Assessment of a satellite power system and six alternative technologies

The satellite power system is assessed in comparison to six alternative technologies. The alternatives are: central-station terrestrial photovoltaic systems, conventional coal-fired power plants, coal-gasification/combined-cycle power plants, light water reactor power plants, liquid-metal fast-breeder reactors, and fusion. The comparison is made regarding issues of cost and performance, health and safety, environmental effects, resources, socio-economic factors, and institutional issues. The criteria for selecting the issues and the alternative technologies are given, and the methodology of the comparison is discussed. Brief descriptions of each of the technologies considered are included

A decision exercise to engage cancer patients and families in Deliberation about Medicare Coverage for advanced Cancer Care

BACKGROUND: Concerns about unsustainable costs in the US Medicare program loom as the number of retirees increase and experiences serious and costly illnesses like cancer. Engagement of stakeholders, particularly cancer patients and their families, in prioritizing insured services offers a valuable strategy for informing Medicare coverage policy. We designed and evaluated a decision exercise that allowed cancer patients and family members to choose Medicare benefits for advanced cancer patients. METHODS: The decision tool, Choosing Health plans All Together (CHAT) was modified to select services for advanced cancer patients. Patients with a cancer history (N = 246) and their family members (N = 194) from North Carolina participated in 70 CHAT sessions. Variables including participants’ socio-demographic characteristics, health status, assessments of the exercise and results of group benefit selections were collected. Routine descriptive statistics summarized participant characteristics and Fisher’s exact test compared group differences. Qualitative analysis of group discussions were used to ascertain reasons for or against selecting benefits. RESULTS: Patients and family members (N = 440) participated in 70 CHAT exercises. Many groups opted for such services as palliative care, nursing facilities, and services not currently covered by the Medicare program. In choosing among four levels of cancer treatment coverage, no groups chose basic coverage, 27 groups (39%) selected intermediate coverage, 39 groups (56%) selected high coverage, and 4 groups (6%) chose the most comprehensive cancer coverage. Reasons for or against benefit selection included fairness, necessity, need for prioritizing, personal experience, attention to family needs, holistic health outlook, preference for comfort, freedom of choice, and beliefs about the proper role of government. Participants found the exercise very easy (59%) or fairly easy (39%) to understand and very informative (66%) or fairly informative (31%). The majority agreed that the CHAT exercise led to fair decisions about priorities for coverage by which they could abide. CONCLUSIONS: It is possible to involve cancer patients and families in explicit discussions of their priorities for affordable advanced cancer care through the use of decision tools designed for this purpose. A key question is whether such a conversation is possible on a broader, national level

Prime osservazioni italiane di attivit\ue0 predatoria da parte dello sciacallo dorato (Canis aureus) su ovini domestici nel Carso goriziano

La presenza della specie sciacallo dorato Canis aureus moreoticus (I. Geoffrey, 1835) documentata per il Friuli Venezia-Giulia a partire dagli anni 80 \ue8 in continua espansione ed incremento con un particolare riferimento all\u2019area carsica. Nel territorio preso in esame, una porzione di landa e boscaglia carsica in cui \ue8 ubicato un parco rurale di circa 100 ha con annesso allevamento ovino, la presenza di sciacallo dorato, documentata anche con l\u2019uso di foto trappole, \ue8 passata da casi sporadici ad un numero certo di 7 esemplari che frequentano l\u2019area. Congiuntamente all\u2019aumento di presenza si sono avuti casi di predazione su ovini adulti mantenuti allo stato semibrado senza ricovero notturno. Sono state esaminate tre carcasse di ovini trovati morti in giornate successive. Le pecore appartenevano tutte alla classe adulta ed in particolare superavano gli 8 anni di et\ue0. Le valutazioni anatomopatologiche delle carcasse, a diversi stadi di decomposizione, hanno messo in evidenza lesioni di carattere lacero contuso dei diversi piani tissutali nella regione del collo e nei garretti causate da morsi, con un consumo, costituito prevalentemente dai tessuti molli delle cavit\ue0 toraciche ed addominali, variabile in base al tempo intercorso tra il ritrovamento ed il decesso. Dall\u2019esame dei morsi ed in particolare dalla misurazione della distanza tra i canini, unite alle caratteristiche della predazione hanno permesso di riferirla a sciacallo dorato. Tale ipotesi \ue8 stata successivamente confermata con il fototrappolaggio. Dopo tali episodi, gli ovini sono stati ricoverati ogni notte in ovile chiuso e protetto. Tale metodologia gestionale \ue8 stata sufficiente a ridurre notevolmente l\u2019impatto della predazione da sciacallo dorato sugli animali allevati

Impact of post-event avoidance behavior on commercial facilities sector venues-literature review.

The terrorist attacks of September 11, 2001 (9/11), focused a great deal of interest and concern on how individual and social perceptions of risk change behavior and subsequently affect commercial sector venues. Argonne conducted a review of the literature to identify studies that quantify the direct and indirect economic consequences of avoidance behaviors that result from terrorist attacks. Despite a growing amount of literature addressing terrorism impacts, relatively little is known about the causal relationships between risk perception, human avoidance behaviors, and the economic effects on commercial venues. Nevertheless, the technical and academic literature does provide some evidence, both directly and by inference, of the level and duration of post-event avoidance behaviors on commercial venues. Key findings are summarized in this Executive Summary. Also included as an appendix is a more detailed summary table of literature findings reproduced from the full report

Learning to be Waste Wise

The Learning to be Waste Wise Activity Guide is a series of curriculum-linked activity packs written for the Waste Wise Schools Program. Each booklet covers a different topic including a general introduction to waste, the ‘3Rs’ (Reduce, Reuse and Recycle), ‘Worms’ and ‘Compost’. The activities are designed to complement the school’s ongoing waste minimisation projects, and to support learning at every stage of a school’s Waste Wise journey. In turn, Waste Wise projects provide real life context to curriculum outcomes while directly involving students in their own learning. By reinforcing Waste Wise principles through the curriculum in an engaging and practical way, teachers will find it easier to incorporate waste reduction practices in their school. In addition, the involvement of students and the modelling of positive behaviours, reinforces the environmental principles and curriculum outcomes. The activities are designed to be fun; to promote life-long learning; to empower and enable students, teachers and the rest of the school community to take responsibility for their waste minimisation actions; to develop positive environmental values and to promote long-term behaviour change

The master developmental regulator Jab1/Cops5/Csn5 is essential for proper bone growth and survival in mice

Jab1, also known as Csn5/Cops5, is a key subunit of the COP9 Signalosome, a highly conserved macromolecular complex. We previously reported that the conditional knockout of Jab1 in mouse limb buds and chondrocytes results in severely shortened limbs and neonatal lethal chondrodysplasia, respectively. In this study, we further investigated the specific role of Jab1 in osteoblast differentiation and postnatal bone growth by characterizing a novel mouse model, the Osx-cre; Jab1flox/flox conditional knockout (Jab1 cKO) mouse, in which Jab1 is deleted in osteoblast precursor cells. Jab1 cKO mutant mice appeared normal at birth, but developed progressive dwarfism. Inevitably, all mutant mice died prior to weaning age. The histological and micro-computed tomography analysis of mutant long bones revealed severely altered bone microarchitecture, with a significant reduction in trabecular thickness. Moreover, Jab1 cKO mouse tibiae had a drastic decrease in mineralization near the epiphyseal growth plates, and Jab1 cKO mice also developed spontaneous fractures near the tibiofibular junction. Additionally, our cell culture studies demonstrated that Jab1 deletion in osteoblast precursors led to decreased mineralization and a reduced response to TGFβ and BMP signaling. Moreover, an unbiased reporter screen also identified decreased TGFβ activity in Jab1-knockdown osteoblasts. Thus, Jab1 is necessary for proper osteoblast differentiation and postnatal bone growth, likely in part through its positive regulation of the TGFβ and BMP signaling pathways in osteoblast progenitor cells

Exercise Training Amount and Intensity Effects on Metabolic Syndrome (From Studies of a Targeted Risk Reduction Intervention through Defined Exercise)

Although exercise improves individual risk factors of the metabolic syndrome (MS), there is little research on the effect of exercise on MS as a whole. The objective of this study was to determine how much exercise is recommended to reduce the prevalence of MS. Of 334 subjects randomized, 227 finished and 171 (80 women, 91 men) had complete data for all 5 Adult Treatment Panel III- defined MS risk factors and were included in this analysis. Subjects were randomly assigned to a six-month control or 1 of 3 eight-month exercise training groups: 1) low-amount/moderate-intensity (equivalent to walking ~19 km/week); 2) low-amount/vigorous-intensity (equivalent to jogging ~19 km/week); 3) high-amount/vigorous-intensity (equivalent to jogging ~32 km/week). The low- amount/moderate-intensity exercise prescription improved MS relative to inactive controls (p<0.05). However, the same amount of exercise at a vigorous intensity was not significantly better than inactive controls, suggesting that lower intensity exercise may be more effective in improving MS. The high-amount/vigorous-intensity group improved MS relative to controls (p<0.0001), the low- amount/vigorous-intensity group (p=0.001), and the moderate intensity group (p=0.07), suggesting an exercise dose effect. In conclusion, a modest amount of moderate intensity exercise, in the absence of dietary changes, significantly improved MS and thus supports the recommendation that adults get 30 minutes of moderate intensity exercise every day. A higher amount of vigorous exercise was shown to have greater and more widespread benefits. Finally, there is an indication that moderate intensity may be better than vigorous intensity exercise for improving MS. Originally published American Journal of Cardiology, Vol. 100, No. 12, Dec 200

Variation of health-related quality of life assessed by caregivers and patients affected by severe childhood infections.

BACKGROUND: The agreement between self-reported and proxy measures of health status in ill children is not well established. This study aimed to quantify the variation in health-related quality of life (HRQOL) derived from young patients and their carers using different instruments. METHODS: A hospital-based cross-sectional survey was conducted between August 2010 and March 2011. Children with meningitis, bacteremia, pneumonia, acute otitis media, hearing loss, chronic lung disease, epilepsy, mild mental retardation, severe mental retardation, and mental retardation combined with epilepsy, aged between five to 14 years in seven tertiary hospitals were selected for participation in this study. The Health Utilities Index Mark 2 (HUI2), and Mark 3 (HUI3), and the EuroQoL Descriptive System (EQ-5D) and Visual Analogue Scale (EQ-VAS) were applied to both paediatric patients (self-assessment) and caregivers (proxy-assessment). RESULTS: The EQ-5D scores were lowest for acute conditions such as meningitis, bacteremia, and pneumonia, whereas the HUI3 scores were lowest for most chronic conditions such as hearing loss and severe mental retardation. Comparing patient and proxy scores (n = 74), the EQ-5D exhibited high correlation (r = 0.77) while in the HUI2 and HUI3 patient and caregiver scores were moderately correlated (r = 0.58 and 0.67 respectively). The mean difference between self and proxy-assessment using the HUI2, HUI3, EQ-5D and EQ-VAS scores were 0.03, 0.05, -0.03 and -0.02, respectively. In hearing-impaired and chronic lung patients the self-rated HRQOL differed significantly from their caregivers. CONCLUSIONS: The use of caregivers as proxies for measuring HRQOL in young patients affected by pneumococcal infection and its sequelae should be employed with caution. Given the high correlation between instruments, each of the HRQOL instruments appears acceptable apart from the EQ-VAS which exhibited low correlation with the others

Notch regulates BMP responsiveness and lateral branching in vessel networks via SMAD6

Functional blood vessel growth depends on generation of distinct but coordinated responses from endothelial cells. Bone morphogenetic proteins (BMP), part of the TGFβ superfamily, bind receptors to induce phosphorylation and nuclear translocation of SMAD transcription factors (R-SMAD1/5/8) and regulate vessel growth. However, SMAD1/5/8 signalling results in both pro- and anti-angiogenic outputs, highlighting a poor understanding of the complexities of BMP signalling in the vasculature. Here we show that BMP6 and BMP2 ligands are pro-angiogenic in vitro and in vivo, and that lateral vessel branching requires threshold levels of R-SMAD phosphorylation. Endothelial cell responsiveness to these pro-angiogenic BMP ligands is regulated by Notch status and Notch sets responsiveness by regulating a cell-intrinsic BMP inhibitor, SMAD6, which affects BMP responses upstream of target gene expression. Thus, we reveal a paradigm for Notch-dependent regulation of angiogenesis: Notch regulates SMAD6 expression to affect BMP responsiveness of endothelial cells and new vessel branch formation

No difference in stroke knowledge between Korean adherents to traditional and western medicine – the AGE study: an epidemiological study

BACKGROUND: Effective stroke intervention and risk reduction depend on the general public's awareness and knowledge of stroke. In Korea, where both traditional Oriental medicine and Western medicine are practiced, estimates of the general public's awareness and knowledge of stroke are poor. The present study sought to describe the inception cohort of the Ansan Geriatric Study (AGE study) and to determine baseline stroke awareness and preferred medical treatment for stroke in this Korean sample. METHODS: A total of 2,767 subjects selected randomly from the Ansan Geriatric Study in South Korea were questioned about stroke. Their answers were compared with their sociodemographic data and other variables. RESULTS: Only 44.8% of participants correctly identified stroke as a vascular disease in the human brain. Sudden numbness or weakness was the most frequently identified stroke warning sign (60.2%). Hypertension (66.7%) and mental stress (62.2%) were most frequently identified as stroke risk factors. The contributions of diabetes mellitus and cardiovascular disease to stroke were underestimated; they were identified as risk factors by 28.3% and 18.6% of participants, respectively. The predictors for poor knowledge of stroke warning signs and risk factors were similar irrespective of preference for Western or Oriental medical treatment, and included those with lower levels of education and inaccurate definition of stroke. Television and radio (40.3%) were the most frequent sources of stroke information for both groups. CONCLUSION: This study shows that knowledge of stroke is similar among Koreans with preferences for either Western or Oriental medical treatment and that misunderstandings about stroke are common among the Korean elderly. In order to prevent and manage stroke effectively, public health education regarding basic concepts of stroke is necessary. This should target those with a lower level of education and a misunderstanding of the definition of stroke