Using funnel plots in public health surveillance

<p>Abstract</p> <p>Background</p> <p>Public health surveillance is often concerned with the analysis of health outcomes over small areas. Funnel plots have been proposed as a useful tool for assessing and visualizing surveillance data, but their full utility has not been appreciated (for example, in the incorporation and interpretation of risk factors).</p> <p>Methods</p> <p>We investigate a way to simultaneously focus funnel plot analyses on direct policy implications while visually incorporating model fit and the effects of risk factors. Health survey data representing modifiable and nonmodifiable risk factors are used in an analysis of 2007 small area motor vehicle mortality rates in Alberta, Canada.</p> <p>Results</p> <p>Small area variations in motor vehicle mortality in Alberta were well explained by the suite of modifiable and nonmodifiable risk factors. Funnel plots of raw rates and of risk adjusted rates lead to different conclusions; the analysis process highlights opportunities for intervention as risk factors are incorporated into the model. Maps based on funnel plot methods identify areas worthy of further investigation.</p> <p>Conclusions</p> <p>Funnel plots provide a useful tool to explore small area data and to routinely incorporate covariate relationships in surveillance analyses. The exploratory process has at each step a direct and useful policy-related result. Dealing thoughtfully with statistical overdispersion is a cornerstone to fully understanding funnel plots.</p

Vector-axial vector correlators in weak electric field and the holographic dynamics of the chiral condensate

The transverse part of the vector-axial vector flavor current correlator in the presence of weak external electric field is studied using holography. The correlator is calculated using a bottom-up model arxiv:1003.2377 {proposed recently}, that includes the non-linear dynamics of the chiral condensate. It is shown that for low momenta the result agrees with the relation proposed by arXiv:1010.0718 {Son and Yamamoto} motivated by a simpler holographic model. For large Euclidean momenta however, the two results diverge. In the process, the difference of the vector and axial vector two point functions is also calculated. At large Euclidean momenta it is found that the first non-perturbative contribution, decreases as $q^{-6}$ as expected from QCD.Comment: 17 pages, 5 figures, typos correcte

The Transcription Factor NFAT5 Is Required for Cyclin Expression and Cell Cycle Progression in Cells Exposed to Hypertonic Stress

Background: Hypertonicity can perturb cellular functions, induce DNA damage-like responses and inhibit proliferation. The transcription factor NFAT5 induces osmoprotective gene products that allow cells to adapt to sustained hypertonic conditions. Although it is known that NFAT5-deficient lymphocytes and renal medullary cells have reduced proliferative capacity and viability under hypertonic stress, less is understood about the contribution of this factor to DNA damage responses and cell cycle regulation. Methodology/Principal Findings: We have generated conditional knockout mice to obtain NFAT5−/− T lymphocytes, which we used as a model of proliferating cells to study NFAT5-dependent responses. We show that hypertonicity triggered an early, NFAT5-independent, genotoxic stress-like response with induction of p53, p21 and GADD45, downregulation of cyclins, and cell cycle arrest. This was followed by an NFAT5-dependent adaptive phase in wild-type cells, which induced an osmoprotective gene expression program, downregulated stress markers, resumed cyclin expression and proliferation, and displayed enhanced NFAT5 transcriptional activity in S and G2/M. In contrast, NFAT5−/− cells failed to induce osmoprotective genes and exhibited poorer viability. Although surviving NFAT5−/− cells downregulated genotoxic stress markers, they underwent cell cycle arrest in G1/S and G2/M, which was associated with reduced expression of cyclins E1, A2 and B1. We also show that pathologic hypertonicity levels, as occurring in plasma of patients and animal models of osmoregulatory disorders, inhibited the induction of cyclins and aurora B kinase in response to T cell receptor stimulation in fresh NFAT5−/− lymphocytes. Conclusions/Significance: We conclude that NFAT5 facilitates cell proliferation under hypertonic conditions by inducing an osmoadaptive response that enables cells to express fundamental regulators needed for cell cycle progression.Molecular and Cellular Biolog

Spaces and Places: Engaging a Mixed-Methods Approach for Exploring the Multiple Geographies of Pedestrian Injury

Reprinted from Spaces and Places: Engaging a Mixed-Methods Approach for Exploring the Multiple Geographies of Pedestrian Injury, in Place, Health, and Diversity (Farnham: Ashgate/Gower, 2015), pp. 96 - 118 . Copyright © 2015.Details of the definitive version are available at http://www.ashgate.com/isbn/9781472445025Book chapte

Cohesion Policies in Italian Metropolitan Cities. Evaluation and Challenges

The 2014–2020 European programming is coming to an end with numerous critical issues that will have to be resolved by 2023, both with reference to spending power and with reference to performance evaluation. The European institutions are currently in the process of drafting the new Cohesion Policy 2021–2027, which will respond to the difficulties encountered in the previous programming through three key rules: simplicity, flexibility, efficiency and transparent administrative processes. The ambition of the new programming is to make the countries of the European Union smart, sustainable and increasingly inclusive economies. Three priorities that mutually reinforce each other to help achieve high levels of employment, productivity and social cohesion in the Member States. In this context, the present study intends to evaluate the “smart specialization” (S3 strategy) deriving from the 11 thematic objectives (or sectors of intervention), in particular that of the “environment”, in the 2007–2013 and 2014–2020 periods, through the Local Indicators of Spatial Association (LISA), thus identifying areas of intelligent specialization

From education to job opportunities. Defining professional profiles for geographers with high competences in GIS environment

In this paper, the importance is underlined of promoting higher education and training courses and opportunities, focused on a close connection between GIS and geography to cover topics of remarkable and daily social interest. In the first part of the contribution, some educational key points are defined in order to fuel a virtuous circle which can provide considerable methodological and applied skills in the use of GIS applications. It is considered fundamental to broaden one’s mind, to provide practice to the theories, to give enthusiasm and security in one’s own skills, to create a community of Geographers able to provide important added value in different research fields and workplaces. Therefore, it seems essential to build a trait d’union between the university and theworkplace. Particular attention is attributed to well-structured university modules founded on GIS applications, to intensive courses for postgraduates and to the geocartographic laboratories. In the second part of the paper, the focus will be on some examples of professional profiles forGeographers in order to define specific professional categories. In particular, ten application fields for Geographers with high competences and abilities in GIS environment are identified and explained with relative examples. In all these cases, a rigorous approach founded on geographical contents and a wide, updated and concrete use of GIS functionalities and extensions is required