Opportunities for Comparative Research in Public Health PBRNs : A Baseline Analysis of Local Practice Settings

This analysis describes the organizational and operational characteristics of local public health agencies participating in an initial cohort of five (5) public health PBRNs in the U.S. We examine variation in practice settings within and between PBRNs; compare practice settings to state and national norms; and identify opportunities for comparative research that can be conducted through PBRNs

Implementation-effectiveness trial of an ecological intervention for physical activity in ethnically diverse low income senior centers.

BackgroundAs the US population ages, there is an increasing need for evidence based, peer-led physical activity programs, particularly in ethnically diverse, low income senior centers where access is limited.Methods/designThe Peer Empowerment Program 4 Physical Activity' (PEP4PA) is a hybrid Type II implementation-effectiveness trial that is a peer-led physical activity (PA) intervention based on the ecological model of behavior change. The initial phase is a cluster randomized control trial randomized to either a peer-led PA intervention or usual center programming. After 18 months, the intervention sites are further randomized to continued support or no support for another 6 months. This study will be conducted at twelve senior centers in San Diego County in low income, diverse communities. In the intervention sites, 24 peer health coaches and 408 adults, aged 50 years and older, are invited to participate. Peer health coaches receive training and support and utilize a tablet computer for delivery and tracking. There are several levels of intervention. Individual components include pedometers, step goals, counseling, and feedback charts. Interpersonal components include group walks, group sharing and health tips, and monthly celebrations. Community components include review of PA resources, walkability audit, sustainability plan, and streetscape improvements. The primary outcome of interest is intensity and location of PA minutes per day, measured every 6 months by wrist and hip accelerometers and GPS devices. Secondary outcomes include blood pressure, physical, cognitive, and emotional functioning. Implementation measures include appropriateness & acceptability (perceived and actual fit), adoption & penetration (reach), fidelity (quantity & quality of intervention delivered), acceptability (satisfaction), costs, and sustainability.DiscussionUsing a peer led implementation strategy to deliver a multi-level community based PA program can enhance program adoption, implementation, and sustainment.Trial registrationClinicalTrials.gov, USA ( NCT02405325 ). Date of registration, March 20, 2015. This website also contains all items from the World Health Organization Trial Registration Data Set

Análisis de la heurística en la contratación empresarial a través de una cartera de derivados reales

Departing from the notion that labour legislation should be founded in the generation of job stability a model for recruitment is presented in which the employer is likened to the holder of an investment portfolio containing two real derivatives – swap or the option of sale. This model allows us on one hand to analyze sensitivity to the variables that are at play in an employment contract and, on the other, look at the effects that the most recent reforms in Spanish labour laws have had on contracting decisions made by employers. The results are clear: social security benefits are shown to be the most sensitive variable on the work contract, and applying the changes proposed in the latest labour reforms, this effect is upheld. The study concludes that reducing the costs of dismissal does not increase the likelihood of employers’ taking on new staff.Dada la situación actual y partiendo del supuesto que como herramienta para una correcta política de empleo la legislación laboral debe sentar las bases sólidas para que en el momento de recuperación económica se generen puestos de trabajo estables, se presenta un modelo de simulación de contratación que nos va a permitir un análisis de sensibilidad de las distintas variables a tener en cuenta en una regulación del mercado laboral. El modelo consiste en asimilar el comportamiento del empresario al del propietario de una cartera de inversión compuesta por dos derivados reales, un swap y una opción de venta americana. Este modelo nos permite, por un lado, hacer un análisis de sensibilidad de las diferentes variables que intervienen en la contratación, y, por otro lado, analizar los efectos que la última reforma laboral española tiene sobre la decisión de contratar del empresario. Los resultados son claros, la variable que más sensibilidad presenta sobre la contratación es la cuota patronal de la seguridad social, y aplicando los cambios propuestos en esta última reforma laboral, se concretan estos efectos y también se concluye que la reducción de los costes de despido no acelera la decisión de contratar.Dada a situação atual e partindo do suposto que como ferramenta para uma correta política de emprego, a legislação laboral deve instituir as bases sólidas para que, no momento da recuperação econômica, se gerem postos de trabalho estáveis, se apresentem um modelo de simulação de contratação que nos permitirá uma análise de sensibilidade das diferentes variáveis a considerar em uma regulação do mercado laboral. O modelo consiste em assimilar o comportamento do empresário ao do proprietário de uma carteira de investimento composto por dois derivados reais, um swap e uma opção de venda americana. Esse modelo nos permite, por um lado, fazer uma análise de sensibilidade das diferentes variáveis que intervêm na contratação e, por outro lado, analisar os efeitos que a última reforma laboral espanhola tem sobre a decisão de contratar do empresário. Os resultados são claros, a variável que mais sensibilidade apresenta sobre a contratação é a cota patronal da previdência social e aplicando as mudanças propostas nesta última reforma laboral, concretizam-se esses efeitos e também se conclui que a redução dos custos de demissão não acelera a decisão de contrata

Targeting BRAF in thyroid cancer

Activating mutations in the gene encoding BRAF are the most commonly identified oncogenic abnormalities in papillary thyroid cancer. In vitro and in vivo models have demonstrated that overexpression of activated BRAF induces malignant transformation and aggressive tumour behaviour. BRAF and other RAF kinases are frequently activated by other thyroid oncogenes and are important mediators of their biological effects including dedifferentiation and proliferation. Because current therapeutic options for patients with thyroid cancers that are aggressive and/or do not respond to standard therapies are limited, BRAF and its downstream effectors represent attractive therapeutic targets. In this review, data supporting a role for BRAF activation in thyroid cancer development and establishing the potential therapeutic efficacy of BRAF-targeted agents in patients with thyroid cancer will be reviewed

The health determinants in young children: Testing a new surveillance system in Italy

In recent years, the scientific community has stressed the need to invest in the first 1,000 days of life - the time spanning between conception and the 2nd birthday - because it is during this period that the foundations of health are laid and whose effects will be present throughout the life and may influence the next generation. Taking this into account, in 2013 the National Centre for Disease Prevention and Control (CCM) of the Italian Ministry of Health promoted and financed a project to test a surveillance system of the main determinants of health concerning the child between the conception period and the 2nd years of life which are included in the National Programme “GenitoriPiù”: folic acid before and during pregnancy, abstention from tobacco and alcohol during pregnancy and lactation, breastfeeding, infant sleep position, vaccination attitude, and early reading. The Project, started in January 2014 and ended in August 2016, has piloted the design, testing, and evaluation of the surveillance system with the view to national extension and the repeatability over time. The surveillance system has been designed to collect data through a questionnaire compiled by mothers in vaccination centres, in order to produce indicators which will enable territorial and intertempo-ral comparisons to be made. The project has shown the feasibility of this system, identifying favourable conditions and possible difficulties, and its ability to collect important information on children's health