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The trade-off between boosting EU member states competitiveness and reducing within-country regional inequalities is important but under investigated relation in competitiveness and regional policy analyses. The article studies the influence of regional inequality in human capital on competitiveness of the EU member states, drawing on a panel dataset of 22 EU countries and its 266 NUTS 2 regions, over the period 2000-2011. Analysis is extended with the variables that can have significant influence on the observed relationship so EU structural and cohesion funds and (development) differences between the EU member states and regions are included. Applying different panel data estimators it is determined that higher regional inequalities in human capital reduce competitiveness of the EU member states. EU structural and cohesion funds payments have positive influence on competitiveness in the long run. EU new member states as well as the EU countries in which most of the regions are classified as less developed regions have lower competitiveness. The conclusions imply that the absorption of EU structural and cohesion funds in less developed regions does not contribute enough to strengthening national competitiveness. The results are also confirming the need to integrate more place-based approach into EU regional and even into national competitiveness policies. With its approach in analysing the influence of regional inequalities this article adds empirically to the existing studies about the ambiguous relation between regional inequalities and competitiveness, while the conclusions can be used in future EU regional policy planning that gives special emphasis on the measures which are directed on developing human capital potential.DOI: http://dx.doi.org/10.5755/j01.ee.26.3.8029

Between 2011 and 2013 the number of recorded malaria cases had more than doubled, and between 2009 and 2013 had increased almost 4-fold in MSF-OCA (Médecins sans Frontières - Operational Centre Amsterdam) programmes in the Democratic Republic of the Congo (DRC). The reasons for this rise are unclear. Incorrect intake of Artemisinin Combination Therapy (ACT) could result in failure to treat the infection and potential recurrence. An adherence study was carried out to assess whether patients were completing the full course of ACT. One hundred and eight malaria patients in Shamwana, Katanga province, DRC were visited in their households the day after ACT was supposed to be completed. They were asked a series of questions about ACT administration and the blister pack was observed (if available). Sixty seven (62.0%) patients were considered probably adherent. This did not take into account the patients that vomited or spat their pills or took them at the incorrect time of day, in which case adherence dropped to 46 (42.6%). The most common reason that patients gave for incomplete/incorrect intake was that they were vomiting or felt unwell (10 patients (24.4%), although the reasons were not recorded for 22 (53.7%) patients). This indicates that there may be poor understanding of the importance of completing the treatment or that the side effects of ACT were significant enough to over-ride the pharmacy instructions. Adherence to ACT was poor in this setting. Health education messages emphasising the need to complete ACT even if patients vomit doses, feel unwell or their health conditions improve should be promoted.

4341 4354 63 12 ; S ; In this paper, combline substrate integrated waveguide (SIW) filters using electric and magnetic couplings are thoroughly studied. Thus, a negative coupling scheme consisting on an open-ended coplanar probe is proposed and analyzed in detail. Several in-line 3-pole filters at C-band are designed, manufactured and measured showing how the presented approach can be used for implementing direct couplings while enabling an important size reduction and improved spurious-free band compared to conventional magnetic irises. A fully-packaged quasi-elliptic 4-pole filter is also designed at 5.75 GHz showing how the negative coupling structure can be used for introducing transmission zeros by means of cross-couplings between non-adjacent resonators. Finally, average and peak power handling capabilities of these filters have been also analyzed from a multiphysics point of view. Measured results validate the theoretical predictions confirming that combline SIW filters can handle significant levels of continuous and peak power, providing at the same time easy integration, compact size and advanced filtering responses. This work was supported in part by MINECO (Spanish Government) under projects TEC2013-47037-C5-1-R and TEC2013-48036-C3-3-R. This paper is an expanded version from the IEEE MTT-S International Microwave Symposium, Phoenix, AZ, USA, May 17-22, 2015. Sirci, S.; Sánchez Soriano, MÁ.; Martínez Pérez, JD.; Boria Esbert, VE.; Gentili, F.; Boesch, W.; Sorrentino, R. (2015). Design and Multiphysics Analysis of Direct and Cross-Coupled SIW Combline Filters Using Electric and Magnetic Couplings. IEEE Transactions on Microwave Theory and Techniques. 63(12):4341-4354. doi:10.1109/TMTT.2015.2495287

The nursing shortage in the USA is expected to reach 260,000 registered nurses (RNs) by 2025. The most profound shortages are expected in California and Florida, translating into 109,779 and 128,364 RN jobs, respectively. Despite a foreseen growth in nursing career opportunities nationwide, the supply of nurses will be insufficient to meet the corresponding demand. Capitalizing on prior education, experience, and skills of military clinical personnel to fill these jobs could significantly reduce the projected nursing shortage. Florida International University's Nicole Wertheim College of Nursing and Health Sciences is circumventing barriers to recruit, retain, and graduate transitioning veteran medics and corpsmen as Bachelor of Science in Nursing prepared RNs who reintegrate into the civilian workforce. The Veteran Bachelor of Science in Nursing (VBSN) program is in the form of a cooperative agreement between Florida International University and the US Health Resources and Services Administration. The VBSN program's main objective is to build upon the unique leadership skills, clinical education, and training of military medics and corpsmen to ensure successful completion of the Bachelor of Science in Nursing curriculum. VBSN students, as veterans themselves, have unique knowledge and exposure to the specific health issues and needs of the veteran population overall. They are poised and best prepared to effectively care for the US population, particularly the current 22 million US veterans and 1.6 million Florida veterans. Additionally, the VBSN program will alleviate the challenges, such as the lack of recognition of military skills, unemployment, the substandard income, and homelessness that many former service members face after separation from the military.

Context: In the Democratic Republic of Congo (DRC), scientific studies on occupational health are scarce. The present study aims at estimating the level of occupational stress, as well as associated factors, in a textile company. Methods: We performed a cross-sectional survey among textile workers in DRC. Data (N= 192 subjects) were collected through a self-questionnaire validated for the assessment of stress (Karasek and Siegrist's scale); supplemented by a medical examination. Frequencies and odds ratios (ORs) were estimated for descriptive analyses. Adjusted ORs were calculated through a logistic regression model to investigate associations between socio-demographic and organisational variable and stress. Results: Our study highlighted a high level of stress among individuals: 28% of them were suffering from stress, according to Karasek, and 22%, when applying Siegrist's model. A 14%-isostrain was calculated when considering all workers. A statistically significant association was observed between stress and age, seniority and perceived no-adaptation to work, considering both approaches. Furthermore, when job strain was determined according to Karasek, it was related to the status of worker, the poor perception of organisation and alcohol consumption, while stress estimated by applying Siegrist's model showed an association with education level and the occurrence of cardiac symptoms. Conclusion: The present study gives evidence of stress among individuals through both models. Several socio-professional factors are associated with stress, which determines populations at risk. The study revealed that both stress models offer complementary information, thus increasing the probability to model workers' health more exactly and to make recommendations on prevention and management. ; Peer reviewed

Altres ajuts: This work was supported by the Spanish government (SAF2008-02036, FIPSE-360731/09, SAF2012-39075, EC10-153, TRA-094, FIS PS09/01297), Red SIDA (RD12-0017-0037 and RD12-0017-0038) and the HIVACAT program. ; TRIAL DESIGN: Previous studies suggested that poxvirus-based vaccines might be instrumental in the therapeutic HIV field. A phase I clinical trial was conducted in HIV-1-infected patients on highly active antiretroviral therapy (HAART), with CD4 T cell counts above 450 cells/mm3 and undetectable viremia. Thirty participants were randomized (2:1) to receive either 3 intramuscular injections of MVA-B vaccine (coding for clade B HIV-1 Env, Gag, Pol and Nef antigens) or placebo,followed by interruption of HAART. METHODS: The magnitude, breadth, quality and phenotype of the HIV-1-specific T cell response were assayed by intracellular cytokine staining (ICS) in 22 volunteers pre- and post-vaccination. RESULTS: MVA-B vaccine induced newly detected HIV-1-specific CD4 T cell responses and expanded pre-existing responses (mostly against Gag, Pol and Nef antigens) that were high in magnitude, broadly directed and showed an enhanced polyfunctionality with a T effector memory (TEM) phenotype, while maintaining the magnitude and quality of the pre-existing HIV-1-specific CD8 T cell responses. In addition, vaccination also triggered preferential CD8+ T cell polyfunctional responses to the MVA vector antigens that increase in magnitude after two and three booster doses. CONCLUSION: MVA-B vaccination represents a feasible strategy to improve T cell responses in individuals with pre-existing HIV-1-specific immunity. TRIAL REGISTRATION: ClinicalTrials. gov NCT01571466.

This study aims to explain the effectiveness of the National Exam Success program at SMK 5 Jakarta. The results showed that the evaluation is based on the input of the 4 aspects and 22 sub-aspects, which have met the objective standard is 2 aspects and 17 sub-aspects, which do not meet the standards are 2 aspects and 5 sub-aspects. Aspects that meet the standards are aspects of teacher competence and aspects of school atmosphere, while some aspects of sub aspects are still not meet objective standards are aspects of infrastructure and commitment aspect Principal, Teachers, Students and Parents. Based on the sub-evaluation process, from 7 aspects and 14 sub-aspects are four aspects that meet objective standards and 3 aspects which do not meet objective standards. Aspects that meet the standards covering aspects of learners determination, determination homeroom, the responsibility of parents, and istigosyah. Medium aspects which do not meet objective standards covering aspects of the deepening of the material outside of school hours, periodically try out both internally and externally, and providing motivation by motivator. Based on the results of the evaluation sub 4 aspects and 7 sub-aspects, there are two aspects that already meet the standards of objective and two aspects that do not meet an objective standard. Aspects that meet objective standards covering aspects of achievement in the National Examination (UN) and the aspect proceed to private universities (PTS) 20%. While aspects not meet the standards covering aspects of the industry's absorbed 40% and accepted in public universities (PTN) of 40%.

Background: The international literature reports that for every completed suicide there are between 8 and 22 visits to an Emergency Department (ED) for attempted suicide/suicidal behavior. Aims: To describe the characteristics of admission to emergency departments (EDs) for suicide-related presenting complaints in the metropolitan area of Bologna; to estimate the risk for all-cause mortality and for suicide; to identify the profiles of subjects most at risk. Method: Follow-up of patients admitted to the EDs of the metropolitan area of Bologna between January 2004 and December 2010 for attempted suicide. A Cox model was used to evaluate the association between sociodemographic variables and the general mortality risk. Results: We identified 505 cases of attempted suicide, which were more frequent for female subjects, over the weekend, and at night (8:00 p.m./8:00 a.m.). The most used suicide methods were psychotropic drugs, sharp or blunt objects, and jumping from high places. In this cohort, 3.6% of subjects completed suicide (4.5% of males vs. 2.9% of females), 2.3% within 1 year of the start of follow-up. The most common causes of death were drug use and hanging. In the multivariate analysis, those who used illicit drugs 24 hr prior to admission to the ED (hazard ratio [HR] = 3.46, 95% CI = 1.23–9.73) and patients who refused the treatment (HR = 6.74, 95% CI = 1.86–24.40) showed an increased mortality risk for suicide. Conclusion: Deliberate self-harm patients presenting to the ED who refuse treatment represent a specific target group for setting up dedicated prevention schemes.

This article reports findings from a study to support the inclusion of a Whole Family Approach (WFA) within policy and provision for children and families conducted in one large northern local authority in England. In recent years mainly from research and good practice elsewhere WFA had been seen to offer opportunities to focus on shared needs, developing strengths and assessing risk factors. The principal aim was to design an evaluation framework to enable partners to assess and measure progress in the delivery of a WF strategy. Methods included individual interviews with professionals and managers (N=22) on knowledge and experience of WFA, for example their understanding of multi-agency work, along with their evidence of adopting a WFA approach. Findings demonstrate the process of how an evaluation framework was constructed based on adapting preexisting outcome-focused 'models' used to evaluate functions of partnership-working along with indigenous sources. The first type of 'model' entailed a number of dimensions including Vision and Strategy, Partnership Dynamics, Impact and Performance Measurement. The second had two key features: it drew upon the idea of realist evaluation, a paradigm used by practitioner researchers where the focus is upon identifying mechanisms that explain how an action affects outcomes in particular contexts; and the 'model' had been applied extensively to an analysis of family intervention projects. What has emerged is an evaluation framework characterised by a number of key 'signifiers' each of which is populated by a series of questions. The framework embraces introducing changes to the culture of planning and delivering services, placing building family strengths at centre-stage.

Background: Little is known about the intergenerational and cross-cultural differences in emotional wellbeing and acceptability of psychological treatments for Arab Australians. Aim: To contribute to the emerging data about the mental health status and needs of Arab Australians. Method: An Internet survey examined psychological distress and functional impairment as measured by the Kessler 10 Item scale (K-10) and the Sheehan Disability Scale (SDS) among Arab Australians. Additional questions enquired about their help-seeking behaviours, barriers to accessing psychological treatments and preferences for delivery of psychological treatments. A total of 252 participants were recruited through public talks, media and online promotions. Results: Forty-three percent of the respondents reported moderate-to-severe functional impairment ( M = 9.5; standard deviation ( SD) = 1.8), 32% reported high psychological distress ( M = 28.5; SD = 5.4) and 30% were born overseas. First-generation Arab Australians experiencing high psychological distress (i.e. K-10 ≥ 22), reported a greater preference for Internet-delivered treatment when compared to their second-generation counterparts. Only 18% of the sample reported seeking help from a mental health professional in the past year. The significant barriers reported by respondents with high psychological distress were poor mental health literacy, lack of time and stigma. Respondents preferred face-to-face (90%) over Internet-delivered treatment (55%). Finally, Arab Australians experienced higher psychological distress and underutilised mental health services when compared to the Australian population. Conclusion: Targeted public health campaigns that make culturally relevant interventions such as modifying existing Internet-delivered treatment for Arab Australians may reduce barriers and increase treatment options for this population.

Objective: The aim of this study was to evaluate the prevalence of upper-body-quadrant pain among ultrasonographers and to evaluate the association between individual ergonomics, musculoskeletal disorders, and occurrence of neck pain. Method: A hundred and ten ( N = 110) Belgian and Dutch male and female hospital ultrasonographers were consecutively enrolled in the study. Data on work-related ergonomic and musculoskeletal disorders were collected with an electronic inquiry, including questions regarding ergonomics (position of the screen, high-low table, and ergonomic chair), symptoms (neck pain, upper-limb pain), and work-related factors (consecutive working hours a day, average working hours a week). Results: Subjects with the screen on their left had significantly more neck pain (odds ratio [OR] = 3.6, p = .0286). Depending on the workspace, high-low tables increased the chance of developing neck pain (OR = 12.9, p = .0246). A screen at eye level caused less neck pain (OR = .22, p = .0610). Employees with a fixed working space were less susceptible to arm pain (OR = 0.13, p = .0058). The prevalence of arm pain was significantly higher for the vascular department compared to radiology, urology, and gynecology departments (OR = 9.2, p = .0278). Conclusions: Regarding prevention of upper-limb pain in ultrasonograph, more attention should be paid to the work environment and more specialty to the ultrasound workstation layout. Primary ergonomic prevention could provide a painless work situation for the ultrasonographer. Application: Further research on the ergonomic conditions of ultrasonography is necessary to develop ergonomic solutions in the work environment that will help to alleviate neck and arm pain.

Abstract
The global contamination with persistent organic pollutants (POPs), or compounds with similar characteristics, is well known. Still there are data gaps for POP concentrations from many areas in the world. The aim of the present study is to assess several legacies POPs and also hexabromocyclododecane (HBCDD) and methoxylated polybrominated diphenyl ethers (MeO-PBDEs) in shellfish from three locations in the Yellow Sea and East China Sea. The sources of the contaminants are discussed. Pooled samples were treated by liquid-liquid extraction and acid and column cleanup prior to analysis by gas chromatogram equipped with electron capture detector (GC-ECD) and gas chromatography-mass spectrometry (GC-MS). The by far most abundant environmental contaminant originates from dichlorodiphenyltrichloroethane (DDT), independent of species analyzed or sampling site. The results indicate ongoing or at least recent discharges of DDT. The second highest concentrations were reported for HBCDD (21–40 ng/g fat) in the shellfish, independent of sampling sites. The two natural products, 6-MeO-BDE-47 and 2′-MeO-BDE-68, were also present in the shellfish (1.3–22 and 1–14 ng/g fat, respectively). The polychlorinated biphenyl (PCB) congener CB-153 (0.8–6.5 ng/g fat), hexachlorobenzene (HCB) (1.1–3.6 ng/g fat), and β-hexachlorocyclohexane (β-HCH) (2.3–4.9 ng/g fat) were all higher than the concentrations of other HCH isomers, β-endosulfan, PBDE congeners, and mirex. Apart from the DDTs and HBCDDs, it is evident that the pollution of shellfish was similar to, or lower than, the contamination of shellfish in other parts of the world.

Les pathologies psychiques, parce qu'elles mettent en doute à la fois les capacités des personnes et leurs aptitudes à les évaluer par elles-mêmes, amènent parfois l'entourage à se poser la question de l'entrée en établissement ou de l'arrêt de la conduite automobile, remaniant ainsi profondément le mode de vie des personnes et, plus largement, leur statut d'individus autonomes. Ces pathologies font donc émerger des interrogations difficiles dans les familles où des points de vue peuvent s'opposer entre patients et entourages. Les médecins généralistes sont sollicités, car de telles décisions supposent d'abord une évaluation médicale des aptitudes des personnes, mais aussi parce qu'elles impliquent un point de vue moral sur la légitimité à dessaisir la personne de son autonomie. Ils sont ainsi sollicités à un double niveau d'expertise technique et d'autorité morale pour la construction et la légitimation de ces décisions. Comment les médecins prennent-ils place dans ces processus décisionnels complexes ? À partir de 22 entretiens de médecins généralistes, nous présenterons trois grands types de situations. Des médecins reconnus aux deux niveaux de l'expertise technique et de l'autorité morale peuvent bénéficier d'une grande autonomie décisionnelle. Mais des divergences avec les familles peuvent survenir et ces médecins sont alors peu enclins à négocier des décisions. D'autres, à l'inverse, privilégient des décisions négociées, tentent de les mettre en débat dans le groupe en refusant d'en être les principaux opérateurs. Un troisième type de situations montre des cas rares, mais difficiles, d'isolement de patients atteints de troubles psychiques et qui refusent toutes les démarches de leurs médecins. C'est alors l'attente paradoxale d'un accident de santé et l'urgence ainsi produite qui rendent possible des décisions.

AbstractJust as in other state-subsidized service areas, in the field of aviation weather there is political pressure as well as a growing economic need to substantiate or at least evaluate the economic benefits of meteorological information. The research presented in this paper has been conducted as part of a broad study concerning the economic benefits of the meteorological services in the Swiss transport sector. For the aviation sector, interviews revealed that meteorological information is a pivotal input factor in the decision-making process of airlines: In addition to security and safety purposes, airlines use meteorological information to optimize the economic efficiency of daily operations as well as for strategic decisions regarding flight routes and flight planning.In this paper a decision-making model is used to evaluate at least part of the economic benefits of the meteorological services to Switzerland's domestic airlines by analyzing the use of terminal aerodrome forecasts (TAF) at Zurich Airport (Switzerland). By lowering the probability of costly wrong decisions, meteorological information generates direct economic benefits for the airlines. The total benefits for all domestic airlines at Zurich Airport amount to between 11 and 17 million Swiss francs per year [12 to 18 million USD; 1 U.S. dollars (USD) = 0.934 Swiss francs (CHF), average exchange rate 2012]. By extrapolating the results based on the number of flights, the total economic benefits of TAF to Switzerland's domestic airlines at both main Swiss airports (Zurich and Geneva) add up to somewhere between 13 and 21 million Swiss francs per year (14 to 22 million USD).

<b><i>Background:</i></b> CYP2D6 is a critical enzyme in the metabolism of tamoxifen and potentially a key determinant in breast cancer outcomes. Our study examined patients' beliefs about how the CYP2D6 genotype would affect their prognoses. <b><i>Methods:</i></b> Women enrolled in a pharmacogenomic clinical trial and on tamoxifen for prevention or treatment of breast cancer underwent CYP2D6 genotyping (EM = extensive, IM = intermediate, PM = poor metabolizing alleles). The informed consent said that the purpose of the trial was to examine effects of dose adjustment based on genotype, but that clinical benefits were uncertain. Our embedded sub-study surveyed 320 patients prior to receiving their genotypes. We experimentally manipulated 6 vignettes to describe hypothetical tamoxifen treatment (no or yes) and hypothetical genotype (EM, IM or PM). For each vignette, women gave their perceived recurrence risk (RR; 0-100%). <b><i>Results:</i></b> Women believed that genotype would not affect their RR if they did not take tamoxifen (p = 0.06). However, women believed that if prescribed tamoxifen, genotype would affect their RR (22% if EM, 30% if IM and 40% if PM, p < 0.001). <b><i>Conclusion:</i></b> Women believed that extensive tamoxifen metabolizers had better prognoses, despite study materials stating uncertainty about any benefit. The rapidly changing nature of genomic science calls for caution when communicating clinical utility.