100 research outputs found
Taxation of Refunded Amounts Deducted in Prior Years: Charitable Contributions
Socialsekreterare som arbetar med barnavĂ„rdsutredningar börjar se barnen alltmer som egna individer och tar del av barnens berĂ€ttelser och Ă„sikter. Socialstyrelsen har utarbetat modellen BBIC som stĂ„r för âBarns behov i Centrumâ. Syftet med BBIC Ă€r att stĂ€rka barns delaktighet i utredningar, vilket pĂ„gĂ„r i flera kommuner runt om i Sverige. BBIC har sin grund frĂ„n den engelska modellen Looking After Children System (LACS). VĂ„r kandidatuppsats handlar om att undersöka socialsekreterarens uppfattningar och syn pĂ„ BBIC under utredning av barn inom individ- och familjeomsorgen. Ăven hur socialsekretare beskriver hur det Ă€r att arbeta med BBIC som dokumentationssystem för att lyfta fram barnets röst och göra barn delaktiga i barnavĂ„rdsutredningar. VĂ„r uppsats gjordes genom kvalitativa semistrukturerade intervjuer med tre socialsekreterare som hade erfarenhet att handlĂ€gga utredningar som rör barn. Urvalsmetoden som anvĂ€nts Ă€r bekvĂ€mlighetsurval. Större delen av de resultat som framkommit i denna undersökning har bekrĂ€ftats av tidigare forskning. Undersökningen visade att socialsekreterarna överlag anser att BBIC lyfter fram ett tydligare barnperspektiv. DĂ€remot visar det Ă€ven att det förekommer en del nackdelar och svĂ„righeter med systemet, bland annat ansĂ„gs datasystemet otympligt samt dokumentationssystemet alltför omfattande
Spacetime structure of the global vortex
We analyse the spacetime structure of the global vortex and its maximal
analytic extension in an arbitrary number of spacetime dimensions. We find that
the vortex compactifies space on the scale of the Hubble expansion of its
worldvolume, in a manner reminiscent of that of the domain wall. We calculate
the effective volume of this compactification and remark on its relevance to
hierarchy resolution with extra dimensions. We also consider strongly
gravitating vortices and derive bounds on the existence of a global vortex
solution.Comment: 19 pages revtex, 2 figures, minor changes, references adde
Frihet under ansvar?
Denna studiens syfte var att undersöka upplevelsen av arbetsgivarkontroll hos tvÄ vitt skilda arbetsplatser och yrkeskategorier. Semistrukturerade intervjuer genomfördes med tio personer och den insamlade datan bearbetades utifrÄn en tematisk analys med fyra pÄ förhand bestÀmda teman: kontroll, inflytande, arbetsglÀdje och effektivitet. I resultaten framkom bÄde skillnader och likheter i upplevelserna av kontrollen hos de olika arbetstagarna. Den upplevelse som var gemensam för alla deltagare handlade om att kontrollen kopplades samman med kÀnslor av misstÀnksamhet och brist pÄ förtroende frÄn arbetsgivarens sida. Resultaten visade inte bara pÄ negativa upplevelser utan vittnade Àven pÄ en förstÄelse om att kontroll i vissa fall kan vara nödvÀndigt
Evaluation of ICD-10 algorithms to identify hypopituitary patients in the Danish National Patient Registry
OBJECTIVE: Routinely collected health data may be valuable sources for conducting research. This study aimed to evaluate the validity of algorithms detecting hypopituitary patients in the Danish National Patient Registry (DNPR) using medical records as reference standard. STUDY DESIGN AND SETTING: Patients with International Classification of Diseases (10th edition [ICD-10]) diagnoses of hypopituitarism, or other diagnoses of pituitary disorders assumed to be associated with an increased risk of hypopituitarism, recorded in the DNPR during 2000â2012 were identified. Medical records were reviewed to confirm or disprove hypopituitarism. RESULTS: Hypopituitarism was confirmed in 911 patients. In a candidate population of 1,661, this yielded an overall positive predictive value (PPV) of 54.8% (95% confidence interval [CI]: 52.4â57.3). Using algorithms searching for patients recorded at least one, three or five times with a diagnosis of hypopituitarism (E23.0x) and/or at least once with a diagnosis of postprocedural hypopituitarism (E89.3x), PPVs gradually increased from 73.3% (95% CI: 70.6â75.8) to 83.3% (95% CI: 80.7â85.7). Completeness for the same algorithms, however, decreased from 90.8% (95% CI: 88.7â92.6) to 82.9% (95% CI: 80.3â85.3) respectively. Including data of hormone replacement in the same algorithms PPVs increased from 73.2% (95% CI: 70.6â75.7) to 82.6% (95% CI: 80.1â84.9) and completeness decreased from 94.3% (95% CI: 92.6â95.7) to 89.7% (95% CI: 87.5â91.6) with increasing records of E23.0x. CONCLUSION: The DNPR is a valuable data source to identify hypopituitary patients using a search criteria of at least five records of E23.0x and/or at least one record of E89.3x. Completeness is increased when including hormone replacement data in the algorithm. The consequences of misclassification must, however, always be considered
Training emergency servicesâ dispatchers to recognise stroke: an interrupted time-series analysis
Background: Stroke is a time-dependent medical emergency in which early presentation to specialist care reduces death and dependency. Up to 70% of all stroke patients obtain first medical contact from the Emergency Medical Services (EMS). Identifying âtrue strokeâ from an EMS call is challenging, with over 50% of strokes being misclassified.
The aim of this study was to evaluate the impact of the training package on the recognition of stroke by Emergency Medical Dispatchers (EMDs).
Methods: This study took place in an ambulance service and a hospital in England using an interrupted time-series
design. Suspected stroke patients were identified in one week blocks, every three weeks over an 18 month period,
during which time the training was implemented. Patients were included if they had a diagnosis of stroke (EMS or
hospital). The effect of the intervention on the accuracy of dispatch diagnosis was investigated using binomial
(grouped) logistic regression.
Results: In the Pre-implementation period EMDs correctly identified 63% of stroke patients; this increased to 80%
Post-implementation. This change was significant (p=0.003), reflecting an improvement in identifying stroke patients
relative to the Pre-implementation period both the During-implementation (OR=4.10 [95% CI 1.58 to 10.66]) and Post-implementation (OR=2.30 [95% CI 1.07 to 4.92]) periods. For patients with a final diagnosis of stroke who had been dispatched as stroke there was a marginally non-significant 2.8 minutes (95% CI â0.2 to 5.9 minutes, p=0.068)reduction between Pre- and Post-implementation periods from call to arrival of the ambulance at scene.
Conclusions: This is the first study to develop, implement and evaluate the impact of a training package for EMDs with
the aim of improving the recognition of stroke. Training led to a significant increase in the proportion of stroke patients dispatched as such by EMDs; a small reduction in time from call to arrival at scene by the ambulance also appeared likely. The training package has been endorsed by the UK Stroke Forum Education and Training, and is free to access on-line
A global view of protein expression in human cells, tissues, and organs
Defining the protein profiles of tissues and organs is critical to understanding the unique characteristics of the various cell types in the human body. In this study, we report on an anatomically comprehensive analysis of 4842 protein profiles in 48 human tissues and 45 human cell lines. A detailed analysis of over 2 million manually annotated, high-resolution, immunohistochemistry-based images showed a high fraction (>65%) of expressed proteins in most cells and tissues, with very few proteins (<2%) detected in any single cell type. Similarly, confocal microscopy in three human cell lines detected expression of more than 70% of the analyzed proteins. Despite this ubiquitous expression, hierarchical clustering analysis, based on global protein expression patterns, shows that the analyzed cells can be still subdivided into groups according to the current concepts of histology and cellular differentiation. This study suggests that tissue specificity is achieved by precise regulation of protein levels in space and time, and that different tissues in the body acquire their unique characteristics by controlling not which proteins are expressed but how much of each is produced
Identification of a methylated oligoribonucleotide as a potent inhibitor of HIV-1 reverse transcription complex
Upon HIV-1 infection of a target cell, the viral reverse transcriptase (RT) copies the genomic RNA to synthesize the viral DNA. The genomic RNA is within the incoming HIV-1 core where it is coated by molecules of nucleocapsid (NC) protein that chaperones the reverse transcription process. Indeed, the RT chaperoning properties of NC extend from the initiation of cDNA synthesis to completion of the viral DNA. New and effective drugs against HIV-1 continue to be required, which prompted us to search for compounds aimed at inhibiting NC protein. Here, we report that the NC chaperoning activity is extensively inhibited in vitro by small methylated oligoribonucleotides (mODN). These mODNs were delivered intracellularly using a cell-penetrating-peptide and found to impede HIV-1 replication in primary human cells at nanomolar concentrations. Extensive analysis showed that viral cDNA synthesis was severely impaired by mODNs. Partially resistant viruses with mutations in NC and RT emerged after months of passaging in cell culture. A HIV-1 molecular clone (NL4.3) bearing these mutations was found to replicate at high concentrations of mODN, albeit with a reduced fitness. Small, methylated ODNs such as mODN-11 appear to be a new type of highly potent inhibitor of HIV-1
Structure, Function, and Evolution of the Thiomonas spp. Genome
Bacteria of the Thiomonas genus are ubiquitous in extreme environments, such as arsenic-rich acid mine drainage (AMD). The genome of one of these strains, Thiomonas sp. 3As, was sequenced, annotated, and examined, revealing specific adaptations allowing this bacterium to survive and grow in its highly toxic environment. In order to explore genomic diversity as well as genetic evolution in Thiomonas spp., a comparative genomic hybridization (CGH) approach was used on eight different strains of the Thiomonas genus, including five strains of the same species. Our results suggest that the Thiomonas genome has evolved through the gain or loss of genomic islands and that this evolution is influenced by the specific environmental conditions in which the strains live
The development of a web- and a print-based decision aid for prostate cancer screening
Background Whether early detection and treatment of prostate cancer (PCa) will reduce disease-related mortality remains uncertain. As a result, tools are needed to facilitate informed decision making. While there have been several decision aids (DAs) developed and tested, very few have included an exercise to help men clarify their values and preferences about PCa screening. Further, only one DA has utilized an interactive web-based format, which allows for an expansion and customization of the material. We describe the development of two DAs, a booklet and an interactive website, each with a values clarification component and designed for use in diverse settings.
Methods We conducted two feasibility studies to assess men\u27s (45-70 years) Internet access and their willingness to use a web- vs. a print-based tool. The booklet was adapted from two previous versions evaluated in randomized controlled trials (RCTs) and the website was created to closely match the content of the revised booklet. Usability testing was conducted to obtain feedback regarding draft versions of the materials. The tools were also reviewed by a plain language expert and the interdisciplinary research team. Feedback on the content and presentation led to iterative modifications of the tools.
Results The feasibility studies confirmed that the Internet was a viable medium, as the majority of men used a computer, had access to the Internet, and Internet use increased over time. Feedback from the usability testing on the length, presentation, and content of the materials was incorporated into the final versions of the booklet and website. Both the feasibility studies and the usability testing highlighted the need to address men\u27s informed decision making regarding screening.
Conclusions Informed decision making for PCa screening is crucial at present and may be important for some time, particularly if a definitive recommendation either for or against screening does not emerge from ongoing prostate cancer screening trials. We have detailed our efforts at developing print- and web-based DAs to assist men in determining how to best meet their PCa screening preferences. Following completion of our ongoing RCT designed to test these materials, our goal will be to develop a dissemination project for the more effective tool
Abdominal aortic aneurysm is associated with a variant in low-density lipoprotein receptor-related protein 1
Abdominal aortic aneurysm (AAA) is a common cause of morbidity and mortality and has a significant heritability. We carried out a genome-wide association discovery study of 1866 patients with AAA and 5435 controls and replication of promising signals (lead SNP with a p value < 1 Ă 10-5) in 2871 additional cases and 32,687 controls and performed further follow-up in 1491 AAA and 11,060 controls. In the discovery study, nine loci demonstrated association with AAA (p < 1 Ă 10-5). In the replication sample, the lead SNP at one of these loci, rs1466535, located within intron 1 of low-density-lipoprotein receptor-related protein 1 (LRP1) demonstrated significant association (p = 0.0042). We confirmed the association of rs1466535 and AAA in our follow-up study (p = 0.035). In a combined analysis (6228 AAA and 49182 controls), rs1466535 had a consistent effect size and direction in all sample sets (combined p = 4.52 Ă 10-10, odds ratio 1.15 [1.10-1.21]). No associations were seen for either rs1466535 or the 12q13.3 locus in independent association studies of coronary artery disease, blood pressure, diabetes, or hyperlipidaemia, suggesting that this locus is specific to AAA. Gene-expression studies demonstrated a trend toward increased LRP1 expression for the rs1466535 CC genotype in arterial tissues; there was a significant (p = 0.029) 1.19-fold (1.04-1.36) increase in LRP1 expression in CC homozygotes compared to TT homozygotes in aortic adventitia. Functional studies demonstrated that rs1466535 might alter a SREBP-1 binding site and influence enhancer activity at the locus. In conclusion, this study has identified a biologically plausible genetic variant associated specifically with AAA, and we suggest that this variant has a possible functional role in LRP1 expression
- âŠ