Missed Opportunities in HPV Vaccination

Objective: To use the 3 dose Human Papillomavirus (HPV) vaccine administration (given at 0, 1-2 and 6 months) to quantify opportunities to improve efficacy in the delivery of preventive health services. Methods: This was a retrospective, claims-based analysis using data provided by a single managed care plan. Female patients aged 9-26 who were continuously enrolled between 2009 through 2011 and received ≥ dose of the HPV vaccine during 2010 were analyzed. The proportion of initiators who did and did not completed the vaccine series, the timing and location of doses, and the number of outpatient visits during which the vaccine could have been given to non-completers were determined. Results: 1,830 patients were analyzed in the 2010 sample. 843 (46%) were continuously enrolled during the three-year observation period. 500 (59%) completed 3 doses. Among completers, the interval range between doses 1 and 2 was 27-619 days (median 96 days). The interval range between doses 2 and 3 was 32-621 days (median 127 days). 261 (52%) completers received dose 2, and 139 (28%) received does 3 over 1 month late. Among the 343 non-completers, 137 (40%), and 206 (60%) completed 1 and 2 doses, respectively. 63% of single-dose recipients and 17% of 2-dose recipients had at least 1 visit within the eligible time period for administration. Conclusion: Nearly half of HPV vaccine initiators do not complete the vaccine series. Of those who do, a large percentage complete it late. This example quantifies the potential for reminders, registries and outreach to improve on-time dosage and completion

Dynamics of the peptidoglycan biosynthetic machinery in the stalked budding bacterium Hyphomonas neptunium

Most commonly studied bacteria grow symmetrically and divide by binary fission, generating two siblings of equal morphology. An exception to this rule are budding bacteria, in which new offspring emerges de novo from a morphologically invariant mother cell. Although this mode of proliferation is widespread in diverse bacterial lineages, the underlying mechanisms are still incompletely understood. Here, we perform the first molecular-level analysis of growth and morphogenesis in the stalked budding alphaproteobacterium Hyphomonas neptunium. Peptidoglycan labeling shows that, in this species, buds originate from a stalk-like extension of the mother cell whose terminal segment is gradually remodeled into a new cell compartment. As a first step toward identifying the machinery mediating the budding process, we performed comprehensive mutational and localization studies of predicted peptidoglycan biosynthetic proteins in H. neptunium. These analyses identify factors that localize to distinct zones of dispersed and zonal growth, and they suggest a critical role of the MreB-controlled elongasome in cell morphogenesis. Collectively, our work shows that the mechanism of growth in H. neptunium is distinct from that in related, polarly growing members of the order Rhizobiales, setting the stage for in-depth analyses of the molecular principles regulating the fascinating developmental cycle of this species

Primary School Teaching Practices and Social Capital Primary School Teaching Practices and Social Capital

Abstract This paper analyzes the impact of primary school teaching methods on social capital on the country-level and on the student-level. Based on the Trends in International Mathematics and Science Study and the Progress in International Reading Literacy that have been conducted by the International Association for the Evaluation of Educational Achievement in 2003 and 2006 respectively, I use a fixed effect regressions approach, such as in I thank Yann Algan for devoting his time and efforts towards the supervision of this Master's thesis. I am grateful towards Amelie, Hannah and Samuel, who have provided continuous support and encouragement

On the Process of Becoming an Authentic Servant-Leader at the Cellular Level through Practicing the Principles of Interpersonal Neurobiology

The purpose of this study was to explore how recursive processing of meaningful language, expressed through resonant relationships, generates the neural architecture that is integral to the process of becoming an authentic servant-leader. Meaningful language does not sit in an isolated silo or echo silently in a vacuum; rather, it is intricately intertwined with the relational occurrences of everyday life. It plays a significant role in the formation and transformation of a person’s mind, brain, thoughts, behaviors, and identity. The principles underlying the power of meaningful language, resonant relationships, and interpersonal neurobiology provide neuroscientific substantiation that changes in physical, mental, and emotional behavior can become indelible actualities in the identity formation of an authentic servant-leader

Field study on crash causal factors of chassis modifications

New vehicle types are extensively tested to check almost all factors that influence ride and handling. With reference to the Association of German Car Tuners" (VDAT e.V.) valuations, approximately 10% of all cars in Germany are being modified by their owners. 28 % of those modifications" sales are divergent wheel-tire combinations, 13 % are tuning measures on the chassis suspension or wheel spacers. In almost all cases the singular modifications present a general permission for specific vehicles they have been tested in. Combined tuning measures, however, are often checked by just one inspector, following a procedure of mostly subjective assessment criteria. Today, critical attributes are only being observed, in case a vehicle is involved in an accident and the modifications are identified as crash causal factors or as a cofactor on the development of a crash. For the first time, a field study allows a survey of safety affecting chassis modifications. The test layout has to comply with some basic conditions. Different vehicle concepts with a wide margin of modifications are required to get a high transferability of the results. A total amount of more than 150 tested vehicles serves the same purpose. The tests are limited concerning the installation time of measurement techniques and the requirement that no damage, defilement or immoderate wear of the vehicles are accepted by their owners. Due to such factors as well as the driver Ìs acceptance, the vehicles are controlled by its owners instead of robots or test drivers. For keeping down the driver- influence, the lane has narrow boundaries and the driver has to drive in strictly adherence to the given instructions. After gathering all modifications, as well as static and kinematic parameters like the toe and camber angle, dynamic testing of predominantly lateral dynamics is conducted. Besides standardized tests like the ISO 3888-2 (Obstacle Avoidance) or the ISO 14512 (Braking on Surfaces with Split Coefficient of Friction), to test the influence of modified kingpin offsets caused by wheel spacers, some deviant tests are conducted. Those are required due to the demand of objective test results for road tests with vertical induced stimulation of the chassis suspension. Hence, new tests on corner braking with and without vertical stimulation have been developed. The interpretation of data includes thresholds, e.g. the maximum entrance velocity without hitting cones, on the one hand, and the analysis of characteristics of data concerning time and frequency range, "1-second values" and peak response times on the other hand. Besides the thresholds as indicators for the achievable velocities, which are mainly affected by friction coefficients, the vehicle reaction in the course of time characterizes the vehicle reaction in the threshold range and consequently the operational demands on the driver. The field study has started and promises the first long-range analysis of chassis modifications. The results offer a basis for hypothesis and resultant further test layouts for oncoming studies of the identified critical tuning measures