Development of a conceptual model of childhood asthma to inform asthma prevention policies

BackgroundThere is no definitive cure for asthma, as prevention remains a major goal. Decision analytic models are routinely used to evaluate the value-for-money proposition of interventions. Following best practice standards in decision-analytic modelling, the objective of this study was to solicit expert opinion to develop a concept map for a policy model for primary prevention of asthma.MethodsWe reviewed currently available decision analytic models for asthma prevention. A steering committee of economic modellers, allergists and respirologists was then convened to draft a conceptual model of paediatric asthma. A modified Delphi method was followed to define the context of the problem at hand (evaluation of asthma prevention strategies) and develop the concept map of the model.ResultsConsensus was achieved after three rounds of discussions, followed by concealed voting. In the final conceptual model, asthma diagnosis was based on three domains of lung function, atopy and their symptoms. The panel recommended several markers for each domain. These domains were in turn affected by several risk factors. The panel clustered all risk factors under three groups of ‘patient characteristic’, ‘family history’ and ‘environmental factors’. To be capable of modelling the interplay among risk factors, the panel recommended the use of microsimulation, with an open-population approach that would enable modelling phased implementation and gradual and incomplete uptake of the intervention.ConclusionsEconomic evaluation of childhood interventions for preventing asthma will require modelling of several codependent risk factors and multiple domains that affect the diagnosis. The conceptual model can inform the development and validation of a policy model for childhood asthma prevention.

Factors Influencing The Mutual-Support Willingness and Needs Among The Rural Elderly in China: A Cross-Sectional Study

Background This study aimed to assess the influence factors of mutual-support eldercare willingness and identify the eldercare requirements of elderly living in rural areas of Hunan Province, China. Methods Using Chi-square test and logistic regression to analyze factors influencing Participants’ eldercare and the needs for mutual-support eldercare. Results Factors influencing the mutual-support willingness and needs included individual characteristic, family security and so on. And rural elderly's demand for mutual support at a relatively high level. The total score on the social support for the aged was 36.944 ± 6.487, at a moderate level. Conclusions It is necessary to objectively evaluate the factors related to mutual-support eldercare willingness and needs, and take steps to enhance social support and meet elderly the needs of mutual- support eldercare, which is of great significance for improving the happiness of the elderly in their later years and alleviating the crisis of population aging in China.

Development of a Conceptual Model of Childhood Asthma to Inform Asthma Prevention Policies

BackgroundThere is no definitive cure for asthma; as such, prevention remains a major goal. Decision-analytic models are routinely used to evaluate the value-for-money proposition of interventions. Following best practice standards in decision-analytic modeling, the objective of this study was to solicit expert opinion to develop a concept map for a policy model for primary prevention of asthma.MethodsWe reviewed currently available decision-analytic models for asthma prevention. A steering committee of economic modelers, allergists, and respirologists was then convened to draft a conceptual model of pediatric asthma. A modified Delphi method was followed to define the context of the problem at hand (evaluation of asthma prevention strategies) and develop the concept map of the model.ResultsConsensus was achieved after three rounds of discussions, followed by concealed voting. In the final conceptual model, asthma diagnosis was based on three domains of lung function, atopy, and their symptoms. The panel recommended several markers for each domain. These domains were in turn affected by several risk factors. The panel clustered all risk factors under three groups of ‘patient characteristic’, ‘family history’, and ‘environmental factors’. To be capable of modeling the interplay among risk factors, the panel recommended the use of microsimulation, with an open-population approach that would enable modeling phased implementation and gradual and incomplete uptake of the intervention.ConclusionsEconomic evaluation of childhood interventions for preventing asthma will require modeling of several co-dependent risk factors and multiple domains that affect the diagnosis. The conceptual model can inform the development and validation of a policy model for childhood asthma prevention.FundingGenome Canada Large-Scale Applied Research Project

Probing Phase Separation and Local Lattice Distortions in Cuprates by Raman Spectroscopy

It is generally accepted that high temperature superconductors emerge when extra carriers are introduced in the parent state, which looks like a Mott insulator. Competition of the order parameters drives the system into a poorly defined pseudogap state before acquiring the normal Fermi liquid behavior with further doping. Within the low doping level, the system has the tendency for mesoscopic phase separation, which seems to be a general characteristic in all high Tc compounds, but also in the materials of colossal magnetoresistance or the relaxor ferroelectrics. In all these systems, metastable phases can be created by tuning physical variables, such as doping or pressure, and the competing order parameters can drive the compound to various states. Structural instabilities are expected at critical points and Raman spectroscopy is ideal for detecting them, since it is a very sensitive technique for detecting small lattice modifications and instabilities. In this article, phase separation and lattice distortions are examined on the most characteristic family of high temperature superconductors, the cuprates. The effect of doping or atomic substitutions on cuprates is examined concerning the induced phase separation and hydrostatic pressure for activating small local lattice distortions at the edge of lattice instability.

Diagnostic validity of ICD-10 acute and transient psychotic disorders and DSM-5 brief psychotic disorder

Background:Short-lived psychotic disorders are currently classified under “acute and transient psychotic disorders” (ATPDs) in ICD-10, and “brief psychotic disorder” (BPD) in DSM-5. This study's aim is to review the literature and address the validity of ATPDs and BPD.Method:Papers published between January 1993 and December 2016 were identified through searches in Web of Science. Reference lists in the located papers provided further sources.Results:A total of 295 articles were found and 100 were included in the review. There were only a few studies about the epidemiology, vulnerability factors, neurobiological correlates and treatment of these disorders, particularly little interest seems to exist in BPD. The available evidence suggests that short-lived psychotic disorders are rare conditions and more often affect women in early to middle adulthood. They also are neither associated with premorbid dysfunctions nor characteristic family predisposition, while there seems to be greater evidence of environmental factors particularly in developing countries and migrant populations. Follow-up studies report a favourable clinical and functional outcome, but case identification has proved difficult owing to high rates of transition mainly either to schizophrenia and related disorders or, to a lesser extent, affective disorders over the short- and longer-terms.Conclusions:Although the lack of neurobiological findings and little predictive power argue against the validity of the above diagnostic categories, it is important that they are kept apart from longer-lasting psychotic disorders both for clinical practice and research. Close overlap between ATPDs and BPD could enhance the understanding of these conditions.

Family Capitals, Livelihood Strategies, and Family Well-Being of Plantation Worker

<strong></strong>This study aimed to analyze the influence of family characteristic, family capitals, and livelihood strategy toward family well-being. The sample of this study was family with wife who worked as a tea picker in Purwabakti, Pamijahan, Bogor. There were 100 families chosen randomly in this research. Family well-being was observed based on indicators defined by National Population and Family Planning Board (NPFPB) and Statistics Indonesia (SI). The analyses used in this research were descriptive analyses, independent sample T-test, and logistic regression. The result showed husband age and family size negatively affected the family well-being. Physical capital and financial capitals positively affected the family well-being. Meanwhile, livelihood strategy did not significantly affect the family well-being.<strong></strong><p><strong>Keywords</strong>: family capitals, family well-being, livelihood strategies</p><p> </p><p>Penelitian ini bertujuan untuk menganalisis pengaruh karakteristik keluarga, kepemilikan modal keluarga, dan strategi nafkah terhadap kesejahteraan keluarga. Contoh dalam penelitian ini adalah keluarga dengan istri yang bekerja sebagai buruh pemetik teh di Desa Purwabakti, Kecamatan Pamijahan, Kabupaten Bogor. Contoh dalam penelitian ini sebanyak 100 orang yang dipilih secara acak. Kesejahteraan keluarga diukur dengan menggunakan indikator BKKBN dan BPS. Analisis yang digunakan merupakan analisis deskriptif, uji beda <em>independent sample T-test</em> dan uji regresi logistik. Hasil penelitian menunjukkan umur suami dan besar keluarga berpengaruh negatif signifikan terhadap kesejahteraan keluarga. Modal fisik dan modal finansial berpengaruh positif signifikan terhadap kesejahteraan keluarga. Sementara itu, strategi nafkah tidak berpengaruh signifikan terhadap kesejahteraan keluarga.</p><p><strong>Kata kunci</strong> : kesejahteraan keluarga, modal keluarga, strategi nafkah</p>

The Influence of Thermal Bridges on the Energy Need for Heating after Renewal: A Case Study

The contribution deals with the influence of additional heat loss caused by thermal bridges of a building on the energy need for heating. Calculations and comparisons were carried out for a simple characteristic family house built in the sixties in the last century. The family house was evaluated in original state and in four variants of a renewal.

Floristic Characteristics of the Zonal Vegetation in Guangzhou and the Implications for Urban Greening

Floristic composition of the evergreen broadleaved forest in Maofengshan, Liantang, and Baiyunshan in Guangzhou suburban areas, was analyzed based on community survey data. Field survey indicated that the community was rich in species diversity, with 101 families of vascular plants including 203 genera and 351 species. Dominant families of the flora were Rubiacea, Euphorbiaceae, Lauraceae, Moraceae, Papilionaceae, and Rutaceae, most of which are of tropical and subtropical nature. As for generic distribution, dominant geographical elements were tropical genera (74.38%) and temperate genera (13.79%), the Pan-tropic areal-type had the majority of genera (27.59%), followed by Tropical Asia and Old World Tropics, while typical tropical genera were rare. Floristic composition of the evergreen broadleaved forest community in Guangzhou suburbs and the characteristic family of the flora epitomizes the zonal flora, which will provide scientific foundation for stand rehabilitation and stand establishment approximating the natural forest community. This study also had important significance of urban greening in Guangzhou.

The prospero gene encodes a divergent homeodomain protein that controls neuronal identity in Drosophila

The Drosophila central nervous system (CNS) develops from a population of stem cells called neuroblasts; each neuroblast goes through an invariant cell lineage to produce a characteristic family of neurons or glia. We are interested in the molecular mechanisms controlling neuroblast cell lineage. Recently we identified the prospero (pros) gene, which is expressed in embryonic neuroblasts. Loss of pros function results in aberrant expression of the homeobox genes fushi tarazu, evenskipped and engrailed in a subset of neuroblast progeny, suggesting that pros plays an early and fundamental role in the specification of neuronal fate (Doe et al. 1991). Here we show that the pros gene encodes a highly divergent homeodomain. The homeodomain contains several of the most conserved amino acids characteristic of known homeodomains, yet it is considerably less basic than previously identified homeodomains. These data are consistent with a model in which pros controls neuroblast cell lineages by regulating gene expression.