogeneous experiential knowledge profiles.
Does Introduction of Thresholds in Decision Aids Benefit the Patient?
Authors: Bisig Bettina , Moreira Juan , Combes Mattieu , Asiimwe Anita , Bisoffi Zeno , Haegeman Frank , Bottieau Emmanuel , Van den Ende Jef
Published: December 2012

Purpose: To assess how different diagnostic decision aids perform in terms of sensitivity, specificity, and harm. Methods: Four diagnostic decision aids were compared, as applied to a simulated patient population: a findings-based algorithm following a linear or branched pathway, a serial threshold–based strategy, and a parallel threshold–based strategy. Headache in immune-compromised HIV patients in a developing country was used as an example. Diagnoses included cryptococcal meningitis, cerebral toxoplasmosis, tuberculous meningitis, bacterial meningitis, and malaria. Data were derived from literature and expert opinion. Diagnostic strategies’ validity was assessed in terms of sensitivity, specificity, and harm related to mortality and morbidity. Sensitivity analyses and Monte Carlo simulation were performed. Results: The parallel threshold–based approach led to a sensitivity of 92% and a specificity of 65%. Sensitivities of the serial threshold–based approach and the branched and linear algorithms were 47%, 47%, and 74%, respectively, and the specificities were 85%, 95%, and 96%. The parallel threshold–based approach resulted in the least harm, with the serial threshold–based approach, the branched algorithm, and the linear algorithm being associated with 1.56-, 1.44-, and 1.17-times higher harm, respectively. Findings were corroborated by sensitivity and Monte Carlo analyses. Conclusion: A threshold-based diagnostic approach is designed to find the optimal trade-off that minimizes expected harm, enhancing sensitivity and lowering specificity when appropriate, as in the given example of a symptom pointing to several life-threatening diseases. Findings-based algorithms, in contrast, solely consider clinical observations. A parallel workup, as opposed to a serial workup, additionally allows for all potential diseases to be reviewed, further reducing false negatives. The parallel threshold–based approach might, however, not be as good in other disease settings.
Quantitative Benefit-Risk Assessment Using Only Qualitative Information on Utilities
Authors: Caster Ola , Norén G. Niklas , Ekenberg Love , Edwards I. Ralph
Published: December 2012

Background: Utilities of pertinent clinical outcomes are crucial variables for assessing the benefits and risks of drugs, but numerical data on utilities may be unreliable or altogether missing. We propose a method to incorporate qualitative information into a probabilistic decision analysis framework for quantitative benefit-risk assessment. Objective: To investigate whether conclusive results can be obtained when the only source of discriminating information on utilities is widely agreed upon qualitative relations, for example ‘‘sepsis is worse than transient headache’’ or ‘‘alleviation of disease is better without than with complications.’’ Method: We used the structure and probabilities of three published models that were originally evaluated based on the standard metric of quality-adjusted life years (QALYs): terfenadine versus chlorpheniramine for the treatment of allergic rhinitis, MCV4 vaccination against meningococcal disease, and alosetron for irritable bowel syndrome. For each model, we identified clinically straightforward qualitative relations among the outcomes. Using Monte Carlo simulations, the resulting utility distributions were then combined with the previously specified probabilities, and the rate of preference in terms of expected utility was determined for each alternative. Results: Our approach conclusively favored MCV4 vaccination, and it was concordant with the QALY assessments for the MCV4 and terfenadine versus chlorpheniramine case studies. For alosetron, we found a possible unfavorable benefit-risk balance for highly risk-averse patients not identified in the original analysis. Conclusion: Incorporation of widely agreed upon qualitative information into quantitative benefit-risk assessment can provide for conclusive results. The methods presented should prove useful in both population and individual-level assessments, especially when numerical utility data are missing or unreliable, and constraints on time or money preclude its collection.
Active planning for underwater inspection and the benefit of adaptivity
Authors: Hollinger Geoffrey A , Englot Brendan , Hover Franz S , Mitra Urbashi , Sukhatme Gaurav S
Published: December 2012

We discuss the problem of inspecting an underwater structure, such as a submerged ship hull, with an autonomous underwater vehicle (AUV). Unlike a large body of prior work, we focus on planning the views of the AUV to improve the quality of the inspection, rather than maximizing the accuracy of a given data stream. We formulate the inspection planning problem as an extension to Bayesian active learning, and we show connections to recent theoretical guarantees in this area. We rigorously analyze the benefit of adaptive re-planning for such problems, and we prove that the potential benefit of adaptivity can be reduced from an exponential to a constant factor by changing the problem from cost minimization with a constraint on information gain to variance reduction with a constraint on cost. Such analysis allows the use of robust, non-adaptive planning algorithms that perform competitively with adaptive algorithms. Based on our analysis, we propose a method for constructing 3D meshes from sonar-derived point clouds, and we introduce uncertainty modeling through non-parametric Bayesian regression. Finally, we demonstrate the benefit of active inspection planning using sonar data from ship hull inspections with the Bluefin-MIT Hovering AUV.
Deriving probabilistic based climate scenarios using pattern scaling and statistically downscaled data
Authors: Fealy Rowan
Published: December 2012

This paper adopts a technique common in the dynamical climate modelling literature, that of pattern scaling, and applies it to previously available statistically downscaled station level data for Ireland for two climatically relevant variables, that of temperature and precipitation. This technique allows for the rapid development of climate scenarios for additional emissions scenarios not previously available from the GCM modelling centres. Having derived the end of century (2080s) change in both these variables for four marker emissions scenarios (A1FI, A2, B2, B1), regional response rates, or the regional rate of warming per °C global warming at each station, were calculated. The estimated ranges in regional responses at each station were then compared to regional response rates for the Irish ‘grid box’ derived from a larger sample of 14 GCMs, in order to determine if the calculated response rates were illustrative of a wider suite of GCMs. A Monte Carlo (MC) resampling approach was then employed to sample regional response rates for selected stations and for different estimates of future warming. On the basis of the MC approach, probability distribution functions (pdfs) of simulated changes in temperature and precipitation were constructed and compared to the original statistically downscaled data. The methodology and results presented represent a significant contribution to the traditional approach of statistical downscaling through the development of associated likelihoods, rather than just a change in the mean value. While the methodology presented should enable the rapid development of probabilistic based climate projections, based on a limited availability of downscaled climate scenarios, caution needs to be exercised in the interpretation of the results. While they provide a basis for risk or policy assessment, estimates of the level of risk are not independent of the method employed.
Psychopathological symptoms in child and adolescent migraine and tension-type headache: A meta-analysis
Authors: Balottin Umberto , Fusar Poli Paolo , Termine Cristiano , Molteni Silvia , Galli Federica
Published: December 2012

Introduction

After decades of research, the importance of psychological factors in child and adolescent headache is no longer in doubt. However, it is not clearly understood whether different types of headache are comorbid with specific kinds of psychopathology. To address this issue, we set out to establish whether young patients with migraine do or do not show significant levels of psychopathological symptoms compared with age-matched healthy controls and patients with tension-type headache (TTH).

Methods

Ten studies were selected on the basis of a widely used psychodiagnostic tool (the Child Behavior Checklist (CBCL)) and by applying rigorous criteria: The studies were compared in a meta-analysis in order to evaluate the presence of Internalizing (mainly anxiety and depression) and Externalizing (mainly behavioral problems) symptoms in different types of headache (and versus healthy controls).

Findings

Patients with migraine showed more psychopathological symptoms than healthy controls. TTH patients also had more psychopathology than controls, although the difference was more marked in the area of Internalizing disorders. Finally, no differences emerged between migraine and TTH.

Discussion and conclusion

Psychopathological symptoms affect children with migraine, but also children with TTH. Biological, pathophysiological and clinical links need to be established. Effective treatment of affected children and adolescents is imperative in order to prevent chronic evolution. In this context, the CBCL may be a good screening instrument with a view to developing a tailored clinical approach.
Taking the Short Route
Authors: Gherghina Sergiu , Chiru Mihail
Published: December 2012

This article illustrates how the growing complexity of regulations regarding party funding in post-communist Romania is paralleled by practices employed by political parties in their attempt to gain increased access to state resources. Our document analysis indicate that political parties managed to exploit the weaknesses of the increasingly complex legislative framework. A cyclical process takes places: parties use the existing flaws in the legislation on party funding to indirectly obtain and exploit state resources for their (electoral) purposes, an improved law tackling those shortcomings is passed, but political parties are able to identify other flaws and use them to gain financial benefits. To make the case, we assess comparatively the evolution of legislative provisions and practices employed by political parties over two decades.
Associated with the Past?
Authors: Pop-Eleches Grigore , Tucker Joshua A.
Published: December 2012

In this article, we test the effect of communist-era legacies on the large and temporally resilient deficit in civic participation in post-communist countries. To do so, we analyze data from 157 surveys conducted between 1990 and 2009 in twenty-four post-communist countries and forty-two non-post-communist countries. The specific hypotheses we test are drawn from a comprehensive theoretical framework of the effects of communist legacies on political behavior in post-communist countries that we have previously developed. Our analysis suggests that three mechanisms were particularly salient in explaining this deficit: first, the demographic profile (including lower religiosity levels) of post-communist countries is less conducive to civic participation than elsewhere. Second, the magnitude of the deficit increases with the number of years an individual spent under communism but the effects were particularly strong for people socialized in the post-totalitarian years and for those who experienced communism in their early formative years (between ages six and seventeen). Finally, we also find that civic participation suffered in countries that experienced weaker economic performance in the post-communist period, though differences in post-communist democratic trajectories had a negligible impact on participation. Taken together, we leave behind a potentially optimistic picture about civic society in post-communist countries, as the evidence we present suggests eventual convergence toward norms in other non post-communist countries.