Theories of Costs of Health and Safety Compliance and Non-Compliance with Regulations

Globally, the economics of health and safety compliance and non-compliance with regulations remains absurd and elusive. Costs of health and safety compliance at enterprise level are elements that organisations find difficult to define or price adequately due to subtle, inconspicuous, and elusive nature. Conversely, evidence shows that costs of health and safety non-compliance with regulations in recent times are eye-watering and mind-boggling. Yet, theory that provides explanation of cost behaviours concerning health and safety compliance and non-compliance with regulations is rare. Aim: The aim of the study is to develop a theoretical concept that can be used to predict costs of health and safety non-compliance with regulations. Research question: put forward by the paper is: What are the predictable cost behaviours of health and safety compliance and non-compliance with regulations? Research Method: Phenomenological research strategy was adopted; with qualitative data collected via focus group discussions; in addition to detailed observation of 20 years real costs of health and safety non-compliance with regulations data. Findings: Reveal that costs of health and safety compliance with regulations are often ill-defined and elusive. Similarly, the study discovered that cost behaviour of health and safety non-compliance with regulations can be erratic and exponential in nature. Other finding reveals that for every health and safety failure (ill-health, injuries/fatalities), there are likely associated costs, that are contingent on specific legislations, rule of law, state (national laws), and commercial viability of organisation involved

Comparison of β-Hydroxylase Enzyme 11 Serum in Obese, Overweight, and Normoweight Young Men

Background: Previous studies showed that cardiovascular risk factor was increased in obese and overweight subjects. Obesity and cardiovascular risk factor are associated with hypothalamic-pituitary-adrenal (HPA) axis hyperactivity that causes hypercortisolism, cortisol level is associated with cardiovascular risk factor on obesity. 11 β-hydroxylase is an enzyme that involved in cortisol synthesis. The aim of this study was to investigate 11 β-Hydroxylase concentration in obesity, overweight, and normal weight young men.Subjects and Method: This was analytic-observational study using cross-sectional design. The study was conducted at HKBP Nommensen University, Medan. The study subjects included by 76 young men aged 18-28 years old, consisting of 25 obese subjects, 25 overweight, and 25 normoweight. The concentration of 11 β-Hydroxylase was evaluated in blood sample after 10 hours fasting. The data was analyzed bivariately.Results: Mean of 11 β-Hydroxylase concentration was 52.76 ± 44.27 in obese subjects, 70.16 ± 46.83 in overweight subjects, and 43.42 ± 27.75 in normoweight subjects. The 11 β-Hydroxylase concentration in overweight subjects was statistically higher than normoweight subjects (p = 0.007), but the 11 β-Hydroxylase concentration on obese subjects statistically was not different from normoweight subjects (p = 0.362).Conclusion: The 11 β-Hydroxylase concentration on overweight subject is higher than normoweight subject. There is no difference of 11 β-Hydroxylase concentration on obese and normoweight subject. Mitochondrial stress and mitochondrial failure mechanism on overweight and obesity merit further investigation

Utility of adenosine stress perfusion CMR to assess paediatric coronary artery disease

AIMS: Cardiovascular magnetic resonance (CMR), using adenosine stress perfusion and late-gadolinium enhancement (LGE), is becoming the 'gold standard' non-invasive imaging modality in the assessment of adults with coronary artery disease (CAD). However, despite its proved feasibility in paediatric patients, clinical utility has not been demonstrated. Therefore, this study aims to establish the role of adenosine stress perfusion CMR as a screening test in paediatric patients with acquired or congenital CAD. METHODS AND RESULTS: A total of 58 paediatric patients underwent 61 consecutive clinically indicated coronary artery assessments for diagnostic and clinical decision-making purposes. The diagnosis was based on X-ray or computed tomography coronary angiography for anatomy, adenosine stress CMR imaging for myocardial perfusion and LGE for tissue characterization. Two studies were aborted because of unwanted side effects of adenosine stress, thus 59 studies were completed in 56 patients [median age 14.1 years (interquartile range 10.9-16.2)]. When compared with coronary anatomical imaging, adenosine stress perfusion CMR performed as follows: sensitivity 100% (95% confidence interval, CI: 71.6-100%), specificity 98% (95% CI: 86.7-99.9%), positive predictive value (PPV) 92.9% (95% CI: 64.2-99.6%), and negative predictive value 100% (95% CI: 89.9-100%). CONCLUSION: In paediatric CAD, adenosine stress perfusion CMR imaging is adequate as an initial, non-invasive screening test for the identification of significant coronary artery lesions, with anatomical imaging used to confirm the extent of the culprit lesion

The operationalized psychodynamic diagnostics system. Clinical relevance, reliability and validity

In this paper, we present a multiaxial system for psychodynamic diagnosis, which has attained wide usage in Germany in the last 10 years. First we will discuss the 4 operationalized psychodynamic diagnostics (OPD) axes: illness experience and treatment assumptions, relationships, mental conflicts, and structure, then clinical applications will be outlined. Focus psychodynamic formulations can be employed both with inpatients and with outpatients. Studies show good reliability in a research context and acceptable reliability for clinical purposes. Validity will be separately summarized as content, criterion, and construct validity. Validity studies indicate good validity for the individual axes. Numerous studies on the OPD indicate areas of possible improvement, for example for clinical purposes the OPD should be more practically formulated

Cosmological spacetimes balanced by a scale covariant scalar field

A scale invariant, Weyl geometric, Lagrangian approach to cosmology is explored, with a a scalar field phi of (scale) weight -1 as a crucial ingredient besides classical matter \cite{Tann:Diss,Drechsler:Higgs}. For a particularly simple class of Weyl geometric models (called {\em Einstein-Weyl universes}) the Klein-Gordon equation for phi is explicitly solvable. In this case the energy-stress tensor of the scalar field consists of a vacuum-like term Lambda g_{mu nu} with variable coefficient Lambda, depending on matter density and spacetime geometry, and of a dark matter like term. Under certain assumptions on parameter constellations, the energy-stress tensor of the phi-field keeps Einstein-Weyl universes in locally stable equilibrium. A short glance at observational data, in particular supernovae Ia (Riess ea 2007), shows interesting empirical properties of these models.Comment: 28 pages, 1 figure, accepted by Foundations of Physic

Technical Design Report for the PANDA Solenoid and Dipole Spectrometer Magnets

This document is the Technical Design Report covering the two large spectrometer magnets of the PANDA detector set-up. It shows the conceptual design of the magnets and their anticipated performance. It precedes the tender and procurement of the magnets and, hence, is subject to possible modifications arising during this process.Comment: 10 pages, 14MB, accepted by FAIR STI in May 2009, editors: Inti Lehmann (chair), Andrea Bersani, Yuri Lobanov, Jost Luehning, Jerzy Smyrski, Technical Coordiantor: Lars Schmitt, Bernd Lewandowski (deputy), Spokespersons: Ulrich Wiedner, Paola Gianotti (deputy

The JUROGAM 3 spectrometer

The jurogam 3 spectrometer has been constructed for in-beam gamma-ray spectroscopy experiments in the Accelerator Laboratory of the University of Jyvaskyla, Finland. jurogam 3 consists of germanium-detector modules in a compact geometry surrounding a target to measure. rays emitted from radioactive nuclei. jurogam 3 can be employed in conjunction with one of two recoil separators, the mara vacuum-mode separator or the ritu gas-filled separator, and other ancillary devices.Peer reviewe

Early detection and intervention for young children with early developmental disabilities in Western Uganda: a mixed-methods evaluation.

BACKGROUND: Early support for children with developmental disabilities is crucial but frequently unavailable in low-resource settings. We conducted a mixed-methods evaluation to assess the feasibility, acceptability, and impact of a programme of early detection and intervention for young children with developmental disabilities in Western Uganda. METHODS: Early child development training for healthcare workers (HCWs) was implemented in three rural districts, and attendance was tracked. HCW knowledge and confidence were assessed pre-/post-intervention, and referral numbers tracked to evaluate impact. Facilitators were trained and mentored to deliver a participatory, group, early intervention programme (EIP) for young children with developmental disabilities and their families. Facilitators were tracked as they were identified, trained, and delivered the intervention, and attendance of families was tracked. Pre-/post-intervention assessments evaluated changes in family quality of life (PedsQL 2.0, Family Impact Module), and child nutritional outcomes. Focus group discussions with stakeholders also assessed feasibility, acceptability and impact. RESULTS: Overall, 93 HCWs from 45 healthcare facilities received training. In the pre-/post-evaluation, median knowledge and confidence scores increased significantly (from 4.0 to 7.0 and from 2.7 to 4.7, respectively (p < 0.001)). HCWs reported feeling empowered to refer and offer care for families with a young child with disability. Referral rates increased significantly from 148 to 251 per annum (70%; p = 0.03). Eleven EIP facilitators were trained, and all delivered the intervention; 84 families were enrolled, of which 78% attended at least 6 out of 10 modules. Amongst those with paired pre-/post-intervention data (n = 48), total family quality of life scores increased significantly (21%, p < 0.001). Improvements were seen across all domains of quality of life, with the largest impacts on emotional functioning and social functioning (p < 0.001). The programme was acceptable to caregivers and facilitators. Caregivers reported improved knowledge, family relationships, hope, emotional wellbeing, and reduced self-stigma. CONCLUSIONS: A programme of early detection and intervention for children with early developmental disabilities and their families was feasible and acceptable in a rural community-based Ugandan setting. HCW training positively impacted knowledge, confidence, attitudes, and referral rates. Families enrolled to the EIP reported significant improvements in quality of life. Important programmatic barriers identified included geographical spread, poverty, gender inequality, and stigma

The association of quantitative PSMA PET parameters with pathologic ISUP grade: an international multicenter analysis.

PURPOSE To assess if PSMA PET quantitative parameters are associated with pathologic ISUP grade group (GG) and upgrading/downgrading. METHODS PCa patients undergoing radical prostatectomy with or without pelvic lymph node dissection staged with preoperative PSMA PET at seven referral centres worldwide were evaluated. PSMA PET parameters which included SUVmax, PSMAvolume, and total PSMA accumulation (PSMAtotal) were collected. Multivariable logistic regression evaluated the association between PSMA PET quantified parameters and surgical ISUP GG. Decision-tree analysis was performed to identify discriminative thresholds for all three parameters related to the five ISUP GGs The ROC-derived AUC was used to determine whether the inclusion of PSMA quantified parameters improved the ability of multivariable models to predict ISUP GG ≥ 4. RESULTS A total of 605 patients were included. Overall, 2%, 37%, 37%, 10% and 13% patients had pathologic ISUP GG1, 2, 3, 4, and 5, respectively. At multivariable analyses, all three parameters SUVmax, PSMAvolume and PSMAtotal were associated with GG ≥ 4 at surgical pathology after accounting for PSA and clinical T stage based on DRE, hospital and radioligand (all p  28, PSMAvol 0-2, 2-9, 9-20 and > 20 and PSMAtotal 0-12, 12-98 and > 98). PSMAvolume was significantly associated with GG upgrading (OR 1.03 95%CI 1.01 - 1.05). In patients with biopsy GG1-3, PSMAvolume ≥ 2 was significantly associated with higher odds for upgrading to ISUP GG ≥ 4, compared to PSMAvolume < 2 (OR 6.36, 95%CI 1.47 - 27.6). CONCLUSION Quantitative PSMA PET parameters are associated with surgical ISUP GG and upgrading. We propose clinically relevant thresholds of these parameters which can improve in PCa risk stratification in daily clinical practice