Continuing the conversation about public health ethics: education for public health professionals in Europe

An important related question is why we should teach public health ethics. Fundamentally, we must teach public health ethics because ethical practice creates and maintains public trust and public health cannot function without public trust. To serve the public—whether through controlling an outbreak of an infectious disease, preparing for or responding to public health emergencies, or reducing the impact of non-communicable diseases—communities and individuals must trust our decisions and actions. This trust grows in large part from past successes, transparent and participatory decision making, and ethical management of the inevitable moral tensions that arise in our work.S

SUSY parameter determination at the LHC using cross sections and kinematic edges

We study the determination of supersymmetric parameters at the LHC from a global fit including cross sections and edges of kinematic distributions. For illustration, we focus on a minimal supergravity scenario and discuss how well it can be constrained at the LHC operating at 7 and 14 TeV collision energy, respectively. We find that the inclusion of cross sections greatly improves the accuracy of the SUSY parameter determination, and allows to reliably extract model parameters even in the initial phase of LHC data taking with 7 TeV collision energy and 1/fb integrated luminosity. Moreover, cross section information may be essential to study more general scenarios, such as those with non-universal gaugino masses, and distinguish them from minimal, universal, models.Comment: 22 pages, 8 figure

Collider signatures of goldstini in gauge mediation

We investigate the collider signatures of the multiple goldstini scenario in the framework of gauge mediation. This class of models is characterized by a visible sector (e.g. the MSSM or any extension) coupled by gauge interactions to more than one SUSY breaking sector. The spectrum consists of a light gravitino LSP, behaving as a goldstino, and a number of neutral fermions (the pseudo-goldstini) with a mass between that of the LSP and that of the lightest particle of the observable sector (LOSP). We consider the two situations where the LOSP is either a gaugino-like neutralino or a stau and we assume only one pseudo-goldstino of a mass of O(100) GeV. The coupling of the LOSP to the pseudo-goldstino can be enhanced with respect to those of the gravitino giving rise to characteristic signatures. We show that the decay modes of the LOSP into a SM particle and a pseudo-goldstino can be significant. For both LOSP scenarios we analyze (pseudo)-goldstini production at colliders. Compared to standard gauge mediation the final state spectrum is softer and more structured.Comment: v2: analysis of the stau LOSP scenario added, sections rearranged, and Introduction and Conclusions rewritten to include the added scenario. Version to appear in JHE

NLO QCD+EW predictions for HV and HV +jet production including parton-shower effects

We present the first NLO QCD+EW predictions for Higgs boson production in association with a ℓνℓ or ℓ+ℓ− pair plus zero or one jets at the LHC. Fixed-order NLO QCD+EW calculations are combined with a QCD+QED parton shower using the recently developed resonance-aware method in the POWHEG framework. Moreover, applying the improved MiNLO technique to Hℓνℓ +jet and Hℓ+ℓ− +jet production at NLO QCD+EW, we obtain predictions that are NLO accurate for observables with both zero or one resolved jet. This approach permits also to capture higher-order effects associated with the interplay of EW corrections and QCD radiation. The behavior of EW corrections is studied for various kinematic distributions, relevant for experimental analyses of Higgsstrahlung processes at the 13 TeV LHC. Exact NLO EW corrections are complemented with approximate analytic formulae that account for the leading and next-to-leading Sudakov logarithms in the high-energy regime. In the tails of transverse-momentum distributions, relevant for analyses in the boosted Higgs regime, the Sudakov approximation works well, and NLO EW effects can largely exceed the ten percent level. Our predictions are based on the POWHEG BOX RES+OpenLoops framework in combination with the Pythia 8.1 parton shower

Measurement of functional microcirculatory geometry and velocity distributions using automated image analysis

This study describes a new method for analyzing microcirculatory videos. It introduces algorithms for quantitative assessment of vessel length, diameter, the functional microcirculatory density distribution and red blood-cell (RBC) velocity in individual vessels as well as its distribution. The technique was validated and compared to commercial software. The method was applied to the sublingual microcirculation in a healthy volunteer and in a patient during cardiac surgery. Analysis time was reduced from hours to minutes compared to previous methods requiring manual vessel identification. Vessel diameter was detected with high accuracy (>80%, d > 3 pixels). Capillary length was estimated within 5 pixels accuracy. Velocity estimation was very accurate (>95%) in the range [2.5, 1,000] pixels/s. RBC velocity was reduced by 70% during the first 10 s of cardiac luxation. The present method has been shown to be fast and accurate and provides increased insight into the functional properties of the microcirculation

Slepton Discovery in Electroweak Cascade Decay

The LHC studies on the MSSM slepton sector have mostly been focused on direct slepton Drell-Yan pair production. In this paper, we analyze the case when the sleptons are lighter than heavy neutralinos and can appear in the on-shell decay of neutralino states. In particular, we have studied the \chi_1^\pm \chi_2^0 associated production, with the consequent decays of \chi_1^\pm and \chi_2^0 via on-shell sleptons. The invariant mass of the lepton pairs, m_{\ell\ell}, from the neutralino decay has a distinctive triangle shape with a sharp kinematic cutoff. We discuss the utilization of this triangle shape in m_{\ell\ell} distribution to identify the slepton signal. We studied the trilepton plus missing E_T signal and obtained the effective cross section, \sigma \times BR \times acceptance, that is needed for a 5\sigma discovery as a function of the cutoff mass for the LHC with center of mass energy 14 TeV and 100 fb^{-1} integrated luminosity. Our results are model independent such that they could be applied to other models with similar decay topology. When applied to the MSSM under simple assumptions, it is found that with 100 fb^{-1} integrated luminosity, a discovery reach in the left-handed slepton mass of about 600 GeV could be reached, which extends far beyond the slepton mass reach in the usual Drell-Yan studies.Comment: 20 pages, 5 figure

Internal medicine specialists' attitudes towards working part-time: a comparison between 1996 and 2004

BACKGROUND: Although medical specialists traditionally hold negative views towards working part-time, the practice of medicine has evolved. Given the trend towards more part-time work and that there is no evidence that it compromises the quality of care, attitudes towards part-time work may have changed as well in recent years. The aim of this paper was to examine the possible changes in attitudes towards part-time work among specialists in internal medicine between 1996 and 2004. Moreover, we wanted to determine whether these attitudes were associated with individual characteristics (age, gender, investments in work) and whether attitudes of specialists within a partnership showed more resemblance than specialists' attitudes from different partnerships. METHODS: Two samples were used in this study: data of a survey conducted in 1996 and in 2004. After selecting internal medicine specialists working in general hospitals in The Netherlands, the sample consisted of 219 specialists in 1996 and 363 specialists in 2004. They were sent a questionnaire, including topics on the attitudes towards part-time work. RESULTS: Internal medicine specialists' attitudes towards working part-time became slightly more positive between 1996 and 2004. Full-time working specialists in 2004 still expressed concerns regarding the investments of part-timers in overhead tasks, the flexibility of task division, efficiency, communication and continuity of care. In 1996 gender was the only predictor of the attitude, in 2004 being a full- or a part-timer, age and the time invested in work were associated with this attitude. Furthermore, specialists' attitudes were not found to cluster much within partnerships. CONCLUSION: In spite of the increasing number of specialists working or preferring to work part-time, part-time practice among internal medicine specialists seems not to be fully accepted. The results indicate that the attitudes are no longer gender based, but are associated with age and work aspects such as the number of hours worked. Though there is little evidence to support them, negative ideas about the consequences of part-time work for the quality of care still exist. Policy should be aimed at removing the organisational difficulties related to part-time work and create a system in which part-time practice is fully integrated and accepted

Patients with persistent medically unexplained symptoms in general practice: characteristics and quality of care

<p>Abstract</p> <p>Background</p> <p>Medically unexplained physical symptoms (MUPS) are common in general practice (GP), and are even more problematic as they become persistent. The present study examines the relationship between persistent MUPS in general practice on the one hand and quality of life, social conditions, and coping on the other hand. Additionally, it is examined how patients with persistent MUPS evaluate the quality of GP-care.</p> <p>Methods</p> <p>Data were used from a representative survey of morbidity in Dutch general practice, in which data from the electronic medical records were extracted. A random sample of patients participated in an extensive health interview and completed self-reported measures on social isolation, coping and the quality of GP-care. Patients with persistent MUPS (N = 192) were compared with general practice patients not meeting the criteria for persistent MUPS (N = 7.314), and with a group of patients that visited the GP in comparable rates for medical diagnoses (N = 2.265). Multiple logistic regression analyses were used to control for relevant socio-demographic variables and chronic diseases.</p> <p>Results</p> <p>After adjustment for demographics and chronic diseases, patients with persistent MUPS reported more psychological distress, more functional impairment, more social isolation, and they evaluated the quality of GP-care less positive than the other two patient groups. Although the majority of MUPS patients were positive about the quality of GP-care, they more often felt that they were not taken seriously or not involved in treatment decisions, and more often reported that the GP did not take sufficient time. The three groups did not differ with respect to the statement that the GP unnecessarily explains physical problems as psychological ones.</p> <p>Conclusion</p> <p>Strengthening MUPS patients' social network and encouraging social activities may be a meaningful intervention in which the GP may play a stimulating role. To further improve MUPS patients' satisfaction with GP-care, GPs may pay extra attention to taking sufficient time when treating MUPS patients, taking the problems seriously, and involving them in treatment decisions.</p

Microsurgery can cure most intracranial dural arteriovenous fistulae of the sinus and non-sinus type

There is consensus that intracranial dural arteriovenous fistulae (dAVF) with direct (non-sinus-type) or indirect (sinus-type) retrograde filling of a leptomeningeal vein should be treated due to the high risk of neurological deficits and hemorrhage. No consensus exists on treatment modality (surgery and/or embolization) and, if surgery is performed, on the best surgical strategy. This series aims to evaluate the role of surgery in the management of aggressive dAVFs. Forty-two patients underwent surgery. Opening and packing the sinus with thrombogenic material was performed in 9 of the 12 sinus-type dAVFs. In two sinus-type fistulae of the cavernous sinus and 1 of the torcular, microsurgery was used as prerequisite for subsequent embolization by providing access to the sinus. In the 30 non-sinus-type dAVFs, surgery consisted of interruption of the draining vein at the intradural entry point. In 41 patients undergoing 43 operations, elimination of the dAVF was achieved (97.6%). In one case, a minimal venous drainage persisted after surgery. The transient surgical morbidity was 11.9% (n = 5) and the permanent surgical morbidity 7.1% (n = 3). Our surgical strategy was to focus on the arterialized leptomeningeal vein in the non-sinus-type and on the arterialized sinus segment in the sinus-type dAVFs allowing us to obliterate all but one dAVF with a low morbidity rate. We therefore propose that microsurgery should be considered early in the treatment of both types of aggressive dAVFs. In selected cases of cavernous sinus dAVFs, the role of microsurgery is reduced to that of an adjunct to endovascular therapy