242 research outputs found
Introducing more transparent and efficient land management in post‐socialist cities: Lessons from Kyrgyzstan
The Urban Institute (UI) worked with five cities in post‐Soviet Kyrgyzstan to apply better management practices through the development of Strategic Land Management Plans. Kyrgyzstan transferred property to local governments, but municipal land management had remained poor owing to a proliferation of responsible agencies, lack of rule of law, corruption, and passiveness on the part of local governments. UI worked with local governments to make an inventory of municipal land, publicize the results, and develop a strategy that articulated principles for land management and an implementation plan. This led to several improvements including proper registration of parcels and proactive policies to lease and sell land through open competition. It also established a model for determining public policy that countered corruption and public deliberation of costs and benefits in the use of local assets. Donor involvement to promote good land legislation, the property registration system, and decentralization was also critical to success.
Santrauka
Urbanistikos institutas bendradarbiavo su penkiais posovietinės Kirgizijos miestais, kad, plėtodamas strateginės žemėtvarkos planus, įvestų geresnę vadybos praktiką. Kirgizijoje nuosavybė perduota vietos valdžiai, tačiau žemėtvarkos būklė savivaldybėse išliko vargana dėl atsakingų tarnybų gausos, įstatymų trūkumo, korupcijos ir vietos valdžios pasyvumo. Urbanistikos institutas bendradarbiavo su vietos valdžia, siekdamas inventorizuoti savivaldybių žemę, paskelbti rezultatus ir sukurti strategiją, pabrėžiančią žemėtvarkos principus ir įgyvendinimo planą. Tai leido kai ką patobulinti, įskaitant deramą sklypų registravimą ir aktyvią žemės nuomos bei pardavimo per atvirus konkursus politiką. Be to, sudarytas modelis, nustatantis viešąją politiką, kovojančią su korupcija, ir viešus sąnaudų ir naudos svarstymus naudojant vietinį turtą. Prie gerų žemės įstatymų, nuosavybės registravimo sistemos ir decentralizacijos sėkmingo propagavimo daug prisidėjo ir rėmėjai.
First published online: 18 Oct 201
Determination of nasal and oropharyngeal microbiomes in a multicenter population-based study – findings from Pretest 1 of the German National Cohort
We examined acceptability, preference and feasibility of collecting nasal and
oropharyngeal swabs, followed by microbiome analysis, in a population-based
study with 524 participants. Anterior nasal and oropharyngeal swabs were
collected by certified personnel. In addition, participants self-collected
nasal swabs at home four weeks later. Four swab types were compared regarding
(1) participants’ satisfaction and acceptance and (2) detection of microbial
community structures based on deep sequencing of the 16 S rRNA gene V1–V2
variable regions. All swabbing methods were highly accepted. Microbial
community structure analysis revealed 846 phylotypes, 46 of which were unique
to oropharynx and 164 unique to nares. The calcium alginate tipped swab was
found unsuitable for microbiome determinations. Among the remaining three swab
types, there were no differences in oropharyngeal microbiomes detected and
only marginal differences in nasal microbiomes. Microbial community structures
did not differ between staff-collected and self-collected nasal swabs. These
results suggest (1) that nasal and oropharyngeal swabbing are highly feasible
methods for human population-based studies that include the characterization
of microbial community structures in these important ecological niches, and
(2) that self-collection of nasal swabs at home can be used to reduce cost and
resources needed, particularly when serial measurements are to be taken
Factors associated with wife beating in Egypt: Analysis of two surveys (1995 and 2005)
Akmatov MK, Mikolajczyk RT, Labeeb S, Dhaher E, Khan MMH. Factors associated with wife beating in Egypt: Analysis of two surveys (1995 and 2005). BMC Women´s Health. 2008;8(1): 15.BACKGROUND: Wife beating is an important public health problem in many developing countries. We assessed the rates of wife beating and examined factors associated with wife beating in 1995 and 2005 in Egypt. METHODS: We used data from two Demographic and Health Surveys (DHS) conducted in Egypt in 1995 and 2005 using multistage household sampling. Data related to wife beating included information from 7122 women in 1995 and 5612 women in 2005. Logistic regression was used to analyze factors independently associated with wife beating. Special weights were used to obtain nationally representative estimates. RESULTS: In 1995 17.5% of married women in Egypt experienced wife beating in the last 12 months, in 2005--18.9% or 16.0%, using different measures. The association between socio-demographic differentials and wife beating was weaker in the newer survey. The 12-month prevalence of wife beating was lower only when both partners were educated, but the differences across education levels were less pronounced in 2005. Based on the information available in the 2005 survey, more educated women experienced less severe forms of wife beating than less educated women. CONCLUSION: Different measures used in both surveys make a direct comparison difficult. The observed patterns indicate that the changes in prevalence may be masked by two opposite processes occurring in the society: a decrease in (severe forms of) wife beating and an increase in reporting of wife beating. Improving the access to education for women and raising education levels in the whole society may help reducing wife beating
prevalence and lack of association with selected cardiovascular and metabolic disorders—findings of a multicenter population-based study
Background We determined the prevalence of anti-nuclear autoantibodies (ANAs)
in the German adult population and examined the association between ANAs and
cardiovascular and metabolic disorders. Methods We used data and blood samples
from the pretest phases of the German National Cohort, obtained from six of
the 18 study centers (n = 1199). All centers applied standardized instruments
including face-to-face interviews, anthropometric measurements and collection
of blood samples. Self-reported histories of diabetes mellitus, heart attack
and elevated blood cholesterol and/or lipids were recorded. Height, weight and
blood pressure were measured. ANAs were detected using a semi-automated system
(AKLIDES®; Medipan GmbH, Dahlewitz, Germany). A positive ANA was defined as a
titer ≥ 1:80. ANA were classified as weakly (1:80 or 1:160), moderately (1:320
or 1:640) or strongly (≥1:1280) positive. Specific autoantibodies against
nuclear antigens were detected with second-step assays according to the ANA
staining pattern. Associations between the assessed disorders and ANA
positivity and pattern were examined using sex and age-adjusted mixed-effects
logistic regression models. Results Thirty-three percent (95% confidence
interval; 31–36%) of the 1196 participants (measurements could not be obtained
from three samples) were ANA positive (titer ≥ 1:80). The proportions of
weakly, moderately and strongly positive ANA were 29%, 3.3% and 1.3%,
respectively. ANA positivity was more common among women than men across all
titers (χ2, p = 0.03). ANA positivity, even when stratified according to
height of titer or immunofluorescent pattern, was not associated with
diabetes, elevated blood cholesterol and/or lipids, obesity or hypertension.
Second-step autoantibody assays were positive in 41 of the 83 samples (49%)
tested, with anti-DFS70 (n = 13) and anti-dsDNA (n = 7) being most frequent.
These subgroups were too small to test for associations with the disorders
assessed. Conclusions The prevalence of ANA positivity in the German general
population was similar to values reported from other countries. Contrary to
other studies, there was no association with selected self-reported and
objectively measured cardiovascular and metabolic variables
Model of Career Guidance Activities of Non-Profit Organization in Kyrgyzstan
В статье рассмотрены вопросы профориентационной работы с молодежью. Изучен опыт НКО в сфере профориентации на примере России. Приведены результаты опроса по наиболее эффективным формам профориентации среди экспертов. Приведен анализ наиболее востребованных форм и методов профориентационной работы среди молодежи Кыргызстана.The article deals with the issues of career guidance work with youth. The experience of non-profit organization in the field of career guidance was studied on the example of Russia. The results of a survey on the most effective forms of career guidance among experts are given. The analysis of the most popular forms and methods of career guidance among the youth of Kyrgyzstan is given
Widening the Spectrum of Risk Factors, Comorbidities, and Prodromal Features of Parkinson Disease
Importance: The prodromal phase of Parkinson disease (PD) may last for more than 10 years. Recognition of the spectrum and occurrence of risk factors, comorbidities, and prodromal features of PD can increase understanding of the causes and development of the disease and help identify individuals at risk. Objective: To identify the association of a subsequent diagnosis of PD with a range of risk factors and prodromal features, including lifestyle factors, comorbidities, and potential extracerebral manifestations of PD. Design, Setting, and Participants: This was a case-control study using insurance claims of outpatient consultations of patients with German statutory health insurance between January 1, 2011, and December 31, 2020. Included were patients with incident diagnosis of PD without a previous diagnosis of parkinsonism or dementia and controls matched 1:2 for age, sex, region, and earliest year of outpatient encounter. Exposures: Exposures were selected based on previous systematic reviews, case-control and cohort studies reporting on risk factors, comorbidities, and prodromal features of PD. Main Outcomes and Measures: Previously postulated risk factors and prodromal features of PD, using the International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10) coding. Results: A total of 138 345 patients with incident PD (mean [SD] age, 75.1 [9.8] years; 73 720 male [53.3%]) and 276 690 matched controls (mean [SD] age, 75.1 (9.8) years; 147 440 male [53.3%]) were identified. Study participants were followed up for a mean (SD) of 6.0 (2.0) years. Consistent with previous reports, risk factors and prodromal features associated with PD included traumatic brain injury, odds ratio (OR), 1.62; 95% CI, 1.36-1.92; alcohol misuse, OR, 1.32; 95% CI, 1.21-1.44; hypertension, OR, 1.29; 95% CI, 1.26-1.31; anosmia, OR, 2.16; 95% CI, 1.59-2.93; and parasomnias (including RBD), OR, 1.62; 95% CI, 1.42-1.84. In addition, there were associations with restless legs syndrome (OR, 4.19; 95% CI, 3.91-4.50), sleep apnea (OR, 1.45; 95% CI, 1.37-1.54), epilepsy (OR, 2.26; 95% CI, 2.07-2.46), migraine (OR, 1.21; 95% CI, 1.12-1.29), bipolar disorder (OR, 3.81; 95% CI, 3.11-4.67), and schizophrenia (OR, 4.48; 95% CI, 3.82-5.25). The following diagnoses were also found to be associated with PD: sensory impairments beyond anosmia, such as hearing loss (OR, 1.14; 95% CI, 1.09-1.20) and changes of skin sensation (OR, 1.31; 95% CI, 1.21-1.43). There were also positive associations with skin disorders (eg, seborrheic dermatitis, OR, 1.30; 95% CI, 1.15-1.46; psoriasis, OR, 1.13; 95% CI, 1.05-1.21), gastrointestinal disorders (eg, gastroesophageal reflux, OR, 1.29; 95% CI, 1.25-1.33; gastritis, OR, 1.28; 95% CI, 1.24-1.33), conditions with a potential inflammatory component (eg, seronegative osteoarthritis, OR, 1.21; 95% CI, 1.03-1.43), and diabetes types 1 (OR, 1.32; 95% CI, 1.21-1.43) and 2 (OR, 1.24; 95% CI, 1.20-1.27). Associations even 5 to 10 years before diagnosis included tremor (odds ratio [OR], 4.49; 95% CI, 3.98-5.06), restless legs syndrome (OR, 3.73; 95% CI, 3.39-4.09), bipolar disorder (OR, 3.80; 95% CI, 2.82-5.14), and schizophrenia (OR, 4.00; 95% CI, 3.31-4.85). Conclusions and Relevance: Results of this case-control study suggest that the associations found between PD and certain risk factors, comorbidities, and prodromal symptoms in a representative population may reflect possible early extrastriatal and extracerebral pathology of PD. This may be due to shared genetic risk with PD, medication exposure, or direct causation, or represent pathophysiologically relevant factors contributing to the pathogenesis of PD
Development of a Bead-Based Multiplex Assay for the Analysis of the Serological Response against the Six Pathogens HAV, HBV, HCV, CMV, T. gondii, and H. pylori
The spread of infectious diseases and vaccination history are common subjects of epidemiological and immunological research studies. Multiplexed serological assays are useful tools for assessing both current and previous infections as well as vaccination efficacy. We developed a serological multi-pathogen assay for hepatitis A, B and C virus, cytomegalovirus (CMV), Toxoplasma gondii, and Helicobacter pylori using a bead-based multiplex assay format. The multi-pathogen assay consisting of 15 antigens was utilized for the analysis of the serological response in elderly individuals of an influenza vaccination study (n = 34). The technical assay validation revealed a mean intra-assay precision of coefficient of variation (CV) = 3.2 ± 1.5% and a mean inter-assay precision of CV = 8.2 ± 5.3% across all 15 antigens and all tested samples, indicating a robust test system. Furthermore, the assay shows high sensitivities (ranging between 94% and 100%) and specificities (ranging between 93% and 100%) for the different pathogens. The highest seroprevalence rates in our cohort were observed for hepatitis A virus (HAV; 73.5%), followed by CMV (70.6%), T. gondii (67.6%) and H. pylori (32.4%). Seroprevalences for hepatitis B virus (HBV, 8.8%) and hepatitis C virus (HCV, 0%) were low. The seroprevalences observed in our study were similar to those from other population-based studies in Germany. In summary, we conclude that our multiplex serological assay represents a suitable tool for epidemiological studies
A feasibility trial to examine the social norms approach for the prevention and reduction of licit and illicit drug use in European University and college students.
Background: Incorrect perceptions of high rates of peer alcohol and tobacco use are predictive of increased personal use in student populations. Correcting misperceptions by providing feedback has been shown to be an effective intervention for reducing licit drug use. It is currently unknown if social norms interventions are effective in preventing and reducing illicit drug use in European students. The purpose of this paper is to describe the design of a multi-site cluster controlled trial of a web-based social norms intervention aimed at reducing licit and preventing illicit drug use in European university students.
Methods/Design: An online questionnaire to assess rates of drug use will be developed and translated based on existing social norms surveys. Students from sixteen universities in seven participating European countries will be invited to complete the questionnaire. Both intervention and control sites will be chosen by convenience. In each country, the intervention site will be the university that the local principal investigator is affiliated with. We aim to recruit 1000 students per site (baseline assessment). All participants will complete the online questionnaire at baseline. Baseline data will be used to develop social norms messages that will be included in a web-based intervention. The intervention group will receive individualized social norms feedback. The website will remain online during the following 5 months. After five months, a second survey will be conducted and effects of the intervention on social norms and drug use will be measured in comparison to the control site.
Discussion: This project is the first cross-national European collaboration to investigate the feasibility of a social norms intervention to reduce licit and prevent illicit drug use among European university students.
Final trial registration number
DRKS00004375 on the ‘German Clinical Trials Register’.This study is funded by the European Commission, Directorate General Justice, Freedom and Security (JLS/2009-2010/DPIP/AG
Assessment of rock massif sustainability in the area of the underground research laboratory (Nizhnekanskii Massif, Enisei site)
The study presents the results of the research on geodynamic and geological conditions of the Enisei site (Krasnoyarsk Krai), chosen for the construction of an underground research laboratory. The laboratory
is being built at a depth of 500 m to assess the suitability of the rock mass for burying high-level radioactive waste. The rocks consist of weakly fractured gneisses, granites, and dikes of metadolerites. Field observations were conducted on bedrock outcrops. They included the determination of rock mass quality indicators, measurement of rock fracturing, and a rating classification of stability using N.Barton's method. GNSS observations were also made to monitor surface deformations. These data were used to develop a three-dimensional structural model, including lithology, fault disruptions, intrusive bodies, elastic-strength properties of rocks, and the sizes of zones influenced by faulting. It will serve as a basis for boundary conditions and the construction of three-dimensional variational models of stress-strain states, identifying zones of concentration of hazardous stresses, and planning in situ geomechanical experiments in underground mines of the laboratory. The obtained values of the modified QR index for the main types of rocks allowed their classification as stable and moderately stable, corresponding to strong and very strong rocks on Barton's scale and the massif rating according to geomechanical classification
Evaluation of a questionnaire to assess selected infectious diseases and their risk factors: Findings of a multicenter study
Background/objectives The risk to die from an infectious disease in Germany has been continuously decreasing over the last century. Since infections are, however, not only causes of death but risk factors for diseases like cardiovascular diseases, it is essential to monitor and analyze their prevalence and frequency, especially in consideration of the increased life expectancy. To gain more knowledge about infectious diseases as risk factors and their implications on the condition and change of the immune status, the German National Cohort (GNC), a population-based prospective cohort study, will recruit 200,000 subjects between 2014 and 2017. In Pretest 1, a feasibility study for the GNC, we evaluated a self-administered and self-report questionnaire on infectious diseases and on the use of health care facilities (hereinafter called “ID Screen”) for feasibility and validity. Methods: From August–November 2011, 435 participants between the ages of 20–69 completed the ID Screen. All subjects had been recruited via a random sample from the local residents’ registration offices by 4 of the 18 participating study centers. The questionnaire encompasses 77 variables in six sections assessing items such as 12-month prevalence of infections, cumulative prevalence of infectious diseases, visit of health care facilities and vaccination. The feasibility was amongst others evaluated by assessing the completeness and comprehensiveness of the questionnaire. To assess the questionnaires ability to measure “immune status” and “susceptibility to infections”, multivariate analysis was used. Results: The overall practicability was good and most items were well understood, demonstrated by 5 % of missing values. However, direct comparison of the items 12-month prevalence and lifetime prevalence of nephritis/pyelitis showed poor agreement and thereby poor understanding by 80 % of the participants, illustrating the necessity for a clear, lay person appropriate description of rare diseases to increase comprehensibility. The questionnaire will be used to support the assessment of immune dysfunction and frequency of infection. An analysis of these constructs in an exploratory factor analysis revealed limited applicability due to low interitem correlation (Cronbach’s α < 0.5). This is corroborated by the extraction of more than one factor with a Kaiser–Meyer–Olkin measure of 0.6 instead of a unidimensional latent construct for “immune status”. Conclusion: All in all, the ID Screen is a good and reliable tool to measure infectious diseases as risk factors and outcome in general, but requires a better translation of infection specific terms into lay person terms. For the assessment of the overall immune status, the tool has strong limitations. Vaccinations status should also rather be assessed based on vaccination certificates than on participants’ recall. Electronic supplementary material The online version of this article (doi: 10.1007/s00103-014-2052-y) contains supplementary material, which is available to authorized users
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