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A key feature of unregulated mHealth research is the diversity of participants in this space. Applying an approach drawn from user experience design, we describe a set of archetypal unregulated mHealth researcher “personas,” which range from individuals who seek empowerment or have philanthropic objectives to those who are primarily motivated by financial gain or have misanthropic objectives. These descriptions are useful for evaluating policies applicable to mHealth to understand how they will impact various stakeholders.
Prior studies indicate greater disease burden for obesity among rural compared with urban residents but no differences for mood disorder based on geographic location. Recent attention has focused on the need to examine regional rural–urban disparities in disease burden. We focused on mood disorders and obesity prevalence within three southeastern Minnesota counties served by the Mayo Clinic Center for Translational Science Award, in Rochester, Minnesota, as these were top priorities identified in community health needs assessments.
Cross-sectional study to assess the association of rural–urban locality on 5-year (2009–2014) prevalence of mood disorder and obesity obtained using the Rochester Epidemiological Project medical records linkage system, among subjects residing in three mixed rural–urban counties on April 1, 2014. Multivariable analyses adjusted for demographics, socioeconomic status using an individual housing-based measure, and counties.
The study cohort (percent rural location) included 91,202 (15%) for Olmsted, 10,197 (51%) in Dodge, and 10,184 (57%) in Wabasha counties. On multivariate analysis, 5-year prevalence of mood disorders and obesity was significantly greater for urban compared with rural residents, after adjusting for confounders; odds ratios (95% confidence intervals): 1.21 (1.17–1.26), P < 0.001, and 1.05 (1.01–1.10), P = 0.016, respectively. Observed effects were not modified in additional models adjusted for health care utilization (HCU; ≥1 general medical examination visit and flu vaccination).
Rural–urban health disparities for burden of mood disorders and obesity are independent of socioeconomic status and HCU in a Midwestern community. It is important to assess potential regional heterogeneity of rural–urban disparities on health outcomes.
This collection of essays, by leading scholars and practitioners from a range of countries, pays homage to a pre-eminent figure in the field of intellectual property: Sam Ricketson. Inspired by the breadth of Ricketson’s work, the contributions explore issues from a perspective that looks across the field – in particular, across the regimes, jurisdictions, disciplines and professions of IP. Topics explored across the regimes include the nature of IP subject matter, overlaps in protection, historical connections between copyright and patents and the transplantation of civil law moral rights to common law copyright. In across jurisdictions, chapters address, inter alia, the application of private international law to cross-border IP disputes, the Berne Convention and AI-authored works, how countries might exit the Berne Convention and dispute settlement under TRIPS. The intersection of copyright and privacy laws, the relationship between privacy, personality and trade mark laws, the teaching of IP and human rights and the conduct of empirical and historical research in IP are among the matters considered across disciplines. Contributions across professions include the participation of scholars in IP policy making, the IP textbook in legal practice, and the role of expert evidence in IP litigation.
Using as a starting point the work of internationally-renowned Australian scholar Sam Ricketson, whose contributions to intellectual property (IP) law and practice have been extensive and richly diverse, this volume examines topical and fundamental issues from across IP law. With authors from the US, UK, Europe, Asia, Australia and New Zealand, the book is structured in four parts, which move across IP regimes, jurisdictions, disciplines and professions, addressing issues that include what exactly is protected by IP regimes; regime differences, overlaps and transplants; copyright authorship and artificial intelligence; internationalization of IP through public and private international law; IP intersections with historical and empirical research, human rights, privacy, personality and cultural identity; IP scholars and universities, and the influence of treatises and textbooks. This work should be read by anyone interested in understanding the central issues in the evolving field of IP law.
Prevention of Clostridioides difficile infection (CDI) is a national priority and may be facilitated by deployment of the Targeted Assessment for Prevention (TAP) Strategy, a quality improvement framework providing a focused approach to infection prevention. This article describes the process and outcomes of TAP Strategy implementation for CDI prevention in a healthcare system.
Hospital A was identified based on CDI surveillance data indicating an excess burden of infections above the national goal; hospitals B and C participated as part of systemwide deployment. TAP facility assessments were administered to staff to identify infection control gaps and inform CDI prevention interventions. Retrospective analysis was performed using negative-binomial, interrupted time series (ITS) regression to assess overall effect of targeted CDI prevention efforts. Analysis included hospital-onset, laboratory-identified C. difficile event data for 18 months before and after implementation of the TAP facility assessments.
The systemwide monthly CDI rate significantly decreased at the intervention (β2, −44%; P = .017), and the postintervention CDI rate trend showed a sustained decrease (β1 + β3; −12% per month; P = .008). At an individual hospital level, the CDI rate trend significantly decreased in the postintervention period at hospital A only (β1 + β3, −26% per month; P = .003).
This project demonstrates TAP Strategy implementation in a healthcare system, yielding significant decrease in the laboratory-identified C. difficile rate trend in the postintervention period at the system level and in hospital A. This project highlights the potential benefit of directing prevention efforts to facilities with the highest burden of excess infections to more efficiently reduce CDI rates.
Background: External ventricular drain (EVD) insertion is a common neurosurgical procedure performed in patients with life-threatening conditions, but can be associated with complications. The objectives of this study are to evaluate data on national practice patterns and complications rates in order to optimize clinical care Methods: The Canadian Neurosurgery Research Collaborative conducted a prospective multi-centre registry of patients undergoing EVD insertions at Canadian residency programs Results: In this interim analysis, 4 sites had recruited 46 patients (mean age: 53.9 years, male:female 2:1). Most EVD insertions occurred outside of the operating theatre, using free-hand technique, and performed by junior neurosurgery residents (R1-R3). The catheter tip was in the ipsilateral frontal horn or body of the lateral ventricle in 76% of cases. Suboptimally placed catheters did not have higher rates of short-term occlusion. EVD-related hemorrhage occurred in 6.5% (3/45) with only 1 symptomatic patient. EVD-related infection occurred in 13% (6/46) at a mean of 6 days and was associated with longer duration of CSF drainage (P=0.039; OR: 1.13) Conclusions: Interim results indicate rates of EVD-related complications may be higher than previously thought. This study will continue to recruit patients to confirm these findings and determine specific risk factors associated with them
Two samples of hydrotalcite, probably worked on by Carl Christian Hochstetter, have been discovered in the Museum für Naturkunde Berlin and given neotype status by the IMA CNMNC (proposal 15-J). The two samples from Snarum, Norway, have been reanalysed and give Mg5.84Al2.07Fe0.09(OH)16(CO3)1.08·4H2O and Mg5.75Al2.21Fe0.04(OH)16(CO3)1.12·4H2O. Both samples have a mix of the two polytypes 3R/2H in the ratio of 69.2/30.8 and 69.5/30.5%. A discussion of hydrotalcite and hydrotalcite-like phase occurrences in the literature is also presented.
Background: The Canadian Neurosurgery Research Collaborative (CNRC) is a trainee-led multi-centre collaboration made up of representatives from 12 of 14 neurosurgical centres with residency programs. To demonstrate the potential of this collaborative network, we gathered administrative operative data from each centre in order to provide a snapshot of the operative landscape in Canadian neurosurgery. Methods: Residents from each training program provided adult neurosurgical operative data for the 2014 calendar year, including the number of surgeries in the subcategories cranial, spinal, and peripheral nerve. Because some residency programs have surgeries distributed among more than one hospital, we calculated mean case load per residency program and per hospital. Results: Interim results from 6 neurosurgery residency programs are presented (with data from other programs forthcoming). Overall, there were on average 2,352 operative cases per residency program (n=6) and 1,176 operative cases per adult hospital (n=12). Among 5 programs with more detailed operative data, the mean numbers of cranial, spinal, peripheral nerve, and miscellaneous surgeries per residency program were 757 (47%), 487 (30%), 47 (3%), and 319 (20%) respectively. Conclusions: We show as a proof-of-concept that a trainee-led nation-wide research collaborative can generate meaningful data in a Canadian context.
Background: The goals of evidence-based neurosurgery are to improve surgical outcomes, reduce complications, and provide an objective basis for altering practice. The need for higher quality studies, typically prospective and multicentre, has been growing especially in light of the evolving complexity of neurosurgical interventions and heterogeneity of patient populations. In the United Kingdom (UK), trainee-led research collaboratives have been established to tackle this problem. Therefore, we sought to evaluate the potential role for a resident-led research collaborative in neurosurgery in Canada based on the UK experience. Methods: A literature review of trainee-led collaboratives was conducted utilizing PubMed and Medline. Identified articles were reviewed for study quality and clinical relevance to explore the potential benefits of collaboratives. Results: In the UK, 27 collaboratives have been established in various specialties by trainees. Some published high quality trials with implications on their clinical fields. Evidence suggests that such endeavors improves trainees’ research skills and may help cultivate a research culture tailored towards clinical trials. Conclusions: Given the growing evidence for research collaboratives in the UK, we propose launching the Canadian Neurosurgery Research Collaborative (CNRC) which currently represents 12 out of 14 neurosurgery programs in Canada, and planning its first multicenter prospective study.
To gain protection under the International Convention for the Protection of New Varieties of Plant, new plant varieties must be distinguishable from existing varieties in at least one important characteristic. Assessment of quantitative characteristics often uses a procedure based on analysis of variance of variety-by-year means for 2 years of trials. In the current paper, a new method is described that can identify those reference varieties that are so different from a candidate that there would be no reason to compare them in the subsequent year, resulting in potential cost savings. It is more objective and transparent than existing practice for quantitative characteristics based on expert opinion. The method calculates thresholds for quantitative characteristics. The thresholds are defined so that if in the first year the difference between two varieties in a characteristic is larger than the characteristic's threshold then it is highly likely that the varieties would be distinct after 2 years. Thresholds were derived based on statistical predictions of the full decision after 2 years using the first year results combined with historical data. It is shown that these thresholds are sensitive to yearly heterogeneity in the variety-by-year variation. The method accommodates this heterogeneity by modelling yearly residual variances with the inverse gamma distribution. This extension meant that exact analytical formulae were not available so an approximation was suggested. Using simulation it was found that the approximation was reasonable; for thresholds corresponding to a high probability of distinctness, the approximate thresholds were a little higher than required. The method was evaluated on a 19-year data set for field pea, comparing decisions based on first year thresholds with those based on the full 2 years. It was found that with the probability of distinctness set at 0·99, the calculated thresholds were generally lower than the existing expert-set thresholds but had acceptable levels of false positives and false negatives.
The current generation of older people who are approaching or recently experiencing retirement form part of a unique generational habitus who have experienced a cultural shift into consumerism. These baby boomers are often portrayed as engaging in excessive levels of consumption which are counter to notions of sustainable living and to intergenerational harmony. This paper focuses on an exploration of the mechanisms underpinning the consumption patterns of baby boomers as they retire. We achieve this through an understanding of the everyday practices of grocery shopping which have the potential to give greater clarity to patterns of consumption than the more unusual or ‘extraordinary’ forms of consumption such as global travel. In-depth interviews with 40 older men and women in four locations across England and Scotland were conducted at three points in time across the period of retirement. We suggest that the grocery shopping practices of these older men and women were influenced by two factors: (a) parental values and upbringing leading to the reification of thrift and frugality as virtues, alongside aspirations for self-actualisation such as undertaking global travel, and (b) the influence of household context, and caring roles, on consumption choices. We conclude with some tentative observations concerning the implications of the ways baby boomers consume in terms of increasing calls for people to live in more sustainable ways.
Crops transformed to provide resistance to herbicides with two different
mechanisms of action provide new opportunities for control of
herbicide-resistant weeds. However, unexpected interactions may develop,
especially for herbicides not generally used in tank-mixtures. The
objectives of this study were to evaluate weed control and determine
herbicide interactions and fluorescence responses with combinations of
glyphosate and glufosinate on selected weeds prevalent in Michigan cropping
systems. Field studies to determine herbicide interactions resulted in
synergism only at 0.84 kg ae ha−1 of glyphosate and 0.47 kg ai
ha−1 glufosinate in 2008. Early synergism (7 d after treatment
[DAT]) was observed in the field at several combined rates for common
lambsquarters and velvetleaf in 2009, and in the greenhouse for giant
foxtail. Differences between years were perhaps due to the effect of
environmental conditions on herbicide absorption and translocation.
Antagonism was observed in the field in 2009 for velvetleaf, common
lambsquarters, and giant foxtail especially at 840 g ae ha−1
glyphosate and 118 g ai ha−1 glufosinate, 28 DAT. Antagonism was
also observed in the greenhouse for giant foxtail and Canada thistle, 28
DAT. Fluorescence measurements on Canada thistle in the greenhouse showed
that glufosinate and glufosinate plus glyphosate acted rapidly to quench
electron transport of photosystem II (PS II) system of photosynthesis, and
the fluorescence characteristics of the glyphosate and glufosinate
combinations were indistinguishable from glufosinate alone.