Talk, Trust and Telecommunications: Alternative Mechanisms for Coordinating Commercial Transactions

Much of the prior work on electronic commerce has used transaction cost economics and coordination theory as general frameworks. These models call attention to the problem of understanding how organizations accomplish effective coordination in complex environments. Applying these models to electronic commerce requires that the processes involved be identified and described. Recent research considering the use of networks focuses on models of commercial exchanges which include activities such as search, execution, settlement, monitoring and after sales services

Age and gender differences in seven tests of functional mobility

BACKGROUND: The objective of this study was to examine age and gender differences in seven tests of functional mobility. METHODS: The study included 50 young participants aged 20 to 39 years, and 684 older participants aged 75 to 98 years. Functional mobility measures included the coordinated stability test, the near tandem balance test, the six metre walk test, the sit to stand test with five repetitions, the alternate step test and the stair ascent and descent tests. RESULTS: Older participants performed significantly worse than the younger participants in all of the functional mobility tests (p < 0.001), with the older women performing worse than the older men in all of the tests (p < 0.05). Significant correlations were found within the older group among all the functional mobility tests scores (r = 0.24–0.87, p < 0.001), and between functional mobility performance and age (r = 0.14–0.35, p < 0.001). People with arthritis and stroke performed worse than people without these conditions in these tests. CONCLUSION: This study provides a normative database for performance of young and older community-dwelling people in a battery of validated and reliable functional mobility tests. The results confirm age-related differences in functional mobility between young and older adults

Variation in Individual Responses to Time-Restricted Feeding and Resistance Training

Time-restricted feeding (TRF) is a form of intermittent fasting which limits all caloric intake to a certain period of time each day in an attempt to reduce daily energy intake, promote weight loss, and improve health. Resistance training (RT) has been reported to increase muscular strength and improve body composition. Very limited information is available on the combination of TRF and RT. The purpose of this study was to examine the variation in individual body composition, dietary intake, and muscular performance responses to an 8-wk TRF and RT program. Healthy males (n = 20; age = 22 ± 3 y; BMI = 27 ± 6 kg/m2; % fat = 22 ± 6 % wt) were randomized to TRF + RT or RT alone for 8 wks. RT was performed 3 dys/wk and consisted of alternate workouts of upper and lower body using a resistance progression scheme. TRF limited energy intake to a 4-hr period on the 4 dys/wk when RT was not performed. Energy intake was not restricted in either group, and eating times were not specified in the RT alone group. Body composition, muscular performance, and dietary records were assessed at 0, 4, and 8 wks. Inter- and intra-individual variations in outcome measures were estimated by hierarchical linear growth modeling. The amount of variability attributable to characteristics between or within participants was evaluated from variance estimates. For TRF + RT, percent changes ranged from -5.5 to +2.6% for body weight, -22.1 to +9.4% for fat mass, -7.7 to +4.6% for lean body mass, +3.4 to +30.4% for bench press 1-RM, and +10.1 to +67.6% for leg press 1-RM. For RT alone, percent changes ranged from -6.6 to +2.1% for body weight, -14.4 to +12.6% for fat mass, -4.1 to +3.9% for lean body mass, +4.9 to +12.9% for bench press 1-RM, and +14.3 to +37.7% for leg press 1-RM. Percentages of total variability attributed to inter-individual factors ranged from 3.3 to 49.2% for dietary measures, 59.0 to 93.9% for muscular performance, and 97.0 to 99.6% for body composition. Remaining variability was attributed to intra-individual factors. Individual responses to the study interventions varied widely. Differences between individuals were an important source of variability, indicating participant samples should be homogenous and/or quite large to examine changes in body composition or muscular performance using nutrition and exercise interventions

Mapping forest growth and degradation stage in the Brigalow Belt Bioregion of Australia through integration of ALOS PALSAR and Landsat-derived foliage projective cover data

Differentiation of forest growth stages through classification of single date or time-series of Landsat sensor data is limited because of insensitivity to their three-dimensional structure. This study therefore evaluated the benefits of integrating the Advanced Land Observing Satellite (ALOS) Phased Array L-band Synthetic Aperture Radar (PALSAR) L-band HH and HV polarisation response from the woody components of vegetation with Landsat-derived foliage projective cover (FPC). Focus was on 12 regional ecosystems (REs) distributed across the Brigalow Belt Bioregion (BRB) of Queensland, Australia, where different stages of growth dominated by brigalow (Acacia harpophylla) were widespread. From remnant areas of brigalow-dominated forests mapped previously for each RE by the Queensland Herbarium through field visits and interpretations of aerial imagery, frequency distributions of all three channels were extracted and compared to those of image segments generated using FPC and PALSAR data. For woody vegetation (with an FPC threshold of ≥ 9%) outside of the remnant areas, mature (non-remnant) forests were associated with segments where the HH and HV backscatter thresholds were within one standard deviation of the mean extracted for remnant forest. Early-stage regrowth was differentiated using an L-band HH threshold o

Immortalized pathological human myoblasts: towards a universal tool for the study of neuromuscular disorders

<p>Abstract</p> <p>Background</p> <p>Investigations into both the pathophysiology and therapeutic targets in muscle dystrophies have been hampered by the limited proliferative capacity of human myoblasts. Isolation of reliable and stable immortalized cell lines from patient biopsies is a powerful tool for investigating pathological mechanisms, including those associated with muscle aging, and for developing innovative gene-based, cell-based or pharmacological biotherapies.</p> <p>Methods</p> <p>Using transduction with both telomerase-expressing and cyclin-dependent kinase 4-expressing vectors, we were able to generate a battery of immortalized human muscle stem-cell lines from patients with various neuromuscular disorders.</p> <p>Results</p> <p>The immortalized human cell lines from patients with Duchenne muscular dystrophy, facioscapulohumeral muscular dystrophy, oculopharyngeal muscular dystrophy, congenital muscular dystrophy, and limb-girdle muscular dystrophy type 2B had greatly increased proliferative capacity, and maintained their potential to differentiate both <it>in vitro </it>and <it>in vivo </it>after transplantation into regenerating muscle of immunodeficient mice.</p> <p>Conclusions</p> <p>Dystrophic cellular models are required as a supplement to animal models to assess cellular mechanisms, such as signaling defects, or to perform high-throughput screening for therapeutic molecules. These investigations have been conducted for many years on cells derived from animals, and would greatly benefit from having human cell models with prolonged proliferative capacity. Furthermore, the possibility to assess <it>in vivo </it>the regenerative capacity of these cells extends their potential use. The innovative cellular tools derived from several different neuromuscular diseases as described in this report will allow investigation of the pathophysiology of these disorders and assessment of new therapeutic strategies.</p

Training family physicians and residents in family medicine in shared decision making to improve clinical decisions regarding the use of antibiotics for acute respiratory infections: protocol for a clustered randomized controlled trial

<p>Abstract</p> <p>Background</p> <p>To explore ways to reduce the overuse of antibiotics for acute respiratory infections (ARIs), we conducted a pilot clustered randomized controlled trial (RCT) to evaluate DECISION+, a training program in shared decision making (SDM) for family physicians (FPs). This pilot project demonstrated the feasibility of conducting a large clustered RCT and showed that DECISION+ reduced the proportion of patients who decided to use antibiotics immediately after consulting their physician. Consequently, the objective of this study is to evaluate, in patients consulting for ARIs, if exposure of physicians to a modified version of DECISION+, DECISION+2, would reduce the proportion of patients who decide to use antibiotics immediately after consulting their physician.</p> <p>Methods/design</p> <p>The study is a multi-center, two-arm, parallel clustered RCT. The 12 family practice teaching units (FPTUs) in the network of the Department of Family Medicine and Emergency Medicine of Université Laval will be randomized to a DECISION+2 intervention group (experimental group) or to a no-intervention control group. These FPTUs will recruit patients consulting family physicians and residents in family medicine enrolled in the study. There will be two data collection periods: pre-intervention (baseline) including 175 patients with ARIs in each study arm, and post-intervention including 175 patients with ARIs in each study arm (total n = 700). The primary outcome will be the proportion of patients reporting a decision to use antibiotics immediately after consulting their physician. Secondary outcome measures include: 1) physicians and patients' decisional conflict; 2) the agreement between the parties' decisional conflict scores; and 3) perception of patients and physicians that SDM occurred. Also in patients, at 2 weeks follow-up, adherence to the decision, consultation for the same reason, decisional regret, and quality of life will be assessed. Finally, in both patients and physicians, intention to engage in SDM in future clinical encounters will be assessed. Intention-to-treat analyses will be applied and account for the nested design of the trial will be taken into consideration.</p> <p>Discussion</p> <p>DECISION+2 has the potential to reduce antibiotics use for ARIs by priming physicians and patients to share decisional process and empowering patients to make informed, value-based decisions.</p> <p>Trial Registration</p> <p>ClinicalTrials.gov: <a href="NCT01116076">NCT01116076</a></p

Correlations between Income inequality and antimicrobial resistance.

Objectives: The aim of this study is to investigate if correlations exist between income inequality and antimicrobial resistance. This study's hypothesis is that income inequality at the national level is positively correlated with antimicrobial resistance within developed countries. Data collection and analysis: income inequality data were obtained from the Standardized World Income Inequality Database. Antimicrobial resistance data were obtained from the European antimicrobial Resistance Surveillance Network and outpatient antimicrobial consumption data, measured by Defined daily Doses per 1000 inhabitants per day, from the European Surveillance of antimicrobial Consumption group. Spearman's correlation coefficient (r) defined strengths of correlations of: > 0.8 as strong, > 0.5 as moderate and > 0.2 as weak. Confidence intervals and p values were defined for all r values. Correlations were calculated for the time period 2003-10, for 15 European countries. Results: income inequality and antimicrobial resistance correlations which were moderate or strong, with 95% confidence intervals > 0, included the following. Enterococcus faecalis resistance to aminopenicillins, vancomycin and high level gentamicin was moderately associated with income inequality (r= ≥0.54 for all three antimicrobials). Escherichia coli resistance to aminoglycosides, aminopenicillins, third generation cephalosporins and fluoroquinolones was moderately-strongly associated with income inequality (r= ≥0.7 for all four antimicrobials). Klebsiella pneumoniae resistance to third generation cephalosporins, aminoglycosides and fluoroquinolones was moderately associated with income inequality (r= ≥0.5 for all three antimicrobials). Staphylococcus aureus methicillin resistance and income inequality were strongly associated (r=0.87). Conclusion: as income inequality increases in European countries so do the rates of antimicrobial resistance for bacteria including E. faecalis, E. coli, K. pneumoniae and S. aureus. Further studies are needed to confirm these findings outside Europe and investigate the processes that could causally link income inequality and antimicrobial resistance

Feasibility of a randomised trial of a continuing medical education program in shared decision-making on the use of antibiotics for acute respiratory infections in primary care: the DECISION+ pilot trial

Abstract Background The misuse and limited effectiveness of antibiotics for acute respiratory infections (ARIs) are well documented, and current approaches targeting physicians or patients to improve appropriate use have had limited effect. Shared decision-making could be a promising strategy to improve appropriate antibiotic use for ARIs, but very little is known about its implementation processes and outcomes in clinical settings. In this matter, pilot studies have played a key role in health science research over the past years in providing information for the planning, justification, and/or refinement of larger studies. The objective of our study was to assess the feasibility and acceptability of the study design, procedures, and intervention of the DECISION+ program, a continuing medical education program in shared decision-making among family physicians and their patients on the optimal use of antibiotics for treating ARIs in primary care. Methods A pilot clustered randomised trial was conducted. Family medicine groups (FMGs) were randomly assigned, to either the DECISION+ program, which included three 3-hour workshops over a four- to six-month period, or a control group that had a delayed exposure to the program. Results Among 21 FMGs contacted, 5 (24%) agreed to participate in the pilot study. A total of 39 family physicians (18 in the two experimental and 21 in the three control FMGs) and their 544 patients consulting for an ARI were recruited. The proportion of recruited family physicians who participated in all three workshops was 46% (50% for the experimental group and 43% for the control group), and the overall mean level of satisfaction regarding the workshops was 94%. Conclusions This trial, while aiming to demonstrate the feasibility and acceptability of conducting a larger study, has identified important opportunities for improving the design of a definitive trial. This pilot trial is informative for researchers and clinicians interested in designing and/or conducting studies with FMGs regarding training of physicians in shared decision-making. Trial Registration Clinicaltrials.Gov NCT0035431

Effects of soil warming and nitrogen foliar applications on bud burst of black spruce

Key message: In mature black spruce, bud burst process is anticipated by soil warming, while delayed by foliar applications of nitrogen; however, the effects depend on growth conditions at the site. Abstract: The observation of phenological events can be used as biological indicator of environmental changes, especially from the perspective of climate change. In boreal forests, the onset of the bud burst is a key factor in the length of the growing season. With current climate change, the major factors limiting the growth of boreal trees (i.e., temperature and nitrogen availability) are changing and studies on mature trees are limited. The aim of this study was to investigate the effects of soil warming and increased nitrogen (N) deposition on bud burst of mature black spruce [Picea mariana (Mill.) BSP]. From 2008 onwards, an experimental manipulation of these environmental growth conditions was conducted in two stands (BER and SIM) at different altitudes in the boreal forest of Quebec, Canada. An increase in soil temperature (H treatment) and a canopy application of artificial rain enriched with nitrogen (N treatment) were performed. Observations of bud phenology were made during May–July 2012 and 2013. In BER, H treatment caused an anticipation (estimated as 1–3 days); while N treatment, a delay (estimated as 1–2 days but only in 2012) in bud burst. No treatments effect was significant in SIM. It has been demonstrated that soil temperature and N availability can play an important role in affecting bud burst in black spruce but the effects of these environmental factors on growth are closely linked with site conditions