Partial bisulfite conversion for unique template sequencing

We introduce a new protocol, mutational sequencing or muSeq, which uses sodium bisulfite to randomly deaminate unmethylated cytosines at a fixed and tunable rate. The muSeq protocol marks each initial template molecule with a unique mutation signature that is present in every copy of the template, and in every fragmented copy of a copy. In the sequenced read data, this signature is observed as a unique pattern of C-to-T or G-to-A nucleotide conversions. Clustering reads with the same conversion pattern enables accurate count and long-range assembly of initial template molecules from short-read sequence data. We explore count and low-error sequencing by profiling 135 000 restriction fragments in a PstI representation, demonstrating that muSeq improves copy number inference and significantly reduces sporadic sequencer error. We explore long-range assembly in the context of cDNA, generating contiguous transcript clusters greater than 3,000 bp in length. The muSeq assemblies reveal transcriptional diversity not observable from short-read data alone

Designing a fashion driving forces website as an educational resource

Electronic educational resources support search activities and manipulate information effectively in learning environments, thus enhancing education. This paper discusses the development of an electronic timeline database that classifies design and fashion details; technological developments; socio-economical influences; availability and popularity within fashion trends; marketing and distribution; and influential people including designers, in a manner that facilitates ease of cross referencing events at the same point in time for a rich analysis of fashion. The study focuses on the driving forces of fashion during the 1920s as a starting point for a much larger database. The data is presented in the form of a website allowing students to better understand fashion trends with macro-environmental and marketing strategies. The electronic resource is a useful tool for fashion, textile and marketing students as an educational interface providing design, production and marketing data for fashion-related products particularly useful for the analysis of fashion trends

Cancer immunotherapy by immunosuppression

We have previously suggested that the stimulatory effect of a weak immune reaction on tumor growth may be necessary for the growth of incipient tumors. In the present paper, we enlarge upon and extend that idea by collecting evidence in the literature bearing upon this new hypothesis that a growing cancer, whether in man or mouse, is throughout its lifespan, probably growing and progressing because of continued immune stimulation by a weak immune reaction. We also suggest that prolonged immunosuppression might interfere with progression and thus be an aid to therapy. While most of the considerable evidence that supports the hypothesis comes from observations of experimental mouse tumors, there is suggestive evidence that human tumors may behave in much the same way, and as far as we can ascertain, there is no present evidence that necessarily refutes the hypothesis

Graduates of Lebanese medical schools in the United States: an observational study of international migration of physicians

BACKGROUND: As healthcare systems around the world are facing increasing physician shortages, more physicians are migrating from low to high income countries. As an illustrative case of international migration of physicians, we evaluated the current number and historical trends of Lebanese medical graduates (LMG) in the US, and compared their characteristics to those of US medical graduates (USMG) and other international medical graduates (IMG). METHODS: We evaluated the number of LMG using the 2004 the American Medical Association Physicians' Professional Data (AMA-PPD) and then compared it to the number of graduates of other countries. We evaluated the historical trends using the 1978–2004 historical files of the AMA-PPD. We analyzed the characteristics of all LMG and compared them to a random sample of 1000 USMG and a random sample of 1000 IMG using the 2004 AMA-PPD. RESULTS: In 2004, there were 2,796 LMG in the US, constituting 1.3% of all IMG. Compared to other foreign countries contributing to the US physician workforce, Lebanon ranked 2nd after adjusting for country population size (about 4 million) and 21st overall. About 40% of those who graduated from Lebanese medical schools in the last 25 years are currently active physicians in the US. Since 1978, the number of LMG in the US showed a consistent upward trend at a rate of approximately 71 additional graduates per year. Compared with USMG and IMG, LMG were more likely to work in medical research (OR = 2.31; 95% Confidence Interval (CI) = 1.21; 4.43 and OR = 2.63; 95% CI = 1.34; 5.01, respectively) and to be board certified (OR = 1.43; 95% CI = 1.14; 1.78 and OR = 2.04; 95% CI = 1.65;2.53, respectively) and less likely to be in family practice (OR = 0.14; 95% CI = 0.10; 0.19 and OR = 0.18; 95% CI = 0.12; 0.26, respectively). CONCLUSION: Given the magnitude and historical trends of migration of LMG to the US, further exploration of its causes and impact is warranted. High income countries should consider the consequences of their human resources policies on both low income countries' and their own healthcare systems

Smoking, drinking and body weight after re-employment: does unemployment experience and compensation make a difference?

<p>Abstract</p> <p>Background</p> <p>The impact of unemployment on behaviours such as smoking, drinking and body weight has been extensively researched. However, little is known about the possible protective effects of social assistance programs on these behavioural changes. This study examines the impact of unemployment periods on smoking, drinking and body weight changes among re-employed individuals and investigates whether the receipt of unemployment benefits influences these behaviours.</p> <p>Methods</p> <p>This study used panel data provided by the Panel Study of Income Dynamics. Logistic regression models were used to analyze whether a period of unemployment in 2000 resulted in an increase in smoking and drinking or fluctuations in body weight among 2001 re-employed individuals in comparison with 1999 baseline levels. A total of 3,451 respondents who had been initially healthy and who had been continuously employed between 1998 and 1999 were included in the analysis.</p> <p>Results</p> <p>Compared to stably employed respondents, those who had experienced periods of unemployment in 2000 and did not receive unemployment benefits were more likely than continuously employed individuals to report an increase in alcohol consumption (OR 1.8, 95% CI 1.0–3.1) and a decrease in body weight (OR 1.7, 95% CI 1.1–2.8) when they were already re-employed in 2001.</p> <p>Conclusion</p> <p>Our findings suggest that the receipt of unemployment benefits confers a protective effect on health behavioural changes following periods of unemployment. These findings underscore the need to monitor the impact of unemployment assistance programs on health, particularly in light of the rapidly changing structure of employment and unemployment benefits.</p

Influence of personality and fatalistic belief on taxi driver behaviour

The religious perception among individuals in sub-Saharan Africa that the ‘Big Five’ personality dimensions and fatalism are predictors of drivers’ behaviours and road accidents has received little scientific investigations. This paucity of research in the roles of psychological factors such as personality and fatalistic beliefs in shaping positive driver behaviour and attitudes has thus provided motivation for the conduct of this quantitative study. We collected data from 203 conveniently sampled taxi drivers in Gauteng province of South Africa by means of a structured questionnaire. Our analysis, using Structural Equation Modelling, found significant positive relationships between agreeableness and positive driver behaviour, conscientiousness and positive driver behaviour, fatalism and extraversion, as well as fatalism and positive driver behaviour. The results highlighted the dimensions of being methodical, organised, and risk aversive on the road, on the one hand, and being social, cooperative, and good-natured, on the other hand. Findings of the study further indicated that fatalistic beliefs are prevalent and indeed characteristic of individuals who are sociable, gregarious, and assertive. These individuals tend to uphold their religious and spiritual beliefs in the linkages between road accidents and destiny. Insights provided by this study could assist the Department of Transport and related Road Safety Authorities in designing road safety campaigns that addresses the erroneous beliefs by drivers that road accidents are pre-destined, and not as a result of individual’s driving behaviour.DHE

Challenges in physician supply planning: the case of Belgium

<p>Abstract</p> <p>Introduction</p> <p>Planning human resources for health (HRH) is a complex process for policy-makers and, as a result, many countries worldwide swing from surplus to shortage. In-depth case studies can help appraising the challenges encountered and the solutions implemented. This paper has two objectives: to identify the key challenges in HRH planning in Belgium and to formulate recommendations for an effective HRH planning, on the basis of the Belgian case study and lessons drawn from an international benchmarking.</p> <p>Case description</p> <p>In Belgium, a numerus clausus set up in 1997 and effective in 2004, aims to limit the total number of physicians working in the curative sector. The assumption of a positive relationship between physician densities and health care utilization was a major argument in favor of medical supply restrictions. This new regulation did not improve recurrent challenges such as specialty imbalances, with uncovered needs particularly among general practitioners, and geographical maldistribution. New difficulties also emerged. In particular, limiting national training of HRH turned out to be ineffective within the open European workforce market. The lack of integration of policies affecting HRH was noteworthy. We described in the paper what strategies were developed to address those challenges in Belgium and in neighboring countries.</p> <p>Discussion and evaluation</p> <p>Planning the medical workforce involves determining the numbers, mix, and distribution of health providers that will be required at some identified future point in time. To succeed in their task, health policy planners have to take a broader perspective on the healthcare system. Focusing on numbers is too restrictive and adopting innovative policies learned from benchmarking without integration and coordination is unfruitful. Evolving towards a strategic planning is essential to control the effects of the complex factors impacting on human resources. This evolution requires an effective monitoring of all key factors affecting supply and demand, a dynamic approach, and a system-level perspective, considering all healthcare professionals, and integrating manpower planning with workforce development.</p> <p>Conclusion</p> <p>To engage in an evidence-based action, policy-makers need a global manpower picture, from their own country and abroad, as well as reliable and comparable manpower databases allowing proper analysis and planning of the workforce.</p

Managing health professional migration from sub-Saharan Africa to Canada: a stakeholder inquiry into policy options

BACKGROUND: Canada is a major recipient of foreign-trained health professionals, notably physicians from South Africa and other sub-Saharan African countries. Nurse migration from these countries, while comparatively small, is rising. African countries, meanwhile, have a critical shortage of professionals and a disproportionate burden of disease. What policy options could Canada pursue that balanced the right to health of Africans losing their health workers with the right of these workers to seek migration to countries such as Canada? METHODS: We interviewed a small sample of émigré South African physicians (n = 7) and a larger purposive sample of representatives of Canadian federal, provincial, regional and health professional departments/organizations (n = 25); conducted a policy colloquium with stakeholder organizations (n = 21); and undertook new analyses of secondary data to determine recent trends in health human resource flows between sub-Saharan Africa and Canada. RESULTS: Flows from sub-Saharan Africa to Canada have increased since the early 1990s, although they may now have peaked for physicians from South Africa. Reasons given for this flow are consistent with other studies of push/pull factors. Of 8 different policy options presented to study participants, only one received unanimous strong support (increasing domestic self-sufficiency), one other received strong support (increased health system strengthening in source country), two others mixed support (voluntary codes on ethical recruitment, bilateral or multilateral agreements to manage flows) and four others little support or complete rejection (increased training of auxiliary health workers in Africa ineligible for licensing in Canada, bonding, reparation payments for training-cost losses and restrictions on immigration of health professionals from critically underserved countries). CONCLUSION: Reducing pull factors by improving domestic supply and reducing push factors by strengthening source country health systems have the greatest policy traction in Canada. The latter, however, is not perceived as presently high on Canadian stakeholder organizations' policy agendas, although support for it could grow if it is promoted. Canada is not seen as "actively' recruiting" ("poaching") health workers from developing countries. Recent changes in immigration policy, ongoing advertising in southern African journals and promotion of migration by private agencies, however, blurs the distinction between active and passive recruitment