29 research outputs found

    Exploiting Seams and Closing Gaps: Lessons from Mumbai and Beyond

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    This article analyzes a single event—the 2008 Mumbai attacks—in order to consider the strategic and operational lessons for dealing with other armed groups. How and why was Lashkar-e-Tayyiba (LeT) able to carry out such a sophisticated attack in the heart of Mumbai? And what lessons does Mumbai hold for strategists seeking to counter other armed groups around the world? While tactical level lessons from Mumbai have been well documented, it is important to also consider what the Mumbai attacks tell us at the strategic and operational levels. Specifically, the Mumbai attacks provide valuable insight into how armed groups use the maritime environment, and how they use surprise, denial, and deception to mask intention and invite over-reaction by states. In addition, studying the Mumbai attacks provides insight into some of the strategic and operational seams and gaps that armed groups seek to exploit. These include environmental and geographical factors; institutional, bureaucratic, and jurisdictional seams and gaps between agencies; cognitive seams and gaps that made the use of the sea by LeT so difficult to conceptualize; and the diplomatic seams and gaps that led to heightened tensions among states— in this case, India, Pakistan, and the United States. This article discusses how to categorize these seams and gaps in order to better address the problems they create, and how states might best direct and focus their limited resources when faced with similar challenges

    PSYCHOSOCIAL FACTORS AND MOBILE HEALTH INTERVENTION: IMPACT ON LONG-TERM OUTCOMES AFTER LUNG TRANSPLANTATION

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    Identifying and intervening on modifiable risk factors may improve outcomes in lung transplantation (LTx), which, despite recent improvements, remain suboptimal. Evidence suggests that two modifiable risk factors, psychiatric disorders and nonadherence, may improve LTx outcomes in the short-term; however, neither has been explored in the long-term. Therefore, the overarching goal of this dissertation was to determine the long-term impact of these modifiable risk factors and intervention to attenuate them. First, we examined the relationship of pre- and early post-transplant psychiatric disorders on LTx-related morbidity and mortality for up to 15 years post-LTx. Our sample included 155 1-year LTx survivors enrolled in a prospective study of mental health post- LTx. We found that depression during the first year post-LTx increased risk of BOS, mortality and graft loss by nearly twofold, and that pre-transplant depression and pre- and post-transplant anxiety were not associated with clinical outcomes. Next, we examined the impact of a mobile health intervention designed to promote adherence to the post-LTx regimen, PocketPATH, on long-term LTx-related morbidity, mortality and nonadherence. We conducted two follow-up studies to the original yearlong randomized controlled trial in which participants assigned to PocketPATH showed improved adherence to the regimen, relative to usual care. Among the 182 LTx recipients (LTxRs) who survived the original trial, we found that PocketPATH had a protective indirect effect on mortality by promoting LTxRs’ communication with the LTx team during the first year. Among the 104 LTxRs who completed the follow-up assessment, we found that PocketPATH’s adherence benefits over the first year were not sustained into the long-term, although LTxRs assigned to PocketPATH were more likely than LTxRs assigned to usual care to perform the home self-care tasks of the regimen at follow-up. Median time since LTx for participants in both follow-up studies was 4.2 years (range, 2.8-5.7 years). This dissertation presents an important first step toward identifying and intervening on modifiable risk factors to improve long-term LTx outcomes. Mobile health technologies offer limitless potential to target these risk factors and others. More work is needed to determine specific features and long-term patient engagement strategies that will optimize and sustain intervention effectiveness

    Smoking in film in New Zealand: measuring risk exposure

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    BACKGROUND: Smoking in film is a risk factor for smoking uptake in adolescence. This study aimed to quantify exposure to smoking in film received by New Zealand audiences, and evaluate potential interventions to reduce the quantity and impact of this exposure. METHODS: The ten highest-grossing films in New Zealand for 2003 were each analysed independently by two viewers for smoking, smoking references and related imagery. Potential interventions were explored by reviewing relevant New Zealand legislation, and scientific literature. RESULTS: Seven of the ten films contained at least one tobacco reference, similar to larger film samples. The majority of the 38 tobacco references involved characters smoking, most of whom were male. Smoking was associated with positive character traits, notably rebellion (which may appeal to adolescents). There appeared to be a low threshold for including smoking in film. Legislative or censorship approaches to smoking in film are currently unlikely to succeed. Anti-smoking advertising before films has promise, but experimental research is required to demonstrate cost effectiveness. CONCLUSION: Smoking in film warrants concern from public health advocates. In New Zealand, pre-film anti-smoking advertising appears to be the most promising immediate policy response

    Communicative competence as a basis for the creative interaction of the professional (vocational-technical) education institution's subjects: the special course for the audience members of the advanced training classes of professional education administra

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    Матеріали спецкурсу присвячено проблемі комунікативної компетентності керівників, новопризначених керівників та педагогічних працівників обласних навчально-(науково)-методичних центрів (кабінетів), закладів професійної (професійно-технічної) освіти для удосконалення власного досвіду та педагогічної майстерності. Зміст спецкурсу спрямовано на розвиток комунікативної взаємодії суб’єктів освітнього процесу, професійно-особистісного розвитку педагогічних кадрів. Спецкурс підготовлений для слухачів курсів підвищення кваліфікації керівних та педагогічних кадрів професійної (професійно-технічної) освіти у Центральному інституті післядипломної освіти ДВНЗ «Університет менеджменту освіти».The materials of special course are devoted to the problem of communicative competence of managers, newly appointed managers and pedagogical workers of regional educational (scientific) -methodic centers (offices), institutions of professional (vocational-technical) education for improving their own experience and pedagogical skills. The content of the special course aims to develop the communicative interaction between the subjects of the educational process, professional and personal development of teaching staff. The special course has been developed for management and pedagogical staff of vocational (vocational-technical) education refresher training at the Central Institute of Postgraduate Education "University of Education Management"

    Patient and stakeholder engagement learnings: PREP-IT as a case study

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    Correction to: Cluster identification, selection, and description in Cluster randomized crossover trials: the PREP-IT trials

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    An amendment to this paper has been published and can be accessed via the original article

    Xanthine Oxidase Activity in Vitro:  Effects of Food Extracts and Components

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    There is significant interest in the direct antioxidant activities of dietary polyphenols, due to associations between consumption of polyphenol-rich foods, such as fruits and vegetables, and decreased incidence of oxidative-stress related disease. However, indirect antioxidant action, such as the inhibition of ROS-producing enzymes, may be equally relevant to health benefits through a general reduction in oxidative stress in vivo. To this end, the effects of food extracts and individual compounds on the in vitro activity of xanthine oxidase (XO) were assessed, many for the first time. Several compounds were shown to be potent inhibitors in vitro, including hesperetin and theaflavin-3,3‘-digallate with IC50 values of 39 and 49 μM, respectively. Of the extracts, cranberry juice, purple grape juice, and black tea were the most potent, with IC50 values of 2.4, 3.5, and 5.8% of extracts, respectively. Some samples were shown to promote XO activity over the concentration ranges tested, including orange juice and pink grapefruit juice. Certain “inhibitors”, such as purple grape juice and black tea, promoted XO activity at low concentration. The possible role of dietary inhibitors of XO in reducing oxidative stress in vivo is discussed
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