The Union and Médecins Sans Frontières approach to operational research.

Operational research (OR) has become a hot topic at national meetings, international conferences and donor fora. The International Union Against Tuberculosis and Lung Disease (The Union) and Médecins Sans Frontières (MSF) Operational Centre Brussels strongly promote and implement OR with colleagues in low- and middle-income countries. Here we describe how the two organisations define OR, and explain the guiding principles and methodology that underpin the strategy for developing and expanding OR in those countries. We articulate The Union's and MSF's approach to supporting OR, highlighting the main synergies and differences. Then, using the Malawi National Tuberculosis Control Programme as an example, we show how OR can be embedded within tuberculosis control activities, leading to changes in policy and practice at the national level. We discuss the difficult, yet vitally important, issue of capacity building, and share our vision of a new paradigm of product-related training and performance-based OR fellowships as two ways of developing the necessary skills at country level to ensure research is actually performed. Finally, we highlight the need to consider and incorporate into practice the ethical components of OR. This is a key moment to be involved in OR. We are confident that in partnership with interested stakeholders, including the World Health Organization, we can stimulate the implementation of quality, relevant OR as an integral part of health service delivery that in turn will lead to better health for people, particularly for those living in the poorer parts of the world

Ground-State Electromagnetic Moments of Calcium Isotopes

High-resolution bunched-beam collinear laser spectroscopy was used to measure the optical hyperfine spectra of the $^{43-51}$Ca isotopes. The ground state magnetic moments of $^{49,51}$Ca and quadrupole moments of $^{47,49,51}$Ca were measured for the first time, and the $^{51}$Ca ground state spin $I=3/2$ was determined in a model-independent way. Our results provide a critical test of modern nuclear theories based on shell-model calculations using phenomenological as well as microscopic interactions. The results for the neutron-rich isotopes are in excellent agreement with predictions using interactions derived from chiral effective field theory including three-nucleon forces, while lighter isotopes illustrate the presence of particle-hole excitations of the $^{40}$Ca core in their ground state.Comment: Accepted as a Rapid Communication in Physical Review

Spins, Electromagnetic Moments, and Isomers of 107-129Cd

The neutron-rich isotopes of cadmium up to the N=82 shell closure have been investigated by high-resolution laser spectroscopy. Deep-UV excitation at 214.5 nm and radioactive-beam bunching provided the required experimental sensitivity. Long-lived isomers are observed in 127Cd and 129Cd for the first time. One essential feature of the spherical shell model is unambiguously confirmed by a linear increase of the 11/2- quadrupole moments. Remarkably, this mechanism is found to act well beyond the h11/2 shell

Nuclear spins, magnetic moments and quadrupole moments of Cu isotopes from N = 28 to N = 46: probes for core polarization effects

Measurements of the ground-state nuclear spins, magnetic and quadrupole moments of the copper isotopes from 61Cu up to 75Cu are reported. The experiments were performed at the ISOLDE facility, using the technique of collinear laser spectroscopy. The trend in the magnetic moments between the N=28 and N=50 shell closures is reasonably reproduced by large-scale shell-model calculations starting from a 56Ni core. The quadrupole moments reveal a strong polarization of the underlying Ni core when the neutron shell is opened, which is however strongly reduced at N=40 due to the parity change between the $pf$ and $g$ orbits. No enhanced core polarization is seen beyond N=40. Deviations between measured and calculated moments are attributed to the softness of the 56Ni core and weakening of the Z=28 and N=28 shell gaps.Comment: 13 pagers, 19 figures, accepted by Physical Review

Academic freedom in Europe: reviewing UNESCO’s recommendation

This paper examines the compliance of universities in the European Union with the UNESCO Recommendation concerning the Status of Higher–Education Teaching Personnel, which deals primarily with protection for academic freedom. The paper briefly surveys the European genesis of the modern research university and academic freedom, before evaluating compliance with the UNESCO recommendation on institutional autonomy, academic freedom, university governance and tenure. Following from this, the paper examines the reasons for the generally low level of compliance with the UNESCO Recommendation within the EU states, and considers how such compliance could be improved

WII-FIT FOR BALANCE AND GAIT IN SKILLED NURSING FACILITY: A RETROSPECTIVE STUDY

Background: Falls in elderly are a major public health problem. Poor balance and gait abnormalities are risk factors for falls. Exercise improves gait and balance in elderly. However, it is difficult to engage patients in exercise programs. Wii-Fit might bridge this gap by providing high level of engagement at an affordable price. Wii-Fit is a Nintendo game used for balance, yoga, aerobics, and strength training. It is a TV based self-directed activity. Virtual trainers talk the user through the activity and track progress while visual and auditory feedback improve engagement. Anecdotal reports suggest improvement in balance and social benefits with Wii-Fit, but no systematic studies are available. Objective: To compare the effect of Wii-Fit augmentation to physical therapy alone in subjects undergoing rehabilitation in skilled nursing facility (SNF) using a retrospective chart review. Methods: 100 charts were reviewed of which seventeen patients were noted to have used Wii-Fit during their rehabilitation. These subjects were matched with seventeen controls who did physical therapy alone. Results: There were no baseline differences between the groups. The mean age was 77.7 years, with 11 females in each group. All the subjects were Caucasians. The average length of stay was 30 days in each group. Mean duration of the Wii-Fit use was 4-weeks. Wii-Fit augmentation group improved significantly in Activities of Daily Living (p=0.008), balance (p=0.0001), and assistance with gait (p=0.05) when compared to the control group. Conclusion: Wii-Fit can be used safely in a SNF, and it may improve balance, gait, and functional status

Language in tuberculosis services: can we change to patient-centred terminology and stop the paradigm of blaming the patients?

The words 'defaulter', 'suspect' and 'control' have been part of the language of tuberculosis (TB) services for many decades, and they continue to be used in international guidelines and in published literature. From a patient perspective, it is our opinion that these terms are at best inappropriate, coercive and disempowering, and at worst they could be perceived as judgmental and criminalising, tending to place the blame of the disease or responsibility for adverse treatment outcomes on one side-that of the patients. In this article, which brings together a wide range of authors and institutions from Africa, Asia, Latin America, Europe and the Pacific, we discuss the use of the words 'defaulter', 'suspect' and 'control' and argue why it is detrimental to continue using them in the context of TB. We propose that 'defaulter' be replaced with 'person lost to follow-up'; that 'TB suspect' be replaced by 'person with presumptive TB' or 'person to be evaluated for TB'; and that the term 'control' be replaced with 'prevention and care' or simply deleted. These terms are non-judgmental and patient-centred. We appeal to the global Stop TB Partnership to lead discussions on this issue and to make concrete steps towards changing the current paradigm