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In 2007, the Ontario Health Technology Advisory Committee (OHTAC) developed a decision framework to guide decision making around nondrug health technologies. In 2012, OHTAC commissioned a revision of this framework to enhance its usability and deepen its conceptual and theoretical foundations.
The committee overseeing this work used several methods: (a) a priori consensus on guiding principles, (b) a scoping review of decision attributes and processes used globally in health technology assessment (HTA), (c) presentations by methods experts and members of review committees, and (d) committee deliberations over a period of 3 years.
The committee adopted a multi-criteria decision-making approach, but rejected the formal use of multi-criteria decision analysis. Three broad categories of attributes were identified: (I) context criteria attributes included factors such as stakeholders, adoption pressures from neighboring jurisdictions, and potential conflicts of interest; (II) primary appraisal criteria attributes included (i) benefits and harms, (ii) economics, and (iii) patient-centered care; (III) feasibility criteria attributes included budget impact and organizational feasibility.
The revised Ontario Decision Framework is similar in some respects to frameworks used in HTA worldwide. Its distinctive characteristics are that: it is based on an explicit set of social values; HTA paradigms (evidence based medicine, economics, and bioethics/social science) are used to aggregate decision attributes; and that it is rooted in a theoretical framework of optimal decision making, rather than one related to broad social goals, such as health or welfare maximization.
The low (high) abnormal returns of stocks with high (low) beta, which we refer to as the beta anomaly, is one of the most persistent anomalies in empirical asset pricing research. This article demonstrates that investors’ demand for lottery-like stocks is an important driver of the beta anomaly. The beta anomaly is no longer detected when beta-sorted portfolios are neutralized to lottery demand, regression specifications control for lottery demand, or factor models include a lottery demand factor. The beta anomaly is concentrated in stocks with low levels of institutional ownership and it exists only when the price impact of lottery demand is concentrated in high-beta stocks.
In the mid-1940s a conflict arose – the battle for Bankside – between two plans for a contested space on London's South Bank. The electricity industry planned to rebuild Bankside power station to alleviate a critical shortage of electricity, whereas the County of London Plan envisaged redevelopment of the area as public gardens, flats and offices. This article examines these plans and their entanglement in the planning system as then constituted; it argues that the significance of the planning principles escalated the arguments from a local issue to the highest level of government. The roles of key actors who manoeuvred to influence the decision-making process are explored. The article demonstrates that the power station approval was crisis driven and imposed ill-considered conditions with long-term implications. Elements of the County of London Plan were realized through deindustrialization and the transformation of the long-derelict power station into Tate Modern in 2000.
Jets from radio galaxies can have dramatic effects on the medium through which they propagate. We review observational evidence for jet-induced star formation in low (‘FR-I’) and high (‘FR-II’) luminosity radio galaxies, at low and high redshifts respectively. We then discuss numerical simulations which are aimed to explain a jet-induced starburst (‘Minkowski's Object’) in the nearby FR-I type radio galaxy NGC 541. We conclude that jets can induce star formation in moderately dense (10 cm−3), warm (104 K) gas; that this may be more common in the dense environments of forming, active galaxies; and that this may provide a mechanism for ‘positive’ feedback from AGN in the galaxy formation process.
A fractal geometry of clast size within the test wall in the Antarctic agglutinated foraminifera Hormosina mortenseni Cushman, 1910 and Cyclammina cancellata Brady, 1879 has been identified with the use of Scanning Electron Microscopic techniques. External surface and internal clast distributions in H. mortenseni display a self-similar distribution. C. cancellata has an internal self-similar grain arrangement, whereas the exterior surface shows an alternative grain distribution. Power law relationships between particle density and grain diameter enable values of fractal dimension (D) to be calculated; these “D-values” represent the absolute gradient of the power law relationship. The dimensions acquired from the foraminiferal study correspond well with those previously obtained from natural fractal geological structures and ideal fractals. The self-similar grain arrangement within walls of the foraminifera exists over three orders of magnitude, after which alternative methods of test wall construction are evident. This suggests that a limit exists where grain selection terminates. A self-similar grain distribution limits the amount of biologically produced adhesive material required by the foraminifera for constructing their tests.
In this contribution I shall review briefly some of the recent research being carried out at the Harvard-Smithsonian Center for Astrophysics in the study of X-ray emission from clusters of galaxies. This work is being done by several of us at CFA, and I particularly wish to thank Drs. Christine Jones, William Forman, and J. Patrick Henry for permission to discuss their results. The data have been obtained from the Einstein X-ray Observatory (HEAO-2) using the imaging instruments, and in particular the Imaging Proportional Counter (IPC). This gives X-ray images with about l½ arc minute resolution over a field of view of ½° × ½° and moderate energy resolution over a band from 0.5 to 3.0 keV. (For further details see Giacconi et al. 1979).
This article examines the local economy of a parish in south-east Essex during a period when economic, social and technological factors were transforming rural Britain. Record linkages are used to construct a microhistory of Hockley to analyse the exploitation of the landscape and rural livelihoods. Agricultural and occupational change reflected many national economic and social influences, but there are also counter examples to regional patterns of farming practice and large scale agrarian capitalist landownership. The agricultural depression of c.1875–96 effected a shift from arable to livestock farming and the development of market gardening facilitated by the railway. A reduction in agricultural employment opportunities, and the absence of a cottage industry for women, led to a significant out-migration of working-age people. The microhistory demonstrates that local factors, such as access to a tidal river, the timing of the arrival of the railway, the availability of brick-making clay and new trades provided livelihood opportunities and influenced the structure and operation of the rural economy.
The Astrophysics Data System (ADS) is an integral part of the Astronomy Digital Library and the collaboration Urania. It provides access to 1 million references and connects these references with many other information centers and their data, such as on-line journals, object databases, and scanned journal articles. This article describes some of the features and links between the ADS and other on-line services.
The quantification of stress in polycrystalline materials by diffraction-based methods relies on the proper choice of grain interaction model that links the observed strain to the elastic stress state in the aggregate. X-ray elastic constants (XEC) relate the strain as measured using X-rays to the state of stress in a quasi-isotropic ensemble of grains. However, the corresponding interaction models (e.g., Voigt and Reuss limits) often possess unlikely assumptions as to mechanical response of the individual grains. The Kröner limit, which employs a self-consistent scheme based on the Eshelby inclusion method, is based on a more physical representation of isotropic grain interaction. For polycrystalline aggregates composed of crystals with cubic symmetry, Kröner limit XEC are equal to those calculated from a linear combination of Reuss and Voigt XEC, where the weighting fraction, xKr, is solely a function of the single-crystal elastic constants and scales with the material's elastic anisotropy. This weighting fraction can also be experimentally determined using a linear, least-squares regression of diffraction data from multiple reflections. Data on metallic thin films reveals that this optimal experimental weighting fraction, x*, can vary significantly from xKr, as well as that of the Neerfeld limit (x = 0.5).
Urban ethnic minority youth are often exposed to high levels of aggression and violence. As such, many aggression intervention programs that have been designed with suburban nonethnic minority youth have been used or slightly adapted in order to try and meet the needs of high-risk urban youth. The current study contributes to the literature base by examining how well a range of social–cognitive, emotional distress and victimization, and prosocial factors are related to youth aggression in a sample of urban youth. This study utilized data gathered from 109 9- to 15-year-old youth (36.7% male; 84.4% African American) and their parents or caregivers. A series of hierarchical multiple regressions were fit predicting youth aggression from social–cognitive variables, victimization and distress, and prosocial variables, controlling for youth gender and age. Each set of variables explained a significant and unique amount of the variance in youth aggressive behavior. The full model including all predictors accounted for 41% of the variance in aggression. Models suggest that youth with stronger beliefs supportive of violence, youth who experience more overt victimization, and youth who experience greater distress in overtly aggressive situations are likely to be more aggressive. In contrast, youth with higher self-esteem and youth who endorse greater leadership efficacy are likely to be less aggressive. Contrary to hypotheses, hostile attributional bias and knowledge of social information processing, experience of relational victimization, distress in relationally aggressive situations, and community engagement were not associated with aggression. Our study is one of the first to address these important questions for low-income, predominately ethnic minority urban youth, and it has clear implications for adapting aggression prevention programs to be culturally sensitive for urban African American youth.
Graphical displays of investigations are increasingly used in clinical care. Summaries of medical records for research or clinical review purposes can generate unmanageably large amounts of data, which may be helpfully summarised and displayed using timelines. During a prospective study of cancer care in primary care, care timelines were generated in Microsoft Visio, using data collected retrospectively from general practice records. Data from primary and secondary care consultations were included. Thirteen timelines were created, which proved valuable in summarising and analysing the data concerning the cases studied. Timelines provide a clear, concise way of displaying large amounts of diverse data, although some selectivity is required to facilitate interpretation. Generation of timelines in the software was time consuming: if they could be automatically generated within clinical IT systems, they would enable clinicians to generate useful summaries of care of complex cases, facilitating care reviews.
This case report describes carbon monoxide toxicity from prolonged shisha (water-pipe) smoking. The evidence base for the source and pathway of toxicity is discussed. This practice has been increasing in the UK in recent years, and emergency physicians need to be aware of the high levels of CO, with the consequent risk of clinical poisoning from water-pipe smoking.
ClarkeSFJ, StephensC, FarhanM, WardP, KeshishianC, MurrayV, ZennerD. Multiple Patients with Carbon Monoxide Toxicity from Water-Pipe Smoking. Prehosp Disaster Med. 2012;27(6):1-3.
Spherical aberration corrected Atomic Number Contrast Scanning Electron Microscopy (Z-STEM) has recently demonstrated an amazing ability to not only obtain sub-angstrom levels of detail but also yield chemical information at that level as well. With an optimal probe size of 0.8 Å, extremely detailed images of CdSe nanocrystals were obtained showing the lattice structure and surface morphology. As an example of the usefulness of this technique, a sample of CdSe nanocrystals prepared using trioctylphosphine oxide (TOPO) as the surfactant was compared to a sample of CdSe prepared using a mixture of TOPO and hexadecylamine (HDA) as the surfactant. The TOPO/HDA nanocrystals exhibit a narrower size distribution and several orders of magnitude greater fluorescence compared to that of the TOPO only nanocrystals. Interestingly, the Z-STEM images show a striking difference in nanocrystal morphology as the result of the addition of HDA to the reaction mixture. This result suggests surface morphology can be tuned through judicious choice of surfactant. A second example of Z- STEM imaging involves the characterization of CdSe/ZnS core/shell nanocrystals. The mass contrast afforded by Z-STEM can easily distinguish between core and shell.