Professional bodies and continuing professional education

This chapter focuses on the role of professional bodies in relation to continuing professional development (CPD) in two different professional spheres - further education and legal services. Similarities and differences between these two areas, and in particular the approaches to continuing professional development, are highlighted. The chapter concludes by identifying commonalities and differences in the trajectories, circumstances and regimes of the professions. We consider whether there are key features of CPD that should be common to all professions or whether models of CPD are contingent and dependent on circumstances. We propose a model that covers emerging factors in the conception of CPD. We argue that these findings have applicability to professions and their professional bodies more widely, as well as employers of professionals

Enhancing the mechanical properties and formability of low carbon steel with dual-phase microstructures

In the present study, a special heat treatment cycle (step quenching) was used to produce a dual-phase (DP) microstructure in low carbon steel. By producing this DP microstructure, the mechanical properties of the investigated steel such as yield stress, tensile strength, and Vickers hardness were increased 14, 55, and 38%, respectively. In order to investigate the effect of heat treatment on formability of the steel, Nakazima forming test was applied and subsequently finite element base modeling was used to predict the outcome on forming limit diagrams. The results show that the DP microstructure also has a positive effect on formability. The results of finite element simulations are in a good agreement with those obtained by the experimental test

Nutritive value of wheat straw treated with Pleurotus fungi

Soaked and pasteurised wheat straw was inoculated with five species of Pleurotus fungi (coded P-21, P-30, P-41, P-60 and P-90), packed in polyethylene bags and incubated in a fermentation chamber for 21 days. The chemical composition, in vitro digestibility and in sacco degradability of the treated and untreated straw were estimated using a complete randomised design consisting of six treatments and four replicates. In a feeding trial, in vivo digestibility and voluntary intake were determined in bulls, using a 3x3 change over design. Dietary treatments were: 1) untreated wheat straw (UWS) as control; 2) fungal treated (P-41) wheat straw before mushroom formation (FTWS); 3) spent wheat straw (SPWS) after mushrooms were harvested. Apart from P-90, fungal treatment significantly (p<0.05) increased the crude protein (CP) and reduced the cell wall components of the straw. The in vitro dry mater and organic mater digestibility significantly (p<0.05) increased in the treated straw particularly with the treatments of P-41 and P-60. The in situ degradability and in vivo digestibility of DM and OM were significantly (p<0.05) increased in treated straws with the highest values observed for treatment P-41. The intake of DM, OM and digestible organic mater (DOM) were significantly (p<0.05) increased in cows fed FTWS

Main determinants of catastrophic health expenditures: a Bayesian logit approach on Iranian household survey data (2010)

BACKGROUND: During recent decades, increase in both health care expenditures and improvement of the awareness as well as health expectations have created some problems with regard to finance healthcare expenditures so that the issue of health financing by households has been determined as a major challenge in health sector. According to the definition by the World Health Organization, catastrophic health expenditure is considered if financial contribution for health service is more than 40 of income remaining after subsistence needs have been met. OBJECTIVES: The purpose of our study was determination of Main factors on catastrophic health expenditures in Iranian households. PATIENTS & METHODS: In this study, using an econometrics Bayesian logit model, determinants of the appearance of catastrophic health expenditure based on household budget data collected in 2010 were evaluated. RESULTS: Among Iranian households, the following groups were more likely to encounter with unsustainable health expenditures: rural households, households with the numbers of the elderly more than 65 years, illiterate householders, unemployed householders, households with some unemployed persons, households in upper rank and households with larger equivalent household size were higher than the average of community could significantly predict catastrophic health expenditures. CONCLUSIONS: About 2.1 of households were faced with catastrophic health expenditures in 2010. Thus, the implemented policies could not make considerable and significant change in improving justice in financing in health systems

Fairness of Financial Contribution in Iranian Health System: Trend Analysis of National Household Income and Expenditure, 2003-2010

BACKGROUND: Social systems are dealing with the challenge of achieving fairness in the distribution of financial burden and protecting the risk of financial loss. The purpose of this paper is to present a trend analysis for the indicators related to fairness in healthcare's financial burden in rural and urban population of Iran during the eight years period of 2003 to 2010. METHODS: We used the information gathered by statistical center of Iran through sampling processes for the household income and expenditures. The indicators of fairness in financial contribution of healthcare were calculated based on the WHO recommended methodology. The indices trend analysis of eight-year period for the rural, urban areas and the country level were computed. RESULTS: This study shows that in Iran the fairness of financial contribution index during the eight-year period has been decreased from 0.841 in 2003 to above 0.827 in 2010 and The percentage of people with catastrophic health expenditures has been increased from 2.3 to above 3.1. The ratio of total treatment costs to the household overall capacity to pay has been increased from 0.055 to 0.068 and from 0.072 to 0.0818 in urban and rural areas respectively. CONCLUSION: There is a decline in fairness of financial contribution index during the study period. While, a trend stability of the proportion of households who suffered catastrophic health expenditures was found

Selection at a single locus leads to widespread expansion of toxoplasma gondii lineages that are virulent in mice

The determinants of virulence are rarely defined for eukaryotic parasites such as T. gondii, a widespread parasite of mammals that also infects humans, sometimes with serious consequences. Recent laboratory studies have established that variation in a single secreted protein, a serine/threonine kinase known as ROPO18, controls whether or not mice survive infection. Here, we establish the extent and nature of variation in ROP18among a collection of parasite strains from geographically diverse regions. Compared to other genes, ROP18 showed extremely high levels of diversification and changes in expression level, which correlated with severity of infection in mice. Comparison with an out-group demonstrated that changes in the upstream region that regulates expression of ROP18 led to an historical increase in the expression and exposed the protein to diversifying selective pressure. Surprisingly, only three atypically distinct protein variants exist despite marked genetic divergence elsewhere in the genome. These three forms of ROP18 are likely adaptations for different niches in nature, and they confer markedly different virulence to mice. The widespread distribution of a single mouse-virulent allele among geographically and genetically disparate parasites may have consequences for transmission and disease in other hosts, including humans

Identification of host proteins interacting with Toxoplasma gondii GRA15 (TgGRA15) by yeast two-hybrid system

Background Toxoplasma gondii, an obligate intracellular protozoan parasite, possesses the remarkable ability to co-opt host cell machinery in order to maintain its intracellular survival. This parasite can modulate signaling pathways of its host through the secretion of polymorphic effector proteins localized in the rhoptry and dense granule organelles. One of such effectors is T. gondii type II-specific dense granule protein 15, TgGRA15, which activates NF-κB pathway. The aim of the present study was to identify the host interaction partner proteins of TgGRA15. Methods We screened a yeast two-hybrid mouse cDNA library using TgGRA15 as the bait. TgGRA15 (PRU strain, Type II) was cloned into the pGBKT7 vector and expressed in the Y2HGold yeast strain. Then, the bait protein expression was validated by western blotting analysis, followed by auto-activation and toxicity tests in comparison with control (Y2HGold yeast strain transformed with empty pGBKT7 vector). Results This screening led to the identification of mouse Luzp1 and AW209491 as host binding proteins that interact with TgGRA15. Luzp1 contains three nuclear localizing signals and is involved in regulating a subset of host non-coding RNA genes. Conclusions These findings reveal, for the first time, new host cell proteins interacting with TgGRA15. The identification of these cellular targets and the understanding of their contribution to the host-pathogen interaction may serve as the foundation for novel therapeutic and prevention strategies against T. gondii infection

Rheological properties of bitumen modified with a combination of FT paraffin wax (sasobit®) and other additives

Fischer–Tropsch paraffin Sasobit® is a popular Warm Mix Asphalt (WMA) modifier applied to improve physi­cal and rheological properties of bitumen. Although there are a number of studies investigating the effects of sasobit on bitumen properties, little has been carried out on evaluation of bitumen modified by sasobit along with other additives. In this study, sasobit modified bitumen is used as the base condition and four common modifiers namely anti-stripping agent, Crumb Rubber (CR), Styrene–Butadiene–Styrene (SBS) and Polyphosphoric Acid (PPA) are added separately to the FT – Wax modified bitumen to evaluate the compatibility of these additives with sasobit. Morphological, rheological and physical properties of modified binders are studied using Fourier Transform Infrared Spectroscopy (FT-IR), Scan­ning Electron Microscopy (SEM), Dynamic Mechanical Analysis (DMA), Bending Beam Rheometer (BBR) alongside with conventional tests. Results show that although anti-stripping agent reduce bitumen viscosity and mixing/compac­tion temperatures of asphalt mixtures, it has significantly increased the stiffness of sasobit modified bitumen at low temperatures. Among all, sasobit and crumb rubber combination exhibited the best performance, especially at low and intermediate temperatures

Effect of fungal treated wheat straw on the diet of lactating cows

This study was conducted to investigate the effects of diets that contained different levels of fungal treated wheat straw on the intake, digestibility and performance of lactating cows. Eight primiparous Holstein cows, in late lactation ranging from 170±10 days in milk and yielding 14.3±1.3 kg/d of fat corrected milk (FCM) were allocated into four diets with 0, 10, 20 and 30% fungal (Pleurotus ostreatus coded P-41) treated wheat straw in a 4×4 Latin Square experiment. The daily intake of DM, OM, DOM, CP and TDN were not affected by substitution of alfalfa hay with fungal treated wheat straw. Inclusion of the treated straw at different levels in the diet did not affect the digestibility of nutrients, except for the ADF that was significantly (p0.05) different among the diets. All cows gained weight, but the inclusion of treated straw to the diet significantly (p<0.05) increased the body weight gain and the highest amount was obtained in the diet containing 20% treated. Inclusion of fungal treated wheat straw up to 30% of the diet of lactating cows supplemented with a protein source such as cottonseed meal had not affected the nutrients intake and lactation performance

Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks for 195 countries and territories, 1990–2017 : a systematic analysis for the Global Burden of Disease Study 2017

Background: The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 comparative risk assessment (CRA) is a comprehensive approach to risk factor quantification that offers a useful tool for synthesising evidence on risks and risk outcome associations. With each annual GBD study, we update the GBD CRA to incorporate improved methods, new risks and risk outcome pairs, and new data on risk exposure levels and risk outcome associations. Methods: We used the CRA framework developed for previous iterations of GBD to estimate levels and trends in exposure, attributable deaths, and attributable disability-adjusted life-years (DALYs), by age group, sex, year, and location for 84 behavioural, environmental and occupational, and metabolic risks or groups of risks from 1990 to 2017. This study included 476 risk outcome pairs that met the GBD study criteria for convincing or probable evidence of causation. We extracted relative risk and exposure estimates from 46 749 randomised controlled trials, cohort studies, household surveys, census data, satellite data, and other sources. We used statistical models to pool data, adjust for bias, and incorporate covariates. Using the counterfactual scenario of theoretical minimum risk exposure level (TMREL), we estimated the portion of deaths and DALYs that could be attributed to a given risk. We explored the relationship between development and risk exposure by modelling the relationship between the Socio-demographic Index (SDI) and risk-weighted exposure prevalence and estimated expected levels of exposure and risk-attributable burden by SDI. Finally, we explored temporal changes in risk-attributable DALYs by decomposing those changes into six main component drivers of change as follows: (1) population growth; (2) changes in population age structures; (3) changes in exposure to environmental and occupational risks; (4) changes in exposure to behavioural risks; (5) changes in exposure to metabolic risks; and (6) changes due to all other factors, approximated as the risk-deleted death and DALY rates, where the risk-deleted rate is the rate that would be observed had we reduced the exposure levels to the TMREL for all risk factors included in GBD 2017. Findings: In 2017,34.1 million (95% uncertainty interval [UI] 33.3-35.0) deaths and 121 billion (144-1.28) DALYs were attributable to GBD risk factors. Globally, 61.0% (59.6-62.4) of deaths and 48.3% (46.3-50.2) of DALYs were attributed to the GBD 2017 risk factors. When ranked by risk-attributable DALYs, high systolic blood pressure (SBP) was the leading risk factor, accounting for 10.4 million (9.39-11.5) deaths and 218 million (198-237) DALYs, followed by smoking (7.10 million [6.83-7.37] deaths and 182 million [173-193] DALYs), high fasting plasma glucose (6.53 million [5.23-8.23] deaths and 171 million [144-201] DALYs), high body-mass index (BMI; 4.72 million [2.99-6.70] deaths and 148 million [98.6-202] DALYs), and short gestation for birthweight (1.43 million [1.36-1.51] deaths and 139 million [131-147] DALYs). In total, risk-attributable DALYs declined by 4.9% (3.3-6.5) between 2007 and 2017. In the absence of demographic changes (ie, population growth and ageing), changes in risk exposure and risk-deleted DALYs would have led to a 23.5% decline in DALYs during that period. Conversely, in the absence of changes in risk exposure and risk-deleted DALYs, demographic changes would have led to an 18.6% increase in DALYs during that period. The ratios of observed risk exposure levels to exposure levels expected based on SDI (O/E ratios) increased globally for unsafe drinking water and household air pollution between 1990 and 2017. This result suggests that development is occurring more rapidly than are changes in the underlying risk structure in a population. Conversely, nearly universal declines in O/E ratios for smoking and alcohol use indicate that, for a given SDI, exposure to these risks is declining. In 2017, the leading Level 4 risk factor for age-standardised DALY rates was high SBP in four super-regions: central Europe, eastern Europe, and central Asia; north Africa and Middle East; south Asia; and southeast Asia, east Asia, and Oceania. The leading risk factor in the high-income super-region was smoking, in Latin America and Caribbean was high BMI, and in sub-Saharan Africa was unsafe sex. O/E ratios for unsafe sex in sub-Saharan Africa were notably high, and those for alcohol use in north Africa and the Middle East were notably low. Interpretation: By quantifying levels and trends in exposures to risk factors and the resulting disease burden, this assessment offers insight into where past policy and programme efforts might have been successful and highlights current priorities for public health action. Decreases in behavioural, environmental, and occupational risks have largely offset the effects of population growth and ageing, in relation to trends in absolute burden. Conversely, the combination of increasing metabolic risks and population ageing will probably continue to drive the increasing trends in non-communicable diseases at the global level, which presents both a public health challenge and opportunity. We see considerable spatiotemporal heterogeneity in levels of risk exposure and risk-attributable burden. Although levels of development underlie some of this heterogeneity, O/E ratios show risks for which countries are overperforming or underperforming relative to their level of development. As such, these ratios provide a benchmarking tool to help to focus local decision making. Our findings reinforce the importance of both risk exposure monitoring and epidemiological research to assess causal connections between risks and health outcomes, and they highlight the usefulness of the GBD study in synthesising data to draw comprehensive and robust conclusions that help to inform good policy and strategic health planning