The potential impact on Florida-based marina and boating industries of a post-embargo Cuba: an analysis of geographic, physical, policy and industry trends

The information in this Technical Paper addresses the future of the US-Cuban marina and recreational boating industries from the geographic, physical, policy making and economic perspectives for a post-embargo Cuba. Each individual paper builds on the presentations made at the workshop, the information obtained in the subsequent trip to Cuba and presents in detailed form information which we hope is useful to all readers. (147pp.

Epidermal growth factor (EGF)-like repeats of human tenascin-C as ligands for EGF receptor.

Signaling through growth factor receptors controls such diverse cell functions as proliferation, migration, and differentiation. A critical question has been how the activation of these receptors is regulated. Most, if not all, of the known ligands for these receptors are soluble factors. However, as matrix components are highly tissue-specific and change during development and pathology, it has been suggested that select growth factor receptors might be stimulated by binding to matrix components. Herein, we describe a new class of ligand for the epidermal growth factor (EGF) receptor (EGFR) found within the EGF-like repeats of tenascin-C, an antiadhesive matrix component present during organogenesis, development, and wound repair. Select EGF-like repeats of tenascin-C elicited mitogenesis and EGFR autophosphorylation in an EGFR-dependent manner. Micromolar concentrations of EGF-like repeats induced EGFR autophosphorylation and activated extracellular signal-regulated, mitogen-activated protein kinase to levels comparable to those induced by subsaturating levels of known EGFR ligands. EGFR-dependent adhesion was noted when the ligands were tethered to inert beads, simulating the physiologically relevant presentation of tenascin-C as hexabrachion, and suggesting an increase in avidity similar to that seen for integrin ligands upon surface binding. Specific binding to EGFR was further established by immunofluorescence detection of EGF-like repeats bound to cells and cross-linking of EGFR with the repeats. Both of these interactions were abolished upon competition by EGF and enhanced by dimerization of the EGF-like repeat. Such low affinity behavior would be expected for a matrix-tethered ligand; i.e., a ligand which acts from the matrix, presented continuously to cell surface EGF receptors, because it can neither diffuse away nor be internalized and degraded. These data identify a new class of insoluble growth factor ligands and a novel mode of activation for growth factor receptors

A safer place for patients: learning to improve patient safety

1 Every day over one million people are treated successfully by National Health Service (NHS) acute, ambulance and mental health trusts. However, healthcare relies on a range of complex interactions of people, skills, technologies and drugs, and sometimes things do go wrong. For most countries, patient safety is now the key issue in healthcare quality and risk management. The Department of Health (the Department) estimates that one in ten patients admitted to NHS hospitals will be unintentionally harmed, a rate similar to other developed countries. Around 50 per cent of these patient safety incidentsa could have been avoided, if only lessons from previous incidents had been learned. 2 There are numerous stakeholders with a role in keeping patients safe in the NHS, many of whom require trusts to report details of patient safety incidents and near misses to them (Figure 2). However, a number of previous National Audit Office reports have highlighted concerns that the NHS has limited information on the extent and impact of clinical and non-clinical incidents and trusts need to learn from these incidents and share good practice across the NHS more effectively (Appendix 1). 3 In 2000, the Chief Medical Officer’s report An organisation with a memory 1 , identified that the key barriers to reducing the number of patient safety incidents were an organisational culture that inhibited reporting and the lack of a cohesive national system for identifying and sharing lessons learnt. 4 In response, the Department published Building a safer NHS for patients3 detailing plans and a timetable for promoting patient safety. The goal was to encourage improvements in reporting and learning through the development of a new mandatory national reporting scheme for patient safety incidents and near misses. Central to the plan was establishing the National Patient Safety Agency to improve patient safety by reducing the risk of harm through error. The National Patient Safety Agency was expected to: collect and analyse information; assimilate other safety-related information from a variety of existing reporting systems; learn lessons and produce solutions. 5 We therefore examined whether the NHS has been successful in improving the patient safety culture, encouraging reporting and learning from patient safety incidents. Key parts of our approach were a census of 267 NHS acute, ambulance and mental health trusts in Autumn 2004, followed by a re-survey in August 2005 and an omnibus survey of patients (Appendix 2). We also reviewed practices in other industries (Appendix 3) and international healthcare systems (Appendix 4), and the National Patient Safety Agency’s progress in developing its National Reporting and Learning System (Appendix 5) and other related activities (Appendix 6). 6 An organisation with a memory1 was an important milestone in the NHS’s patient safety agenda and marked the drive to improve reporting and learning. At the local level the vast majority of trusts have developed a predominantly open and fair reporting culture but with pockets of blame and scope to improve their strategies for sharing good practice. Indeed in our re-survey we found that local performance had continued to improve with more trusts reporting having an open and fair reporting culture, more trusts with open reporting systems and improvements in perceptions of the levels of under-reporting. At the national level, progress on developing the national reporting system for learning has been slower than set out in the Department’s strategy of 2001 3 and there is a need to improve evaluation and sharing of lessons and solutions by all organisations with a stake in patient safety. There is also no clear system for monitoring that lessons are learned at the local level. Specifically: a The safety culture within trusts is improving, driven largely by the Department’s clinical governance initiative 4 and the development of more effective risk management systems in response to incentives under initiatives such as the NHS Litigation Authority’s Clinical Negligence Scheme for Trusts (Appendix 7). However, trusts are still predominantly reactive in their response to patient safety issues and parts of some organisations still operate a blame culture. b All trusts have established effective reporting systems at the local level, although under-reporting remains a problem within some groups of staff, types of incidents and near misses. The National Patient Safety Agency did not develop and roll out the National Reporting and Learning System by December 2002 as originally envisaged. All trusts were linked to the system by 31 December 2004. By August 2005, at least 35 trusts still had not submitted any data to the National Reporting and Learning System. c Most trusts pointed to specific improvements derived from lessons learnt from their local incident reporting systems, but these are still not widely promulgated, either within or between trusts. The National Patient Safety Agency has provided only limited feedback to trusts of evidence-based solutions or actions derived from the national reporting system. It published its first feedback report from the Patient Safety Observatory in July 2005

A Probit Model of NLRB Bargaining Order Cases in the Appellate Courts

This study examines NLRB bargaining orders that have gone to appeals courts and ascertains what factors influence whether or not the order is enforced and to what degree these factors influence the likelihood of enforcement. Substantial information has been collected from each reported appellate decision that reviewed NLRB bargaining orders issued over a four-year period. A probit regression model is employed to examine whether factors related to an employer\u27s unfair labor practice campaign are involved in the circuit court\u27s enforcement decisions or if more weight is given to unrelated factors, such as the circuit in which the appeal is heard or the amount of judicial delay involved in the appeals process

A Probit Model of NLRB Bargaining Order Cases in the Appellate Courts

This study examines NLRB bargaining orders that have gone to appeals courts and ascertains what factors influence whether or not the order is enforced and to what degree these factors influence the likelihood of enforcement. Substantial information has been collected from each reported appellate decision that reviewed NLRB bargaining orders issued over a four-year period. A probit regression model is employed to examine whether factors related to an employer\u27s unfair labor practice campaign are involved in the circuit court\u27s enforcement decisions or if more weight is given to unrelated factors, such as the circuit in which the appeal is heard or the amount of judicial delay involved in the appeals process

Optimal measurements for relative quantum information

We provide optimal measurement schemes for estimating relative parameters of the quantum state of a pair of spin systems. We prove that the optimal measurements are joint measurements on the pair of systems, meaning that they cannot be achieved by local operations and classical communication. We also demonstrate that in the limit where one of the spins becomes macroscopic, our results reproduce those that are obtained by treating that spin as a classical reference direction.Comment: 6 pages, 1 figure, published versio

Using Jet Observations to Constrain Enceladus' Rotation State

Observations of Enceladus have revealed active jets of material erupting from cracks on its surface. It has been proposed that diurnal tidal stress may open these cracks daily when they experience tensile stresses across them, allowing eruptions to occur. An analysis of the tidal stress on jet source regions, as identified by the triangulation of jet observations, finds that there is a correlation between observations and tensile stress on the cracks. However, not all regions are predicted to be in tension when jets were observed to be active. Enceladus' rotation state, such as a physical libration or obliquity, will affect the diurnal stresses on these cracks, changing when in its orbit they experience tension and compression. We will use observations of jet activity from 2005-2007 to place constraints on rotation states of Enceladus