Hasil untuk "Office management"

Hsing-Ju Wu, Yueh-Shan Weng, Yu-Chang Liu et al.

Abstract Background and purpose Triple-negative breast cancer (TNBC) is an aggressive subtype lacking ER, PR, and HER2 expression, with limited treatment options and poor prognosis. Recent evidence suggests the antidepressant fluoxetine may possess antitumor activity. This study evaluated the therapeutic potential and mechanisms of fluoxetine in TNBC. Methods MDA-MB-231 human and 4T1 murine TNBC cell lines were treated with fluoxetine. Cell viability, apoptosis, migration, invasion, and molecular pathway changes were assessed in vitro. A 4T1 orthotopic mouse model was used to evaluate in vivo antitumor efficacy, toxicity, and immune modulation. Results Fluoxetine reduced TNBC cell viability in a dose- and time-dependent manner, induced apoptosis via extrinsic (Fas/FasL, caspase-8) and intrinsic (mitochondrial membrane loss, caspase-9) pathways, and activated caspase-3. It inhibited migration and invasion by downregulating VEGF-A, MMP-2, MMP-9, and Cyclin D1, and suppressed the Src/JAK/NF-κB signaling axis and epithelial–mesenchymal transition markers. In vivo, fluoxetine significantly reduced tumor growth without systemic toxicity, enhanced cleaved caspase-3/8/9 expression, suppressed Src/JAK/NF-κB signaling, and increased cytotoxic T lymphocyte activity while reducing tumor-associated macrophages, myeloid-derived suppressor cells, and regulatory T cells. Conclusions and implications Fluoxetine exerts potent antitumor effects against TNBC by inducing apoptosis, inhibiting metastatic signaling, and enhancing antitumor immunity. These findings support its potential as an adjunctive agent for use in parallel with existing TNBC therapies and warrant further clinical investigation.

Xiaoyuan Sun, Liyuan Qiao, Haifeng Ding et al.

Abstract Background In recent years, the prevalence of AIDS has shown a high increase, which has become a major public health problem of international concern. According to research, the quality of life(QoL) of AIDS patients is often lower than that of patients with other chronic diseases, so how to improve the QoL of AIDS patients has become a problem that needs to be urgently focused on at present. The purpose of this study is to develop and validate the AIDS scale among the System of Quality of Life Instruments for Chronic Diseases(QLICD), name as QLICD-HIV V2.0. Methods QLICD-HIV V2.0 was developed using a programmed modular approach with multiple nominal and focus group discussions, in-depth interviews and quantitative statistical procedures. Pre-surveys and formal surveys were conducted on the preliminary version of the scale, thus completing the scale development and validation process. The reliability of the scale was analyzed using the correlation coefficient method, the variability method, and the Cronbach’s α coefficient method of classical test theory(CTT), the validity of the scale was analyzed using factor analysis and correlation analysis with the SF-36 as a criterion, and the responsiveness of the scale and of each domain/facet was assessed through paired t-tests of before and after admission scores, and calculation of the standardized response mean (SRM). Results QLICD-HIV V2.0 ultimately retained 43 items, resulting in a structure of 4 domains, subdivided into 12 facets. The scale was shown to have high reliability overall by several methods of CTT. The Cronbach’s α coefficient and test-retest reliability for the total scale were 0.90 and 0.88, respectively, with domain Cronbach’s α coefficient ranging from 0.74 to 0.85 and test-retest reliabilities ranging from 0.69 to 0.89. Factor analysis results showed KMO = 0.852, with three common factors extracted from 15 items of the specific module, accounting for 55.2% of the cumulative variance, and correlation and factor analyses confirmed good structural and criterion-related validity. Conclusions QLICD-HIV V2.0 was developed in a systematic and scientific way, and showed good reliability and validity after preliminary application, which can be further promoted and used as a new QoL scale for AIDS patients with Chinese characteristics.

Juarez C.B. Pezzuti, Jansen Zuanon, Priscila F.M. Lopes et al.

Lula’s presidency in Brazil offers great hope for the environment but plans for hydroelectric dams in Amazonia represent an area of concern. The Belo Monte hydroelectric power plant that Lula promoted in his previous administrations and still defends illustrates the contradictions. In 2015 Belo Monte diverted water from the Xingu River through a canal that, since 2019, has left a 130-km river stretch with less than 30% of its natural annual discharge. This has compromised the food security of three Indigenous groups and of traditional non-indigenous river-dwelling people dependent on the river’s fish and turtles. Endemic (and threatened) species and unique ecosystems are now being eliminated. The pending renewal of Belo Monte’s operating license poses a test for the Lula administration’s socioenvironmental commitment. We offer suggestions for improved governance for existing dams like Belo Monte but conclude that no more large dams should be built in Amazonia.

Arkadiusz Ciach

Research objectives and hypothesis/research questions The aim is to critically analyze the challenges and inequalities in the management of the financing of the tasks of local government units (LGUs) in Poland, with particular emphasis on the impact of legislative, political, and financial factors on the effectiveness of their tasks. Research questions: 1. Does the presence of councilors employed in units subordinate to local government units lead to a conflict of interest, which negatively impacts the transparency and independence of financial decisions made? 2. Does the amount of subsidies and subsidies awarded depend solely on the economic situation of municipalities, or is it also influenced by political links between local authorities and the ruling party at the central level? 3. As a result of underestimating the educational subsidy, are local government units forced to redirect their funds to finance educational tasks at the expense of other public activity areas? 4. Do the currently used algorithms for the distribution of subsidies reflect the real needs of local government units, and, as a result, there is an optimal allocation of public funds? 5. Is there equal access for local government units to European and national funds? Research methods 1. Analysis of empirical data: Examination of data from local government units (LGUs) between 2019 and 2023. 2. Comparative analysis: Evaluation of financial indicators for LGUs based on their size, own revenues, and political affiliations. 3. Statistical analysis: Investigation of differences in the allocation of financial resources to identify disparities. 4. Analysis of source documents: Review legal documents, Supreme Audit Office (NIK) reports, and local budget data from LGUs. 5. Case study: Analysis of municipalities in the Radomsko focusing on underestimating educational subsidies and conflicts of interest. 6. Critical literature review: Examination of domestic and international literature to provide context and identify relevant issues. Main results 1. The amount of subsidies and grants awarded often depends on the political affiliations of local authorities with the ruling party. 2. Educational subsidies fall short of covering actual educational costs, straining resources for other public responsibilities. 3. Councilors employed by subordinate LGU units cause conflicts of interest, harming transparency and financial independence. 4. Under governmental support programs, grant allocation processes lacked transparency and clear criteria, enabling abuses and discretionary fund distribution. 5. Financial support was unevenly distributed, worsening inequalities between wealthier and poorer regions. Implications for theory and practice For theory: the research brought a new perspective to the analysis of decentralization and self-government, showing the impact of political, legislative, and financial factors on the functioning of local governments. In particular, the results confirm the importance of political distribution theory, pointing to the practice of favoring individuals associated with the ruling party, reflecting the phenomenon of political allocation of resources. The problems of unequal allocation of resources and underestimation of education subsidies bring new elements to the theory of distributive justice, highlighting the imbalance in access to public resources between regions. For practice: research indicates an urgent need for legislative reforms aimed at simplifying and stabilizing the regulations governing the activities of local government units. Recommendation for the introduction of more transparent mechanisms for allocating public funds. Emphasize the importance of support for less developed local government units, which would reduce regional inequalities and make more efficient use of available funds.

Andre Beblek, Florian Felix Sehr, Viktor Grinewitschus et al.

The energy challenges of overcoming climate change and economic and global political crises require not only the increased integration of renewable energies but also an optimisation of energy generation and use and, as a result, a reduction in energy consumption in various sectors. Thermal energy consumption in buildings in particular accounts for a significant proportion of final energy consumption. With respect to commercial buildings, a central problem in optimising the system settings is the lack of or only limited information about the actual room temperatures as well as the comfort requirements and temperature perception of the users in the rooms on the one hand and the operational management and settings specified by the facility management, for example, the heating curves of the heating circuits, on the other. The aim here is to create a bidirectional flow of data and information so that the compromise between the necessary room temperatures and the comfort of the users and the most energy-efficient operational management possible can be achieved. In this context, the paper presents a developed and tested web platform that makes it possible to optimise the operation of the system technology, particularly the heating system in the building, from an energy point of view and to involve the building user (e.g., office employees) and to pass on information to the facility management, thus pursuing a holistic approach. In the associated Living Lab project (called ComfortLab), it was possible to obtain over 6500 votes on temperature perception and combine this with building operation and the parameters relevant to facility management. This made it possible to bridge the gap between user requirements and room temperatures on the one hand and energy consumption and the inlet temperature of the heating system and supply circuits on the other. The use of the platform makes it possible to optimise the setpoint specification, specifically the inlet temperature of individual heating circuits, considering both regular building operation at times of presence and the setting of weekend and night setback times. The results show a diversified picture regarding temperature perception and possible room temperature reductions of several degrees Celsius and energy savings in the double-digit percentage range.

Alessandra Constantini Leopardi, Alberto Adanero Velasco, Miguel Espí Mayor et al.

Introduction: One of the main challenges in pediatric dentistry is to provide a favorable experience to the patient, and the success of the treatment depends on this to a large extent. For this reason, multiple methods have arisen, among which are virtual reality glasses, that try to facilitate the management of behavior in the dental office by reducing the dental anxiety of patients. Objectives: The effectiveness of the use of virtual reality glasses as a distraction in pediatric dentistry was studied. In addition, a bibliographic review was performed to determine whether the use of virtual reality reduces anxiety and improves the behavior of children during their dental consultations and dental treatments. Methodology: To obtain the information, we performed a bibliographic review using electronic bibliographic sources from scientific databases, high-impact journals and specialized search engines. Results and Discussion: It is relatively easy to obtain information on the level of dental anxiety of the child patient by means of different scales and the use of a digital pulse oximeter, which helps us to know the effectiveness of the use of virtual reality glasses at the time of the dental procedure. The greatest controversy is found in cases in which it is not possible to adjust them because of the age and size of the child or because of the personal use of glasses. Conclusions: There are multiple studies that confirm the effectiveness of the use of virtual reality glasses as a distraction in pediatric dentistry, and these studies support the effectiveness of virtual reality glasses in reducing dental anxiety and improving the behavior of patients during their consultations and dental treatments.

Xiaowen Zhang, Fangping Tang, Yueting Chen et al.

A bidirectional axial flow pump can realize bidirectional pumping, which has a wide application prospect in coastal low-head pumping stations and water jet propulsion systems. In this paper, a typical bidirectional axial flow pump is taken as the research object, and the hydraulic model of the bidirectional axial flow pump is manufactured. The hydrodynamic characteristics of the bidirectional axial flow pump are tested on the high-precision hydraulic mechanical test bench, including the positive and negative directions. In the experiment, multiple pressure pulsation monitoring points were arranged in the impeller chamber, and the pressure fluctuations in the pump under a total of 42 flow conditions were measured by a micro pressure pulsation sensor, involving 21 working conditions of forward operation and 21 working conditions of reverse operation. According to the experimental results, the hydrodynamic characteristics, especially the pressure pulsation characteristics in the pump, of the two-way axial flow pump under positive and negative operation are comprehensively compared and analyzed, and the energy characteristics and the propagation law of pressure pulsation of the two-way axial flow pump under positive and negative operation are revealed. The research results provide an important reference for the safe and stable operation of coastal bidirectional axial flow pump stations.

Koffi Dodji Noumonvi, Gal Oblišar, Ana Žust et al.

Phenological events are good indicators of the effects of climate change, since phenological phases are sensitive to changes in environmental conditions. Although several national phenological networks monitor the phenology of different plant species, direct observations can only be conducted on individual trees, which cannot be easily extended over large and continuous areas. Remote sensing has often been applied to model phenology for large areas, focusing mostly on pure forests in which it is relatively easier to match vegetation indices with ground observations. In mixed forests, phenology modelling from remote sensing is often limited to land surface phenology, which consists of an overall phenology of all tree species present in a pixel. The potential of remote sensing for modelling the phenology of individual tree species in mixed forests remains underexplored. In this study, we applied the seasonal midpoint (SM) method with MODIS GPP to model the start of season (SOS) and the end of season (EOS) of six different tree species in Slovenian mixed forests. First, substitute locations were identified for each combination of observation station and plant species based on similar environmental conditions (aspect, slope, and altitude) and tree species of interest, and used to retrieve the remote sensing information used in the SM method after fitting the best of a Gaussian and two double logistic functions to each year of GPP time series. Then, the best thresholds were identified for SOS and EOS, and the results were validated using cross-validation. The results show clearly that the usual threshold of 0.5 is not best in most cases, especially for estimating the EOS. Despite the difficulty in modelling the phenology of different tree species in a mixed forest using remote sensing, it was possible to estimate SOS and EOS with moderate errors as low as <8 days (<i>Fagus sylvatica</i> and <i>Tilia</i> sp.) and <10 days (<i>Fagus sylvatica</i> and <i>Populus tremula</i>), respectively.

M. Mutenje, U. Chipfupa, W. Mupangwa et al.

Livestock production provides a pathway for improving livelihoods and reducing poverty in semi-arid tropical regions. However, this contribution has been affected by low livestock productivity. Most livestock programmes have also failed due to, among other things, the inability to understand the dynamics in smallholder breeding preferences. Using data from the sub-humid region in Zimbabwe, this paper sought to provide evidence on smallholder cattle breeding preferences and the implication on livestock improvement programmes. It applies the choice experiment approach to model farmer preferences for selected cattle breeding attributes. The results show three attributes that significantly affect breeding preferences. The attributes ‘cow body condition score’ and the ‘useful life of a bull/semen’ have a positive influence while ‘artificial insemination/bull maintenance cost’ negatively affects farmer preferences. This means farmers prefer breeding strategies which improve the nutrition of their cows, have a longer lifespan for the bull/semen and whose cost of breeding services is low. However, access to education and income affected these preferences. Education made farmers to make informed choices while higher incomes increased the propensity of investing in livestock breeding technologies. The findings also show that existing institutional arrangements in animal management and community grazing do not promote investment in livestock improvement. Thus, more attention should be given to improving animal nutritional management which includes promoting sustainable grazing schemes. There is also a need to provide affordable livestock breeding services through recruiting and training more artificial insemination service providers. Strong and effective institutions that provide incentives for collective participation are integral to any community-based livestock breeding programme. There is also a need to promote access to information and enhance farmers’ knowledge and capacity in improved livestock management practices.

Vineet Bhatia, Rahul Srivastava, K Srikanth Reddy et al.

The Southeast Asia Region continues to battle tuberculosis (TB) as one of its most severe health and development challenges. Unless there is a substantial increase in investments for TB prevention, diagnosis, care and treatment, there will be catastrophic effects for the region. The uncontrolled TB burden impacts socioeconomic development and increase of drug resistance in the region. Based on epidemiological inputs from a mathematical model, a costing analysis estimates that the desired targets of ending TB are achievable with additional interventions, and critical thresholds require an increase in spending by almost double the current levels. The data source for financial allocation to TB programmes is the report submitted by countries to WHO, while projections are based on modelling. The model accounts for funding needs for all strategies based on published data and accounts for programme and patient costs. This paper delineates the resource needs, availability and gaps of ending TB in the region. It is estimated that close to US$2 billion per year are needed in the region for TB-related activities for a meaningful bending of the incidence curve towards ending TB.

Caze II, Todd, Knell, Gregory P, Abt, John et al.

BackgroundApproximately 2 million children in the United States sustain a concussion annually, resulting in an economic impact as high as US $20 billion. Patients who receive treatment at concussion specialty clinics, versus primary care, experience faster recovery, thereby reducing patient burden and subsequent medical-related costs. Accessibility to specialty clinics is typically limited by the availability of in-office visits. This is particularly relevant in light of the severe acute respiratory syndrome coronavirus 2 pandemic and subsequent guidance to eliminate all non–medically necessary in-clinic visits. Telehealth has been used to effectively deliver in-clinic care across several disciplines including psychiatry, psychology, and neuropsychology. However, a model of telehealth delivered concussion assessment, treatment, and management has not been established. ObjectiveThe purposes of this paper are to describe a pediatric concussion specialty clinic’s experiences in delivering telehealth concussion services and to provide preliminary descriptive data on a sample of pediatric telehealth patients with concussions. MethodsThe specialty pediatric concussion clinic described here began providing telehealth services in 2019 and is part of the largest and fastest-growing telehealth hospital network in the United States. The clinical care process will be described, including accessing the telehealth platform, assessment during the initial appointment, injury management including communication with relevant patient stakeholders (eg, parent or guardians, athletic trainers), dissemination of rehabilitation exercises, and nature of follow-up visits. Descriptive data will include patient demographics, the radius of care, the time between the date of injury and initial visit, the average number of follow-up visits, and days until medically cleared for return-to-learn and return-to-play. ResultsThe analytic sample included 18 patients with concussions who were seen for all of their visits via telehealth between August 2019 and April 2020. The mean age of the sample was 14.5 (SD 2.5) years. The radius of care was a median of 17 (IQR 11.0-31.0) miles from the clinic with a median time between injury and the first visit of 21 (IQR 6.0-41.5) days. The mean number of visits was 2.2 (SD 0.8) with a median days between visits of 5.4 (IQR 3.0-9.3) to manage and treat the concussion. Of the 18 patients, 55.6% (n=10) were medically cleared for return-to-learn or -play in a median of 15.5 (IQR 11.0-29.0) days. ConclusionsLimited access to health care is a well-understood barrier for receiving quality care. Subsequently, there are increasing demands for flexibility in delivering concussion services remotely and in-clinic. This is the first paper to provide a clinically relevant framework for the assessment, management, and treatment of acute concussion via telehealth in a pediatric population.

Salmon Situmoran, Riandani Rezki Prana, Dewi Shinta Wulandari Lubis

This study aims to determine the effect of product quality, price and quality of service to the satisfaction of users of the Onna brand products at PT. Tunas Interior Batam. The samples in this study were 89 consumers who bought Onna products at PT. Tunas Interior in January 2018 until December 2018, sampling using the Slovin formula with a population of 851 people. Data analysis using Multiple Regression test, hypothesis testing using the coefficient of determination (R2), partial test (t test), and simultaneous test (F test), while processing using SPSS 20. The results of research using the coefficient of determination test showed that the quality of the product, price and quality of service are able to explain its existence to the variable of customer satisfaction, besides that partially product quality, price and service quality has a positive and significant effect on customer satisfaction, simultaneously product quality, price and quality of service have a positive and significant effect on customer satisfaction.

Rosalina Das, Patricia Avissar, Jessica Diaz et al.

OBJECTIVES/GOALS: The goal of this project was to a) evaluate the first five years of Miami CTSI’s Pilot Translational and Clinical Studies Program using outcome measures that quantify research productivity augmented by the CTSA Common Metrics; and b) use the results to shape future program management. METHODS/STUDY POPULATION: Pilot Program applicant and awardee demographic data were collected during the first 5-year cycle of the Miami CTSI grant. Projects were categorized into the translation spectrum based on type of research using published guidelines. Research productivity from funded pilot projects were tracked annually using internal institutional grant award databases and external databases such as PubMed and NIH Reporter. CTSA Common Metrics were tracked using the Results Based Accountability framework. Relative Citation Ratio (RCR), NIH percentile and translation impact of pilot project publications were determined using the iCite tool (NIH Office of Portfolio Analysis). RESULTS/ANTICIPATED RESULTS: The Miami CTSI’s Pilot Award Program demonstrated notable success in its first five years. Of the twenty-two projects that were funded during that time period, 45% led to follow-on funding for a total of $17.2M—a strong return on investment of 15:1. Further, 77% of awardees had at least one publication. A total of four patents and 43 publications resulted directly from the funded projects. The mean RCR for all publications was 2.7, weighted RCR was 99.87, and nine papers were been cited by clinical documents. Overall, 63% of the projects were classified as T1/T2 (pre-clinical/clinical research) and 37% as T3/T4 (post-clinical translational research/public health). DISCUSSION/SIGNIFICANCE OF IMPACT: Miami CTSI’s Pilot Award Program demonstrated success in scholarly output, follow on funding, and scientific impact. These results will serve as benchmarks going forward and will allow the CTSI to leverage program strengths in collaborating with other institutional internal award mechanisms.

Guoshuang Feng, Yueping Zeng, Jian Tian et al.

Abstract Importance Morbidity and mortality of children are important indicators of the performance of the public health system in any country. In China, the children's disease spectrum has gradually changed in recent years. However, the gender‐ and age‐specific disease spectrum for hospitalized children under 15 years old is still unclear. Objective To explore the gender‐ and age‐based distribution of diseases in hospitalized children under 15 years in China. Methods Medical records home page data for 2016 to 2018 were collected from 18 tertiary children's hospitals in China. The gender‐ and age‐specific disease spectrum was analyzed, using the tenth revision of the International Statistical Classification of Diseases and Related Health Problems (ICD‐10). Results The most common diseases were those of the respiratory system (25.7% of all 2 232 142 hospitalized children). The top three diseases for boys were diseases of the respiratory system (25.6%), diseases of the digestive system (11.4%) and certain conditions originating in the perinatal period (8.6%). The top three diseases for girls were diseases of the respiratory system (25.9%), certain conditions originating in the perinatal period (10.1%), and factors influencing health status and contact with health services (9.4%). The most common diseases for children under 1 year old were certain conditions originating in the perinatal period (38.1%). For all other age groups, the most common conditions were respiratory diseases (33.8% for those aged 1–3 years, 25.2% for those aged 4–6 years, and 12.2% for those aged 7–14 years). Interpretation This study analyzed the medical records home pages of 18 children's hospitals to provide the first overview of the disease spectrum and its gender‐ and age‐specific distribution among children in China.

Anna Hörberg, Susanne Kalén, Maria Jirwe et al.

Abstract Background Working in the emergency medical service (EMS) can be extremely varying and sometimes physically and psychologically demanding. Being new in this context can be a great challenge. This study aim to describe what ambulance nurses consider to be important support during the first year in the EMS. Methods Three hundred and eighty-nine eligible participants that had graduated from the prehospital emergency care program were identified via university registrations office in Sweden. The eligible participants received a study specific questionnaire via mail consisting of 70 statements about support during the first year. The perceived importance of each statement were graded on a 7-point Likert scale. The gradings were analysed using descriptive statistics and frequencies, mean and SD were calculated. Results Two hundred and thirty questionnaires were returned fully completed, giving a response rate of 59%. Fourteen statements regarding desirable support were rated with mean values > 6.00 and SD < 1.00 and considered as being the most important during the first year in the EMS. The important supports regarded; colleagues and work environment, management and organisation, experience-based knowledge, introduction period, practical support, and theoretical support. Most statements regarded culture and climate and the way the newcomers wanted to be treated. Conclusion It was concluded that an important way to support newcomers in the EMS is to treat them ‘nice’. This can be achieved by creating an open climate and a welcoming culture where the new professionals feel trusted and treated with respect, created ways to work structurally, have applicable medical guidelines, and for newcomers to receive feedback on their actions.

Francisco Goiana-da-Silva

Na página 191, onde se lê na linha de autoria: Francisco GOIANA-DA-SILVA1,2, Alexandre Morais NUNES3,4, Marisa MIRALDO5, Alexandra BENTO6, João BREDA7, Fernando Ferreira ARAÚJO8,9 Deverá ler-se Francisco GOIANA-DA-SILVA1,2, Alexandre Morais NUNES3,4, Marisa MIRALDO5, Alexandra BENTO6, João BREDA7,8, Fernando Ferreira ARAÚJO9,10 Na mesma página, em rodapé, onde nas afiliações dos autores se lê: 1. Estudante Doutorando em Politicas de Saúde. Department of Surgery and Cancer. Imperial College Medical School. Londres. Reino Unido. 2. Assistente Convidado de Gestão e Liderança em Saúde. Faculdade de Ciências da Saúde. Universidade da Beira Interior. Covilhã. Portugal. 3. Professor Auxiliar Convidado. Unidade Curricular de Políticas de Saúde. Instituto Superior de Ciências Sociais e Políticas. Universidade de Lisboa. Lisboa. Portugal. 4. Investigador. Centro de Administração e Políticas Públicas. Instituto Superior de Ciências Sociais e Políticas. Universidade de Lisboa. Lisboa. Portugal. 5. Associate Professor. Health Economics Department. Imperial College London Business School. Healthcare Management Group. Londres. Reino Unido. 6. Bastonária. Ordem dos Nutricionistas. Lisboa. Portugal. 7. Programme Manager. Nutrition, Physical Activity and Obesity. World Health Organisation. Lisboa. Portugal. 8. Secretário de Estado Adjunto e da Saúde. XXI Governo Constitucional. Lisboa. Portugal. 9. Professor Auxiliar Convidado. Faculdade de Medicina. Universidade do Porto. Porto. Portugal. Deverá ler-se: 1. Estudante Doutorando em Politicas de Saúde. Department of Surgery and Cancer. Imperial College Medical School. Londres. Reino Unido. 2. Assistente Convidado de Gestão e Liderança em Saúde. Faculdade de Ciências da Saúde. Universidade da Beira Interior. Covilhã. Portugal. 3. Professor Auxiliar Convidado. Unidade Curricular de Políticas de Saúde. Instituto Superior de Ciências Sociais e Políticas. Universidade de Lisboa. Lisboa. Portugal. 4. Investigador. Centro de Administração e Políticas Públicas. Instituto Superior de Ciências Sociais e Políticas. Universidade de Lisboa. Lisboa. Portugal. 5. Associate Professor. Health Economics Department. Imperial College London Business School. Healthcare Management Group. Londres. Reino Unido. 6. Bastonária. Ordem dos Nutricionistas. Lisboa. Portugal. 7. Programme Manager. Nutrition, Physical Activity and Obesity. World Health Organisation. Lisboa. Portugal. 8. Head of the WHO European Office for Prevention and Control of Noncommunicable Diseases. Moscow. Russian Federation. 9. Secretário de Estado Adjunto e da Saúde. XXI Governo Constitucional. Lisboa. Portugal. 10. Professor Auxiliar Convidado. Faculdade de Medicina. Universidade do Porto. Porto. Portugal. Na página 194, entre o corpo do manuscrito e a listagem final de referências, deverá ler-se o seguinte parágrafo: OBSERVAÇÕES João Breda é funcionário da OMS. As suas declarações no âmbito deste artigo são da sua exclusiva responsabilidade. Artigo publicado com erros: https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/10222

Tunbosun B. Oyedokun, Neil Dunse, Colin Jones

The perceived wisdom in many studies is that the establishment of a premium value is an essential prerequisite for the promotion of green buildings. This green premium is then a driver of the development of new green buildings, as well as an agent of the green transformation of the existing non-labeled properties. In this study, green premium is assessed as a potential driver of labeled office property development. Thirty-two commercial real estate professionals, working for organizations that are involved in the development, sale, letting or management of green offices, were interviewed across four cities in the United Kingdom: London, Manchester, Birmingham, and Edinburgh. The results reveal that after 15 years of an active development of green offices, the existence of a green rent premium remains elusive. Similarly, no evidence was found of a willingness to pay more to occupy green-labeled offices. The results suggest that a green premium cannot be simply seen in terms of a headline rent but more widely by reference to future income streams. Consequently, we propose a “green letting premium” as the primary motivation for the development of green offices. Our study contributes significantly to how green premium is defined, understood, and valued globally.

L. Zhan, Z. Wang, X. Zhao et al.

The painting is one of the most decorative elements of ancient Chinese architecture and it is sensitive to the natural environment. The outdoor painting is very easily to be affected by the natural environment and its color is easily to decay. In order to study the relationship between the painting decay and the physical environment, the two paintings on both east and west inner eaves of Jilan Pavilion beside the Kunming Lake in Summer Palace are taken as the research objects, because these two paintings are painted at the same period but their decay degrees are greatly different. Since 2013, the research group regularly monitors the color decay of these two paintings. Meanwhile, the physical environment around these two paintings has been monitored. Based on the analysis of the monitor data, it can be seen that the illumination is the major factor that causes the decay of the painting. Meanwhile, by using the ECOTECT software to stimulate the light environment around the Jilan Pavilion, it can be seen that it is the mirror reflection of the lake that causes the result that the illumination of the west eave (face east) is stronger than that of the east eave (face west).

Alison M. Meadow, Zack Guido, Michael A. Crimmins et al.

The National Research Council (NRC) proposed six principles for effective decision support in its 2009 report Informing Decisions in a Changing Climate. We structured a collaborative project between the Federal Emergency Management Agency Region R9 (FEMA R9), the Western Region Headquarters of the National Weather Service (WR-NWS), and the Climate Assessment of the Southwest (CLIMAS) at the University of Arizona around the application of the NRC principles. The goal of the project was to provide FEMA R9's Watch Office with climate information scaled to their temporal and spatial interests to aid them in assessing the potential risk of flood disasters. We found that we needed specific strategies and activities in order to apply the principles effectively. By using a set of established collaborative research approaches we were better able to assess FEMA R9's information needs and WR-NWS's capacity to meet those needs. Despite our diligent planning of engagement strategies, we still encountered some barriers to transitioning our decision support tool from research to operations. This paper describes our methods for planning and executing a three-party collaborative effort to provide climate services, the decision support tool developed through this process, and the lessons we will take from this deliberate collaborative process to our future work and implications of the NRC principles for the broader field of climate services. Keywords: Climate services, Emergency management, Flood risk, Decision support

Hamid Ravaghi, Ali Akbari Sari, Sima Sarvari et al.

Background: Positron emission tomography (PET) scan is a non-invasive, complicated   and expensive medical imaging technology used for diagnosis and treatment of various  diseases including cancers. This study aimed to evaluate the safety and effectiveness of this technology in Iran. Methods: The major medical electronic databases including Cochrane Library, Google Scholar, MEDLINE and IranMedex were searched. Studies that compared PET scan with another diagnostic method in terms of sensitivity, specificity and safety were used. Findings: PET scan has been found to be a non-invasive and safe procedure for diagnosing metastatic NSCLC with a sensitivity and specificity of 74% to 95% and 81% to 97%, respectively. On the other hand, the sensitivity and specificity of computed tomography (CT) scan have been reported as 60% to 67% and 73% to 77%, respectively. The corresponding values for mediastinoscopy have been 78% and 100%. In lymphoma, the specificity and sensitivity of PET scan (90% and 79% to 100%, respectively) have been higher than those of gamma scan. Although PET scan is not an appropriate method for screening and diagnosing cancer, it can contribute to staging and follow-up processes in cases of NSCLC and lymphoma. This technology adds 0.046 years (about 17 days) to the patient’s life. Conclusion: PET scan is a safe technology that has better diagnostic performance compared to similar technologies. The application of this method in staging and follow-up of NSCLC and lymphoma can prevent unnecessary surgeries and adds a few years to patients’ longevity and quality of life.