DRIVER COMPETENCE PERFORMANCE INDICATORS USING OTMR

What co-curricular interventions contribute to the academic success and retention of non-traditional commencing undergraduate students identified to be at risk of academic failure or early attrition from university when taking into account distal and proximal factors?

Understanding HIV risk and addressing barriers to testing for men who have sex with men in Australia

The base paper calls for urgent implementation of activities to achieve the targets for TB control set by the 1991 World Health Assembly, the 2015 Millennium Development Goals and the Stop TB Partnership. Laserson & Wells conclude that the greatest challenge is the devastating impact of the HIV epidemic. They suggest that countries will only achieve success with an accelerated political commitment to TB/HIV collaborative activities through national revised plans built upon the Stop TB Strategy and the Global Plan to Stop TB 2006–2015. The Dominican Republic faces several challenges in addressing these targets. While the incidence of all forms of TB in the Dominican Republic has been estimated to be among the highest in the Americas (91 cases per 100 000 people in 2005),1 much progress has been achieved since the implementation of DOTS in 1999. By 2005, DOTS services had been made available to 80% of the population and detection of infectious cases was 83% for the whole country and 76% in DOTS areas. The 2003 cohort analysis suggested 80% treatment success.1 Funding for TB control has been secured for the next 3 to 5 years and technical support has been provided. A steady supply of high-quality anti-TB drugs has been assured via the Global Drug Facility, fixed-dose combinations have been introduced and a MDR-TB unit has recently been created. This impressive list of achievements was realized in a short period of time. However, to ensure sustainability and guarantee that targets are reached, 5- to 10-year national planning in line with the Global Plan to Stop TB 2006–2015 and implementation of the new Stop TB Strategy are vital. The Dominican national TB programme and its partners face several of the barriers acknowledged in the base paper. Notably, the latest data suggest that progress to address TB/HIV, MDR-TB and XDR-TB has been slow. Data on TB/HIV coinfection, which are limited to certain areas of the country, suggest that between 6% and 11% of TB patients are infected with HIV.2,3 A recent survey suggests that young adults, provinces with a high rate of tourism and sugar-mill camps should be targeted for interventions.3,4 While the country has introduced some TB/HIV collaborative activities (e.g. isoniazid prophylaxis for HIV-infected people and provision of antiretroviral drugs), there are no data on the number of HIV-infected TB patients receiving antiretroviral drugs. There is no surveillance of HIV among TB patients, no information is available on coinfected patients receiving cotrimoxazole, and a proper referral/counter referral mechanism for patients has not been established. Collaboration between TB and HIV/AIDS programmes needs to advance immediately and concretely in line with the new Stop TB Strategy.5 The recent development of national TB/HIV guidelines and inclusion of TB/HIV activities on national plans are steps in this direction. MDR-TB has been one of the greatest challenges for the Dominican Republic, which was classified by WHO in the mid-1990s as one of the world’s hot spots for MDR-TB.6 This high rate of MDR was associated with poor programme performance and lack of political will to fight the disease. TB control has now been implemented according to internationally recommended guidelines for more than 7 years, and a project to manage MDR-TB has recently started. The use of second-line drugs must be fully supervised to prevent the rise of extensively drug-resistant TB. New data on the magnitude of MDR-TB is urgently needed. In addition, a strengthened national network of properly-equipped laboratories with trained personnel and a fully functioning national reference laboratory are necessary to ensure access to quality-assured sputum smear microscopy, culture and drug-susceptibility testing. Surveillance efforts in the Dominican Republic, although following WHO/PAHO standards, need to be strengthened. While case reporting in DOTS areas suggests a steady increase in the number of cases detected, nationally there is an inconsistent pattern of increases and decreases. The quality of case finding across the country and TB programme/health system issues, such as the quality of the workforce, may be contributing factors explaining disparities. The national TB programme needs to develop and maintain a strong stewardship capacity to guide and oversee collaboration between private and public providers. Public–private approaches, including monitoring and evaluation, should be explored and implemented. Increased advocacy and social mobilization to engage civil society in TB-control efforts is also needed to increase access to DOTS services in urban and rural areas. The implementation of locally relevant operational research can also be useful in identifying programme limitations and strengths, as well as mechanisms to facilitate scaling up of activities. Finally, TB-control efforts must progress hand-in-hand with strengthening of the health system as a whole. International cooperation, financial sustainability and strong political commitment to work at all levels with different stakeholders will be the recipe to achieve targets for TB control in the Dominican Republic. ■

Mining people's semantic trajectory behaviours from geotagged photographs

On the epidemiology, biology and food-dependent reproduction of the feral pigeon (Columba livia)

La mesure de la performance financière est une question cruciale pour les parties prenantes de l’entreprise que sont les actionnaires, les membres des conseils d’administration, les dirigeants ou les bailleurs de fonds. Par ailleurs, l’efficacité de plusieurs systèmes de gestion (l’évaluation de la performance, la rémunération) est tributaire d’une sélection de mesures de performance appropriées. Dans le cadre de cette étude, cinq mesures de performance financière sont évaluées quant à leur pertinence pour les marchés boursiers et à leur utilité prédictive en matière de flux de trésorerie (modèle comptable américain) et de valeur ajoutée (modèle comptable européen). Ces mesures sont le résultat net, le résultat d’exploitation, le flux de trésorerie d’exploitation, le résultat résiduel et la valeur ajoutée. L’échantillon regroupe des firmes de trois pays dont le processus de normalisation de la comptabilité diffère : la France, les États-Unis et la Suisse. Il se dégage des résultats que la pertinence et l’utilité prédictive des mesures de performance financière dépendent des règles régissant le fonctionnement des marchés financiers et la normalisation comptable dans chaque pays. Ainsi, un processus de normalisation comptable plus souple orienté vers les besoins des investisseurs génère une relation plus étroite entre les mesures de performance et les rendements boursiers. En revanche, pour prédire les flux de trésorerie, les mesures de performance doivent reposer sur des normes comptables qui favorisent la précision et qui laissent peu de place à la flexibilité (mesures fiables). Une trop grande latitude dans l’application des règles comptables peut réduire considérablement l’utilité prédictive des mesures de performance. En outre, pour prédire la valeur ajoutée, une mesure macro-économique, le cadre français est nettement plus performant que le cadre suisse ou américain. Enfin, le fait de respecter ou non les normes IAS n’a qu’un impact mineur sur la pertinence et l’utilité prédictive des mesures de performance. Toutefois, ces résultats sont tributaires des modes de calcul utilisés pour les différents indicateurs de performance et du fait que les règles en matière de comptes consolidés pour les firmes françaises peuvent différer des règles régissant les comptes individuels.

Pharmacoepidemiology is the science of the use and the effects of drugs in large human populations. Although originally confined to post-marketing drug surveillance of rare or long-latency adverse drug events, the science is gaining increased importance and is regularly applied to assess drug utilization patterns and cost-effectiveness, to characterize target populations of drugs in development, to evaluate undiscovered beneficial or detrimental drug effects, or to provide evidence of effectiveness when randomized controlled trials face ethical or practical barriers.
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\nStevens-Johnson syndrome and toxic epidermal necrolysis (SJS/TEN) are rare but life-threatening mucocutaneous diseases that predominantly occur as adverse reactions to newly administered drugs. The current knowledge of SJS/TEN is sparse, mainly due to the rare nature of SJS/TEN and the long-time unclear classification of the disease. As a consequence many aspects of SJS/TEN remain unclear despite the severe impact of SJS/TEN on affected patients.
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\nThe aim of this comprehensive SJS/TEN project presented within this thesis was to contribute to the general understanding of SJS/TEN, thereby focusing on the epidemiology and potential culprit drugs. The project comprises five individual observational studies using data from the Clinical Practice Research Datalink (CPRD). This United Kingdom (UK)-based database contains longitudinal primary-care records of millions of patients, representative of the UK population. Information is recorded by general practitioners and includes demographics, lifestyle factors, medical diagnoses, referrals to secondary care, laboratory and diagnostic results, and a complete history of drug prescriptions.
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\nIn Study 3.1 we comprehensively validated incident SJS/TEN diagnoses recorded in the CPRD between 1995 and 2013. The aim of this study was to assess whether SJS/TEN can be studied using CPRD data, and to establish a large and valid SJS/TEN case population. Using diagnoses from secondary care as a gold standard, we managed to compose a case population consisting of 551 SJS/TEN patients with a positive predictive value of 90% in cooperation with two specialised clinicians.
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\nIn Study 3.2 we calculated an overall incidence rate in the UK of 5.76 SJS/TEN cases/1’000’000 person-years, whereby incidence rates were highest in patients aged <10 or ≥80 years. In a case-control analysis, we further found that patients of black, Asian, or mixed ethnicity were at increased risk of SJS/TEN when compared to Caucasians, and observed associations between SJS/TEN and pre-existing depression, lupus erythematosus, chronic kidney disease, recent pneumonia, and active cancer.
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\nIn the Studies 3.3, 3.4, and 3.5, we conducted case-control analyses to assess associations between SJS/TEN and drugs which have previously been associated with SJS/TEN. We furthermore calculated cumulative incidences of SJS/TEN for each of these drugs to assess the absolute risk of SJS/TEN among drug users.
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\nStudy 3.3 confirms associations between SJS/TEN and the aromatic antiepileptics carbamazepine, phenytoin, and lamotrigine, with absolute risks of 20-46 SJS/TEN cases/100’000 new users. Conversely to previous reports we did not find any exposed cases for valproate, gabapentin and pregabalin despite high number of new users (>40’000).
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\nWhile previous case-control studies reported a strong association between SJS/TEN and cotrimoxazole (sulfamethoxazole+trimethoprim), Study 3.4 was the first to show an association between SJS/TEN and trimethoprim as a single agent with an absolute risk of 1 SJS/TEN case/100’000 users. Only few patients were exposed to sulfonamide antibiotics in the CPRD which is why we were not able to study associations for sulfamethoxazole and other anti-infective sulfonamides. This study further corroborates previously reported associations between SJS/TEN and use of penicillins, quinolones, cephalosporins, and macrolides (0.3-1.0 SJS/TEN cases/100’000 users). 
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\nStudy 3.5 confirms the previously reported association between SJS/TEN and allopurinol with an absolute risk of 6 SJS/TEN cases/100’000 new users. Further drugs identified as possible triggers of SJS/TEN were coxibs (1.9 cases/100’000 new users), sulfasalazine (4.3 cases/100’000 new users), mesalamine (3.8 cases/100’000 new users), mirtazapine (1.6 cases/100’000 new users), and fluoxetine (0.2 cases/100’000 new users). We further observed an association between SJS/TEN and proton pump inhibitors (0.5-1.3 cases/100’000 new users). However, proton pumps are often used in combination with other drugs (e.g nonsteroidal anti-inflammatory drugs) which could potentially confound such an association. Only little evidence previously suggested associations between SJS/TEN and these drugs. For various other drugs which have been suggested as culprit drugs of SJS/TEN in case reports (oxicam analgesics, benzodiazepines, citalopram, sertraline, paroxetine, venlafaxine, and phosphodiesterase-5 inhibitors), we did not find any exposed SJS/TEN cases despite a high number of new users (>100’000) in the CPRD. Our results suggest that these drugs appear to be at least relatively safe in terms of SJS/TEN.
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\nIn summary, the population-based observational studies presented in this thesis contribute to the understanding of the epidemiology of SJS/TEN yielding the first calculated incidence rates of SJS/TEN in the UK and information on patients at higher risk of SJS/TEN. They further include comprehensive analyses of culprit drugs of SJS/TEN, which provide important evidence for the successful treatment of SJS/TEN patients, as early discontinuation of the culprit drug is crucial and often decisive for the outcome of SJS/TEN.

Despite several clinical tests that have been developed to qualitatively describe complex motor tasks by functional testing, these methods often depend on clinicians' interpretation, experience and training, which make the assessment results inconsistent, without the precision required to objectively assess the effect of the rehabilitative intervention. A more detailed characterization is required to fully capture the various aspects of motor control and performance during complex movements of lower and upper limbs. The need for cost-effective and clinically applicable instrumented tests would enable quantitative assessment of performance on a subject-specific basis, overcoming the limitations due to the lack of objectiveness related to individual judgment, and possibly disclosing subtle alterations that are not clearly visible to the observer. Postural motion measurements at additional locations, such as lower and upper limbs and trunk, may be necessary in order to obtain information about the inter-segmental coordination during different functional tests involved in clinical practice. With these considerations in mind, this Thesis aims: i) to suggest a novel quantitative assessment tool for the kinematics and dynamics evaluation of a multi-link kinematic chain during several functional motor tasks (i.e. squat, sit-to-stand, postural sway), using one single-axis accelerometer per segment, ii) to present a novel quantitative technique for the upper limb joint kinematics estimation, considering a 3-link kinematic chain during the Fugl-Meyer Motor Assessment and using one inertial measurement unit per segment. The suggested methods could have several positive feedbacks from clinical practice. The use of objective biomechanical measurements, provided by inertial sensor-based technique, may help clinicians to: i) objectively track changes in motor ability, ii) provide timely feedback about the effectiveness of administered rehabilitation interventions, iii) enable intervention strategies to be modified or changed if found to be ineffective, and iv) speed up the experimental sessions when several subjects are asked to perform different functional tests.

Obsessive compulsive disorder (OCD) is a neuropsychiatric disorder with a global prevalence of 2-3%. OCD can have an enormous impact on the lives of those with the disorder, with some studies suggesting suicidal ideation is present in over 50% of individuals with OCD, and other data showing a significant number of individuals attempt suicide. It is therefore important that individuals with OCD receive the best possible treatment. A greater understanding of the underlying pathophysiology of neuropsychiatric disorders among professionals and future clinicians can lead to improved treatment. However, data suggests that many students and clinicians experience "neurophobia", a lack of knowledge or confidence in cases involving the nervous system. In addition, research suggests that the relationship many students have with neurological conditions deteriorates over time, and can persist into practice.If individuals living with conditions such as OCD are to receive the best possible treatment, it is crucial that those administering care are equipped with a thorough understanding of such disorders. While research has shown that the use of interactive 3D models can improve anatomy education and more specifically neurology education, the efficacy of using of such models to engage with neuropsychiatric conditions, specifically OCD, has not been assessed. This study seeks to address this gap.In this study an interactive application for Android devices was designed using standardised software engineering methods in order to improve neuropsychiatry literacy by empowering self-pace learning through interactive 3D visualisations and animations of the neural circuitry involved in OCD. A pilot test and a usability assessment were conducted among five postgraduate life science students. Findings relating to user experience were promising, and pre-test vs. post-test evaluation suggested encouraging outcomes regarding the effectiveness of the application in improving the knowledge and understanding of OCD. In short, this study suggests that interactive 3D visualisations can improve neuropsychiatry education. For this reason, more efforts should be made to construct similar applications in order to ensure patients always receive the best possible care. Fig. 2.1 A diagrammatic representation of the CSTC circuit, based on a similar diagram by Robertson et al. (2017).

The aim of the present work was to get a more detailed understanding of the functional significance of the P300 latency. P300 latency is often used as measure of stimulus evaluation time. However, the interpretation of P300 latency as stimulus evaluation time was challenged by findings of a P300 latency sensitivity to response-related manipulations. In two studies with samples from two different countries, not only RT, but also P300 latency were used as measures of speed of information processing examining the Hick paradigm. P300 latency has been used as speed of information processing measure before, but to my knowledge never in the Hick task. The advantage of using the Hick paradigm is that the influence of response selection on P300 latency can be systematically investigated while keeping stimulus evaluation constant and minimal. Furthermore, a comparison of P300 latency and RT revealed some more information about the functionality of P300 latency. By contrasting both speed of information processing measures as predictors of intelligence, it was also investigated if RT and P300 latency explain common and/or unique parts of variance in intelligence. The present investigation replicated once more the increase of RT in dependence of the amount of bit of information that needs to be processed. Furthermore, in accordance with the mental speed approach of intelligence, participants with higher intelligence were performing faster in the Hick task than participants with lower intelligence levels. Moreover, this inverse relation between RT and intelligence was enhanced across complexity. In addition, the present work also revealed some new insights about the functional significance of P300 latency. These insights are the following: 1. A clear P300 component was elicited under all four bit conditions, including the 0 bit condition. This indicates that even in simple reaction time tasks some cognitive processing is activated. P300 is often associated with a context updating of the current mental representation in the working memory. Since each stimulus under the 0 bit condition is exactly the same as the previous one, present data suggests that P300 might have other or additional functions than context updating. One alternative function could be a monitoring role, which is determining the stimulus-response association. 2. P300 latency did increase across bit conditions. This indicates that P300 latency is not only sensitive to manipulations that focus on stimulus evaluation, but also to manipulations focusing on response selection. This finding is not compatible with the idea of P300 latency as an index of stimulus evaluation time. 3. RT and P300 latency are often expected to capture the time of similar underlying processes. Indeed, P300 latency is, similar as RT, increasing across bit conditions. However, P300 latency and RT were not related. This suggests that P300 latency and RT are not reflecting the same aspects of speed of information processing. P300 latency might be proportional to stimulus evaluation time in task that focus on stimulus evaluation. But, as the current results show, it is probably determined by completely different processes than RT. Further research is needed to get a more complex pictures of the determinants of the P300 component. 4. The relation between P300 latency and intelligence is still not clear. Present data does not confirm the suggestion of Houlihan et al. (1998) that the relation of RT and intelligence might be partly mediated by response-related processes. However, there might be other factors like subjective task difficulty and complexity, or the subject’s strategy that play a significant role in individual differences in both, P300 latency and intelligence. Further research is needed to get a more complex pictures of these factors.

نماتدهای ریشه گرهی (Meloidogyne spp) از جمله عوامل بیماریزای بسیار مهمی هستند که خسارت زیادی به محصولات کشاورزی وارد می‌سازند. روش‌های متعددی (تناوب زراعی، ارقام مقاوم و ترکیبات شیمیایی) برای کنترل آنها به کار گرفته شده است. هزینه بالا و مشکلات زیست‌محیطی (ترکیبات شیمیایی)، توجه محققان را به استفاده از روش های غیر‌شیمیایی همچون استفاده از گیاهان و فرآورده های گیاهی برای مدیریت این نماتدها معطوف کرده است. جهت بررسی تأثیر حضور تعدادی از گیاهان خانواده نعناع روی نماتد ریشه‌گرهی، از سه گیاه دارویی آویشن باغی (Thymus vulgaris)، مرزه (Saturea hortensis) و زوفا (Hyssopus officinalis) استفاده شد. این آزمایش در گلخانه ای بصورت فاکتوریل و در قالب طرح کاملا تصادفی با چهار تکرار با کشت تنها و مخلوط گوجه‌فرنگی با گیاهان دارویی زوفا، آویشن و مرزه، در حضور و بدون حضور نماتد انجام شد. ارزیابی نتایج سه ماه بعد از تلقیح نماتد و بر اساس شاخص های رشدی گوجه فرنگی و پارامترهای بیماری زایی نماتد صورت گرفت. تجزیه و تحلیل آماری داده های حاصل ‌‌نشان دهنده اثر معنی‌دار حضور سه گیاه دارویی مذکور روی کاهش خسارت نماتد بود. مؤثرترین گیاه در کاهش خسارت و بیماری زایی نماتد مرزه بود و آویشن باغی، و زوفا در درجات بعدی قرار گرفتند. در مجموع بررسی‌های گلخانه‌ای گیاهان دارویی مورد آزمایش، اثرات کنترلی مطلوبی علیه نماتد ریشه گرهی از خود نشان دادند و می‌توان استفاده از آنها را در برنامه‌های مدیریت نماتد ریشه‌گرهی مورد توجه قرار داد.

DNA Aberrations in Atypical Cancer Cohorts

Computer-Based Social Anxiety Regulation in Virtual Reality Exposure Therapy

Vegetative status of children as a territorial bio-indicator of ecological safety

Performance measurement and evaluation systems are among the most common management instruments. An integral element of this process is the use of targets, typically set in appraisal interviews and formalized via written target agreements. In this paper, we investigate the relationship between performance management and evaluation systems and individual effort, proxied by the commonly used concept of work engagement. Using four waves of a new representative, linked employer-employee data set, the Linked Personnel Panel (LPP), we apply fixed effects estimations to account for unobserved heterogeneity. Our results show positive and statistically significant relationships between the presence of a performance management and evaluation process and employee engagement on the individual level. We are further able to differentiate between appraisal interviews and written target agreements which allows us to show a positive effect of appraisal interviews and an additional positive effect of target agreements. In addition, we find first evidence that these direct relationships are partially mediated by goal clarity and procedural fairness.