789 research outputs found
Data Analytics (Ab)Use in Healthcare Fraud Audits
This study explores how government-adopted audit data analytic tools promote the abuse of power by auditors enabling politically sensitive processes that encourage industry-wide normalization of behavior. In an audit setting, we investigate how a governmental organization enables algorithmic decision-making to alter power relationships to effect organizational and industry-wide change. While prior research has identified discriminatory threats emanating from the deployment of algorithmic decision-making, the effects of algorithmic decision-making on inherently imbalanced power relationships have received scant attention. Our results provide empirical evidence of how systemic and episodic power relationships strengthen each other, thereby enabling the governmental organization to effect social change that might be too politically prohibitive to enact directly. Overall, the results suggest that there are potentially negative effects caused by the use of algorithmic decision-making and the resulting power shifts, and these effects create a different view of the level of purported success attained through auditor use of data analytics
Method for molding structural parts utilizing modified silicone rubber
This invention improves upon a method for molding structural parts from preform material. Preform material to be used for the part is provided. A silicone rubber composition containing entrained air voids is prepared. The silicone rubber and preform material assembly is situated within a rigid mold cavity used to shape the preform material to the desired shape. The entire assembly is heated in a standard heating device so that the thermal expansion on the silicone rubber exerts the pressure necessary to force the preform material into contact with the mold container. The introduction of discrete air voids into the silicone rubber allows for accurately controlled pressure application on the preform material at the cure temperature
Substance abuse and HIV risk behaviours amongst primary health care service users in Cape Town
Objective: To document prevalence of, and association between, substance use and HIV risk behaviours among primary care patients.Method: Cross-sectional survey. Four primary care clinics in Cape Town. We selected clinics using stratified sampling, and systematically selected 131 patients from attendance logs. We assessed substance use with the Alcohol, Smoking and Substance Involvement Screening Test, and HIV risk with items addressing injection drug use, blood-sharing rituals, and sexual risk behaviours. Results: Substances most used at hazardous levels were tobacco (28.2%) and alcohol (14.8%). Among possible HIV risk factors, highest prevalence was participation in blood-sharing rituals (25%), and having had an STI (19.8%). An association between substance use and sexual risk behaviours was only found among those aged 18-24. Conclusion: In younger patients, presence of substance use or HIV risk behaviours increases the probability that the other is present. Keywords: substance abuse, HIV risk behaviours, primary care South African Psychiatry Review Vol. 8(4) 2005: 160-16
ADHD in context: Young adults’ reports of the impact of occupational environment on the manifestation of ADHD
Does changing context play a role in the decline in ADHD symptoms in adulthood? Insufficient research has explored the functioning of adults with ADHD. As adults, individuals with ADHD have significantly more latitude to control aspects of their day-to-day environments. Do the new contexts young adults find themselves in alter their experience of ADHD? Are there particular occupational or educational contexts in which young adults report functioning better than others
A Cognitive Model of an Epistemic Community: Mapping the Dynamics of Shallow Lake Ecosystems
We used fuzzy cognitive mapping (FCM) to develop a generic shallow lake
ecosystem model by augmenting the individual cognitive maps drawn by 8
scientists working in the area of shallow lake ecology. We calculated graph
theoretical indices of the individual cognitive maps and the collective
cognitive map produced by augmentation. The graph theoretical indices revealed
internal cycles showing non-linear dynamics in the shallow lake ecosystem. The
ecological processes were organized democratically without a top-down
hierarchical structure. The steady state condition of the generic model was a
characteristic turbid shallow lake ecosystem since there were no dynamic
environmental changes that could cause shifts between a turbid and a clearwater
state, and the generic model indicated that only a dynamic disturbance regime
could maintain the clearwater state. The model developed herein captured the
empirical behavior of shallow lakes, and contained the basic model of the
Alternative Stable States Theory. In addition, our model expanded the basic
model by quantifying the relative effects of connections and by extending it.
In our expanded model we ran 4 simulations: harvesting submerged plants,
nutrient reduction, fish removal without nutrient reduction, and
biomanipulation. Only biomanipulation, which included fish removal and nutrient
reduction, had the potential to shift the turbid state into clearwater state.
The structure and relationships in the generic model as well as the outcomes of
the management simulations were supported by actual field studies in shallow
lake ecosystems. Thus, fuzzy cognitive mapping methodology enabled us to
understand the complex structure of shallow lake ecosystems as a whole and
obtain a valid generic model based on tacit knowledge of experts in the field.Comment: 24 pages, 5 Figure
Political activism across the life course
The study of political activism has neglected people’s personal and social relationships to time. Age, life course and generation have become increasing important experiences for understanding political participation and political outcomes (e.g. Brexit), and current policies of austerity across the world are affecting people of all ages. At a time when social science is struggling to understand the rapid and unexpected changes to the current political landscape, the essay argues that the study of political activism can be enriched by engaging with the temporal dimensions of people’s everyday social experiences because it enables the discovery of political activism in mundane activities as well as in banal spaces. The authors suggest that a values-based approach that focuses on people’s relationships of concern would be a suitable way to surface contemporary political sites and experiences of activism across the life course and for different generations
Transcriptional regulatory dynamics drive coordinated metabolic and neural response to social challenge in mice
Agonistic encounters are powerful effectors of future behavior, and the ability to learn from this type of social challenge is an essential adaptive trait. We recently identified a conserved transcriptional program defining the response to social challenge across animal species, highly enriched in transcription factor (TF), energy metabolism, and developmental signaling genes. To understand the trajectory of this program and to uncover the most important regulatory influences controlling this response, we integrated gene expression data with the chromatin landscape in the hypothalamus, frontal cortex, and amygdala of socially challenged mice over time. The expression data revealed a complex spatiotemporal patterning of events starting with neural signaling molecules in the frontal cortex and ending in the modulation of developmental factors in the amygdala and hypothalamus, underpinned by a systems-wide shift in expression of energy metabolism-related genes. The transcriptional signals were correlated with significant shifts in chromatin accessibility and a network of challenge-associated TFs. Among these, the conserved metabolic and developmental regulator ESRRA was highlighted for an especially early and important regulatory role. Cell-type deconvolution analysis attributed the differential metabolic and developmental signals in this social context primarily to oligodendrocytes and neurons, respectively, and we show that ESRRA is expressed in both cell types. Localizing ESRRA binding sites in cortical chromatin, we show that this nuclear receptor binds both differentially expressed energy-related and neurodevelopmental TF genes. These data link metabolic and neurodevelopmental signali ng to social challenge, and identify key regulatory drivers of this process with unprecedented tissue and temporal resolution
Public Health Interventions for Osteoarthritis - updates on the Osteoarthritis Action Alliance's efforts to address the 2010 OA Public Health Agenda Recommendations
Osteoarthritis (OA) is a painful joint disease affecting more than 32.5 million adults in the US and over 350 million adults worldwide. The prevalence is expected to rise continually over the next several decades with significant impacts to societal health and economic costs as well as individuals' daily activities and quality of life. In 2008, the Centers for Disease Control and Prevention (CDC) and the Arthritis Foundation (AF) led a collaborative effort to address approaches to reduce the burden of OA via public health interventions, policies (systems and environmental), and communication strategies. This collaboration resulted in the National Public Health Agenda for OA (OA Agenda), which was vetted by more than 75 stakeholder organisations and released in 2010. The OA Agenda listed ten recommendations focused on public health interventions for OA including weight management, physical activity, self-management education, and injury prevention, and policies, systems, communication, research and evaluation. In 2011, the CDC and AF mobilised the OA Action Alliance (OAAA), a national coalition of organisations concerned with mitigating the public health impact of OA, to operationalise the recommendations set forth in the OA Agenda. Since then, the OAAA has grown to include more than 110 organisations that work collectively to increase awareness about the prevention and management of OA, provide educational resources, and expand access to evidence-based programmes for target audiences including individuals with OA, community-based organisations, healthcare systems and providers, and policymakers. This review highlights the OAAA's progress to date in addressing the OA Agenda recommendations; successes and challenges in delivery of effective communication, programmes, and resources; and future implications
Inadequate lopinavir concentrations with modified 8-hourly lopinavir/ritonavir 4:1 dosing during rifampicin-based tuberculosis treatment in children living with HIV
BACKGROUND: Lopinavir/ritonavir plasma concentrations are profoundly reduced when co-administered with rifampicin. Super-boosting of lopinavir/ritonavir is limited by nonavailability of single-entity ritonavir, while double-dosing of co-formulated lopinavir/ritonavir given twice-daily produces suboptimal lopinavir concentrations in young children. We evaluated whether increased daily dosing with modified 8-hourly lopinavir/ritonavir 4:1 would maintain therapeutic plasma concentrations of lopinavir in children living with HIV receiving rifampicin-based antituberculosis treatment. METHODS: Children with HIV/tuberculosis coinfection weighing 3.0 to 19.9 kg, on rifampicin-based antituberculosis treatment were commenced or switched to 8-hourly liquid lopinavir/ritonavir 4:1 with increased daily dosing using weight-band dosing approach. A standard twice-daily dosing of lopinavir/ritonavir was resumed 2 weeks after completing antituberculosis treatment. Plasma sampling was conducted during and 4 weeks after completing antituberculosis treatment. RESULTS: Of 20 children enrolled; 15, 1-7 years old, had pharmacokinetics sampling available for analysis. Lopinavir concentrations (median [range]) on 8-hourly lopinavir/ritonavir co-administered with rifampicin (n = 15; area under the curve 0-24 55.32 mg/h/L [0.30-398.7 mg/h/L]; C max 3.04 mg/L [0.03-18.6 mg/L]; C 8hr 0.90 mg/L [0.01-13.7 mg/L]) were lower than on standard dosing without rifampicin (n = 12; area under the curve 24 121.63 mg/h/L [2.56-487.3 mg/h/L]; C max 9.45 mg/L [0.39-26.4 mg/L]; C 12hr 3.03 mg/L [0.01-17.7 mg/L]). During and after rifampicin cotreatment, only 7 of 15 (44.7%) and 8 of 12 (66.7%) children, respectively, achieved targeted pre-dose lopinavir concentrations ≥1mg/L. CONCLUSIONS: Modified 8-hourly dosing of lopinavir/ritonavir failed to achieve adequate lopinavir concentrations with concurrent antituberculosis treatment. The subtherapeutic lopinavir exposures on standard dosing after antituberculosis treatment are of concern and requires further evaluation
Cellular model system to dissect the isoform-selectivity of Akt inhibitors
The protein kinase Akt plays a pivotal role in cellular processes. However, its isoforms’ distinct functions have not been resolved to date, mainly due to the lack of suitable biochemical and cellular tools. Against this background, we present the development of an isoform-dependent Ba/F3 model system to translate biochemical results on isoform specificity to the cellular level. Our cellular model system complemented by protein X-ray crystallography and structure-based ligand design results in covalent-allosteric Akt inhibitors with unique selectivity profiles. In a first proof-of-concept, the developed molecules allow studies on isoform-selective effects of Akt inhibition in cancer cells. Thus, this study will pave the way to resolve isoform-selective roles in health and disease and foster the development of next-generation therapeutics with superior on-target properties
- …