Alien Registration- Breton, Marie Anne (Fairfield, Somerset County)

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The concept of mechanism from a realist approach: a scoping review to facilitate its operationalization in public health program evaluation

International audienceBackground: Public health interventions are complex by nature, and their evaluation requires unpacking their intervention logic and their interactions with open social systems. By focusing on the interrelationships between context, mechanism, and outcome, Pawson and Tilley's realist approach appears a promising innovation for public health-related evaluation works. However, and as expected of any methodological innovation, this approach is being constructed gradually by answering the multiple challenges to its operationalization that fall in its path. One of these challenges, users of this approach agree on, is the necessity of clarifying its key concept of mechanism.Method: We first collected the definitions of mechanism from published works of Pawson and colleagues. Secondly, a scoping review was conducted to identify the ones quoted by users of the realist approach for evaluating public health interventions (1997–2012). We then appraised the clarity and precision of this concept against the three dimensions defined by Daigneault and Jacobs " term, sense and referent. "Results: Of the 2344 documents identified in the scoping review, 49 documents were included. Term: Users of the realist approach use adjectives qualifying the term mechanism that were not specifically endorsed by Pawson and colleagues. Sense: None of the attributes stated by Pawson and colleagues has been listed in all of the documents analyzed, and some contributions clarified its attributes. Referent: The concept of mechanism within a realist approach can be ascribed to theory-based evaluation, complex social interventions, and critical realism.Conclusion: This review led us to reconsider the concept of mechanism within the realist approach by confronting the theoretical stance of its proponents to the practical one of its users. This resulted in a clearer, more precise definition of the concept of mechanism which may in turn trigger further improvements in the way the realist approach is applied in evaluative practice in public health and potentially beyond. A mechanism is hidden but real, is an element of reasoning and reactions of agents in regard to the resources available in a given context to bring about changes through the implementation of an intervention, and evolves within an open space-time and social system of relationships

Transboundary Cooperation and Sustainable Development in the Rhine Basin

The Rhine connects millions of people from the Alps to the North Sea. With a length of 1233 km, its catchment includes nine states, an area of about 200,000 km2, 60 million inhabitants as well as important cities and fascinating landscapes. Consequently, the Rhine is culturally, historically and economically one of the most important rivers in Europe. The International Commission for the Protection of the Rhine (ICPR) was founded in 1950 with the first common goal in history to reduce water pollution. The whole process got a new impetus with the chemical catastrophe at the Sandoz plant (near Basel) in 1986, which saw aquatic ecosystems being seriously damaged. This disaster led to a better integration of the issue of ecology into the tasks of the ICPR. Depollution and rehabilitation programmes with actions and measures were established. In the 1990s, severe flood events forced the ICPR to add flood prevention to its sustainability goals enabling a better protection of citizens. This chapter presents the common work of the countries aimed at protecting the Rhine basin and the most important environmental outcomes of this special and long-lasting partnership

Changes to inhaled corticosteroid dose when initiating combination inhaler therapy in long-acting β agonist-naive patients with asthma : a retrospective database analysis

Retrospective prescribing data were obtained from 46 general practice surgeries in NHS Scotland. Patients with asthma who were naïve to previous long-acting β agonist therapy and initiated combination inhaler therapy in 2008–2009 were classified according to the inhaled corticosteroid (ICS) dose in their combination inhaler compared with the highest dose of ICS they received before initiation. Among the 685 patients (541 (79.0%) who had been prescribed an ICS previously), those originally on low-, medium- or high-dose ICS were changed to high-dose combination therapy in 122/250 (48.8%), 94/151 (62.3%) or 85/113 (75.2%) cases in each ICS dose category, respectively. These results suggest that evaluation of appropriate high-dose ICS prescribing in general practice is needed

La conscience morphologique est-elle une variable importante dans l’apprentissage de la lecture?

Le présent article est une revue synthétique des travaux portant sur lesliens entre conscience morphologique et apprentissage de la lecture. Cettesynthèse permet de confirmer que la conscience morphologique contribuebien à l’apprentissage de la lecture (tant au niveau de l’installation deshabiletés de décodage qu’au niveau du développement de la compréhension).Toutefois, il semble que ce ne sont pas tout à fait les mêmes aspects de la conscience morphologique qui sont liés aux capacités de décodage et aux capacités de compréhension. Des recherches doivent donc être développées pour mieux appréhender les rôles respectifs de chacune des composantes de la conscience morphologique

La conscience morphologique est-elle une variable importante dans l’apprentissage de la lecture?

Le présent article est une revue synthétique des travaux portant sur lesliens entre conscience morphologique et apprentissage de la lecture. Cettesynthèse permet de confirmer que la conscience morphologique contribuebien à l’apprentissage de la lecture (tant au niveau de l’installation deshabiletés de décodage qu’au niveau du développement de la compréhension).Toutefois, il semble que ce ne sont pas tout à fait les mêmes aspects de la conscience morphologique qui sont liés aux capacités de décodage et aux capacités de compréhension. Des recherches doivent donc être développées pour mieux appréhender les rôles respectifs de chacune des composantes de la conscience morphologique

Identification of the bacteria and their metabolic activities associated with the microbial spoilage of custard cream desserts

The famous French dessert “ile flottante” consists of a sweet egg white foam floating on a vanilla custard cream,which contains highly nutritive raw materials, including milk, sugar and egg. Spoilage issues are therefore a keyconcern for the manufacturers. This study explored the bacterial diversity of 64 spoiled custard cream dessertsmanufactured by 2 French companies. B. cereus group bacteria, coagulase negative Staphylococcus, Enterococcus and Leuconostoc spp. were isolated from spoiled products. Thirty-one bacterial isolates representative of the main spoilage species were tested for their spoilage abilities. Significant growth and pH decrease were observed regardless of species. While off-odours were detected with B. cereus group and staphylococci, yoghurt odours were detected with Enterococcus spp. and Leuconostoc spp. B. cereus group bacteria produced various esters and several compounds derived from amino acid and sugar metabolism. Most Staphylococci produced phenolic compounds. Enterococcus spp. and Leuconostoc spp. isolates produced high levels of compounds derived from sugar metabolism. Each type of spoilage bacteria was associated with a specific volatile profile and lactic acid was identified as a potential marker of spoilage of custard cream-based desserts. These findings provide valuable information for manufacturers to improve food spoilage detection and prevention of chilled desserts made with milk and egg

Early Miocene tectono-sedimentary shift in the eastern North Alpine Foreland Basin and its relation to changes in tectonic style in the Eastern Alps

A striking difference along the Alpine Orogen is the style of collisional tectonics during the Oligo-Miocene, with the onset of escape tectonics in the Eastern Alps (Fig. 1A). The indentation of the Adriatic Plate into the Eastern Alpine Orogen resulted in the formation of conjugate dextral and sinistral strike-slip faults in the vicinity of the Tauern Window. Moreover, major changes occurred in the foreland of the Eastern and Southern Alps in the Early Miocene, with the cessation of the northern Alpine front propagation and the onset of thrusting along the Southern Alpine Front. In this study, we present new results from structural, stratigraphic and subsidence analyses of the eastern North Alpine Foreland Basin (NAFB; Fig. 1B) as part of the “Mountain Building in 4 Dimensions” project, German branch of the European AlpArray initiative, which aims at better understanding the deep crustal-mantle structures of the Alpine Orogen and their relation to surface processes. Our results show a first phase of onset of foreland sedimentation in the eastern NAFB between c. 33-28 Ma, followed by a strong tectonic-driven subsidence between c. 28-25 Ma ending by a phase of erosion and the formation of a basin-wide Northern Slope Unconformity (NSU; Fig. 1C & 1D). During this time period, the rift-related Mesozoic normal faults of the European platform were reactivated and are capped by the NSU (Fig. 1D). We interpret this phase as an increase in the flexure of the subducting European Plate under the growing Alpine Orogen. Between 25-19 Ma, the eastern NAFB remained in a deep-marine, underfilled state with a gently increase in subsidence. A major shift took place around 19-17 Ma with strong tectonic-driven uplift, ranging from 200 m (absolute minimum) to 1200 m depending on uncertainties on paleo-water depths, and rapid sedimentary infill of the basin (Fig. 1C & 1D). We discuss the possible causes for this major tectono-sedimentary shift in the eastern NAFB in relation to contemporaneous changes in collisional tectonics within the Eastern and Southern Alps, and with a potential Early Miocene slab break-off event beneath the Eastern Alps

Racial and Geographic Variation in Effects of Maternal Education and Neighborhood-Level Measures of Socioeconomic Status on Gestational Age at Birth: Findings From the ECHO Cohorts

Preterm birth occurs at excessively high and disparate rates in the United States. In 2016, the National Institutes of Health (NIH) launched the Environmental influences on Child Health Outcomes (ECHO) program to investigate the influence of early life exposures on child health. Extant data from the ECHO cohorts provides the opportunity to examine racial and geographic variation in effects of individual- and neighborhood-level markers of socioeconomic status (SES) on gestational age at birth. The objective of this study was to examine the association between individual-level (maternal education) and neighborhood-level markers of SES and gestational age at birth, stratifying by maternal race/ethnicity, and whether any such associations are modified by US geographic region. Twenty-six ECHO cohorts representing 25,526 mother-infant pairs contributed to this disseminated meta-analysis that investigated the effect of maternal prenatal level of education (high school diploma, GED, or less; some college, associate\u27s degree, vocational or technical training [reference category]; bachelor\u27s degree, graduate school, or professional degree) and neighborhood-level markers of SES (census tract [CT] urbanicity, percentage of black population in CT, percentage of population below the federal poverty level in CT) on gestational age at birth (categorized as preterm, early term, full term [the reference category], late, and post term) according to maternal race/ethnicity and US region. Multinomial logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals (CIs). Cohort-specific results were meta-analyzed using a random effects model. For women overall, a bachelor\u27s degree or above, compared with some college, was associated with a significantly decreased odds of preterm birth (aOR 0.72; 95% CI: 0.61-0.86), whereas a high school education or less was associated with an increased odds of early term birth (aOR 1.10, 95% CI: 1.00-1.21). When stratifying by maternal race/ethnicity, there were no significant associations between maternal education and gestational age at birth among women of racial/ethnic groups other than non-Hispanic white. Among non-Hispanic white women, a bachelor\u27s degree or above was likewise associated with a significantly decreased odds of preterm birth (aOR 0.74 (95% CI: 0.58, 0.94) as well as a decreased odds of early term birth (aOR 0.84 (95% CI: 0.74, 0.95). The association between maternal education and gestational age at birth varied according to US region, with higher levels of maternal education associated with a significantly decreased odds of preterm birth in the Midwest and South but not in the Northeast and West. Non-Hispanic white women residing in rural compared to urban CTs had an increased odds of preterm birth; the ability to detect associations between neighborhood-level measures of SES and gestational age for other race/ethnic groups was limited due to small sample sizes within select strata. Interventions that promote higher educational attainment among women of reproductive age could contribute to a reduction in preterm birth, particularly in the US South and Midwest. Further individual-level analyses engaging a diverse set of cohorts are needed to disentangle the complex interrelationships among maternal education, neighborhood-level factors, exposures across the life course, and gestational age at birth outcomes by maternal race/ethnicity and US geography