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The ‘non-identity problem’ raises a well-known challenge to the person-affecting view, according to which an action can be wrong only if it affects someone for the worse. In a recent article, however, Thomas D. Bontly proposes a novel way to solve the non-identity problem in person-affecting terms. Bontly's argument is based on a contrastive causal account of harm. In this response, we argue that Bontly's argument fails even assuming that the contrastive causal account is correct.
In the production of automotive body components, fixtures are an important part of the ongoing work on geometrical assurance. The fixture is uniquely defined for each component, and the design and configuration of these are time-consuming and takes a lot of effort. The objective with this paper is to explore the use of a design automation approach and application to semi-automate the configuration process of the fixture product. The paper presents an approach to automate the configuration of the fixtures in a flexible way, by reverse engineering the configuration of the fixture product from a generic blueprint that represents the expected outcome of the process, using a knowledge-based engineering approach applied to a computer aided design (CAD) environment. A reverse-engineered design automation toolbox for a CAD-software is developed. The toolbox is developed to lead a user through the configuration process, in the way that the experts want it done, end-to-end, making use of some unconventional solutions from a design automation perspective.
Studies of supplier involvement in product development have revealed potential benefits including faster time to market, reduced cost and increased quality. However, existing literature has mainly focused on the customer's perspective on advantages, disadvantages and factors to be considered when involving suppliers in product development. This paper addresses the supplier's perspective by answering following research question: How do challenges that originate from involvement in customer's product development affect a supplier? The question is answered through a single case study at a supplier that develops and manufacture products primary used in capital goods. Thirteen challenges are identified, classified as being internal or external, and categorised into five areas: (A) Customer requirements, (B) Information exchange between customer and supplier, (C) Product variety management, (D) Design- manufacturing integration and (E) Processes and work instructions. The findings suggest that internal challenges need as much attention as external ones that originate from the customer. Also, an indication of when the challenges affect the supplier during product development is presented.
This study aimed to investigate the rate of dizziness and occurrence of benign paroxysmal positional vertigo in the elderly by physical examination in those reporting dizziness symptoms when lying down or turning over in bed.
A total of 498 people, aged 70–85 years, were asked to complete a questionnaire regarding dizziness symptoms. Subjects answering that they became dizzy in bed were asked to participate in a physical examination and diagnostic manoeuvres investigating benign paroxysmal positional vertigo.
A total of 324 participants (65 per cent) completed the questionnaire. More than one-quarter (29 per cent) reported dizziness and 32 (10 per cent) reported dizziness when turning in bed. Of these 32 persons, 22 (69 per cent) underwent a physical examination. Six participants tested positive for benign paroxysmal positional vertigo.
Ten per cent of the elderly participants reported positional symptoms, and 6 out of 22 fulfilled diagnostic criteria for benign paroxysmal positional vertigo. Furthermore, benign paroxysmal positional vertigo was established despite a delay between questionnaire completion and investigation, emphasising that this type of dizziness may not be a self-limiting disorder.
The St. Louis aerosol was sampled during the period 16-22 August 1973 simultaneously at two locations using cascade impactors for sequential 12-hour samples. The six particle size fractions of each sampling were individually analyzed using PIXE for elements from S to Br and beyond and for heavy elements including Pb which permitted time variations of concentrations and particle size distributions to be followed and related to meteorological changes during the sampling period. In addition, the data were compared with average levels of the elements in coastal north Florida and maritime Bermuda as well as at a third St. Louis site. From this it appeared that some of the concentrations in St. Louis were at natural levels whereas others appeared to be higher and linked to air pollution sources. These relationships and others in this study may lead to criteria for distinguishing between pollutants and natural background in urban aerosols.
Using protons in the MeV range as excitation source and a high resolution Si(Li) detector, X-ray emission spectroscopy is shown to be capable of analysing many elements with Z > 15 simultaneously at the 10-12 g level, This work discusses a theoretical lower limit of detection at moderate proton energies and gives examples of possible applications: analysis of the elemental composition of air-borne particles as a function of particle size, oil slick identification, and analysis of water and blood serum.
A lasting legacy of the International Polar Year (IPY) 2007–2008 was the promotion of the Permafrost Young Researchers Network (PYRN), initially an IPY outreach and education activity by the International Permafrost Association (IPA). With the momentum of IPY, PYRN developed into a thriving network that still connects young permafrost scientists, engineers, and researchers from other disciplines. This research note summarises (1) PYRN’s development since 2005 and the IPY’s role, (2) the first 2015 PYRN census and survey results, and (3) PYRN’s future plans to improve international and interdisciplinary exchange between young researchers. The review concludes that PYRN is an established network within the polar research community that has continually developed since 2005. PYRN’s successful activities were largely fostered by IPY. With >200 of the 1200 registered members active and engaged, PYRN is capitalising on the availability of social media tools and rising to meet environmental challenges while maintaining its role as a successful network honouring the legacy of IPY.
We study I(T), the number of inversions in a tree T with its vertices labelled uniformly at random, which is a generalization of inversions in permutations. We first show that the cumulants of I(T) have explicit formulas involving the k-total common ancestors of T (an extension of the total path length). Then we consider Xn, the normalized version of I(Tn), for a sequence of trees Tn. For fixed Tn's, we prove a sufficient condition for Xn to converge in distribution. As an application, we identify the limit of Xn for complete b-ary trees. For Tn being split trees , we show that Xn converges to the unique solution of a distributional equation. Finally, when Tn's are conditional Galton–Watson trees, we show that Xn converges to a random variable defined in terms of Brownian excursions. By exploiting the connection between inversions and the total path length, we are able to give results that significantly strengthen and broaden previous work by Panholzer and Seitz .
Disorder-specific internet-based cognitive–behavioural therapy (ICBT) is effective for depression, panic disorder and social anxiety. In this benchmarking study, a new, individually tailored, ICBT programme (TAIL) showed effects on depression (n = 284, d = 1.33) that were non-inferior to disorder-specific ICBT for depression in routine care (n = 2358, d = 1.35). However, the hypotheses that TAIL for individuals with social anxiety or panic disorder is inferior to disorder-specific ICBT could not be rejected (social anxiety: TAIL d = 0.74 versus disorder-specific d = 0.81; panic: TAIL d = 1.11 versus disorder-specific d = 1.47). Our findings strengthen the empirical base for TAIL as an alternative to disorder-specific ICBT for depression.
Depression is a major contributor to the burden of disease in the adolescent population. Internet-based interventions can increase access to treatment.
To evaluate the efficacy of internet-based cognitive–behavioural therapy (iCBT), including therapist chat communication, in treatment of adolescent depression.
Seventy adolescents, 15–19 years of age and presenting with depressive symptoms, were randomised to iCBT or attention control. The primary outcome was the Beck Depression Inventory II (BDI-II).
Significant reductions in depressive symptoms were found, favouring iCBT over the control condition (F(1,67) = 6.18, P < 0.05). The between-group effect size was Cohen's d = 0.71 (95% CI 0.22–1.19). A significantly higher proportion of iCBT participants (42.4%) than controls (13.5%) showed a 50% decrease in BDI-II score post-treatment (P < 0.01). The improvement for the iCBT group was maintained at 6 months.
The intervention appears to effectively reduce symptoms of depression in adolescents and may be helpful in overcoming barriers to care among young people.
Declaration of interest
N.T. and G.A. designed the programme. N.T. authored the treatment material. The web platform used for treatment is owned by Linköping University and run on a non-for-profit basis. None of the authors receives any income from the programme.
This Element on cost-benefit analysis provides a summary of recent theoretical and empirical developments and summarizes state-of-the-art stated-preference and revealed-preference valuation methods. The Element discusses how to assess small (or marginal) as well as large (or non-marginal) projects that have a significant impact on prices and/or other economic variables. It also discusses distortions like taxes, market power, and sticky prices. In addition, risk/uncertainty is considered. A novel feature is the elaboration on flexible evaluation rules for reasonably small projects. Conventional point-estimates of projects should be used with care, because they typically give biased results.
Thrombocytopenia is common in patients with invasive bacterial infections. Bacteria can activate platelets, but it is unclear if this affects platelet count. The aim of this study was to examine whether bacteraemia with Staphylococcus aureus, which readily activate human platelets, was more likely to be complicated by thrombocytopenia than bacteraemia with Escherichia coli or Streptococcus pneumoniae with different abilities to activate platelets.
We compared information from 600 adult patients with community-acquired bacteraemia with S. aureus (n = 140), E. coli (n = 420) and S. pneumoniae (n = 40) in Southern Sweden, 2012, linking information on positive blood cultures from microbiological databases and medical charts. The proportion of patients with thrombocytopenia (platelet count <150 × 109/ml) was calculated. Logistic regression was used to estimate the odds ratios (OR) for thrombocytopenia according to bacterial species adjusted for confounders.
The proportion of thrombocytopenia was 29% in S. aureus, 28% in E. coli and 20% in S. pneumonia bacteraemia (P = 0.50), corresponding to an OR of 1.2 (95% confidence interval 0.7–1.9) for thrombocytopenia for S. aureus as compared with E. coli or S. pneumoniae, adjusted for confounders.
This study indicates that platelet activation by bacteria is not a major causative mechanism in sepsis-associated thrombocytopenia.
The aim of this study is to explore the perceptions among primary health center staff concerning competencies, values, skills and resources related to team-based diabetes management and to describe the availability of needed resources for team-based approaches.
The diabetes epidemic challenges services available at primary health care centers in the Middle East. Therefore, there is a demand for evaluation of the available resources and team-based diabetes management in relation to the National Diabetes Management Guidelines.
A cross-sectional study was conducted with 26 public primary health care centers in Muscat, the capital of Oman. Data were collected from manual and electronic resources as well as a questionnaire that was distributed to the physician-in-charge and diabetes management team members.
The study revealed significant differences between professional groups regarding how they perceived their own competencies, values and skills as well as available resources related to team-based diabetes management. The perceived competencies were high among all professions. The perceived team-related values and skills were also generally high but with overall lower recordings among the nurses. This pattern, along with the fact that very few nurses have specialized qualifications, is a barrier to providing team-based diabetes management. Participants indicated that there were sufficient laboratory resources; however, reported that pharmacological, technical and human resources were lacking. Further work should be done at public primary diabetes management clinics in order to fully implement team-based diabetes management.
Schizophrenia guidelines list family interventions as an efficient means in reducing relapses. Interventions aim to help families cope with their relative's problems more effectively, provide support and education, and reduce levels of distress and improve the family communication (see deHaan et al., 2002).
Knowledge of Arctic sea-ice conditions is of great interest for Arctic residents, as well as for commercial usage, and to study the effects of climate change. Information gained from analysis of satellite data contributes to this understanding. In the course of using in situ data in combination with remotely sensed data, the question of how representative local scale measurements are of a wider region may arise. We compare in situ total sea-ice thickness measurements from the Norwegian young sea ICE expedition in the area north of Svalbard with airborne-derived total sea-ice thickness from electromagnetic soundings. A segmented and classified synthetic aperture radar (SAR) quad-pol ALOS-2 Palsar-2 satellite scene was grouped into three simplified ice classes. The area fractions of the three classes are: 11.2% ‘thin’, 74.4% ‘level’, and 14.4% ‘deformed’. The area fractions of the simplified classes from ground- and helicopter-based measurements are comparable with those achieved from the SAR data. Thus, this study shows that there is potential for a stepwise upscaling from in situ, to airborne, to satellite data, which allow us to assess whether in situ data collected are representative of a wider region as observed by satellites.
Sourdough fermentation is considered to have beneficial effects on postprandial satiety and metabolic responses, but studies demonstrating effects at physiological conditions are lacking. The aim of this acute breakfast intervention study was to determine the effect of consumption of sourdough-fermented and unfermented rye crispbread on self-rated appetite, postprandial glucose and insulin response in healthy subjects. In all, twenty-four Swedish adults were included in a single-blinded, randomised cross-over trial. Three crispbreads (sourdough-fermented and unfermented whole grain rye and yeast-fermented refined wheat as control) were consumed as part of a standardised breakfast. Subjective appetite score, assessed using visual analogue scale, and plasma glucose and insulin concentrations were measured at baseline and postprandially until 360 and 240 min, respectively. Structural changes and viscosity during mastication and gastric digestion were investigated using in vitro methods. Hunger and desire to eat were lower (P<0·05) based on AUC measurements after intake of sourdough-fermented rye crispbread compared with after intake of yeast-fermented refined wheat crispbread. On the basis of AUC (0–230 min), insulin response was lowest after intake of unfermented rye crispbread compared with sourdough-fermented rye and yeast-fermented refined wheat crispbread. Degradation of viscous fibres and faster bolus disintegration for the sourdough-fermented bread may partly explain the less favourable metabolic responses compared with unfermented bread. Our results showed that food processing affects the composition and structural characteristics of rye bread, which has implications for appetite and metabolic responses.
A recently published study suggests that Gamma-Glutamyltransferase (GGT) in midlife is related to an increased risk of dementia. In the present longitudinal study, we explore the effects of serum GGT on cognitive decline and dementia also in more advanced ages.
We analyzed GGT in a sample of 452 individuals, aged 80 years and older at baseline, with the purpose to explore subsequent effects on cognitive performance. We specifically modeled GGT to cognitive change, time to death, and dementia.
Our main finding is that a higher level of GGT is associated with cognitive decline prior to death and vascular dementia in late life. These findings were evident across cognitive domains.
This is the first longitudinal study to report on significant associations in late life between GGT, cognitive performance and dementia. Further research is needed to examine the underlying mechanisms of GGT as a marker of age-related cognitive decline.
A policy shift has taken place in Sweden towards individualised elder-care and consumer choice. The aim of the study is to investigate how older users of home care services view and experience their opportunities of exerting influence and having choice and control in their everyday living, in terms of receiving preferred services that are flexible and responsive to their actual needs and priorities. The study was conducted in three local elder-care authorities, reflecting diverse present models of organising home care services in Sweden. Data consisted of responses to a postal survey (N = 2,792) and reports from qualitative interviews (N = 28) with older users. Our findings point to similarities rather than differences between the views and experiences of the users in the three participating local municipal elder-care authorities. A majority of users were positive about their home care services. The experiences ranged from being active and enabled to choose between providers and services, to being more or less passive dependants having to rely on the decisions of family and staff. The importance of supportive relationships, and interdependence between older people and their formal as well as informal support networks, became clear. Our findings may guide policy makers in refining home care services, irrespective of preferred model. In particular, efforts to facilitate staff continuity and prevent high staff turnover need to be prioritised.