Fidaxomicin versus Vancomycin as a First-Line Treatment for Clostridium difficile-Associated Diarrhea in Specific Patient Populations: A Pharmacoeconomic Evaluation.

PubMed

Reveles, Kelly R; Backo, Jennifer L; Corvino, Frank A; Zivkovic, Marko; Broderick, Kelly C

2017-12-01

The reduction in recurrent Clostridium difficile-associated diarrhea (CDAD) with fidaxomicin therapy may reduce hospital readmissions and lead to lower overall CDAD costs. However, studies assessing the cost-effectiveness of fidaxomicin as first-line therapy from the U.S. hospital perspective are lacking. This study evaluated the costs associated with utilizing fidaxomicin or vancomycin as a first-line therapy for CDAD in specific patient populations from a U.S. hospital perspective. A decision-analytic model was developed to estimate total costs (hospitalization and drug costs) associated with using fidaxomicin or vancomycin as first-line therapy for a first episode and up to two recurrences of CDAD in five patient populations: general population, elderly, patients receiving concomitant antibiotics, and patients with renal impairment or cancer. The total cost of CDAD treatment using fidaxomicin first line in the general population was $14,442 per patient versus $14,179 per patient with vancomycin first line. In subgroup analyses, fidaxomicin use resulted in total hospital cost savings of $616 per patient in patients with cancer and $312 in patients with concomitant antibiotic use; vancomycin use was associated with total hospital cost savings of $243 per patient in the elderly and $371 in patients with renal impairment. Fidaxomicin as first-line CDAD therapy is associated with similar total costs as compounded vancomycin oral solution in the general population. In elderly and renally impaired patients, slight increases in hospital cost were observed with fidaxomicin therapy, and in patients with cancer or concomitant antibiotic use, hospital cost savings were observed. © 2017 Pharmacotherapy Publications, Inc.

Population Health Science: A Core Element of Health Science Education in Sub-Saharan Africa.

PubMed

Hiatt, Robert A; Engmann, Natalie J; Ahmed, Mushtaq; Amarsi, Yasmin; Macharia, William M; Macfarlane, Sarah B; Ngugi, Anthony K; Rabbani, Fauziah; Walraven, Gijs; Armstrong, Robert W

2017-04-01

Sub-Saharan Africa suffers an inordinate burden of disease and does not have the numbers of suitably trained health care workers to address this challenge. New concepts in health sciences education are needed to offer alternatives to current training approaches.A perspective of integrated training in population health for undergraduate medical and nursing education is advanced, rather than continuing to take separate approaches for clinical and public health education. Population health science educates students in the social and environmental origins of disease, thus complementing disease-specific training and providing opportunities for learners to take the perspective of the community as a critical part of their education.Many of the recent initiatives in health science education in sub-Saharan Africa are reviewed, and two case studies of innovative change in undergraduate medical education are presented that begin to incorporate such population health thinking. The focus is on East Africa, one of the most rapidly growing economies in sub-Saharan Africa where opportunities for change in health science education are opening. The authors conclude that a focus on population health is a timely and effective way for enhancing training of health care professionals to reduce the burden of disease in sub-Saharan Africa.

Whither countertransference in couples and family therapy: a systemic perspective.

PubMed

Kaslow, F W

2001-08-01

This study addresses various perspectives on transference and countertransference dynamics from the context of couples and family therapy. It considers the phenomena of countertransference in couple and family therapy and illustrates treatment with three specific kinds of patient populations: adult survivors of childhood incest who receive therapy with their partner; couples group therapy; and psychotherapists and their families. How supervisors help trainees recognize and deal with the transference and countertransference in clinical practice also is explored. These reciprocal phenomena are even more complex to identify and handle in couple and family treatment than in individual therapy.

Rapid Population Growth and Human Carrying Capacity: Two Perspectives. World Bank Staff Working Papers No. 690 and Population and Development Series No. 15.

ERIC Educational Resources Information Center

Mahar, Dennis J., Ed.; And Others

Two perspectives on carrying capacity and population growth are examined. The first perspective, "Carrying Capacity and Rapid Population Growth: Definition, Cases, and Consequences" (Robert Muscat), explores the possible meanings of the idea of carrying capacity under developing country conditions, looks at historical and present-day cases of…

Science, Technology and Society in Contemporary Egypt: Background Information for Social Studies Teachers.

ERIC Educational Resources Information Center

1989

Egypt is having a very difficult time supplying enough food to meet the demands of its swelling population. This complex problem is analyzed and discussed from a variety of perspectives. Factors such as foreign aid, family planning, agriculture, demographics, and religious and social culture are examined, as well as more specific issues such as…

Special Populations At-Risk for Dropping out of School: A Discipline-Based Analysis of STEM Educators

ERIC Educational Resources Information Center

Williams, Thomas O., Jr.; Ernst, Jeremy V.; Kaui, Toni Marie

2015-01-01

This study investigated, from a national perspective, the instructional teaching load of STEM educators specific to students with disabilities and limited English Proficiency (LEP). The most recent School and Staffing Survey results of in-service science, technology, and mathematics teachers were compiled and analyzed to form subject area…

Integrating macro- and micro-level approaches in the explanation of population change

PubMed Central

Billari, Francesco C.

2015-01-01

Demographers study population change across time and place, and traditionally they place a strong emphasis on a long-range view of population change. This paper builds on current reflections on how to structure the study of population change and proposes a two-stage perspective. The first stage, discovery, focuses on the production of novel evidence at the population level. The second stage, explanation, develops accounts of demographic change and tests how the action and interaction of individuals generate what is discovered in the first stage. This explanatory stage also provides the foundation for the prediction of demographic change. The transformation of micro-level actions and interactions into macro-level population outcomes is identified as a key challenge for the second stage. Specific instances of research are discussed. PMID:25912913

Culture diversity/a mobile workforce command creative leadership, new partnerships, and innovative approaches to integration.

PubMed

Foley, Regina; Wurmser, Theresa A

2004-01-01

Today's healthcare environment requires that nursing leaders meet the needs of a growing multicultural workforce and patient population. Cultural factors may be overlooked as healthcare delivery becomes increasingly dominated by technological, economic, and social changes. Through creative leadership, the chief nurse executive (CNE) can encourage staff to pay closer attention to cultural factors that will impact on patient, staff, and hospital outcomes. The CNE can begin by enhancing his/her own multicultural competency, building these competencies in his/her staff, and then empowering staff to respect and accommodate cultural differences. An understanding to transcultural nursing theory can enhance the development and maintenance of a multicultural perspective. The use of Madeline Leininger's Culture Care modalities can assist staff in making culturally competent decisions and in implementing actions. This article will provide an overview of one community hospital's experiences in integrating a multicultural perspective to better meet the needs of specific patient populations.

Patient Populations, Clinical Associations, and System Efficiency in Healthcare Delivery System

NASA Astrophysics Data System (ADS)

Liu, Yazhuo

The efforts to improve health care delivery usually involve studies and analysis of patient populations and healthcare systems. In this dissertation, I present the research conducted in the following areas: identifying patient groups, improving treatments for specific conditions by using statistical as well as data mining techniques, and developing new operation research models to increase system efficiency from the health institutes' perspective. The results provide better understanding of high risk patient groups, more accuracy in detecting disease' correlations and practical scheduling tools that consider uncertain operation durations and real-life constraints.

Public health oncology: a framework for progress in low- and middle-income countries.

PubMed

Love, R R; Ginsburg, O M; Coleman, C N

2012-12-01

The problems of cancer are increasing in low- and middle-income countries (LMCs), which now have significant majorities of the global case and mortality burdens. The professional oncology community is being increasingly called upon to define pragmatic and realistic approaches to these problems. Focusing on mortality and case burden outcomes defines public health oncology or population-affecting cancer medicine. We use this focus to consider practical approaches. The greatest cancer burdens are in Asia. A public health oncology perspective mandates: first, addressing the major and social challenges of cancer medicine for populations: human rights, health systems, corruption, and our limited knowledge base for value-conscious interventions. Second, adoption of evolving concepts and models for sustainable development in LMCs. Third, clear and realistic statements of action and inaction affecting populations, grounded in our best cancer science, and attention to these. Finally, framing the goals and challenges for population-affecting cancer medicine requires a change in paradigm from historical top-down models of technology transfer, to one which is community-grounded and local-evidence based. Public health oncology perspectives define clear focus for much needed research on country-specific practical approaches to cancer control.

Public health oncology: a framework for progress in low- and middle-income countries†

PubMed Central

Love, R. R.; Ginsburg, O. M.; Coleman, C. N.

2012-01-01

Background The problems of cancer are increasing in low- and middle-income countries (LMCs), which now have significant majorities of the global case and mortality burdens. The professional oncology community is being increasingly called upon to define pragmatic and realistic approaches to these problems. Patients and methods Focusing on mortality and case burden outcomes defines public health oncology or population-affecting cancer medicine. We use this focus to consider practical approaches. Results The greatest cancer burdens are in Asia. A public health oncology perspective mandates: first, addressing the major and social challenges of cancer medicine for populations: human rights, health systems, corruption, and our limited knowledge base for value-conscious interventions. Second, adoption of evolving concepts and models for sustainable development in LMCs. Third, clear and realistic statements of action and inaction affecting populations, grounded in our best cancer science, and attention to these. Finally, framing the goals and challenges for population-affecting cancer medicine requires a change in paradigm from historical top-down models of technology transfer, to one which is community-grounded and local-evidence based. Conclusion Public health oncology perspectives define clear focus for much needed research on country-specific practical approaches to cancer control. PMID:23087162

Population Health Science: A Core Element of Health Science Education in Sub-Saharan Africa

PubMed Central

Engmann, Natalie J.; Ahmed, Mushtaq; Amarsi, Yasmin; Macharia, William M.; Macfarlane, Sarah B.; Ngugi, Anthony K.; Rabbani, Fauziah; Walraven, Gijs; Armstrong, Robert W.

2017-01-01

Sub-Saharan Africa suffers an inordinate burden of disease and does not have the numbers of suitably trained health care workers to address this challenge. New concepts in health sciences education are needed to offer alternatives to current training approaches. A perspective of integrated training in population health for undergraduate medical and nursing education is advanced, rather than continuing to take separate approaches for clinical and public health education. Population health science educates students in the social and environmental origins of disease, thus complementing disease-specific training and providing opportunities for learners to take the perspective of the community as a critical part of their education. Many of the recent initiatives in health science education in sub-Saharan Africa are reviewed, and two case studies of innovative change in undergraduate medical education are presented that begin to incorporate such population health thinking. The focus is on East Africa, one of the most rapidly growing economies in sub-Saharan Africa where opportunities for change in health science education are opening. The authors conclude that a focus on population health is a timely and effective way for enhancing training of health care professionals to reduce the burden of disease in sub-Saharan Africa. PMID:27508343

Disease-associated protein seeding suggests a dissociation between misfolded protein accumulation and neurodegeneration in prion disease

PubMed Central

Alibhai, James; Diack, Abigail; Manson, Jean

2017-01-01

ABSTRACT Chronic neurodegenerative diseases, such as prion diseases or Alzheimer's disease, are associated with progressive accumulation of host proteins which misfold and aggregate. Neurodegeneration is restricted to specific neuronal populations which show clear accumulation of misfolded proteins, whilst neighbouring neurons remain unaffected. Such data raise interesting questions about the vulnerability of specific neuronal populations to neurodegeneration and much research has concentrated only on the mechanisms of neurodegeneration in afflicted neuronal populations. An alternative, undervalued and almost completely unstudied question however is how and why neuronal populations are resilient to neurodegeneration. One potential answer is unaffected regions do not accumulate misfolded proteins, thus mechanisms of neurodegeneration do not become activated. In this perspectives, we discuss novel data from our laboratories which demonstrate that misfolded proteins do accumulate in regions of the brain which do not show evidence of neurodegeneration and further evidence that microglial responses may define the severity of neurodegeneration. PMID:29023184

Exploring Migratory Dynamics on HIV Transmission: The Case of Mexicans in New York City and Puebla, Mexico

PubMed Central

Guilamo-Ramos, Vincent; McCarthy, Katharine; Muñoz-Laboy, Miguel A.; de Lourdes Rosas López, Maria

2014-01-01

Migration and population movement are increasingly viewed as important factors associated with HIV transmission risk. With growing awareness of the potential impact of migration on HIV transmission, several perspectives have emerged that posit differing dynamics of risk. We considered available data on the role of migration on HIV transmission among Mexican migrants in New York City and Puebla, Mexico. Specifically, we examined 3 distinct models of migratory dynamics of HIV transmission—namely, the structural model, the local contextual model, and the interplay model. In doing so, we reframed current public health perspectives on the role of migration on HIV transmission. PMID:24825203

Climate Vulnerability and Human Migration in Global Perspective

PubMed Central

Grecequet, Martina; DeWaard, Jack; Hellmann, Jessica J.; Abel, Guy J.

2018-01-01

The relationship between climate change and human migration is not homogenous and depends critically on the differential vulnerability of population and places. If places and populations are not vulnerable, or susceptible, to climate change, then the climate–migration relationship may not materialize. The key to understanding and, from a policy perspective, planning for whether and how climate change will impact future migration patterns is therefore knowledge of the link between climate vulnerability and migration. However, beyond specific case studies, little is known about this association in global perspective. We therefore provide a descriptive, country-level portrait of this relationship. We show that the negative association between climate vulnerability and international migration holds only for countries least vulnerable to climate change, which suggests the potential for trapped populations in more vulnerable countries. However, when analyzed separately by life supporting sector (food, water, health, ecosystem services, human habitat, and infrastructure) and vulnerability dimension (exposure, sensitivity, and adaptive capacity), we detect evidence of a relationship among more, but not the most, vulnerable countries. The bilateral (i.e., country-to-country) migration show that, on average, people move from countries of higher vulnerability to lower vulnerability, reducing global risk by 15%. This finding is consistent with the idea that migration is a climate adaptation strategy. Still, ~6% of bilateral migration is maladaptive with respect to climate change, with some movement toward countries with greater climate change vulnerability. PMID:29707262

Climate Vulnerability and Human Migration in Global Perspective.

PubMed

Grecequet, Martina; DeWaard, Jack; Hellmann, Jessica J; Abel, Guy J

2017-05-01

The relationship between climate change and human migration is not homogenous and depends critically on the differential vulnerability of population and places. If places and populations are not vulnerable, or susceptible, to climate change, then the climate-migration relationship may not materialize. The key to understanding and, from a policy perspective, planning for whether and how climate change will impact future migration patterns is therefore knowledge of the link between climate vulnerability and migration. However, beyond specific case studies, little is known about this association in global perspective. We therefore provide a descriptive, country-level portrait of this relationship. We show that the negative association between climate vulnerability and international migration holds only for countries least vulnerable to climate change, which suggests the potential for trapped populations in more vulnerable countries. However, when analyzed separately by life supporting sector (food, water, health, ecosystem services, human habitat, and infrastructure) and vulnerability dimension (exposure, sensitivity, and adaptive capacity), we detect evidence of a relationship among more, but not the most, vulnerable countries. The bilateral (i.e., country-to-country) migration show that, on average, people move from countries of higher vulnerability to lower vulnerability, reducing global risk by 15%. This finding is consistent with the idea that migration is a climate adaptation strategy. Still, ~6% of bilateral migration is maladaptive with respect to climate change, with some movement toward countries with greater climate change vulnerability.

An ecological perspective on U.S. industrial poultry production: the role of anthropogenic ecosystems on the emergence of drug-resistant bacteria from agricultural environments.

PubMed

Davis, Meghan F; Price, Lance B; Liu, Cindy Meng-Hsin; Silbergeld, Ellen K

2011-06-01

The industrialization of food animal production, specifically the widespread use of antimicrobials, not only increased pressure on microbial populations, but also changed the ecosystems in which antimicrobials and bacteria interact. In this review, we argue that industrial food animal production (IFAP) is appropriately defined as an anthropogenic ecosystem. This paper uses an ecosystem perspective to frame an examination of these changes in the context of U.S. broiler chicken production. This perspective emphasizes multiple modes by which IFAP has altered microbiomes and also suggests a means of generating hypotheses for understanding and predicting the ecological impacts of IFAP in terms of the resistome and the flow of resistance within and between microbiomes. Copyright © 2011 Elsevier Ltd. All rights reserved.

Cost-effectiveness of rosuvastatin 20 mg for the prevention of cardiovascular morbidity and mortality: a Swedish economic evaluation of the JUPITER trial.

PubMed

Ohsfeldt, Robert L; Olsson, Anders G; Jensen, Marie M; Gandhi, Sanjay K; Paulsson, Thomas

2012-01-01

This study estimated the long-term health outcomes, healthcare costs, and cost-effectiveness of rosuvastatin 20 mg therapy in primary prevention of major cardiovascular disease (CVD) in a Swedish population. Based on data from the JUPITER trial, long-term CVD outcomes with rosuvastatin vs no active treatment were estimated for patients with an elevated baseline CVD risk (Framingham CVD score >20%, sub-population of JUPITER population) and for a population similar to the total JUPITER population. Using a decision-analytic model, trial CVD event rates were combined with epidemiological and cost data specific for Sweden. First and subsequent CVD events and death were estimated over a lifetime perspective. The observed relative risk reduction was extrapolated beyond the trial duration. Incremental effectiveness was measured as life-years gained (LYG) and quality-adjusted life-years (QALYs) gained. Treating 100,000 patients with rosuvastatin 20 mg was estimated to avoid 14,692 CVD events over the lifetime (8021 non-fatal MIs, 3228 non-fatal strokes, and 4924 CVD deaths) compared to placebo. This translated into an estimated gain of 42,122 QALYs and 36,865 total life years (LYG). Rosuvastatin was both more effective and less costly over a lifetime perspective, and rosuvastatin is subsequently a dominant alternative compared to no treatment in the assessed population. Using the overall JUPITER population, rosuvastatin was dominant for the lifetime horizon. In the sensitivity analysis, rosuvastatin was the dominant treatment strategy over a 20-year time horizon, and cost-effective with an incremental cost-effectiveness ratio (cost per QALY) of SEK 1783 over a 10-year time horizon. Some model inputs were derived from literature or other data sources, but uncertainty was controlled by sensitivity analyses. Results indicate that rosuvastatin 20 mg treatment is a cost-effective option vs no-treatment in patients with Framingham CVD risk >20% in Sweden and might even be cost saving if taking a long-term perspective.

Slaves immersed in a liberal ideology.

PubMed

Daly, Leslie Kim

2012-01-01

Paradigm debates have been featured in the nursing literature for over four decades. There are at least two opposing paradigms specific to nursing that have remained central in these debates. Advocates of the unitary perspective (or simultaneity paradigm) consider their theories to be more philosophically advanced and contemporary alternatives when compared to the older more traditional ideas characteristic of models they describe as originating from the totality paradigm. In the context of these debates, I focus on some theoretical positions embedded in the unitary perspective, noting their limitations with respect to integrating the individual and social mandates of nursing; nurses are responsible not only for individual health-related needs, but also for the health of the collective. I explore two hypotheses that may explain the powers of endurance of the unitary perspective. Paley, who outlines the origins of nurses' 'slave morality', inspires the first hypothesis. The second hypothesis speaks to the location of nursing knowledge development in the context of liberal ideology. In this work, I outline key conceptualizations of the unitary perspective in order to clearly illustrate the limitations of the unitary perspective for nurses' social mandate. Then, I explore how slave morality and liberal ideological assumptions might both work to sustain the unitary perspective. A paradigm for nursing must have utility in addressing both the health-related needs of individuals, and for addressing the health of the collective. To this end, I advance suggestions in three areas: first, to transform nurses' slave morality to more honest and noble aspirations; second, to examine liberal ideological premises; and third, to end paradigm debate by resituating elements of the unitary perspective to the level of mid-range theory, where it could be most effective for research and practice with specific populations. © 2011 Blackwell Publishing Ltd.

Assessment of personal care and medical robots from older adults' perspective.

PubMed

Goher, K M; Mansouri, N; Fadlallah, S O

2017-01-01

Demographic reports indicate that population of older adults is growing significantly over the world and in particular in developed nations. Consequently, there are a noticeable number of demands for certain services such as health-care systems and assistive medical robots and devices. In today's world, different types of robots play substantial roles specifically in medical sector to facilitate human life, especially older adults. Assistive medical robots and devices are created in various designs to fulfill specific needs of older adults. Though medical robots are utilized widely by senior citizens, it is dramatic to find out into what extent assistive robots satisfy their needs and expectations. This paper reviews various assessments of assistive medical robots from older adults' perspectives with the purpose of identifying senior citizen's needs, expectations, and preferences. On the other hand, these kinds of assessments inform robot designers, developers, and programmers to come up with robots fulfilling elderly's needs while improving their life quality.

Decision making with regard to antiviral intervention during an influenza pandemic.

PubMed

Shim, Eunha; Chapman, Gretchen B; Galvani, Alison P

2010-01-01

Antiviral coverage is defined by the proportion of the population that takes antiviral prophylaxis or treatment. High coverage of an antiviral drug has epidemiological and evolutionary repercussions. Antivirals select for drug resistance within the population, and individuals may experience adverse effects. To determine optimal antiviral coverage in the context of an influenza outbreak, we compared 2 perspectives: 1) the individual level (the Nash perspective), and 2) the population level (utilitarian perspective). We developed an epidemiological game-theoretic model of an influenza pandemic. The data sources were published literature and a national survey. The target population was the US population. The time horizon was 6 months. The perspective was individuals and the population overall. The interventions were antiviral prophylaxis and treatment. The outcome measures were the optimal coverage of antivirals in an influenza pandemic. At current antiviral pricing, the optimal Nash strategy is 0% coverage for prophylaxis and 30% coverage for treatment, whereas the optimal utilitarian strategy is 19% coverage for prophylaxis and 100% coverage for treatment. Subsidizing prophylaxis by $440 and treatment by $85 would bring the Nash and utilitarian strategies into alignment. For both prophylaxis and treatment, the optimal antiviral coverage decreases as pricing of antivirals increases. Our study does not incorporate the possibility of an effective vaccine and lacks probabilistic sensitivity analysis. Our survey also does not completely represent the US population. Because our model assumes a homogeneous population and homogeneous antiviral pricing, it does not incorporate heterogeneity of preference. The optimal antiviral coverage from the population perspective and individual perspectives differs widely for both prophylaxis and treatment strategies. Optimal population and individual strategies for prophylaxis and treatment might be aligned through subsidization.

Decision Making with Regard to Antiviral Intervention during an Influenza Pandemic

PubMed Central

Shim, Eunha; Chapman, Gretchen B.; Galvani, Alison P.

2012-01-01

Background Antiviral coverage is defined by the proportion of the population that takes antiviral prophylaxis or treatment. High coverage of an antiviral drug has epidemiological and evolutionary repercussions. Antivirals select for drug resistance within the population, and individuals may experience adverse effects. To determine optimal antiviral coverage in the context of an influenza outbreak, we compared 2 perspectives: 1) the individual level (the Nash perspective), and 2) the population level (utilitarian perspective). Methods We developed an epidemiological game-theoretic model of an influenza pandemic. The data sources were published literature and a national survey. The target population was the US population. The time horizon was 6 months. The perspective was individuals and the population overall. The interventions were antiviral prophylaxis and treatment. The outcome measures were the optimal coverage of antivirals in an influenza pandemic. Results At current antiviral pricing, the optimal Nash strategy is 0% coverage for prophylaxis and 30% coverage for treatment, whereas the optimal utilitarian strategy is 19% coverage for prophylaxis and 100% coverage for treatment. Subsidizing prophylaxis by $440 and treatment by $85 would bring the Nash and utilitarian strategies into alignment. For both prophylaxis and treatment, the optimal antiviral coverage decreases as pricing of antivirals increases. Our study does not incorporate the possibility of an effective vaccine and lacks probabilistic sensitivity analysis. Our survey also does not completely represent the US population. Because our model assumes a homogeneous population and homogeneous antiviral pricing, it does not incorporate heterogeneity of preference. Conclusions The optimal antiviral coverage from the population perspective and individual perspectives differs widely for both prophylaxis and treatment strategies. Optimal population and individual strategies for prophylaxis and treatment might be aligned through subsidization. PMID:20634545

from the Adolescents’ Perspective in Malaysia

PubMed

Mohd Zin, Faridah; Hillaluddin, Azlin Hilma; Mustaffa, Jamaludin

2017-05-01

Objective: This study aims to develop, validate and determine the reliability of an interactive multimedia strategy to prevent tobacco use among the young (TUPY-S) from an adolescents’ perspective. Methods: A descriptive study design was utilized. A modular instruction guideline by Russel (1974) was followed in the entire process, comprising a feasibility study, a review of existing modules, specification of the objectives, identification of the construct criterion items, learner analysis and entry behavior specification, establishment of the sequence instruction and media selection, a tryout with students and a field test. Result: Feasibility was agreed among the researchers and the school authorities. Culturally suitable rigorously developed tobacco use preventive strategies delivered using information technology (IT) are lacking in the literature. The objective of TUPY-S is to prevent tobacco use among adolescents living in Malaysia. Identified construct criterion items include knowledge, attitude, intention to use, self-efficacy, and refusal skill. The target population was early adolescents belonging to generation-Z. Content was developed from the adolescents’ perspective and delivered using IT in Malay language. Content validity, assessed by six experts in the field and module development, was good at 86%. The students’ tryout showed satisfactory face validity subjectively and objectively (85.5%) and high alpha Cronbach reliability (0.91). Conclusion: TUPY-S was confirmed to suit early adolescents of the current generation living in Malaysia. It demonstrated good content validity among the experts, satisfactory face validity and reliability among the target population. TUPY-S is ready to be evaluated for its effectiveness among early adolescents. Creative Commons Attribution License

Tobacco Use Prevention for the Young (TUPY-S): Development, Validity and Reliability of an Interactive Multimedia Strategy from the Adolescents’ Perspective in Malaysia

PubMed Central

Zin, Faridah Mohd; Hillaluddin, Azlin Hilma; Mustaffa, Jamaludin

2017-01-01

Objective: This study aims to develop, validate and determine the reliability of an interactive multimedia strategy to prevent tobacco use among the young (TUPY-S) from an adolescents’ perspective. Methods: A descriptive study design was utilized. A modular instruction guideline by Russel (1974) was followed in the entire process, comprising a feasibility study, a review of existing modules, specification of the objectives, identification of the construct criterion items, learner analysis and entry behavior specification, establishment of the sequence instruction and media selection, a tryout with students and a field test. Result: Feasibility was agreed among the researchers and the school authorities. Culturally suitable rigorously developed tobacco use preventive strategies delivered using information technology (IT) are lacking in the literature. The objective of TUPY-S is to prevent tobacco use among adolescents living in Malaysia. Identified construct criterion items include knowledge, attitude, intention to use, self-efficacy, and refusal skill. The target population was early adolescents belonging to generation-Z. Content was developed from the adolescents’ perspective and delivered using IT in Malay language. Content validity, assessed by six experts in the field and module development, was good at 86%. The students’ tryout showed satisfactory face validity subjectively and objectively (85.5%) and high alpha Cronbach reliability (0.91). Conclusion: TUPY-S was confirmed to suit early adolescents of the current generation living in Malaysia. It demonstrated good content validity among the experts, satisfactory face validity and reliability among the target population. TUPY-S is ready to be evaluated for its effectiveness among early adolescents. PMID:28612599

Integrative studies of cultural evolution: crossing disciplinary boundaries to produce new insights

PubMed Central

2018-01-01

Culture evolves according to dynamics on multiple temporal scales, from individuals' minute-by-minute behaviour to millennia of cultural accumulation that give rise to population-level differences. These dynamics act on a range of entities—including behavioural sequences, ideas and artefacts as well as individuals, populations and whole species—and involve mechanisms at multiple levels, from neurons in brains to inter-population interactions. Studying such complex phenomena requires an integration of perspectives from a diverse array of fields, as well as bridging gaps between traditionally disparate areas of study. In this article, which also serves as an introduction to the current special issue, we highlight some specific respects in which the study of cultural evolution has benefited and should continue to benefit from an integrative approach. We showcase a number of pioneering studies of cultural evolution that bring together numerous disciplines. These studies illustrate the value of perspectives from different fields for understanding cultural evolution, such as cognitive science and neuroanatomy, behavioural ecology, population dynamics, and evolutionary genetics. They also underscore the importance of understanding cultural processes when interpreting research about human genetics, neuroscience, behaviour and evolution. This article is part of the theme issue ‘Bridging cultural gaps: interdisciplinary studies in human cultural evolution’. PMID:29440515

Integrative studies of cultural evolution: crossing disciplinary boundaries to produce new insights.

PubMed

Kolodny, Oren; Feldman, Marcus W; Creanza, Nicole

2018-04-05

Culture evolves according to dynamics on multiple temporal scales, from individuals' minute-by-minute behaviour to millennia of cultural accumulation that give rise to population-level differences. These dynamics act on a range of entities-including behavioural sequences, ideas and artefacts as well as individuals, populations and whole species-and involve mechanisms at multiple levels, from neurons in brains to inter-population interactions. Studying such complex phenomena requires an integration of perspectives from a diverse array of fields, as well as bridging gaps between traditionally disparate areas of study. In this article, which also serves as an introduction to the current special issue, we highlight some specific respects in which the study of cultural evolution has benefited and should continue to benefit from an integrative approach. We showcase a number of pioneering studies of cultural evolution that bring together numerous disciplines. These studies illustrate the value of perspectives from different fields for understanding cultural evolution, such as cognitive science and neuroanatomy, behavioural ecology, population dynamics, and evolutionary genetics. They also underscore the importance of understanding cultural processes when interpreting research about human genetics, neuroscience, behaviour and evolution.This article is part of the theme issue 'Bridging cultural gaps: interdisciplinary studies in human cultural evolution'. © 2018 The Author(s).

Non-fatal disease burden for subtypes of depressive disorder: population-based epidemiological study.

PubMed

Biesheuvel-Leliefeld, Karolien E M; Kok, Gemma D; Bockting, Claudi L H; de Graaf, Ron; Ten Have, Margreet; van der Horst, Henriette E; van Schaik, Anneke; van Marwijk, Harm W J; Smit, Filip

2016-05-12

Major depression is the leading cause of non-fatal disease burden. Because major depression is not a homogeneous condition, this study estimated the non-fatal disease burden for mild, moderate and severe depression in both single episode and recurrent depression. All estimates were assessed from an individual and a population perspective and presented as unadjusted, raw estimates and as estimates adjusted for comorbidity. We used data from the first wave of the second Netherlands-Mental-Health-Survey-and-Incidence-Study (NEMESIS-2, n = 6646; single episode Diagnostic and Statistical Manual (DSM)-IV depression, n = 115; recurrent depression, n = 246). Disease burden from an individual perspective was assessed as 'disability weight * time spent in depression' for each person in the dataset. From a population perspective it was assessed as 'disability weight * time spent in depression *number of people affected'. The presence of mental disorders was assessed with the Composite International Diagnostic Interview (CIDI) 3.0. Single depressive episodes emerged as a key driver of disease burden from an individual perspective. From a population perspective, recurrent depressions emerged as a key driver. These findings remained unaltered after adjusting for comorbidity. The burden of disease differs between the subtype of depression and depends much on the choice of perspective. The distinction between an individual and a population perspective may help to avoid misunderstandings between policy makers and clinicians.

Effectiveness and cost-effectiveness of a cardiovascular risk prediction algorithm for people with severe mental illness (PRIMROSE).

PubMed

Zomer, Ella; Osborn, David; Nazareth, Irwin; Blackburn, Ruth; Burton, Alexandra; Hardoon, Sarah; Holt, Richard Ian Gregory; King, Michael; Marston, Louise; Morris, Stephen; Omar, Rumana; Petersen, Irene; Walters, Kate; Hunter, Rachael Maree

2017-09-05

To determine the cost-effectiveness of two bespoke severe mental illness (SMI)-specific risk algorithms compared with standard risk algorithms for primary cardiovascular disease (CVD) prevention in those with SMI. Primary care setting in the UK. The analysis was from the National Health Service perspective. 1000 individuals with SMI from The Health Improvement Network Database, aged 30-74 years and without existing CVD, populated the model. Four cardiovascular risk algorithms were assessed: (1) general population lipid, (2) general population body mass index (BMI), (3) SMI-specific lipid and (4) SMI-specific BMI, compared against no algorithm. At baseline, each cardiovascular risk algorithm was applied and those considered high risk ( > 10%) were assumed to be prescribed statin therapy while others received usual care. Quality-adjusted life years (QALYs) and costs were accrued for each algorithm including no algorithm, and cost-effectiveness was calculated using the net monetary benefit (NMB) approach. Deterministic and probabilistic sensitivity analyses were performed to test assumptions made and uncertainty around parameter estimates. The SMI-specific BMI algorithm had the highest NMB resulting in 15 additional QALYs and a cost saving of approximately £53 000 per 1000 patients with SMI over 10 years, followed by the general population lipid algorithm (13 additional QALYs and a cost saving of £46 000). The general population lipid and SMI-specific BMI algorithms performed equally well. The ease and acceptability of use of an SMI-specific BMI algorithm (blood tests not required) makes it an attractive algorithm to implement in clinical settings. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Cities and health: history, approaches, and key questions.

PubMed

Vlahov, David; Gibble, Emily; Freudenberg, Nicholas; Galea, Sandro

2004-12-01

The majority of the world's population will live in cities in the next few years, and the pace of urbanization worldwide will continue to accelerate over the coming decades. Such a dramatic demographic shift can be expected to have an impact on population health. Although there has been historic interest in how city living is associated with health, this interest has waxed and waned and a cogent framework has yet to evolve that encompasses key issues in urban health. In this article, the authors discuss three alternate approaches to the study of urban health today; these include considering urban health from the perspective of a presumed urban health penalty, from an urban sprawl perspective, and more comprehensively, considering how urban living conditions may be associated with health. The authors also propose three key questions that may help guide the study and practice of urban health in coming decades. These include considering what specific features of cities are causally related to health, the extent to which these features are unique to a particular city or are different between cities, and ultimately, to what extent these features of cities are modifiable in order to allow interventions that can improve the health of urban populations.

Parent–Child Interaction Therapy: current perspectives

PubMed Central

Lieneman, Corey C; Brabson, Laurel A; Highlander, April; Wallace, Nancy M; McNeil, Cheryl B

2017-01-01

Parent–Child Interaction Therapy (PCIT) is an empirically supported intervention originally developed to treat disruptive behavior problems in children between the ages of 2 and 7 years. Since its creation over 40 years ago, PCIT has been studied internationally with various populations and has been found to be an effective intervention for numerous behavioral and emotional issues. This article summarizes progress in the PCIT literature over the past decade (2006–2017) and outlines future directions for this important work. Recent PCIT research related to treatment effectiveness, treatment components, adaptations for specific populations (age groups, cultural groups, military families, individuals diagnosed with specific disorders, trauma survivors, and the hearing-impaired), format changes (group and home-based), teacher–child interaction training (TCIT), intensive PCIT (I-PCIT), treatment as prevention (for externalizing problems, child maltreatment, and developmental delays), and implementation are discussed. PMID:28790873

Long-term observation of amphibian populations inhabiting urban and forested areas in Yekaterinburg, Russia

NASA Astrophysics Data System (ADS)

Vershinin, Vladimir L.; Vershinina, Svetlana D.; Berzin, Dmitry L.; Zmeeva, Darya V.; Kinev, Alexander V.

2015-05-01

This article presents data derived from a 36 year-long uninterrupted observational study of amphibian populations living in the city and vicinity of Yekaterinburg, Russia. This area is inhabited by six amphibian species. Based on a degree of anthropogenic transformation, the urban territory is divided into five highly mosaic zones characterized by vegetation, temperature, and a distinctive water pollution profile. Population data is presented year-by-year for the number of animals, sex ratio, and species-specific fecundity including the number and quality of spawns for the following amphibian species: Salamandrella keyserligii, Rana arvalis, R. temporaria, Lissotriton vulgaris, and Pelophylax ridibundus. These data provide an excellent opportunity to assess an urban environment from an animal population-wide perspective, as well as revealing the forces driving animal adaptation to the anthropogenic transformation of habitats.

The Impact of Perspective Change As a Cognitive Reappraisal Strategy on Affect: A Systematic Review

PubMed Central

Wallace-Hadrill, Sophie M. A.; Kamboj, Sunjeev K.

2016-01-01

The strategic or deliberate adoption of a cognitively distanced, third-person perspective is proposed to adaptively regulate emotions. However, studies of psychological disorders suggest spontaneous adoption of a third-person perspective reflects counter-productive avoidance. Here, we review studies that investigate the deliberate adoption of a third- or first-person vantage perspective and its impact on affect in healthy people, “sub-clinical” populations and those with psychological disorders. A systematic search was conducted across four databases. After exclusion criteria were applied, 38 studies were identified that investigated the impact of both imagery and verbal instructions designed to encourage adoption of a third-person perspective on self-reported affect. The identified studies examined a variety of outcomes related to recalling memories, imagining scenarios and mood induction. These were associated with specific negative emotions or mood states (dysphoria/sadness, anxiety, anger), mixed or neutral affect autobiographical memories, and self-conscious affect (e.g., guilt). Engaging a third-person perspective was generally associated with a reduction in the intensity of positive and negative affect. Studies that included measures of semantic change, suggested that this is a key mediator in reduction of affect following perspective change. Strategically adopting a “distanced,” third-person perspective is linked to a reduction in affect intensity across valence, but in addition has the potential to introduce new information that regulates emotion via semantic change. Such reappraisal distinguishes deliberate adoption of a distanced perspective from the habitual and/or spontaneous shift in perspective that occurs in psychopathology. PMID:27867366

The role of consumer perspectives in estimating population need for substance use services: a scoping review.

PubMed

Hyshka, Elaine; Karekezi, Kamagaju; Tan, Benjamin; Slater, Linda G; Jahrig, Jesse; Wild, T Cameron

2017-03-20

A growing body of research assesses population need for substance use services. However, the extent to which survey research incorporates expert versus consumer perspectives on service need is unknown. We conducted a large, international review to (1) describe extant research on population need for substance use services, and the extent to which it incorporates expert and consumer perspectives on service need, (2) critically assess methodological and measurement approaches used to study consumer-defined need, and (3) examine the potential for existing research that prioritizes consumer perspectives to inform substance use service system planning. Systematic searches of seven databases identified 1930 peer-reviewed articles addressing population need for substance use services between January 1980 and May 2015. Empirical studies (n = 1887) were categorized according to source(s) of data used to derive population estimates of service need (administrative records, biological samples, qualitative data, and/or quantitative surveys). Quantitative survey studies (n = 1594) were categorized as to whether service need was assessed from an expert and/or consumer perspective; studies employing consumer-defined need measures (n = 217) received further in-depth quantitative coding to describe study designs and measurement strategies. Almost all survey studies (96%; n = 1534) used diagnostically-oriented measures derived from an expert perspective to assess service need. Of the small number (14%, n = 217) of survey studies that assessed consumer's perspectives, most (77%) measured perceived need for generic services (i.e. 'treatment'), with fewer (42%) examining self-assessed barriers to service use, or informal help-seeking from family and friends (10%). Unstandardized measures were commonly used, and very little research was longitudinal or tested hypotheses. Only one study used a consumer-defined need measure to estimate required service system capacity. Rhetorical calls for including consumer perspectives in substance use service system planning are belied by the empirical literature, which is dominated by expert-driven approaches to measuring population need. Studies addressing consumer-defined need for substance use services are conceptually underdeveloped, and exhibit methodological and measurement weaknesses. Further scholarship is needed to integrate multidisciplinary perspectives in this literature, and fully realize the promise of incorporating consumer perspectives into substance use service system planning.

An overview of depression in the elderly: a US perspective.

PubMed Central

Baker, F. M.

1996-01-01

This article is organized in seven sections. The first section presents a review of the existing epidemiologic data on the prevalence of depressive illness in different, elderly US populations (community residents versus the medically ill). Section two describes the US elderly population. Section three describes three presentations of depression in the elderly. Section four addresses the outcome of depressive disorder untreated or partially treated. In section five the data on suicide in the elderly is reviewed. An overview of specific considerations for the psychopharmacologic and psychotherapeutic treatment of depression is presented in section six. Section seven provides a summary of the major points of the article. PMID:8839033

Promiscuity, sexual selection, and genetic diversity: a reply to Spurgin.

PubMed

Lifjeld, Jan T; Gohli, Jostein; Johnsen, Arild

2013-10-01

We recently reported a positive association between female promiscuity and genetic diversity across passerine birds, and launched the hypothesis that female promiscuity acts as a balancing selection, pressure maintaining genetic diversity in populations (Gohli et al.2013). Spurgin (2013) questions both our analyses and interpretations. While we agree that the hypothesis needs more comprehensive empirical testing, we find his specific points of criticism unjustified. In a more general perspective, we call for a more explicit recognition of female mating preferences as mechanisms of selection in population genetics theory. © 2013 The Author(s). Evolution © 2013 The Society for the Study of Evolution.

Perspectives on “Disease” and “Disability” in Child Health: The Case of Childhood Neurodisability

PubMed Central

Miller, Anton Rodney; Rosenbaum, Peter

2016-01-01

Chronic health conditions are often associated with what is termed disability. Traditional thinking has focused on diagnosis and treatment of chronic diseases and disorders, with less attention to people’s functional abilities and their contextual determinants. Understanding all of these factors is integral to addressing the predicaments and needs of persons with chronic conditions. However, these complementary yet distinct “worldviews” reflected in what we call disease and disability perspectives often remain, at best, only vaguely articulated. In this paper, we explore and expand on these perspectives in light of conceptual advances, specifically the framework of the World Health Organization’s International Classification of Functioning, Disability and Health, and their epistemic underpinnings with reference to Wilhelm Windelband’s notions of nomothetic and idiographic types of knowledge. Our primary focus is the children with neurodisability – life-long conditions that onset early in life and have functional consequences that impact developmental trajectories. We critically review and analyze conceptual material, along with clinical and research evidence relevant to the experiential and clinical realities of this population, to demonstrate the limitations of a biomedically based diagnostic–therapeutic paradigm at the expense of a developmental and disability-oriented perspective. Our main aim in this paper is to argue for an explicit recognition of both disease and disability perspectives, and a more balanced and appropriate deployment of these concepts across the continuum of clinical services, research, policy-making and professional and public education in relation to children with neurodisability; we also provide concrete recommendations to advance this progressive strategy. The relevance of these aims and strategies, however, extends beyond this particular population. PMID:27833905

[Attention deficit hyperactivity disorder: from a neurodevelopmental perspective].

PubMed

Fernandez-Jaen, A; Lopez-Martin, S; Albert, J; Martin Fernandez-Mayoralas, D; Fernandez-Perrone, A L; Calleja-Perez, B; Lopez-Arribas, S

2017-02-24

Neurodevelopmental disorders cover a heterogeneous group of disorders such as intellectual disability, autism spectrum disorders or specific learning difficulties, among others. The neurobiological and clinical variables seem to clearly justify the recent inclusion of attention deficit hyperactivity disorder (ADHD) as a neurodevelopmental disorder in the international classifications. Neurodevelopmental disorders are characterised by their dimensional nature and the distribution of the different symptoms in the population. These aspects are reviewed, specifically from the perspective of the clinical features and the neuropsychology of ADHD. The dimensional symptomatic nature of ADHD contrasts with the diagnostic criteria of this disorder according to different classifications or clinical guidelines. It also contrasts with the data collected by means of different complementary examinations (scales, tests, etc.). It is essential to understand the clinical continuum within each neurodevelopmental disorder (including ADHD), among the different neurodevelopmental disorders, and among the neurodevelopmental disorders and normality for their research, diagnosis and management. The development of instruments that provide support for this dimensional component is equally significant.

Clinical characteristics and treatment of inflammatory bowel disease: A comparison of Eastern and Western perspectives

PubMed Central

Park, Soo Jung; Kim, Won Ho; Cheon, Jae Hee

2014-01-01

Inflammatory bowel disease (IBD) is a chronic, relapsing intestinal inflammatory disorder with unidentified causes. Both environmental factors and genetic aspects are believed to be crucial to the pathogenesis of IBD. The incidence and prevalence of IBD have recently been increasing throughout Asia, presumably secondary to environmental changes. This increasing trend in IBD epidemiology necessitates specific health care planning and education in Asia. To this end, we must gain a precise understanding of the distinctive clinical and therapeutic characteristics of Asian patients with IBD. The phenotypes of IBD reportedly differ considerably between Asians and Caucasians. Thus, use of the same management strategies for these different populations may not be appropriate. Moreover, investigation of the Asian-specific clinical aspects of IBD offers the possibility of identifying causative factors in the pathogenesis of IBD in this geographical area. Accordingly, this review summarizes current knowledge of the phenotypic manifestations and management practices of patients with IBD, with a special focus on a comparison of Eastern and Western perspectives. PMID:25206259

Future Directions in Painful Knee Osteoarthritis: Harnessing Complexity in a Heterogeneous Population

PubMed Central

George, Steven Z.; Maluf, Katrina S.; Stevens-Lapsley, Jennifer E.

2014-01-01

This perspective article proposes a conceptual model for the pain experience for individuals diagnosed with knee osteoarthritis (OA). Pain in knee OA is likely a heterogeneous, multifactorial phenomenon that involves not only the OA disease process but also elements specific to patient psychology and pain neurophysiology. The relevant contributions to the pain experience for any individual patient remain difficult, if not impossible, to definitively determine, and the rationale for many clinical treatment decisions arises primarily from a mechanistic understanding of OA pathophysiology. The Osteoarthritis Research Society International (OARSI) recently identified “phenotyping” of OA pain as a research priority to “better target pain therapies to individual patients.” This perspective article proposes that contributions from 3 domains—knee pathology, psychological distress, and pain neurophysiology—should be considered equally important in future efforts to understand pain phenotypes in knee OA. Ultimately, characterization of pain phenotypes may aid in the understanding of the pain experience and the development of interventions specific to pain for individual patients. PMID:24179141

Catholic Perspectives on Population Issues. Population Bulletin, Vol. 30, No. 6.

ERIC Educational Resources Information Center

Murphy, Francis X.; Erhart, Joseph F.

The bulletin provides information on the position of the Catholic Church on population issues. The purpose is to help responsible thinkers and world organizations understand the Catholic perspective. The booklet focuses on religious, human, and ethical dimensions of the demographic situation and is presented in seven chapters. The first chapter…

Exploring geographic variation in US mortality rates using a spatial Durbin approach

PubMed Central

Yang, Tse-Chuan; Noah, Aggie; Shoff, Carla

2015-01-01

Previous studies focused on identifying the determinants of mortality in US counties have examined the relationships between mortality and explanatory covariates within a county only, and have ignored the well-documented spatial dependence of mortality. We challenge earlier literature by arguing that the mortality rate of a certain county may also be associated with the features of its neighboring counties beyond its own features. Drawing from both the spillover (i.e., same direction effect) and social relativity (i.e., opposite direction effect) perspectives, our spatial Durbin modeling results indicate that both theoretical perspectives provide valuable frameworks to guide the modeling of mortality variation in US counties. Our empirical findings support that mortality rate of a certain county is associated with the features of its neighbors beyond its own features. Specifically, we found support for the spillover perspective in which the percentage of the Hispanic population, concentrated disadvantage, and the social capital of a specific county are negatively associated with the mortality rate in the specific county and also in neighboring counties. On the other hand, the following covariates fit the social relativity process: health insurance coverage, percentage of non-Hispanic other races, and income inequality. Their direction of the associations with mortality in the specific county is opposite to that of the relationships with mortality in neighboring counties. Methodologically, spatial Durbin modeling addresses the shortcomings of traditional analytic approaches used in ecological mortality research such as ordinary least squares, spatial error, and spatial lag regression. Our results produce new insights drawn from unbiased estimates. PMID:25642156

Population Health Measurement: Applying Performance Measurement Concepts in Population Health Settings

PubMed Central

Stoto, Michael A.

2014-01-01

Introduction: Whether the focus of population-health improvement efforts, the measurement of health outcomes, risk factors, and interventions to improve them are central to achieving collective impact in the population health perspective. And because of the importance of a shared measurement system, appropriate measures can help to ensure the accountability of and ultimately integrate the efforts of public health, the health care delivery sector, and other public and private entities in the community to improve population health. Yet despite its importance, population health measurement efforts in the United States are poorly developed and uncoordinated. Collaborative Measurement Development: To achieve the potential of the population health perspective, public health officials, health system leaders, and others must work together to develop sets of population health measures that are suitable for different purposes yet are harmonized so that together they can help to improve a community’s health. This begins with clearly defining the purpose of a set of measures, distinguishing between outcomes for which all share responsibility and actions to improve health for which the health care sector, public health agencies, and others should be held accountable. Framework for Population Health Measurement: Depending on the purpose of the analysis, then, measurement systems should clearly specify what to measure—in particular the population served (the denominator), what the critical health dimensions are in a measurement framework, and how the measures can be used to ensure accountability. Building on a clear understanding of the purpose and dimensions of population health that must be measured, developers can then choose specific measures using existing data or developing new data sources if necessary, with established validity, reliability, and other scientific characteristics. Rather than indiscriminately choosing among the proliferating data streams, this systematic approach to measure development can yield measurement systems that are more appropriate and useful for improving population health. PMID:25995988

The Many Dimensions of Diet Breadth: Phytochemical, Genetic, Behavioral, and Physiological Perspectives on the Interaction between a Native Herbivore and an Exotic Host

PubMed Central

Harrison, Joshua G.; Gompert, Zachariah; Fordyce, James A.; Buerkle, C. Alex; Grinstead, Rachel; Jahner, Joshua P.; Mikel, Scott; Nice, Christopher C.; Santamaria, Aldrin; Forister, Matthew L.

2016-01-01

From the perspective of an herbivorous insect, conspecific host plants are not identical, and intraspecific variation in host nutritional quality or defensive capacity might mediate spatially variable outcomes in plant-insect interactions. Here we explore this possibility in the context of an ongoing host breadth expansion of a native butterfly (the Melissa blue, Lycaeides melissa) onto an exotic host plant (alfalfa, Medicago sativa). We examine variation among seven alfalfa populations that differed in terms of colonization by L. melissa; specifically, we examined variation in phytochemistry, foliar protein, and plant population genetic structure, as well as responses of caterpillars and adult butterflies to foliage from the same populations. Regional patterns of alfalfa colonization by L. melissa were well predicted by phytochemical variation, and colonized patches of alfalfa showed a similar level of inter-individual phytochemical diversity. However, phytochemical variation was a poor predictor of larval performance, despite the fact that survival and weight gain differed dramatically among caterpillars reared on plants from different alfalfa populations. Moreover, we observed a mismatch between alfalfa supporting the best larval performance and alfalfa favored by ovipositing females. Thus, the axes of plant variation that mediate interactions with L. melissa depend upon herbivore life history stage, which raises important issues for our understanding of adaptation to novel resources by an organism with a complex life history. PMID:26836490

Health care and social service providers' descriptions of pacific islander mothers' breastfeeding patterns.

PubMed

Flood, Jeanie L; Dodgson, Joan E

2010-01-01

Despite recommendations and numerous health benefits attributed to breastfeeding, rates in the United States are below desired levels, particularly within vulnerable populations. In Hawaií, breastfeeding rates are higher than national averages except in Native Hawaiian and other Pacific Islander populations. Health care and social service providers are integral to successful breastfeeding promotion efforts. They are in an ideal position to reflect on the context in which their clients live and on its relationship to breastfeeding activities. The aim of this study was to describe health care and social service providers' perceptions of the influences on the breastfeeding patterns of Pacific Islander women. Focus ethnographic methods were used to collect interview data from health care and social service providers (N=20) serving Native Hawaiian and Pacific Islander women in one rural community. An iterative analysis process of coding and categorizing, followed by conceptual abstraction into patterns, was completed. Four patterns emerged: shaped by connections, lived unfamiliarity, stressed by circumstance, and missed opportunities. Participants' insights concerning the needs of this population yielded population-specific issues and health care system issues affecting breastfeeding promotion. A number of gaps in breastfeeding services were identified. Sociocultural, maternal knowledge, and workload barriers to successful breastfeeding predominated providers' perspectives. Broader system and community level issues were implied, but not directly addressed. The nature of successful breastfeeding support and promotion requires inclusion of this broader level perspective.

Augmenting Predictive Modeling Tools with Clinical Insights for Care Coordination Program Design and Implementation.

PubMed

Johnson, Tracy L; Brewer, Daniel; Estacio, Raymond; Vlasimsky, Tara; Durfee, Michael J; Thompson, Kathy R; Everhart, Rachel M; Rinehart, Deborath J; Batal, Holly

2015-01-01

The Center for Medicare and Medicaid Innovation (CMMI) awarded Denver Health's (DH) integrated, safety net health care system $19.8 million to implement a "population health" approach into the delivery of primary care. This major practice transformation builds on the Patient Centered Medical Home (PCMH) and Wagner's Chronic Care Model (CCM) to achieve the "Triple Aim": improved health for populations, care to individuals, and lower per capita costs. This paper presents a case study of how DH integrated published predictive models and front-line clinical judgment to implement a clinically actionable, risk stratification of patients. This population segmentation approach was used to deploy enhanced care team staff resources and to tailor care-management services to patient need, especially for patients at high risk of avoidable hospitalization. Developing, implementing, and gaining clinical acceptance of the Health Information Technology (HIT) solution for patient risk stratification was a major grant objective. In addition to describing the Information Technology (IT) solution itself, we focus on the leadership and organizational processes that facilitated its multidisciplinary development and ongoing iterative refinement, including the following: team composition, target population definition, algorithm rule development, performance assessment, and clinical-workflow optimization. We provide examples of how dynamic business intelligence tools facilitated clinical accessibility for program design decisions by enabling real-time data views from a population perspective down to patient-specific variables. We conclude that population segmentation approaches that integrate clinical perspectives with predictive modeling results can better identify high opportunity patients amenable to medical home-based, enhanced care team interventions.

An Ethnolinguistic and Genetic Perspective on the Origins of the Dravidian-Speaking Brahui in Pakistan

PubMed Central

Pagani, Luca; Colonna, Vincenza; Tyler-Smith, Chris; Ayub, Qasim

2017-01-01

Pakistan is a part of South Asia that modern humans encountered soon after they left Africa ~50 – 70,000 years ago. Approximately 9,000 years ago they began establishing cities that eventually expanded to represent the Harappan culture, rivalling the early city states of Mesopotamia. The modern state constitutes the north western land mass of the Indian sub-continent and is now the abode of almost 200 million humans representing many ethnicities and linguistic groups. Studies utilising autosomal, Y chromosomal and mitochondrial DNA markers in selected Pakistani populations revealed a mixture of Western Eurasian-, South- and East Asian-specific lineages, some of which were unequivocally associated with past migrations. Overall in Pakistan, genetic relationships are generally predicted more accurately by geographic proximity than linguistic origin. The Dravidian-speaking Brahui population are a prime example of this. They currently reside in south-western Pakistan, surrounded by Indo-Europeans speakers with whom they share a common genetic origin. In contrast, the Hazara share the highest affinity with East Asians, despite their Indo-European linguistic affiliation. In this report we reexamine the genetic origins of the Brahuis, and compare them with diverse populations from India, including several Dravidian-speaking groups, and present a genetic perspective on ethnolinguistic groups in present-day Pakistan. Given the high affinity of Brahui to the other Indo-European Pakistani populations and the absence of population admixture with any of the examined Indian Dravidian groups, we conclude that Brahui are an example of cultural (linguistic) retention following a major population replacement. PMID:28381901

An Ethnolinguistic and Genetic Perspective on the Origins of the Dravidian-Speaking Brahui in Pakistan.

PubMed

Pagani, Luca; Colonna, Vincenza; Tyler-Smith, Chris; Ayub, Qasim

2017-01-01

Pakistan is a part of South Asia that modern humans encountered soon after they left Africa ~50 - 70,000 years ago. Approximately 9,000 years ago they began establishing cities that eventually expanded to represent the Harappan culture, rivalling the early city states of Mesopotamia. The modern state constitutes the north western land mass of the Indian sub-continent and is now the abode of almost 200 million humans representing many ethnicities and linguistic groups. Studies utilising autosomal, Y chromosomal and mitochondrial DNA markers in selected Pakistani populations revealed a mixture of Western Eurasian-, South- and East Asian-specific lineages, some of which were unequivocally associated with past migrations. Overall in Pakistan, genetic relationships are generally predicted more accurately by geographic proximity than linguistic origin. The Dravidian-speaking Brahui population are a prime example of this. They currently reside in south-western Pakistan, surrounded by Indo-Europeans speakers with whom they share a common genetic origin. In contrast, the Hazara share the highest affinity with East Asians, despite their Indo-European linguistic affiliation. In this report we reexamine the genetic origins of the Brahuis, and compare them with diverse populations from India, including several Dravidian-speaking groups, and present a genetic perspective on ethnolinguistic groups in present-day Pakistan. Given the high affinity of Brahui to the other Indo-European Pakistani populations and the absence of population admixture with any of the examined Indian Dravidian groups, we conclude that Brahui are an example of cultural (linguistic) retention following a major population replacement.

Preliminary study of visual perspective in mental time travel in schizophrenia.

PubMed

Wang, Ya; Wang, Yi; Zhao, Qing; Cui, Ji-Fang; Hong, Xiao-Hong; Chan, Raymond Ck

2017-10-01

This study explored specificity and visual perspective of mental time travel in schizophrenia. Fifteen patients with schizophrenia and 18 controls were recruited. Participants were asked to recall or imagine specific events according to cue words. Results showed that schizophrenia patients generated fewer specific events than controls, the recalled events were more specific than imagined events. Schizophrenia adopted less field perspective and more observer perspective than controls. These results suggested that patients with schizophrenia were impaired in mental time travel both in specificity and visual perspective. Further studies are needed to identify the underlying mechanisms. Copyright © 2017 Elsevier B.V. All rights reserved.

The population health perspective as a framework for studying child maltreatment outcomes.

PubMed

Tonmyr, L; MacMillan, H L; Jamieson, E; Kelly, K

2002-01-01

The population health perspective (PHP) is commonly used in addressing a wide range of health issues. This article examines the strengths and limitations of the perspective. The determinants of health that are an integral part of the PHP are used as a framework in considering the range of outcomes associated with exposure to child maltreatment. Directions for further research are outlined.

How Resource Phenology Affects Consumer Population Dynamics.

PubMed

Bewick, Sharon; Cantrell, R Stephen; Cosner, Chris; Fagan, William F

2016-02-01

Climate change drives uneven phenology shifts across taxa, and this can result in changes to the phenological match between interacting species. Shifts in the relative phenology of partner species are well documented, but few studies have addressed the effects of such changes on population dynamics. To explore this, we develop a phenologically explicit model describing consumer-resource interactions. Focusing on scenarios for univoltine insects, we show how changes in resource phenology can be reinterpreted as transformations in the year-to-year recursion relationships defining consumer population dynamics. This perspective provides a straightforward path for interpreting the long-term population consequences of phenology change. Specifically, by relating the outcome of phenological shifts to species traits governing recursion relationships (e.g., consumer fecundity or competitive scenario), we demonstrate how changes in relative phenology can force systems into different dynamical regimes, with major implications for resource management, conservation, and other areas of applied dynamics.

Self-concept of children with cerebral palsy measured using the population-specific myTREEHOUSE Self-Concept Assessment.

PubMed

Cheong, Sau Kuan; Lang, Cathryne P; Johnston, Leanne M

2018-02-01

Self-concept is an individual's perception of him/herself. Research into the self-concept of children with cerebral palsy (CP) has been sparse due to the lack of a population-specific self-concept instrument. Using the new myTREEHOUSE Self-Concept Assessment, this study investigated the self-concept of children with CP in relation to age, gender, motor, communication and cognitive function. Children with CP aged 8-12 years (n = 50; 29 males; mean 10 years 2 months; GMFCS-E&R I = 36, II = 8, III = 5, IV = 1) completed myTREEHOUSE and a standardised intelligence measure. Most children reported positive self-concept from all three myTREEHOUSE Performance Perspectives and over half (60%) fell within the Low range for the Personal Concern Score. Self-concept was not associated with age, gender, motor function, or communication function. However, for cognitive function, associations were observed for Social Skills (Below Average > Average cognitive function; Cohen's d = 1.07) and Learning Skills (Above Average > Average cognitive function; Cohen's d = 0.95) domains when rated from a Personal Performance Perspective. As the first study of the self-concept of children with CP using a CP-specific assessment, this study offers important insights into what children with CP think about themselves. Generally, the self-concept of children with CP was sound. Future research on environmental facilitators and barriers to robust self-concept development is recommended. Copyright © 2017 Elsevier Ltd. All rights reserved.

Comparative phylogeny and historical perspectives on population genetics of the Pacific hawksbill (Eretmochelys imbricata) and green turtles (Chelonia mydas), inferred from feeding populations in the Yaeyama Islands, Japan.

PubMed

Nishizawa, Hideaki; Okuyama, Junichi; Kobayashi, Masato; Abe, Osamu; Arai, Nobuaki

2010-01-01

Mitochondrial DNA sequence polymorphisms and patterns of genetic diversity represent the genealogy and relative impacts of historical, geographic, and demographic events on populations. In this study, historical patterns of population dynamics and differentiation in hawksbill (Eretmochelys imbricata) and green turtles (Chelonia mydas) in the Pacific were estimated from feeding populations in the Yaeyama Islands, Japan. Phylogenetic relationships of the haplotypes indicated that hawksbill and green turtles in the Pacific probably underwent very similar patterns and processes of population dynamics over the last million years, with population subdivision during the early Pleistocene and population expansion after the last glacial maximum. These significant contemporary historical events were suggested to have been caused by climatic and sea-level fluctuations. On the other hand, comparing our results to long-term population dynamics in the Atlantic, population subdivisions during the early Pleistocene were specific to Pacific hawksbill and green turtles. Therefore, regional differences in historical population dynamics are suggested. Despite limited sampling locations, these results are the first step in estimating the historical trends in Pacific sea turtles by using phylogenetics and population genetics.

A construct analysis of meal convenience applied to military foods.

PubMed

Jaeger, Sara R; Cardello, Armand V

2007-07-01

The present research investigates the concept of food convenience within the institutional framework of military feeding. The approach views food-related convenience in terms of two broad dimensions: "type of convenience" and "timing of convenience." A discrete choice experiment was conducted with US military personnel (n=179) regarding their perceptions of the (in)convenience associated with the use and consumption of low-preparation, all-in-one, military meals (MREs-meals, ready-to-eat). The obtained data strongly suggest that perceived (in)convenience, time and effort are separate constructs. A food provisioning process perspective was captured in the "timing of convenience" dimension, and the contribution of different stages in the consumption process to the perceived convenience of the meal situation was empirically demonstrated. The latter result has important implications for the study of food convenience outside this specific population and context. As opposed to the product perspective that is currently predominant in the literature, it demonstrates the necessity of adopting a meal perspective in analysing food-related convenience.

Linking Resilience of Aquatic Species to Watershed Condition

NASA Astrophysics Data System (ADS)

Flitcroft, R. L.

2017-12-01

Watershed condition means different things to different people. From the perspective of aquatic ecology, watershed condition may be interpreted to mean the capacity of a watershed to support life history diversity of native species. Diversity in expression of life history is thought to confer resilience allowing portions of the broader population to survive stressful conditions. Different species have different life history strategies, many of which were developed through adaptation to regional or local environmental conditions and natural disturbance regimes. By reviewing adaptation strategies for species of interest at regional scales, characteristics of watersheds that confer resilience may be determined. Such assessments must be completed at multiple levels of spatial organization (i.e. sub-watershed, watershed, region) allowing assessments to be inferred across broad spatial extents. In a project on the Wenatchee River watershed, we guided models of wildfire effects on bull trout and spring Chinook from a meta-population perspective to determine risks to survival at local and population scales over multiple extents of spatial organization. In other work in the Oregon Coast Range, we found that historic landslides continue to exert habitat-forming pressure at local scales, leading to patchiness in distribution of habitats for different life stages of coho salmon. Further, climate change work in Oregon estuaries identified different vulnerabilities in terms of juvenile rearing habitat depending on the species of interest and the intensity of future changes in climate. All of these studies point to the importance of considering physical conditions in watersheds at multiple spatial extents from the perspective of native aquatic species in order to understand risks to long-term survival. The broader implications of watershed condition, from this perspective, is the determination of physical attributes that confer resilience to native biota. This may require regionally specific metrics, and across-species synthesis of survival strategies and environmental conditions that confer resilience.

Clinical Trials in a Dish: A Perspective on the Coming Revolution in Drug Development.

PubMed

Fermini, Bernard; Coyne, Shawn T; Coyne, Kevin P

2018-05-01

The pharmaceutical industry is facing unprecedented challenges as the cost of developing new drugs has reached unsustainable levels, fueled in large parts by a high attrition rate in clinical development. Strategies to bridge studies between preclinical testing and clinical trials are needed to reduce the knowledge gap and allow earlier decisions to be made on the continuation or discontinuation of further development of drugs. The discovery and development of human induced pluripotent stem cells (hiPSCs) have opened up new avenues that support the concept of screening for cell-based safety and toxicity at the level of a population. This approach, termed "Clinical Trials in a Dish" (CTiD), allows testing medical therapies for safety or efficacy on cells collected from a representative sample of human patients, before moving into actual clinical trials. It can be applied to the development of drugs for specific populations, and it allows predicting not only the magnitude of effects but also the incidence of patients in a population who will benefit or be harmed by these drugs. This, in turn, can lead to the selection of safer drugs to move into clinical development, resulting in a reduction in attrition. The current article offers a perspective of this new model for "humanized" preclinical drug development.

The facilitators and barriers of physical activity among Aboriginal and Torres Strait Islander regional sport participants.

PubMed

Péloquin, Claudie; Doering, Thomas; Alley, Stephanie; Rebar, Amanda

2017-10-01

Disparities in health perspectives between Indigenous and non-Indigenous populations are major concerns in many of the world's well-developed nations. Indigenous populations are largely less healthy, more prone to chronic diseases, and have an earlier overall mortality than non-Indigenous populations. Low levels of physical activity (PA) contribute to the high levels of disease in Indigenous Australians. Qualitative analysis of structured one-on-one interviews discussing PA in a regional setting. Participants were 12 Indigenous Australian adults, and 12 non-Indigenous Australian adults matched on age, sex, and basketball division. Most participants reported engaging in regular exercise; however, the Indigenous group reported more barriers to PA. These factors included cost, time management and environmental constraints. The physical facilitators identified by our Indigenous sample included social support, intrinsic motivation and role modelling. Findings describe individual and external factors that promote or constraint PA as reported by Indigenous Australian adults. Results indicate that Indigenous people face specific barriers to PA when compared to a non-Indigenous sample. Implications for public health: This study is the first to compare the perspective of Indigenous Australians to a matched group of non-Indigenous Australians and provides useful knowledge to develop public health programs based on culturally sensitive data. © 2017 The Authors.

Pacific salmonines in the Great Lakes Basin

USGS Publications Warehouse

Claramunt, Randall M.; Madenjian, Charles P.; Clapp, David; Taylor, William W.; Lynch, Abigail J.; Léonard, Nancy J.

2012-01-01

Pacific salmon (genus Oncorhynchus) are a valuable resource, both within their native range in the North Pacific rim and in the Great Lakes basin. Understanding their value from a biological and economic perspective in the Great Lakes, however, requires an understanding of changes in the ecosystem and of management actions that have been taken to promote system stability, integrity, and sustainable fisheries. Pacific salmonine introductions to the Great Lakes are comprised mainly of Chinook salmon, coho salmon, and steelhead and have accounted for 421, 177, and 247 million fish, respectively, stocked during 1966-2007. Stocking of Pacific salmonines has been effective in substantially reducing exotic prey fish abundances in several of the Great Lakes (e.g., lakes Michigan, Huron, and Ontario). The goal of our evaluation was to highlight differences in management strategies and perspectives across the basin, and to evaluate policies for Pacific salmonine management in the Great Lakes. Currently, a potential conflict exists between Pacific salmonine management and native fish rehabilitation goals because of the desire to sustain recreational fisheries and to develop self-sustaining populations of stocked Pacific salmonines in the Great Lakes. We provide evidence that suggests Pacific salmonines have not only become naturalized to the food webs of the Great Lakes, but that their populations (specifically Chinook salmon) may be fluctuating in concert with specific prey (i.e., alewives) whose populations are changing relative to environmental conditions and ecosystem disturbances. Remaining questions, however, are whether or not “natural” fluctuations in predator and prey provide enough “stability” in the Great Lakes food webs, and even more importantly, would a choice by managers to attempt to reduce the severity of predator-prey oscillations be antagonistic to native fish restoration efforts. We argue that, on each of the Great Lakes, managers are pursuing appropriate goals, managing the aquatic resources of the lakes for the greatest public good, given the variability in conditions and likelihood for success specific to each lake.

The Epidemiology of Delirium: Challenges and Opportunities for Population Studies

PubMed Central

Davis, Daniel H.J.; Kreisel, Stefan H.; Muniz Terrera, Graciela; Hall, Andrew J.; Morandi, Alessandro; Boustani, Malaz; Neufeld, Karin J.; Lee, Hochang Benjamin; MacLullich, Alasdair M.J.; Brayne, Carol

2013-01-01

Delirium is a serious and common acute neuropsychiatric syndrome that is associated with short- and long-term adverse health outcomes. However, relatively little delirium research has been conducted in unselected populations. Epidemiologic research in such populations has the potential to resolve several questions of clinical significance in delirium. Part 1 of this article explores the importance of population selection, case-ascertainment, attrition, and confounding. Part 2 examines a specific question in delirium epidemiology: What is the relationship between delirium and trajectories of cognitive decline? This section assesses previous work through two systematic reviews and proposes a design for investigating delirium in the context of longitudinal cohort studies. Such a design requires robust links between community and hospital settings. Practical considerations for case-ascertainment in the hospital, as well as the necessary quality control of these programs, are outlined. We argue that attention to these factors is important if delirium research is to benefit fully from a population perspective. PMID:23907068

Population research potentials in Africa.

PubMed

Hyden, G

1980-01-01

There is a need in Africa to test prevailing theories and concepts in population studies to see how they apply to this culture. Most of the prevailing perspective on population issues can be influenced by development strategies and policies affecting demographic variables. So research designed to determine the longterm consequences of rural settlement policies on subsequent access to family planning or family planning policies are also needed, as are studies which zero in on the work and results of specific population projects. The following issues are considered worth special consideration in Africa, where the vast majority of women live in rural areas where family planning services will not reach for some time. The areas of investigation which seem most pertinent in sub-saharan Africa are: side effect of contraceptive devices and agents; infertility assessments, social and medical consequences of adolescent pregnancies, the means of offering effective population education in rural African areas, the possible effects of fertility control programs on demographic transition, and potential funding sources.

Offenders become the victim in virtual reality: impact of changing perspective in domestic violence.

PubMed

Seinfeld, S; Arroyo-Palacios, J; Iruretagoyena, G; Hortensius, R; Zapata, L E; Borland, D; de Gelder, B; Slater, M; Sanchez-Vives, M V

2018-02-09

The role of empathy and perspective-taking in preventing aggressive behaviors has been highlighted in several theoretical models. In this study, we used immersive virtual reality to induce a full body ownership illusion that allows offenders to be in the body of a victim of domestic abuse. A group of male domestic violence offenders and a control group without a history of violence experienced a virtual scene of abuse in first-person perspective. During the virtual encounter, the participants' real bodies were replaced with a life-sized virtual female body that moved synchronously with their own real movements. Participants' emotion recognition skills were assessed before and after the virtual experience. Our results revealed that offenders have a significantly lower ability to recognize fear in female faces compared to controls, with a bias towards classifying fearful faces as happy. After being embodied in a female victim, offenders improved their ability to recognize fearful female faces and reduced their bias towards recognizing fearful faces as happy. For the first time, we demonstrate that changing the perspective of an aggressive population through immersive virtual reality can modify socio-perceptual processes such as emotion recognition, thought to underlie this specific form of aggressive behaviors.

Assessing Institutional Fitness: A Population Ecology Perspective on College and University Health.

ERIC Educational Resources Information Center

Emmert, Mark A.

1985-01-01

A population ecology model of institutional fitness broadens the scope of perspectives on organizational success. The approach allows systematic thinking about internal and external factors identifies the critical dependency relationships between a college and other organizations that supply resources. (MLW)

Communication and marketing as climate change-intervention assets a public health perspective.

PubMed

Maibach, Edward W; Roser-Renouf, Connie; Leiserowitz, Anthony

2008-11-01

The understanding that global climate change represents a profound threat to the health and well-being of human and nonhuman species worldwide is growing. This article examines the potential of communication and marketing interventions to influence population behavior in ways consistent with climate change prevention and adaptation objectives. Specifically, using a framework based on an ecologic model of public health, the paper examines: (1) the potential of communication and marketing interventions to influence population behaviors of concern, including support for appropriate public policies; (2) potential target audiences for such programs; and (3) the attributes of effective climate change messages. Communication and marketing interventions appear to have considerable potential to promote important population behavior change objectives, but there is an urgent need for additional translational research to effectively harvest this potential to combat climate change.

Prostate-Specific Antigen (PSA)–Based Population Screening for Prostate Cancer: An Economic Analysis

PubMed Central

Tawfik, A

2015-01-01

Background The prostate-specific antigen (PSA) blood test has become widely used in Canada to test for prostate cancer (PC), the most common cancer among Canadian men. Data suggest that population-based PSA screening may not improve overall survival. Objectives This analysis aimed to review existing economic evaluations of population-based PSA screening, determine current spending on opportunistic PSA screening in Ontario, and estimate the cost of introducing a population-based PSA screening program in the province. Methods A systematic literature search was performed to identify economic evaluations of population-based PSA screening strategies published from 1998 to 2013. Studies were assessed for their methodological quality and applicability to the Ontario setting. An original cost analysis was also performed, using data from Ontario administrative sources and from the published literature. One-year costs were estimated for 4 strategies: no screening, current (opportunistic) screening of men aged 40 years and older, current (opportunistic) screening of men aged 50 to 74 years, and population-based screening of men aged 50 to 74 years. The analysis was conducted from the payer perspective. Results The literature review demonstrated that, overall, population-based PSA screening is costly and cost-ineffective but may be cost-effective in specific populations. Only 1 Canadian study, published 15 years ago, was identified. Approximately $119.2 million is being spent annually on PSA screening of men aged 40 years and older in Ontario, including close to $22 million to screen men younger than 50 and older than 74 years of age (i.e., outside the target age range for a population-based program). A population-based screening program in Ontario would cost approximately $149.4 million in the first year. Limitations Estimates were based on the synthesis of data from a variety of sources, requiring several assumptions and causing uncertainty in the results. For example, where Ontario-specific data were unavailable, data from the United States were used. Conclusions PSA screening is associated with significant costs to the health care system when the cost of the PSA test itself is considered in addition to the costs of diagnosis, staging, and treatment of screen-detected PCs. PMID:26366237

A Whole Community Approach toward Child and Youth Resilience Promotion: A Review of Resilience Literature.

PubMed

Khanlou, Nazilla; Wray, Ron

2014-01-01

A literature review of child and youth resilience with a focus on: definitions and factors of resilience; relationships between resilience, mental health and social outcomes; evidence for resilience promoting interventions; and implications for reducing health inequities. To conduct the review, the first two following steps were conducted iteratively and informed the third step: 1) Review of published peer-review literature since 2000; and 2) Review of grey literature; and 3) Quasi-realist synthesis of evidence. Evidence from three perspectives were examined: i) whether interventions can improve 'resilience' for vulnerable children and youth; ii) whether there is a differential effect among different populations; and, iii) whether there is evidence that resilience interventions 'close the gap' on health and social outcome measures. Definitions of resilience vary as do perspectives on it. We argue for a hybrid approach that recognizes the value of combining multiple theoretical perspectives, epistemologies (positivistic and constructivist/interpretive/critical) in studying resilience. Resilience is: a) a process (rather than a single event), b) a continuum (rather than a binary outcome), and c) likely a global concept with specific dimensions. Individual, family and social environmental factors influence resilience. A social determinants perspective on resilience and mental health is emphasized. Programs and interventions to promoting resilience should be complimentary to public health measures addressing the social determinants of health. A whole community approach to resilience is suggested as a step toward closing the public health policy gap. Local initiatives that stimulate a local transformation process are needed. Recognition of each child's or youth's intersections of gender, lifestage, family resources within the context of their identity markers fits with a localized approach to resilience promotion and, at the same time, requires recognition of the broader determinants of population health.

Methodological considerations for economic modelling of latent tuberculous infection screening in migrants.

PubMed

Shedrawy, J; Siroka, A; Oxlade, O; Matteelli, A; Lönnroth, K

2017-09-01

Tuberculosis (TB) in migrants from endemic to low-incidence countries results mainly from the reactivation of latent tuberculous infection (LTBI). LTBI screening policies for migrants vary greatly between countries, and the evidence on the cost-effectiveness of the different approaches is weak and heterogeneous. The aim of this review was to assess the methodology used in published economic evaluations of LTBI screening among migrants to identify critical methodological options that must be considered when using modelling to determine value for money from different economic perspectives. Three electronic databases were searched and 10 articles were included. There was considerable variation across this small number of studies with regard to economic perspective, main outcomes, modelling technique, screening options and target populations considered, as well as in parameterisation of the epidemiological situation, test accuracy, efficacy, safety and programme performance. Only one study adopted a societal perspective; others adopted a health care or wider government perspective. Parameters representing the cascade of screening and treating LTBI varied widely, with some studies using highly aspirational scenarios. This review emphasises the need for a more harmonised approach for economic analysis, and better transparency in how policy options and economic perspectives influence methodological choices. Variability is justifiable for some parameters. However, sufficient data are available to standardise others. A societal perspective is ideal, but can be challenging due to limited data. Assumptions about programme performance should be based on empirical data or at least realistic assumptions. Results should be interpreted within specific contexts and policy options, with cautious generalisations.

Value-based design: a new powerful perspective for worksite health promotion.

PubMed

Riedel, John E; Nayer, Cyndy

2010-01-01

The growth in recognition of the employee's role in health improvement is driving the development of new perspectives for managing the health of individuals in defined populations, such as a working population. Value-Based Design is one of these newer perspectives and is introduced in this edition of The Art of Health Promotion. The core of this approach uses data to design benefits and incentives that are then implemented effectively and tracked as to their outcome. This perspective helps practitioners focus their interventions and helps move programming more directly to the production of desired outcomes. Behavioral "levers" are identified and integrated across a useful intervention continuum.

Diversity, geographic distribution, and habitat-specific variations of microbiota in natural populations of the chicken mite, Dermanyssus gallinae.

PubMed

Moro, Claire Valiente; Thioulouse, Jean; Chauve, Claude; Zenner, Lionel

2011-07-01

Dermanyssus gallinae is considered to be the most economically significant ectoparasite to affect egg-laying poultry in Europe. This mite can also act as a vector for a number of pathogens. The array of bacteria associated with D. gallinae mites could provide insight into the biology and population dynamics of arthropods, but at the present time little information is available. To understand the intra- and interpopulation diversity of its associated microbiota, we analyzed the whole internal bacterial community of natural populations of D. gallinae originating from two types of poultry farm habitats (standard and free-range) in two regions of France (Brittany and the Rhone-Alpes). Total DNA was extracted from individual or pooled mites, and polymerase chain reaction temporal temperature gradient gel electrophoresis of 16S rRNA was then done to separate bacterial DNA fragments associated with the host arthropod. A large diversity of bacteria was detected, but principally firmicutes and gamma-Proteobacteria. Between-group analyses of temporal temperature gradient gel electrophoresis-banding patterns revealed that bacterial populations clustered into categories according to their geographic origin and the habitat specifics of the farms. Some degree of stability of bacterial populations was observed within a specific time scale. These results suggest that environmental factors either recent (e.g., poultry farming practices) or long-standing (e.g., geographic isolation) may affect the bacterial communities present in D. gallinae. Further knowledge of the microbiota associated with D. gallinae and its variation would indeed offer new perspectives for biological control methods to prevent the establishment, proliferation, and transmission of pathogenic bacteria.

Public, patient and carers' views on palliative and end-of-life care in India.

PubMed

Ramasamy Venkatasalu, M; Sirala Jagadeesh, N; Elavally, S; Pappas, Y; Mhlanga, F; Pallipalayam Varatharajan, R

2018-06-01

To systematically review the existing evidence on the Indian public, patient and carers' perspectives on palliative and end-of-life care. With a growing population of terminally ill people across the world, there is also an increasing awareness among international health policy makers of the need to improve the quality of life for terminally ill patients. Understanding service users' (patients, family and public) perspectives is crucial in developing and sustaining successful community-centred palliative nursing policies and service models especially in countries like India with diverse population. An integrative review was performed on five databases, using hand searches of key journals and reference citation tracking for empirical studies published in English from 1990 to 2015. A thematic analysis framework was used to analyse and identify key themes. Analysis of the six eligible studies revealed five themes. Themes describe how social, economic, cultural, religious, spiritual and traditional factors influenced the palliative and end-of-life care perspectives and experiences among Indians. They also illustrated preferences relating to place of care, as well as benefits and challenges of family caregiving during the last days of life. Although we found minimal evidence on user perspectives, nurses need to aware of those unique components of context-specific palliative and end-of-life care practices in India - socioeconomic, cultural and religious factors - on their nursing encounters. Nurses need to advocate same in policy development to enable accessibility and utility of palliative and end-of-life care services, which are scant in India. Nurses can be central in gathering the contextual evidence that advocate users' perspectives to inform further studies and national palliative care policies in India. Emerging policies in nursing education need to focus on integrating family-centred palliative and end-of-life care within curricula, whereas nursing practice may promote nurse-led community models to address the patchy palliative and end-of-life service provision in India. © 2017 International Council of Nurses.

Single-cell sequencing in stem cell biology.

PubMed

Wen, Lu; Tang, Fuchou

2016-04-15

Cell-to-cell variation and heterogeneity are fundamental and intrinsic characteristics of stem cell populations, but these differences are masked when bulk cells are used for omic analysis. Single-cell sequencing technologies serve as powerful tools to dissect cellular heterogeneity comprehensively and to identify distinct phenotypic cell types, even within a 'homogeneous' stem cell population. These technologies, including single-cell genome, epigenome, and transcriptome sequencing technologies, have been developing rapidly in recent years. The application of these methods to different types of stem cells, including pluripotent stem cells and tissue-specific stem cells, has led to exciting new findings in the stem cell field. In this review, we discuss the recent progress as well as future perspectives in the methodologies and applications of single-cell omic sequencing technologies.

Bridging the Timescales of Single-Cell and Population Dynamics

NASA Astrophysics Data System (ADS)

Jafarpour, Farshid; Wright, Charles S.; Gudjonson, Herman; Riebling, Jedidiah; Dawson, Emma; Lo, Klevin; Fiebig, Aretha; Crosson, Sean; Dinner, Aaron R.; Iyer-Biswas, Srividya

2018-04-01

How are granular details of stochastic growth and division of individual cells reflected in smooth deterministic growth of population numbers? We provide an integrated, multiscale perspective of microbial growth dynamics by formulating a data-validated theoretical framework that accounts for observables at both single-cell and population scales. We derive exact analytical complete time-dependent solutions to cell-age distributions and population growth rates as functionals of the underlying interdivision time distributions, for symmetric and asymmetric cell division. These results provide insights into the surprising implications of stochastic single-cell dynamics for population growth. Using our results for asymmetric division, we deduce the time to transition from the reproductively quiescent (swarmer) to the replication-competent (stalked) stage of the Caulobacter crescentus life cycle. Remarkably, population numbers can spontaneously oscillate with time. We elucidate the physics leading to these population oscillations. For C. crescentus cells, we show that a simple measurement of the population growth rate, for a given growth condition, is sufficient to characterize the condition-specific cellular unit of time and, thus, yields the mean (single-cell) growth and division timescales, fluctuations in cell division times, the cell-age distribution, and the quiescence timescale.

The author who wasn't there? Fairness and attribution in publications following access to population biobanks.

PubMed

Kleiderman, Erika; Pack, Amy; Borry, Pascal; Zawati, Ma'n

2018-01-01

We conducted a document analysis that explored publication ethics and authorship in the context of population biobanks from both a theoretical (e.g. normative documents) and practical (e.g. biobank-specific documentation) perspective. The aim was to provide an overview of the state of authorship attribution in population biobanks and attempt to fill the gap in discussions around the issue. Our findings demonstrate that the most common approach adopted in both the normative and biobank-specific documentation is acknowledgment. A co-authorship approach was second and highlighted concerns surrounding the fairness of imposing authorship of the scientific leadership as a condition to access data and biosamples, as well as the alignment with the International Committee of Medical Journal Editors' criteria such as what is deemed a significant contribution and how to ensure accountability. Based on these findings, we propose a three-prong approach, that may be cumulative, to address the issue of authorship attribution in the context of population biobanks, namely 1) the biobank should be appropriately acknowledged; 2) an invitation for co-authorship should be made based on the spirit of collaboration and provided a substantial contribution has been made; and 3) a citation/referencing option should be available.

Correlates of low back pain in a general population sample: a multidisciplinary perspective.

PubMed

Roncarati, A; McMullen, W

1988-06-01

This study identifies correlates of low back pain in a general population sample and defines a profile of subjects with low back pain. A multidisciplinary approach was employed that required surveying and physically assessing 674 subjects on 105 variables in biographical, anatomical, strength and flexibility measurement categories. No attempt was made to select subjects from specific occupational, age, athletic, psychological and anatomical groups or subjects with specific biographical features, which may have resulted in a sample that was atypical of the general population. The results of this study based on a causal comparative ex post facto research design corroborated selected findings of previous research conducted on nongeneral population samples. These findings include relationships between low back pain and age, body type, sex, stress, smoking, selected types of physical activity, occupation and previous injuries to the neck, shoulders, back and upper legs, as well as previous episodes of low back pain. Additional correlates of low back pain that were identified and have little or controversial review in the back literature include: delayed low back pain syndrome caused by abrupt changes in running frequency, Q angle, pes cavus, leg length (right and left), trunk length, genu recurvatum and multiplane strength and flexibility limitations in the hip joints.

Hologenomics: Systems-Level Host Biology.

PubMed

Theis, Kevin R

2018-01-01

The hologenome concept of evolution is a hypothesis explaining host evolution in the context of the host microbiomes. As a hypothesis, it needs to be evaluated, especially with respect to the extent of fidelity of transgenerational coassociation of host and microbial lineages and the relative fitness consequences of repeated associations within natural holobiont populations. Behavioral ecologists are in a prime position to test these predictions because they typically focus on animal phenotypes that are quantifiable, conduct studies over multiple generations within natural animal populations, and collect metadata on genetic relatedness and relative reproductive success within these populations. Regardless of the conclusion on the hologenome concept as an evolutionary hypothesis, a hologenomic perspective has applied value as a systems-level framework for host biology, including in medicine. Specifically, it emphasizes investigating the multivarious and dynamic interactions between patient genomes and the genomes of their diverse microbiota when attempting to elucidate etiologies of complex, noninfectious diseases.

Sea ice occurrence predicts genetic isolation in the Arctic fox.

PubMed

Geffen, Eli; Waidyaratne, Sitara; Dalén, Love; Angerbjörn, Anders; Vila, Carles; Hersteinsson, Pall; Fuglei, Eva; White, Paula A; Goltsman, Michael; Kapel, Christian M O; Wayne, Robert K

2007-10-01

Unlike Oceanic islands, the islands of the Arctic Sea are not completely isolated from migration by terrestrial vertebrates. The pack ice connects many Arctic Sea islands to the mainland during winter months. The Arctic fox (Alopex lagopus), which has a circumpolar distribution, populates numerous islands in the Arctic Sea. In this study, we used genetic data from 20 different populations, spanning the entire distribution of the Arctic fox, to identify barriers to dispersal. Specifically, we considered geographical distance, occurrence of sea ice, winter temperature, ecotype, and the presence of red fox and polar bear as nonexclusive factors that influence the dispersal behaviour of individuals. Using distance-based redundancy analysis and the BIOENV procedure, we showed that occurrence of sea ice is the key predictor and explained 40-60% of the genetic distance among populations. In addition, our analysis identified the Commander and Pribilof Islands Arctic populations as genetically unique suggesting they deserve special attention from a conservation perspective.

Conducting an agricultural life cycle assessment: challenges and perspectives.

PubMed

Caffrey, Kevin R; Veal, Matthew W

2013-12-10

Agriculture is a diverse field that produces a wide array of products vital to society. As global populations continue to grow the competition for natural resources will increase pressure on agricultural production of food, fiber, energy, and various high value by-products. With elevated concerns related to environmental impacts associated with the needs of a growing population, a life cycle assessment (LCA) framework can be used to determine areas of greatest impact and compare reduction strategies for agricultural production systems. The LCA methodology was originally developed for industrial operations but has been expanded to a wider range of fields including agriculture. There are various factors that increase the complexity of determining impacts associated with agricultural production including multiple products from a single system, regional and crop specific management techniques, temporal variations (seasonally and annually), spatial variations (multilocation production of end products), and the large quantity of nonpoint emission sources. The lack of consistent methodology of some impacts that are of major concern to agriculture (e.g., land use and water usage) increases the complexity of this analysis. This paper strives to review some of these issues and give perspective to the LCA practitioner in the field of agriculture.

Conducting an Agricultural Life Cycle Assessment: Challenges and Perspectives

PubMed Central

Caffrey, Kevin R.; Veal, Matthew W.

2013-01-01

Agriculture is a diverse field that produces a wide array of products vital to society. As global populations continue to grow the competition for natural resources will increase pressure on agricultural production of food, fiber, energy, and various high value by-products. With elevated concerns related to environmental impacts associated with the needs of a growing population, a life cycle assessment (LCA) framework can be used to determine areas of greatest impact and compare reduction strategies for agricultural production systems. The LCA methodology was originally developed for industrial operations but has been expanded to a wider range of fields including agriculture. There are various factors that increase the complexity of determining impacts associated with agricultural production including multiple products from a single system, regional and crop specific management techniques, temporal variations (seasonally and annually), spatial variations (multilocation production of end products), and the large quantity of nonpoint emission sources. The lack of consistent methodology of some impacts that are of major concern to agriculture (e.g., land use and water usage) increases the complexity of this analysis. This paper strives to review some of these issues and give perspective to the LCA practitioner in the field of agriculture. PMID:24391463

Directions for new developments on statistical design and analysis of small population group trials.

PubMed

Hilgers, Ralf-Dieter; Roes, Kit; Stallard, Nigel

2016-06-14

Most statistical design and analysis methods for clinical trials have been developed and evaluated where at least several hundreds of patients could be recruited. These methods may not be suitable to evaluate therapies if the sample size is unavoidably small, which is usually termed by small populations. The specific sample size cut off, where the standard methods fail, needs to be investigated. In this paper, the authors present their view on new developments for design and analysis of clinical trials in small population groups, where conventional statistical methods may be inappropriate, e.g., because of lack of power or poor adherence to asymptotic approximations due to sample size restrictions. Following the EMA/CHMP guideline on clinical trials in small populations, we consider directions for new developments in the area of statistical methodology for design and analysis of small population clinical trials. We relate the findings to the research activities of three projects, Asterix, IDeAl, and InSPiRe, which have received funding since 2013 within the FP7-HEALTH-2013-INNOVATION-1 framework of the EU. As not all aspects of the wide research area of small population clinical trials can be addressed, we focus on areas where we feel advances are needed and feasible. The general framework of the EMA/CHMP guideline on small population clinical trials stimulates a number of research areas. These serve as the basis for the three projects, Asterix, IDeAl, and InSPiRe, which use various approaches to develop new statistical methodology for design and analysis of small population clinical trials. Small population clinical trials refer to trials with a limited number of patients. Small populations may result form rare diseases or specific subtypes of more common diseases. New statistical methodology needs to be tailored to these specific situations. The main results from the three projects will constitute a useful toolbox for improved design and analysis of small population clinical trials. They address various challenges presented by the EMA/CHMP guideline as well as recent discussions about extrapolation. There is a need for involvement of the patients' perspective in the planning and conduct of small population clinical trials for a successful therapy evaluation.

Mendelian Diseases and Conditions in Croatian Island Populations: Historic Records and New Insights

PubMed Central

Saftić, Vanja; Rudan, Diana; Zgaga, Lina

2006-01-01

Among Croatian islands, there are several which are known for unusual autochthonous diseases and specific medical conditions that result from the reproductive isolation and specific population genetic structure. These populations are characterized by high degree of genetic isolation, consanguinity, and inbreeding. The reported diseases include Mal de Meleda on Mljet island, hereditary dwarfism on Krk island, familial learning disability on Susak island, familial ovarian cancer on Lastovo island, and several other rare diseases and conditions inherited in Mendelian fashion. We present a historical perspective on how these conditions were first described, interpreted, and assessed. We reviewed the information obtained through genetic research in the past several years, when the genetic etiology of some of these conditions was explained. The disease gene causing Mal de Meleda was first localized at 8q chromosome, and mutations in the ARS (component B) gene encoding SLURP-1 (secreted mammalian Ly-6/uPAR-related protein 1) protein were identified subsequently. The genetic etiology of dwarfism on the island of Krk is explained by a mutation in the PROP1 gene, responsible for the short stature. The search for mutations underlying other monogenic diseases in Croatian islands is under way. PMID:16909451

Response to Dr. Moya's Comments to Article by Thoene M et al., Nutrients 2016, 8, 451.

PubMed

Thoene, Melissa; Anderson-Berry, Ann

2016-12-16

This reply is a supplementary addition to our previous article entitled "Comparison of a Powdered, Acidified Liquid, and Non-Acidified Liquid Human Milk Fortifier on Clinical Outcomes in Premature Infants" as published in Nutrients in July 2016. It provides a response to a comment made by Dr. Fernando Moya to this original article, so the purpose of this is to compare and contrast various perspectives between researchers conducting nutrition research in the preterm infant population. It specifically focuses on human milk fortification and subsequent outcomes.

Next-generation small molecule therapies for heart failure: 2015 and beyond.

PubMed

Malinowski, Justin T; St Jean, David J

2018-05-15

Poor prognosis coupled with significant economic burden makes heart failure (HF) one of the largest issues currently facing the world population. Although a significant number of new therapies have emerged over the past 20 years to treat the underlying physiological risk factors, only two new medications specifically for HF have been approved since 2007. This perspective provides an overview of recently approved treatment options for HF and as well as an update on additional small molecule therapies currently in clinical development. Copyright © 2018 Elsevier Ltd. All rights reserved.

Field visual perspective during autobiographical memory recall is less frequent among patients with schizophrenia.

PubMed

Potheegadoo, Jevita; Berna, Fabrice; Cuervo-Lombard, Christine; Danion, Jean-Marie

2013-10-01

There is growing interest in clinical research regarding the visual perspective adopted during memory retrieval, because it reflects individuals' self-attitude towards their memories of past personal events. Several autobiographical memory deficits, including low specificity of personal memories, have been identified in schizophrenia, but visual perspective during autobiographical memory retrieval has not yet been investigated in patients. The aim of this study was therefore to investigate the visual perspective with which patients visualize themselves when recalling autobiographical memories and to assess the specificity of their memories which is a major determinant of visual perspective. Thirty patients with schizophrenia and 30 matched controls recalled personal events from 4 life periods. After each recall, they were asked to report their visual perspective (Field or Observer) associated with the event. The specificity of their memories was assessed by independent raters. Our results showed that patients reported significantly fewer Field perspectives than comparison participants. Patients' memories, whether recalled with Field or Observer perspectives, were less specific and less detailed. Our results indicate that patients with schizophrenia adopt Field perspectives less frequently than comparison participants, and that this may contribute to a weakened sense of the individual of being an actor of his past events, and hence to a reduced sense of self. They suggest that this may be related to low specificity of memories and that all the important aspects involved in re-experiencing autobiographical events are impaired in patients with schizophrenia. © 2013 Elsevier B.V. All rights reserved.

A Perspective: Educational Goals and Changes, 1988-2010. Educational Benchmarks 2000 Series

ERIC Educational Resources Information Center

Edmonds, Rick

2010-01-01

The author provides a perspective on progress in the Southern Regional Education Board (SREB) states since 1988, when SREB developed 12 goals to reach by the year 2000. Growth in population and school enrollment trends are highlighted--what was expected and the huge population and job growth that occurred. Looking ahead to 2010, projected job…

The 3 faces of clinical reasoning: Epistemological explorations of disparate error reduction strategies.

PubMed

Monteiro, Sandra; Norman, Geoff; Sherbino, Jonathan

2018-06-01

There is general consensus that clinical reasoning involves 2 stages: a rapid stage where 1 or more diagnostic hypotheses are advanced and a slower stage where these hypotheses are tested or confirmed. The rapid hypothesis generation stage is considered inaccessible for analysis or observation. Consequently, recent research on clinical reasoning has focused specifically on improving the accuracy of the slower, hypothesis confirmation stage. Three perspectives have developed in this line of research, and each proposes different error reduction strategies for clinical reasoning. This paper considers these 3 perspectives and examines the underlying assumptions. Additionally, this paper reviews the evidence, or lack of, behind each class of error reduction strategies. The first perspective takes an epidemiological stance, appealing to the benefits of incorporating population data and evidence-based medicine in every day clinical reasoning. The second builds on the heuristic and bias research programme, appealing to a special class of dual process reasoning models that theorizes a rapid error prone cognitive process for problem solving with a slower more logical cognitive process capable of correcting those errors. Finally, the third perspective borrows from an exemplar model of categorization that explicitly relates clinical knowledge and experience to diagnostic accuracy. © 2018 John Wiley & Sons, Ltd.

Inequality measures for wealth distribution: Population vs individuals perspective

NASA Astrophysics Data System (ADS)

Pascoal, R.; Rocha, H.

2018-02-01

Economic inequality is, nowadays, frequently perceived as following a growing trend with impact on political and religious agendas. However, there is a wide range of inequality measures, each of which pointing to a possibly different degree of inequality. Furthermore, regardless of the measure used, it only acknowledges the momentary population inequality, failing to capture the individuals evolution over time. In this paper, several inequality measures were analyzed in order to compare the typical single time instant degree of wealth inequality (population perspective) to the one obtained from the individuals' wealth mean over several time instants (individuals perspective). The proposed generalization of a simple addictive model, for limited time average of individual's wealth, allows us to verify that the typically used inequality measures for a given snapshot instant of the population significantly overestimate the individuals' wealth inequality over time. Moreover, that is more extreme for the ratios than for the indices analyzed.

The basic principles of migration health: Population mobility and gaps in disease prevalence

PubMed Central

Gushulak, Brian D; MacPherson, Douglas W

2006-01-01

Currently, migrants and other mobile individuals, such as migrant workers and asylum seekers, are an expanding global population of growing social, demographic and political importance. Disparities often exist between a migrant population's place of origin and its destination, particularly with relation to health determinants. The effects of those disparities can be observed at both individual and population levels. Migration across health and disease disparities influences the epidemiology of certain diseases globally and in nations receiving migrants. While specific disease-based outcomes may vary between migrant group and location, general epidemiological principles may be applied to any situation where numbers of individuals move between differences in disease prevalence. Traditionally, migration health activities have been designed for national application and lack an integrated international perspective. Present and future health challenges related to migration may be more effectively addressed through collaborative global undertakings. This paper reviews the epidemiological relationships resulting from health disparities bridged by migration and describes the growing role of migration and population mobility in global disease epidemiology. The implications for national and international health policy and program planning are presented. PMID:16674820

Augmenting Surgery via Multi-scale Modeling and Translational Systems Biology in the Era of Precision Medicine: A Multidisciplinary Perspective

PubMed Central

Kassab, Ghassan S.; An, Gary; Sander, Edward A.; Miga, Michael; Guccione, Julius M.; Ji, Songbai; Vodovotz, Yoram

2016-01-01

In this era of tremendous technological capabilities and increased focus on improving clinical outcomes, decreasing costs, and increasing precision, there is a need for a more quantitative approach to the field of surgery. Multiscale computational modeling has the potential to bridge the gap to the emerging paradigms of Precision Medicine and Translational Systems Biology, in which quantitative metrics and data guide patient care through improved stratification, diagnosis, and therapy. Achievements by multiple groups have demonstrated the potential for 1) multiscale computational modeling, at a biological level, of diseases treated with surgery and the surgical procedure process at the level of the individual and the population; along with 2) patient-specific, computationally-enabled surgical planning, delivery, and guidance and robotically-augmented manipulation. In this perspective article, we discuss these concepts, and cite emerging examples from the fields of trauma, wound healing, and cardiac surgery. PMID:27015816

Barriers to health education in adolescents: health care providers' perspectives compared to high school adolescents.

PubMed

Abedian, Kobra; Shahhosseini, Zohreh

2015-11-01

Although adolescence is marked by profound and dynamic changes, it is virtually neglected by health care providers, by society, and even by most parents, teachers, and health professionals. The aim of this study was to investigate barriers to health education in adolescents from health care providers' views compared to teens. The study population consisted of 72 health care providers and 402 high school female students in Northern Iran in 2012. They completed a self-administered questionnaire about their views on barriers to adolescents' health education. It is revealed that the major barrier to adolescents' health education from a health care providers' perspective is "Lack of private room for adolescents' health education", while "Lack of adolescents' interest to content of educational programs" is a significantly greater barrier to health education among adolescents. The results suggest that for adolescent health education, specific strategies should be used in adolescent health promotion programs.

Return migration and the health of older aged parents: evidence from rural Thailand.

PubMed

Zimmer, Zachary; Knodel, John

2010-10-01

To examine the extent to which an association exists between health of older parents and return migration of children in rural Thailand. Data come from the 2006 Migration Impact Survey specifically designed to obtain information on the impact of migration on older adults in rural areas. Associations are examined from both the perspectives of parents (N = 883) and migrating children (N = 2,150) using equations that adjust for demographic characteristics of parents and children and factors that may indicate unmet support needs. A robust association with poor health promoting migration returns from both parent and child perspective exists and remains even with controls that might attenuate the relationship. Although media discussions have pointed out dangers of out-migration for older adults, little systematic evidence exists. This study supports the viewpoint that accommodations for older adults can be made despite social changes promoting out-migration and demographic aging of the population.

Minimally invasive surgery for inflammatory bowel disease: Review of current developments and future perspectives

PubMed Central

Neumann, Philipp-Alexander; Rijcken, Emile

2016-01-01

Patients with inflammatory bowel disease (IBD) comprise a population of patients that have a high likelihood of both surgical treatment at a young age and repetitive operative interventions. Therefore surgical procedures need to aim at minimizing operative trauma with best postoperative recovery. Minimally invasive techniques have been one of the major advancements in surgery in the last decades and are nowadays almost routinely performed in colorectal resections irrespective of underlying disease. However due to special disease related characteristics such as bowel stenosis, interenteric fistula, abscesses, malnutrition, repetitive surgeries, or immunosuppressive medications, patients with IBD represent a special cohort with specific needs for surgery. This review summarizes current evidence of minimally invasive surgery for patients with Crohn’s disease or ulcerative colitis and gives an outlook on the future perspective of technical advances in this highly moving field with its latest developments in single port surgery, robotics and trans-anal techniques. PMID:27158537

Progress and challenges to the global waste management system.

PubMed

Singh, Jagdeep; Laurenti, Rafael; Sinha, Rajib; Frostell, Björn

2014-09-01

Rapid economic growth, urbanization and increasing population have caused (materially intensive) resource consumption to increase, and consequently the release of large amounts of waste to the environment. From a global perspective, current waste and resource management lacks a holistic approach covering the whole chain of product design, raw material extraction, production, consumption, recycling and waste management. In this article, progress and different sustainability challenges facing the global waste management system are presented and discussed. The study leads to the conclusion that the current, rather isolated efforts, in different systems for waste management, waste reduction and resource management are indeed not sufficient in a long term sustainability perspective. In the future, to manage resources and wastes sustainably, waste management requires a more systems-oriented approach that addresses the root causes for the problems. A specific issue to address is the development of improved feedback information (statistics) on how waste generation is linked to consumption. © The Author(s) 2014.

Cost-effectiveness of specific subcutaneous immunotherapy in patients with allergic rhinitis and allergic asthma.

PubMed

Brüggenjürgen, Bernd; Reinhold, Thomas; Brehler, Randolf; Laake, Eckard; Wiese, Günther; Machate, Ulrich; Willich, Stefan N

2008-09-01

Specific immunotherapy is the only potentially curative treatment in patients with allergic rhinitis and allergic asthma. Health economic evaluations on this treatment, particularly in a German context, are sparse. To evaluate the cost-effectiveness of specific subcutaneous immunotherapy (SCIT) in addition to symptomatic treatment (ST) compared with ST alone in a German health care setting. The analysis was performed as a health economic model calculation based on Markov models. In addition, we performed a concomitant expert board composed of allergy experts in pediatrics, dermatology, pneumology, and otolaryngology. The primary perspective of the study was societal. Additional sensitivity analyses were performed to prove our results for robustness. The SCIT and ST combination was associated with annual cost savings of Euro140 per patient. After 10 years of disease duration, SCIT and ST reach the breakeven point. The overall incremental cost-effectiveness ratio (ICER) was Euro-19,787 per quality-adjusted life-year (QALY), with a range that depended on patient age (adults, Euro-22,196; adolescents, Euro-14,747; children, Euro-12,750). From a third-party payer's perspective, SCIT was associated with slightly additional costs. Thus, the resulting ICER was Euro8,308 per QALY for all patients. Additional SCIT was associated with improved medical outcomes and cost savings compared with symptomatic treatment alone according to a societal perspective. Taking a European accepted ICER threshold of up to Euro50,000 per QALY into account, additional SCIT is considered clearly cost-effective compared with routine care in Germany. The degree of cost-effectiveness is strongly affected by costs related to SCIT and the target population receiving such treatment.

Inbreeding Depression and Male Survivorship in Drosophila: Implications for Senescence Theory

PubMed Central

Swindell, William R.; Bouzat, Juan L.

2006-01-01

The extent to which inbreeding depression affects longevity and patterns of survivorship is an important issue from several research perspectives, including evolutionary biology, conservation biology, and the genetic analysis of quantitative traits. However, few previous inbreeding depression studies have considered longevity as a focal life-history trait. We maintained laboratory populations of Drosophila melanogaster at census population sizes of 2 and 10 male-female pairs for up to 66 generations and performed repeated assays of male survivorship throughout this time period. On average, significant levels of inbreeding depression were observed for median life span and age-specific mortality. For age-specific mortality, the severity of inbreeding depression increased over the life span. We found that a baseline inbreeding load of 0.307 lethal equivalents per gamete affected age-specific mortality, and that this value increased at a rate of 0.046 per day of the life span. With respect to some survivorship parameters, the differentiation of lineages was nonlinear with respect to the inbreeding coefficient, which suggested that nonadditive genetic variation contributed to variation among lineages. These findings provide insights into the genetic basis of longevity as a quantitative trait and have implications regarding the mutation-accumulation evolutionary explanation of senescence. PMID:16204222

Black, Male and Teaching: Exploring the Experiences, Perspectives and Teaching Practices of Black Male Teachers

ERIC Educational Resources Information Center

Fant, Tyrie Lavyal

2017-01-01

As America's K-12 student population continues to become more diverse, it is important that the ethnic background of the teacher population reflect this change. A crucial aspect of this diversification effort includes black male teachers. The purpose of this study was to explore and examine the experiences and perspectives of African American male…

Measurement Error and Environmental Epidemiology: A Policy Perspective

PubMed Central

Edwards, Jessie K.; Keil, Alexander P.

2017-01-01

Purpose of review Measurement error threatens public health by producing bias in estimates of the population impact of environmental exposures. Quantitative methods to account for measurement bias can improve public health decision making. Recent findings We summarize traditional and emerging methods to improve inference under a standard perspective, in which the investigator estimates an exposure response function, and a policy perspective, in which the investigator directly estimates population impact of a proposed intervention. Summary Under a policy perspective, the analysis must be sensitive to errors in measurement of factors that modify the effect of exposure on outcome, must consider whether policies operate on the true or measured exposures, and may increasingly need to account for potentially dependent measurement error of two or more exposures affected by the same policy or intervention. Incorporating approaches to account for measurement error into such a policy perspective will increase the impact of environmental epidemiology. PMID:28138941

Examining School Psychologists' Perspectives about Specific Learning Disabilities: Implications for Practice

ERIC Educational Resources Information Center

Cottrell, Joseph M.; Barrett, Courtenay A.

2017-01-01

Debate regarding the causes of specific learning disabilities (SLDs), precise definitions of SLDs, and the most effective identification methods has persisted for over 50 years. Two prominent schools of thought regarding SLDs exist: (1) biological perspectives and (2) environmental perspectives. Three identification methods are outlined in the…

Exploring the patient perspective of fatigue in adults with visual impairment: a qualitative study

PubMed Central

Bode, Christina; van der Aa, Hilde P A; Hulshof, Carel T J; Bosmans, Judith E; van Rens, Gerardus H M B; van Nispen, Ruth M A

2017-01-01

Objectives Fatigue is an often mentioned symptom by patients with irreversible visual impairment. This study explored the patient perspective of fatigue in visually impaired adults with a focus on symptoms of fatigue, causes, consequences and coping strategies. Setting Two large Dutch low vision multidisciplinary rehabilitation organisations. Participants 16 visually impaired adults with severe symptoms of fatigue selected by purposive sampling. Methods A qualitative study involving semistructured interviews. A total of four first-level codes were top–down predetermined in correspondence with the topics of the research question. Verbatim transcribed interviews were analysed with a combination of a deductive and inductive approach using open and axial coding. Results Participants often described the symptoms of fatigue as a mental, daily and physical experience. The most often mentioned causes of fatigue were a high cognitive load, the intensity and amount of activities, the high effort necessary to establish visual perception, difficulty with light intensity and negative cognitions. Fatigue had the greatest impact on the ability to carry out social roles and participation, emotional functioning and cognitive functioning. The most common coping strategies were relaxation, external support, socialising and physical exercise and the acceptance of fatigue. Conclusions Our results indicate that low vision-related fatigue is mainly caused by population specific determinants that seem different from the fatigue experience described in studies with other patient populations. Fatigue may be central to the way patients react, adapt and compensate to the consequences of vision loss. These findings indicate a need for future research aimed at interventions specifically tailored to the unique aspects of fatigue related to vision loss. PMID:28775181

Firefighter Hand Anthropometry and Structural Glove Sizing: A New Perspective.

PubMed

Hsiao, Hongwei; Whitestone, Jennifer; Kau, Tsui-Ying; Hildreth, Brooke

2015-12-01

We evaluated the current use and fit of structural firefighting gloves and developed an improved sizing scheme that better accommodates the U.S. firefighter population. Among surveys, 24% to 30% of men and 31% to 62% of women reported experiencing problems with the fit or bulkiness of their structural firefighting gloves. An age-, race/ethnicity-, and gender-stratified sample of 863 male and 88 female firefighters across the United States participated in the study. Fourteen hand dimensions relevant to glove design were measured. A cluster analysis of the hand dimensions was performed to explore options for an improved sizing scheme. The current national standard structural firefighting glove-sizing scheme underrepresents firefighter hand size range and shape variation. In addition, mismatch between existing sizing specifications and hand characteristics, such as hand dimensions, user selection of glove size, and the existing glove sizing specifications, is significant. An improved glove-sizing plan based on clusters of overall hand size and hand/finger breadth-to-length contrast has been developed. This study presents the most up-to-date firefighter hand anthropometry and a new perspective on glove accommodation. The new seven-size system contains narrower variations (standard deviations) for almost all dimensions for each glove size than the current sizing practices. The proposed science-based sizing plan for structural firefighting gloves provides a step-forward perspective (i.e., including two women hand model-based sizes and two wide-palm sizes for men) for glove manufacturers to advance firefighter hand protection. © 2015, Human Factors and Ergonomics Society.

"I don't want to be Henrietta Lacks": diverse patient perspectives on donating biospecimens for precision medicine research.

PubMed

Lee, Sandra S-J; Cho, Mildred K; Kraft, Stephanie A; Varsava, Nina; Gillespie, Katie; Ormond, Kelly E; Wilfond, Benjamin S; Magnus, David

2018-06-11

To determine whether patients distinguish between biospecimens and electronic health records (EHRs) when considering research participation to inform research protections. We conducted 20 focus groups with individuals who identified as African American, Hispanic, Chinese, South Asian, and non-Hispanic white on the collection of biospecimens and EHR data for research. Our study found that many participants did not distinguish between biospecimens and EHR data. However, some participants identified specific concerns about biospecimens. These included the need for special care and respect for biospecimens due to enduring connections between the body and identity; the potential for unacceptable future research, specifically the prospect of human cloning; heightened privacy risks; and the potential for unjust corporate profiteering. Among those who distinguished biospecimens from EHR data, many supported separate consent processes and would limit their own participation to EHR data. Considering that the potential misuse of EHR data is as great as, if not greater than, for biospecimens, more research is needed to understand how attitudes differ between biospecimens and EHR data across diverse populations. Such research should explore mechanisms beyond consent that can address diverse values, perspectives, and misconceptions about sources of patient information to build trust in research relationships.

Critical Review of Health Impacts of Wildfire Smoke Exposure.

PubMed

Reid, Colleen E; Brauer, Michael; Johnston, Fay H; Jerrett, Michael; Balmes, John R; Elliott, Catherine T

2016-09-01

Wildfire activity is predicted to increase in many parts of the world due to changes in temperature and precipitation patterns from global climate change. Wildfire smoke contains numerous hazardous air pollutants and many studies have documented population health effects from this exposure. We aimed to assess the evidence of health effects from exposure to wildfire smoke and to identify susceptible populations. We reviewed the scientific literature for studies of wildfire smoke exposure on mortality and on respiratory, cardiovascular, mental, and perinatal health. Within those reviewed papers deemed to have minimal risk of bias, we assessed the coherence and consistency of findings. Consistent evidence documents associations between wildfire smoke exposure and general respiratory health effects, specifically exacerbations of asthma and chronic obstructive pulmonary disease. Growing evidence suggests associations with increased risk of respiratory infections and all-cause mortality. Evidence for cardiovascular effects is mixed, but a few recent studies have reported associations for specific cardiovascular end points. Insufficient research exists to identify specific population subgroups that are more susceptible to wildfire smoke exposure. Consistent evidence from a large number of studies indicates that wildfire smoke exposure is associated with respiratory morbidity with growing evidence supporting an association with all-cause mortality. More research is needed to clarify which causes of mortality may be associated with wildfire smoke, whether cardiovascular outcomes are associated with wildfire smoke, and if certain populations are more susceptible. Reid CE, Brauer M, Johnston FH, Jerrett M, Balmes JR, Elliott CT. 2016. Critical review of health impacts of wildfire smoke exposure. Environ Health Perspect 124:1334-1343; http://dx.doi.org/10.1289/ehp.1409277.

Density regulation in Northeast Atlantic fish populations: Density dependence is stronger in recruitment than in somatic growth.

PubMed

Zimmermann, Fabian; Ricard, Daniel; Heino, Mikko

2018-05-01

Population regulation is a central concept in ecology, yet in many cases its presence and the underlying mechanisms are difficult to demonstrate. The current paradigm maintains that marine fish populations are predominantly regulated by density-dependent recruitment. While it is known that density-dependent somatic growth can be present too, its general importance remains unknown and most practical applications neglect it. This study aimed to close this gap by for the first time quantifying and comparing density dependence in growth and recruitment over a large set of fish populations. We fitted density-dependent models to time-series data on population size, recruitment and age-specific weight from commercially exploited fish populations in the Northeast Atlantic Ocean and the Baltic Sea. Data were standardized to enable a direct comparison within and among populations, and estimated parameters were used to quantify the impact of density regulation on population biomass. Statistically significant density dependence in recruitment was detected in a large proportion of populations (70%), whereas for density dependence in somatic growth the prevalence of density dependence depended heavily on the method (26% and 69%). Despite age-dependent variability, the density dependence in recruitment was consistently stronger among age groups and between alternative approaches that use weight-at-age or weight increments to assess growth. Estimates of density-dependent reduction in biomass underlined these results: 97% of populations with statistically significant parameters for growth and recruitment showed a larger impact of density-dependent recruitment on population biomass. The results reaffirm the importance of density-dependent recruitment in marine fishes, yet they also show that density dependence in somatic growth is not uncommon. Furthermore, the results are important from an applied perspective because density dependence in somatic growth affects productivity and catch composition, and therefore the benefits of maintaining fish populations at specific densities. © 2018 The Authors. Journal of Animal Ecology published by John Wiley & Sons Ltd on behalf of British Ecological Society.

Somatic clonal evolution: A selection-centric perspective.

PubMed

Scott, Jacob; Marusyk, Andriy

2017-04-01

It is generally accepted that the initiation and progression of cancers is the result of somatic clonal evolution. Despite many peculiarities, evolution within populations of somatic cells should obey the same Darwinian principles as evolution within natural populations, i.e. variability of heritable phenotypes provides the substrate for context-specific selection forces leading to increased population frequencies of phenotypes, which are better adapted to their environment. Yet, within cancer biology, the more prevalent way to view evolution is as being entirely driven by the accumulation of "driver" mutations. Context-specific selection forces are either ignored, or viewed as constraints from which tumor cells liberate themselves during the course of malignant progression. In this review, we will argue that explicitly focusing on selection forces acting on the populations of neoplastic cells as the driving force of somatic clonal evolution might provide for a more accurate conceptual framework compared to the mutation-centric driver gene paradigm. Whereas little can be done to counteract the "bad luck" of stochastic occurrences of cancer-related mutations, changes in selective pressures and the phenotypic adaptations they induce can, in principle, be exploited to limit the incidence of cancers and to increase the efficiency of existing and future therapies. This article is part of a Special Issue entitled: Evolutionary principles - heterogeneity in cancer?, edited by Dr. Robert A. Gatenby. Copyright © 2017 Elsevier B.V. All rights reserved.

Muslim patients and cross-gender interactions in medicine: an Islamic bioethical perspective.

PubMed

Padela, Aasim I; Rodriguez del Pozo, Pablo

2011-01-01

As physicians encounter an increasingly diverse patient population, socioeconomic circumstances, religious values and cultural practices may present barriers to the delivery of quality care. Increasing cultural competence is often cited as a way to reduce healthcare disparities arising from value and cultural differences between patients and providers. Cultural competence entails not only a knowledge base of cultural practices of disparate patient populations, but also an attitude of adapting one's practice style to meet patient needs and values. Gender roles, relationship dynamics and boundaries are culture specific, and are frequently shaped by religious teachings. Consequently, religion may be conceptualised as a cultural repertoire, or dynamic tool-kit, by which members of a faith adapt and negotiate their identity in multicultural societies. The manner in which Islamic beliefs and values inform Muslim healthcare behaviours is relatively under-investigated. In an effort to explore the impact of Islam on the relationship between patients and providers, we present an Islamic bioethical perspective on cross-gender relations in the patient-doctor relationship. We will begin with a clinical scenario highlighting three areas of gender interaction that bear clinical relevance: dress code, seclusion of members of the opposite sex and physical contact. Next, we provide a brief overview of the foundations of Islamic law and ethical deliberation and then proceed to develop ethicolegal guidelines pertaining to gender relations within the medical context. At the end of this reflection, we offer some practice recommendations that are attuned to the cultural sensitivities of Muslim patient populations.

PERSPECTIVE: Is acuity enough? Other considerations in clinical investigations of visual prostheses

NASA Astrophysics Data System (ADS)

Lepri, Bernard P.

2009-06-01

Visual impairing eye diseases are the major frontier facing ophthalmic research today in light of our rapidly aging population. The visual skills necessary for improving the quality of daily function and life are inextricably linked to these impairing diseases. Both research and reimbursement programs are emphasizing outcome-based results. Is improvement in visual acuity alone enough to improve the function and quality of life of visually impaired persons? This perspective summarizes the types of effectiveness endpoints for clinical investigations of visual prostheses that go beyond visual acuity. The clinical investigation of visual prostheses should include visual function, functional vision and quality of life measures. Specifically, they encompass contrast sensitivity, orientation and mobility, activities of daily living and quality of life assessments. The perspective focuses on the design of clinical trials for visual prostheses and the methods of determining effectiveness above and beyond visual acuity that will yield outcomes that are measured by improved function in the visual world and quality of life. The visually impaired population is the primary consideration in this presentation with particular emphases on retinitis pigmentosa and age-related macular degeneration. Clinical trials for visual prostheses cannot be isolated from the need for medical rehabilitation in order to obtain measurements of effectiveness that produce outcomes/evidence-based success. This approach will facilitate improvement in daily function and quality of life of patients with diseases that cause chronic vision impairment. The views and opinions are those of the author and do not necessarily reflect those of the US Food and Drug Administration, the US Department of Health and Human Services or the Public Health Service.

Obesity among Black Adolescent Girls: Genetic, Psychosocial, and Cultural Influences

ERIC Educational Resources Information Center

Alleyne, Sylvan I.; LaPoint, Velma

2004-01-01

This article focuses on the causes, consequences, and prevention of obesity among a subgroup of the American population, Black adolescent girls. Using an ecological perspective on obesity among Black adolescent girls, including feminist-womanist perspectives and historical and medical sociological perspectives, the authors discuss genetic,…

Epigenetics as an answer to Darwin’s “special difficulty,” Part 2: natural selection of metastable epialleles in honeybee castes

PubMed Central

Ruden, Douglas M.; Cingolani, Pablo E.; Sen, Arko; Qu, Wen; Wang, Luan; Senut, Marie-Claude; Garfinkel, Mark D.; Sollars, Vincent E.; Lu, Xiangyi

2015-01-01

In a recent perspective in this journal, Herb (2014) discussed how epigenetics is a possible mechanism to circumvent Charles Darwin’s “special difficulty” in using natural selection to explain the existence of the sterile-fertile dimorphism in eusocial insects. Darwin’s classic book “On the Origin of Species by Means of Natural Selection” explains how natural selection of the fittest individuals in a population can allow a species to adapt to a novel or changing environment. However, in bees and other eusocial insects, such as ants and termites, there exist two or more castes of genetically similar females, from fertile queens to multiple sub-castes of sterile workers, with vastly different phenotypes, lifespans, and behaviors. This necessitates the selection of groups (or kin) rather than individuals in the evolution of honeybee hives, but group and kin selection theories of evolution are controversial and mechanistically uncertain. Also, group selection would seem to be prohibitively inefficient because the effective population size of a colony is reduced from thousands to a single breeding queen. In this follow-up perspective, we elaborate on possible mechanisms for how a combination of both epigenetics, specifically, the selection of metastable epialleles, and genetics, the selection of mutations generated by the selected metastable epialleles, allows for a combined means for selection amongst the fertile members of a species to increase colony fitness. This “intra-caste evolution” hypothesis is a variation of the epigenetic directed genetic error hypothesis, which proposes that selected metastable epialleles increase genetic variability by directing mutations specifically to the epialleles. Natural selection of random metastable epialleles followed by a second round of natural selection of random mutations generated by the metastable epialleles would allow a way around the small effective population size of eusocial insects. PMID:25759717

Lower levels of maternal capital in early life predict offspring obesity in adulthood.

PubMed

Gillette, Meghan T; Lohman, Brenda J; Neppl, Tricia K

2017-05-01

As of 2013, 65% of the world's population lived in countries where overweight/obesity kills more people than being underweight. Evolutionary perspectives provide a holistic understanding of both how and why obesity develops and its long-term implications. To test whether the maternal capital hypothesis, an evolutionary perspective, is viable for explaining the development of obesity in adulthood. Restricted-use data from the National Longitudinal Study of Adolescent Health (Add Health; n = 11 403) was analysed using logistic regressions. The sample included adolescents and their biological mothers. The odds of obesity in adulthood increased by 22% for every standard deviation increase in lack of maternal capital (Exp (B) = 1.22, p < .001). That is, individuals whose mothers were young, of an ethnic minority and had short breastfeeding durations were more likely to be obese in adulthood, even after controlling for other factors in infancy, adolescence and adulthood. The results showed that those whose mothers had lower capital were more prone to later life disease (specifically, obesity). The maternal capital perspective is useful for explaining how and why early life characteristics (including maternal resources) predict obesity in adulthood. Implications of the findings are discussed.

Polytobacco Use and the "Customization Generation"-New Perspectives for Tobacco Control.

PubMed

Horn, Kimberly; Pearson, Jennifer L; Villanti, Andrea C

2016-12-01

In recent years, the United States observed a significant uptake in concurrent use of multiple tobacco products and alternative nicotine delivery devices among youth-a phenomenon identified as polytobacco use-making tobacco control efforts more complex for clinicians, policy makers, and scientists, alike.The present commentary stimulates new perspectives on tobacco control in the context of polytobacco use and a youth culture of customization. This culture-based value of today's youth may inform current patterns of tobacco use. More specifically, the authors hypothesize a concept of tobacco customization-the concurrent use of multiple tobacco products to create personalized tobacco experience matching lifestyle, culture, values, and addiction levels. With a range of experiences made possible through an ever-increasing menu of tobacco products, flavors, and novel devices, the current youth culture of customization may also translate to tobacco customization. Given the predominance of polytobacco use in youth-tobacco users, tobacco control initiatives must be challenged to new perspectives. Should we discover the viability of tobacco customization, tobacco use strategies that target cultural values, harness popular trends, and culture and provide customizable experiences may have a notable impact on tobacco use in this population.

Supporting youth involved in domestic minor sex trafficking: Divergent perspectives on youth agency.

PubMed

Sapiro, Beth; Johnson, Laura; Postmus, Judy L; Simmel, Cassandra

2016-08-01

Domestic-minor sex trafficking (DMST) continues to affect youth in the United States; however, lack of empirical evidence for interventions and the complex sociopolitical discourses surrounding sex trafficking and the commercial sexual exploitation of children (CSEC) hamper delivery of effective services to this population. To explore perspectives on best practices with these young people, 20 in-depth interviews were conducted with key stakeholders whose work provides them with a unique vantage point on the needs and experiences of survivors of DMST in New Jersey. Notes from interviews were coded and analyzed for emergent themes. While key stakeholders generally agreed on best practices, there were several important areas of dispute that emerged regarding how best to serve youth involved in DMST, specifically with regard to youth running away from services, models of service provision, and the use of technology by these youth. Findings suggest that professionals from diverse backgrounds may disagree about the extent to which youth involved in DMST possess agency in their decision-making capacities as adolescents. This study explores these areas of dispute, and discusses the implications for the many different professionals and systems that must work together in providing services to this population. Copyright © 2016 Elsevier Ltd. All rights reserved.

Theory's role in shaping behavioral health research for population health.

PubMed

King, Abby C

2015-11-26

The careful application of theory often is used in the behavioral health field to enhance our understanding of how the world currently works. But theory also can help us visualize what the world can become, particularly through its potential impacts on population-wide health. Applying a multi-level ecological perspective can help in expanding the field's focus upward toward the population at large. While ecological frameworks have become increasingly popular, arguably such perspectives have fallen short of their potential to actively bridge conceptual constructs and, by extension, intervention approaches, across different levels of population impact. Theoretical and conceptual perspectives that explicitly span levels of impact offer arguably the greatest potential for achieving scientific insights that may in turn produce the largest population health effects. Examples of such "bridging" approaches include theories and models that span behavioral + micro-environment, behavioral + social/cultural, and social + physical environment constructs. Several recommendations are presented related to opportunities for leveraging theories to attain the greatest impact in the population health science field. These include applying the evidence obtained from person-level theories to inform methods for positively impacting the behaviors of community gatekeepers and decision-makers for greater population change and reach; leveraging the potential of residents as "citizen scientists"--a resource for enacting behavioral health changes at the individual, environmental, and policy levels; using empirical observations and theory in equal parts to build more robust, relevant, and solution-oriented behavior change programs; exploring moderators and mediators of change at levels of impact that go beyond the individual; and considering the circumstances in which applying conceptual methods that embrace a "complexity" as opposed to "causality" perspective may lead to more flexible and agile scientific approaches that could accelerate both population-relevant discoveries and applications in the field. The commentary closes with suggestions concerning additional areas to be considered to facilitate continued advances in the health behavior field more generally to attain the greatest impacts on population health.

Assessing the Degree of Possessing Study Skills by the Students of Tafila Technical University from Their Perspectives

ERIC Educational Resources Information Center

Al-Roud, Atallah A.; Thawabiah, Ahmad

2016-01-01

The study aimed to identify the degree of possessing study skills (SS) by the students of Tafila Technical (TTU) University from their perspectives. The population of the study consisted of 5015 students in TTU for the second semester of the academic year 2015/2016. The sample of the study was chosen randomly from the population of the study with…

The Struggle for the Soul of Public Health.

PubMed

Wiley, Lindsay F

2016-12-01

Prevention has become a central focus for health care payers, providers, policy makers, and the general public. Given the centrality of prevention to public health science, practice, and law, it would seem that conditions are ripe for the public health law renaissance to expand beyond legal and scientific circles to permeate the general consciousness. Yet, public health law and policy interventions continue to face considerable political and legal opposition. The population perspective-which emphasizes the social determinants of health, collective action to create healthier communities, and communitarian rationales for prioritizing health-is as important to public health problem-solving as the prevention orientation. But it conflicts with the individualistic orientation that dominates American legal, cultural, and social discourse. This article suggests that public health law and policy debates offer important opportunities for public health advocates to reach across silos to promote the population perspective that unites the field. The article explores contrasting explanations for disease, injury, premature death, and health disparities offered by the population perspective and the individualistic orientation; political and cultural barriers that stand in the way of innovative law and policy interventions; and normative tensions between the communitarian population perspective and self-interested rationales for investment in prevention. Copyright © 2016 by Duke University Press.

Alliance members' roles in collective field-building: an assessment of leadership and championship within the Population Health Intervention Research Initiative for Canada.

PubMed

Di Ruggiero, Erica; Kishchuk, Natalie; Viehbeck, Sarah; Edwards, Nancy; Robinson, Kerry; Riley, Barbara; Fowler, Heather Smith

2017-12-06

The Population Health Intervention Research Initiative for Canada (PHIRIC) is a multi-stakeholder alliance founded in 2006 to advance population health intervention research (PHIR). PHIRIC aimed to strengthen Canada's capacity to conduct and use such research to inform policy and practice to improve the public's health by building PHIR as a field of research. In 2014, an evaluative study of PHIRIC at organisational and system levels was conducted, guided by a field-building and collaborative action perspective. The study involved 17 qualitative key informant interviews with 21 current and former PHIRIC Planning Committee and Working Group members. The interviews examined how individuals and organisations were acting as champions and exerting leadership in building the field of PHIR. Founding PHIRIC organisational members have been championing PHIR at organisational and system levels. While the PHIR field has progressed in terms of enhanced funding, legitimacy, profile and capacity, some members and organisations faced constraints and challenges acting as leaders and champions in their respective environments. Expectations about the future of PHIRIC and field-building of PHIR were mixed, where longer-term and founding members of PHIRIC expressed more optimism than recent members. All agreed on the need for incorporating perspectives of decision-makers into PHIR directions and initiatives. The findings contribute to understanding alliance members' roles in leadership and championship for field-building more generally, and for population health and PHIR specifically. Building this field requires multi-level efforts, collaborative action and distributed leadership to create the necessary conditions for PHIRIC members to both benefit from and contribute to advancing PHIR as a field. Lessons from this 'made in Canada' model may be of interest to other countries regarding the structures needed for PHIR field-building.

Classical biological control of an invasive forest pest: a world perspective of the management of Sirex noctilio using the parasitoid Ibalia leucospoides (Hymenoptera: Ibaliidae).

PubMed

Fischbein, D; Corley, J C

2015-02-01

Classical biological control is a key method for managing populations of pests in long-lived crops such as plantation forestry. The execution of biological control programmes in general, as the evaluation of potential natural enemies remains, to a large extent, an empirical endeavour. Thus, characterizing specific cases to determine patterns that may lead to more accurate predictions of success is an important goal of the much applied ecological research. We review the history of introduction, ecology and behaviour of the parasitoid Ibalia leucospoides. The species is a natural enemy of Sirex noctilio, one of the most important pests of pine afforestation worldwide. We use an invasion ecology perspective given the analogy between the main stages involved in classical biological control and the biological invasion processes. We conclude that success in the establishment, a common reason of failure in biocontrol, is not a limiting factor of success by I. leucospoides. A mismatch between the spread capacity of the parasitoid and that of its host could nevertheless affect control at a regional scale. In addition, we suggest that given its known life history traits, this natural enemy may be a better regulator than suppressor of the host population. Moreover, spatial and temporal refuges of the host population that may favour the local persistence of the interaction probably reduce the degree to which S. noctilio population is suppressed by the parasitoid. We emphasize the fact that some of the biological attributes that promote establishment may negatively affect suppression levels achieved. Studies on established non-native pest-parasitoid interactions may contribute to defining selection criteria for classical biological control which may prove especially useful in integrated pest management IPM programmes of invasive forest insects.

[The older patient with malignant diseases].

PubMed

Buske, C; Hiddemann, W

2007-11-01

Most malignancies show a steep increase of incidence with growing age. Because of this age specific incidence and the general aging of the population in western industrial countries the number of elderly cancer patients continuously and rapidly increases. Despite this development elderly cancer patients are currently underrepresented in clinical trials. This is caused in part by the lack of a common definition of the elderly patient and by the fact that a part of the elderly patients suffers from co-morbidities, not allowing a more dose intense treatment in these patients. It is one of the key current challenges to compensate this deficit and to develop therapeutic concepts specifically for the elderly patients, taking the individual somatic, but also social situation and finally the quality and perspective of life of the elderly patient into account.

Access to orphan drugs in the Middle East: Challenge and perspective

PubMed Central

Almalki, Ziyad S.; Alahmari, Abdullah K.; Guo, Jeff J.; Kelton, Christina M.L.

2012-01-01

Summary An orphan drug is a drug developed specifically to treat a rare medical condition. With a combined population of less than 400 million, about 2.8 million patients are estimated to be suffering from a rare disease in the Middle East. Some disorders such as hemoglobinopathy, glucose-6-phosphate dehydrogenase deficiency, autosomal recessive syndromes, and several metabolic disorders have a presence throughout the Middle East. In order to promote the treatment of these diseases, Middle Eastern governments need to facilitate education and training of healthcare personnel; develop and execute a method for obtaining and paying for orphan drugs; and, finally, provide tax, marketing, and other incentives to domestic and international firms to develop drugs specifically for the diseases of most importance to Middle Eastern patients. PMID:25343087

The Role of Clinical Psychology and Peer to Peer Support in the Management of Chronic Medical Conditions - A Practical Example With Adults With Congenital Heart Disease.

PubMed

Callus, Edward; Pravettoni, Gabriella

2018-01-01

Clinical psychology services and peer to peer support can both contribute in increasing the psychological wellbeing of patients with chronic medical conditions. In this perspective paper, indications are given about the provision these services for the specific case of adults with congenital heart disease. These patients are at an increased risk of psychological distress, neurocognitive deficits, and social challenges. The psychosocial characteristics and mental health treatment preferences of these patients are briefly described, followed by guidelines and indications for the implementation of clinical psychology services. The most structured peer to peer program available for this population is subsequently illustrated and finally, specific benefits and challenges when it comes to the integration of both services are reported.

Parent Perspectives on Community Mental Health Services for Children with Autism Spectrum Disorders

ERIC Educational Resources Information Center

Brookman-Frazee, Lauren; Baker-Ericzen, Mary; Stadnick, Nicole; Taylor, Robin

2012-01-01

The community mental health (CMH) system provides treatment for behavioral and psychiatric problems in children with autism spectrum disorders (ASD). Although parent stakeholder perspectives are important to improving care, these perspectives have not been systematically examined for this population in the CMH sector. Twenty-one semi-structured…

[Migration and rehabilitation of mental diseases -- perspectives and limitations in the reporting of official data of service providers].

PubMed

Rommel, A

2005-04-01

Health and social monitoring are important foundations of political decision making. In order to make statements about populations and subgroups different sources of information are generally used. The potential contribution which aggregated official health data of service providers can make is discussed in the exemplary context of the utilisation of medical rehabilitation of mental diseases. Age specific rates and age standardised ratios show a significantly increased utilisation of services for depression and somatoform disorders amongst women in general and the migrant population in particular. It is demonstrated that the interpretation of such results raises new research questions rather than providing explanations that could prove to be conducive for practical measures. In a methodological discussion it is stated that the reason for this has to be seen in the fact that important structures of action within the care system are concealed by the specific method of collecting and processing official health data. Nevertheless, conceivable interpretations are given regarding the psycho-social living conditions of large parts of the migrant population as well as their difficulties in the interaction with the medical system. This enables the formulation of a hypothetical framework for further research which could help to clarify statistical phenomena found in the official data of service providers.

Human pluripotent stem cells on artificial microenvironments: a high content perspective

PubMed Central

Viswanathan, Priyalakshmi; Gaskell, Terri; Moens, Nathalie; Culley, Oliver J.; Hansen, Darrick; Gervasio, Mia K. R.; Yeap, Yee J.; Danovi, Davide

2014-01-01

Self-renewing stem cell populations are increasingly considered as resources for cell therapy and tools for drug discovery. Human pluripotent stem (hPS) cells in particular offer a virtually unlimited reservoir of homogeneous cells and can be differentiated toward diverse lineages. Many diseases show impairment in self-renewal or differentiation, abnormal lineage choice or other aberrant cell behavior in response to chemical or physical cues. To investigate these responses, there is a growing interest in the development of specific assays using hPS cells, artificial microenvironments and high content analysis. Several hurdles need to be overcome that can be grouped into three areas: (i) availability of robust, homogeneous, and consistent cell populations as a starting point; (ii) appropriate understanding and use of chemical and physical microenvironments; (iii) development of assays that dissect the complexity of cell populations in tissues while mirroring specific aspects of their behavior. Here we review recent progress in the culture of hPS cells and we detail the importance of the environment surrounding the cells with a focus on synthetic material and suitable high content analysis approaches. The technologies described, if properly combined, have the potential to create a paradigm shift in the way diseases are modeled and drug discovery is performed. PMID:25071572

Parkinson's disease as a result of aging

PubMed Central

Rodriguez, Manuel; Rodriguez-Sabate, Clara; Morales, Ingrid; Sanchez, Alberto; Sabate, Magdalena

2015-01-01

It is generally considered that Parkinson's disease is induced by specific agents that degenerate a clearly defined population of dopaminergic neurons. Data commented in this review suggest that this assumption is not as clear as is often thought and that aging may be critical for Parkinson's disease. Neurons degenerating in Parkinson's disease also degenerate in normal aging, and the different agents involved in the etiology of this illness are also involved in aging. Senescence is a wider phenomenon affecting cells all over the body, whereas Parkinson's disease seems to be restricted to certain brain centers and cell populations. However, reviewed data suggest that Parkinson's disease may be a local expression of aging on cell populations which, by their characteristics (high number of synaptic terminals and mitochondria, unmyelinated axons, etc.), are highly vulnerable to the agents promoting aging. The development of new knowledge about Parkinson's disease could be accelerated if the research on aging and Parkinson's disease were planned together, and the perspective provided by gerontology gains relevance in this field. PMID:25677794

d/Deaf and Hard of Hearing Multilingual Learners: The Development of Communication and Language.

PubMed

Pizzo, Lianna

2016-01-01

The author examines the theory and research relevant to educating d/Deaf and Hard of Hearing Multilingual Learners (DMLs). There is minimal research on this population, yet a synthesis of related theory, research, and practice on spoken-language bilinguals can be used to add to the body of knowledge on these learners. Specifically, the author reports on three major areas: (a) population characteristics of DMLs, (b) theories relevant to understanding the language development of DMLs, and (c) considerations for programs in designing and implementing educational services for DMLs. In the interest of ensuring that children receive the foundation for linguistic success, aspects of linguistically responsive teaching (Lucas & Villegas, 2013) are addressed, with a focus on adopting an asset-based perspective on educating DMLs that honors all of a child's language, identity, and cultural memberships.

Role of conformational dynamics in the evolution of novel enzyme function.

PubMed

Maria-Solano, Miguel A; Serrano-Hervás, Eila; Romero-Rivera, Adrian; Iglesias-Fernández, Javier; Osuna, Sílvia

2018-05-21

The free energy landscape concept that describes enzymes as an ensemble of differently populated conformational sub-states in dynamic equilibrium is key for evaluating enzyme activity, enantioselectivity, and specificity. Mutations introduced in the enzyme sequence can alter the populations of the pre-existing conformational states, thus strongly modifying the enzyme ability to accommodate alternative substrates, revert its enantiopreferences, and even increase the activity for some residual promiscuous reactions. In this feature article, we present an overview of the current experimental and computational strategies to explore the conformational free energy landscape of enzymes. We provide a series of recent publications that highlight the key role of conformational dynamics for the enzyme evolution towards new functions and substrates, and provide some perspectives on how conformational dynamism should be considered in future computational enzyme design protocols.

Controlling disease and creating disparities: a fundamental cause perspective.

PubMed

Phelan, Jo C; Link, Bruce G

2005-10-01

The United States and other developed countries experienced enormous improvements in population health during the 20th century. In the context of this dramatic positive change, health disparities by race and socioeconomic status emerged for several potent killers. Any explanation for current health disparities must take these changing patterns into account. Any explanation that ignores large improvements in population health and fails to account for the emergence of disparities for specific diseases is an inadequate explanation of current disparities. We argue that genetic explanations and some prominent social causation explanations are incompatible with these facts. We propose that the theory of "fundamental causes" can account for both vast improvements in population health and the creation of large socioeconomic and racial disparities in mortality for specific causes of death over time. Specifically, we argue that it is our enormously expanded capacity to control disease and death in combination with existing social and economic inequalities that create health disparities by race and socioeconomic status: When we develop the ability to control disease and death, the benefits of this new-found ability are distributed according to resources of knowledge, money, power, prestige, and beneficial social connections. We present data on changing mortality patterns by race and socioeconomic status for two types of diseases: those for which our capacity to prevent death has increased significantly and those for which we remain largely unable to prevent death. Time trends in mortality patterns are consistent with the fundamental cause explanation.

A physiological perspective on fisheries-induced evolution.

PubMed

Hollins, Jack; Thambithurai, Davide; Koeck, Barbara; Crespel, Amelie; Bailey, David M; Cooke, Steven J; Lindström, Jan; Parsons, Kevin J; Killen, Shaun S

2018-06-01

There is increasing evidence that intense fishing pressure is not only depleting fish stocks but also causing evolutionary changes to fish populations. In particular, body size and fecundity in wild fish populations may be altered in response to the high and often size-selective mortality exerted by fisheries. While these effects can have serious consequences for the viability of fish populations, there are also a range of traits not directly related to body size which could also affect susceptibility to capture by fishing gears-and therefore fisheries-induced evolution (FIE)-but which have to date been ignored. For example, overlooked within the context of FIE is the likelihood that variation in physiological traits could make some individuals within species more vulnerable to capture. Specifically, traits related to energy balance (e.g., metabolic rate), swimming performance (e.g., aerobic scope), neuroendocrinology (e.g., stress responsiveness) and sensory physiology (e.g., visual acuity) are especially likely to influence vulnerability to capture through a variety of mechanisms. Selection on these traits could produce major shifts in the physiological traits within populations in response to fishing pressure that are yet to be considered but which could influence population resource requirements, resilience, species' distributions and responses to environmental change.

Yellowstone bison genetics: let us move forward

USGS Publications Warehouse

Halbert, Natalie D.; Gogan, Peter J.P.; Hedrick, Philip W.; Wahl, Jacquelyn M.; Derr, James N.

2012-01-01

White and Wallen (2012) disagree with the conclusions and suggestions made in our recent assessment of population structure among Yellowstone National Park (YNP) bison based on 46 autosomal microsatellite loci in 661 animals (Halbert et al. 2012). First, they suggest that "the existing genetic substructure (that we observed) was artificially created." Specifically, they suggest that the substructure observed between the northern and central populations is the result of human activities, both historical and recent. In fact, the genetic composition of all known existing bison herds was created by, or has been influenced by, anthropogenic activities, although this obviously does not reduce the value of these herds for genetic conservation (Dratch and Gogan 2010). As perspective, many, if not most, species of conservation concern have been influenced by human actions and as a result currently exist as isolated populations. However, it is quite difficult to distinguish between genetic differences caused by human actions and important ancestral variation contained in separate populations without data from early time periods. Therefore, to not lose genetic variation that may be significant or indicative of important genetic variation, the generally acceptable management approach is to attempt to retain this variation based on the observed population genetic subdivision (Hedrick et al. 1986).

The crowded life is a slow life: Population density and life history strategy.

PubMed

Sng, Oliver; Neuberg, Steven L; Varnum, Michael E W; Kenrick, Douglas T

2017-05-01

The world population has doubled over the last half century. Yet, research on the psychological effects of human population density, once a popular topic, has decreased over the past few decades. Applying a fresh perspective to an old topic, we draw upon life history theory to examine the effects of population density. Across nations and across the U.S. states (Studies 1 and 2), we find that dense populations exhibit behaviors corresponding to a slower life history strategy, including greater future-orientation, greater investment in education, more long-term mating orientation, later marriage age, lower fertility, and greater parental investment. In Studies 3 and 4, experimentally manipulating perceptions of high density led individuals to become more future-oriented. Finally, in Studies 5 and 6, experimentally manipulating perceptions of high density seemed to lead to life-stage-specific slower strategies, with college students preferring to invest in fewer rather than more relationship partners, and an older MTurk sample preferring to invest in fewer rather than more children. This research sheds new insight on the effects of density and its implications for human cultural variation and society at large. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Gaming for Safer Sex: Young German and Turkish People Report No Specific Culture-Related Preferences Toward Educational Games Promoting Safer Sex.

PubMed

Brüll, Phil; Ruiter, Robert A C; Wiers, Reinout W; Kok, Gerjo

2016-12-01

Comprehensive sex education programs specifically designed for adolescents and young adults that take into account gender norms and cultural background have shown promise as a means of countering the high sexually transmitted infection rate in young people. Recently, digital gaming interventions delivered on computers or mobile devices have emerged as another way to promote safer sex behavior in a young population. Tailoring these computer-based interventions to their target population has been recognized to increase positive behavior outcomes. In this qualitative study, we investigated whether young female and male adults from two different cultural backgrounds (all living in Germany) would have different preferences and needs in relation to an educational game promoting safer sex. We conducted four semistructured focus group interviews comprising open-ended questions with male and female participants who had either a German or a Turkish background. In total, 20 individuals, aged between 18 and 22 years, from two socially diverse and ethnically mixed vocational schools in Germany participated. Independent of cultural background and gender, participants preferred a real-world design with a first-person visual perspective over a fantasy-like third-person perspective. Furthermore, they preferred highly customizable avatars. All participants mentioned the importance of including an alcohol-intoxicated avatar and most participants wanted there to be additional information available about various safer sex approaches and about the use of different barrier protection methods. Males and females reported similar preferences for the design of an educational game promoting safer sex, with the only difference being exactly how the topic of having sexual intercourse should be addressed in the game. Males preferred a direct approach, whereas females had a preference for treating this subject more sympathetically. Educational games offer anonymity and can provide young people across different cultural backgrounds with gender-tailored opportunities to experiment with specific safer sex precautions in a nonthreatening virtual environment, free from unwanted parental control and peer monitoring.

South Asian and Middle Eastern patients' perspectives on medicine-related problems in the United Kingdom.

PubMed

Alhomoud, Faten; Dhillon, Soraya; Aslanpour, Zoe; Smith, Felicity

2015-08-01

There has been little research which specifically examines medicine use among South Asian (SA) and Middle Eastern (ME) groups, although evidence suggests that medicine-related needs may be poorly met for these groups. To describe medicine-related problems (MRPs) experienced by SA and ME patients from their perspectives and identify possible contributory factors that may be specific to their cultures. The data were collected in seven pharmacies in London, United Kingdom (UK). The study was a qualitative study. Patients were from SA and ME origins, aged over 18 and prescribed three or more regular medicines. Patients were identified when presenting with a prescription. The data were collected in 80 face-to-face semi-structured interviews using Gordon's MRPs tool. Interviews were audiotaped, transcribed verbatim and analysed thematically using Gordon's coding frame and Nvivo 10 software. Describing MRPs experienced by SA and ME patients from their perspectives and identifying possible contributory factors that may be specific to their cultures. Results Eighty participants (61 % male) had mean (SD) age 58 (13.4) years and a mean (SD) of 8 (4) medicines. Interviews revealed that several factors contributed to the development of MRPs; some appeared to be specific to SA and ME cultures and others were similar to the general population. The factors that were reported to be specific to SA and ME groups comprised religious practices and beliefs, use of non-prescription medicines, extent of family support, and travelling abroad--to patient's homeland or to take religious journeys. Illiteracy, language and communication barriers, lack of translated resources, perceptions of healthcare providers, and difficulty consulting a doctor of the same gender may also contribute to the problems. Many of these factors could be expected to influence patient's safety, adherence, and informed decision-making. This study demonstrated that SA and ME patients have their own problems and needs regarding both medicine use and service access. By uncovering particular problems experienced by these groups, the study can inform healthcare professionals to support SA and ME patients in the use of their medicines.

The non-specific effects of vaccines and other childhood interventions: the contribution of INDEPTH Health and Demographic Surveillance Systems

PubMed Central

Sankoh, Osman; Welaga, Paul; Debpuur, Cornelius; Zandoh, Charles; Gyaase, Stephney; Poma, Mary Atta; Mutua, Martin Kavao; Hanifi, SM Manzoor Ahmed; Martins, Cesario; Nebie, Eric; Kagoné, Moubassira; Emina, Jacques BO; Aaby, Peter

2014-01-01

Most childhood interventions (vaccines, micronutrients) in low-income countries are justified by their assumed effect on child survival. However, usually the interventions have only been studied with respect to their disease/deficiency-specific effects and not for their overall effects on morbidity and mortality. In many situations, the population-based effects have been very different from the anticipated effects; for example, the measles-preventive high-titre measles vaccine was associated with 2-fold increased female mortality; BCG reduces neonatal mortality although children do not die of tuberculosis in the neonatal period; vitamin A may be associated with increased or reduced child mortality in different situations; effects of interventions may differ for boys and girls. The reasons for these and other contrasts between expectations and observations are likely to be that the immune system learns more than specific prevention from an intervention; such training may enhance or reduce susceptibility to unrelated infections. INDEPTH member centres have been in an ideal position to document such additional non-specific effects of interventions because they follow the total population long term. It is proposed that more INDEPTH member centres extend their routine data collection platform to better measure the use and effects of childhood interventions. In a longer perspective, INDEPTH may come to play a stronger role in defining health research issues of relevance to low-income countries. PMID:24920644

Source-to-exposure assessment with the Pangea multi-scale framework - case study in Australia.

PubMed

Wannaz, Cedric; Fantke, Peter; Lane, Joe; Jolliet, Olivier

2018-01-24

Effective planning of airshed pollution mitigation is often constrained by a lack of integrative analysis able to relate the relevant emitters to the receptor populations at risk. Both emitter and receptor perspectives are therefore needed to consistently inform emission and exposure reduction measures. This paper aims to extend the Pangea spatial multi-scale multimedia framework to evaluate source-to-receptor relationships of industrial sources of organic pollutants in Australia. Pangea solves a large compartmental system in parallel by block to determine arrays of masses at steady-state for 100 000+ compartments and 4000+ emission scenarios, and further computes population exposure by inhalation and ingestion. From an emitter perspective, radial spatial distributions of population intakes show high spatial variation in intake fractions from 0.68 to 33 ppm for benzene, and from 0.006 to 9.5 ppm for formaldehyde, contrasting urban, rural, desert, and sea source locations. Extending analyses to the receptor perspective, population exposures from the combined emissions of 4101 Australian point sources are more extended for benzene that travels over longer distances, versus formaldehyde that has a more local impact. Decomposing exposure per industrial sector shows petroleum and steel industry as the highest contributing industrial sectors for benzene, whereas the electricity sector and petroleum refining contribute most to formaldehyde exposures. The source apportionment identifies the main sources contributing to exposure at five locations. Overall, this paper demonstrates high interest in addressing exposures from both an emitter perspective well-suited to inform product oriented approaches such as LCA, and from a receptor perspective for health risk mitigation.

Recruitment and retention of physicians in rural Alberta: the spousal perspective.

PubMed

Myroniuk, Lana; Adamiak, Paul; Bajaj, Sameer; Myhre, Douglas L

2016-01-01

The overall geographic distribution of physicians in Canada, including Alberta, is misaligned with the population distribution. Some strategies, such as debt repayment, are currently in practice to increase recruitment and retention of physicians in rural locations. Of the factors influencing choice of practice location, 'spousal influence' is considered to play a significant role in recruitment and retention of physicians in literature. Most studies have focused on the physicians' perspective of their spouses' influence on staying in a rural location. This study is unique as it approaches rural recruitment and retention from the perspective of the physician spouse. The physician population for this study consisted of doctors practicing in rural southern Alberta. Participants were recruited via an email invitation and were invited to complete an online survey. The survey collected information regarding physician demographics and some relationship characteristics. The email invitation also contained a link to a second survey specific to the physician spouse or partner, asking a similar panel of questions. Physicians were asked to request their spouse or partner to complete this survey. Semi-structured interviews were conducted for those who consented to be contacted for interviews. Descriptive statistical analysis of the survey data was carried out. Thematic analysis of the qualitative interview data was conducted and was organized into three sections. The first and second sections present the personal experiences of rural recruitment and rural retention. The third section presents recommendations made by physicians and spouses to improve these processes. Specific interview quotes led the authors to derive themes under each section. The results of this study raise the voice and profile of the spouse in the process of rural recruitment and retention. In this study, the spouses of Canadian medical graduates were a positive influence in rural recruitment and retention, while the spouses of international medical graduates were generally less supportive of a rural lifestyle. Considerations to accommodate the educational, professional and cultural needs of the physician spouse must be incorporated into policy if large areas of underserved rural communities will continue to rely on international recruitment.

An experimental investigation of mentalization ability in borderline personality disorder.

PubMed

Petersen, Robyn; Brakoulias, Vlasios; Langdon, Robyn

2016-01-01

Deficits in mentalization ability have been theorized to underlie borderline personality disorder (BPD) and have led to mentalization-based treatments. Yet there has been little empirical investigation into whether mentalization deficits do differentiate the BPD population from healthy controls, and the specific nature of these differences. Five pre-existing Theory of Mind (ToM) tasks that assessed simple to complex mentalization capacity in both the affective and cognitive domains were administered to the same groups of age and gender matched patients with BPD and controls. Self-report measures assessed cognitive and affective empathy and childhood trauma and abuse. The BPD group did not differ significantly from the healthy control group on basic cognitive false-belief picture-sequencing tasks, or on overall accuracy when discriminating mental states from viewing images of eyes, and attributing emotions based on social events. They were, however, significantly less accurate in identifying positive mental states on the Reading the Mind in the Eyes (RME) task and showed significantly more mentalization errors on affective and cognitive understanding of faux pas (faux pas total score p<.01) and on a Joke Appreciation task (p=.01), that required integration of multiple perspectives. They also self-reported less empathic perspective taking (p<.01). Observation of patterns of performance hinted at specific underlying biases (e.g. a default tendency to use superficial black-and-white attributions to others, such as, "he is mean", when explaining behavior). It was also found that as childhood experiences of punishment increased, adulthood mentalization ability decreased on all affective ToM tasks and on the cognitive and affective components of understanding faux pas. The BPD group was as capable as controls in undertaking simple mentalization. However, deficits in mentalization capacity became evident when mentalization tasks became more complex and required the integration of multiple perspectives. Increasing childhood experiences of punishment were related to decreasing mentalization ability in adulthood. Findings support the use of treatments to improve mentalization skills in BPD, however, further research is needed to better specify the nature of underlying mentalizing biases in this population. Copyright © 2015 Elsevier Inc. All rights reserved.

Critical Review of Health Impacts of Wildfire Smoke Exposure

PubMed Central

Reid, Colleen E.; Brauer, Michael; Johnston, Fay H.; Jerrett, Michael; Balmes, John R.; Elliott, Catherine T.

2016-01-01

Background: Wildfire activity is predicted to increase in many parts of the world due to changes in temperature and precipitation patterns from global climate change. Wildfire smoke contains numerous hazardous air pollutants and many studies have documented population health effects from this exposure. Objectives: We aimed to assess the evidence of health effects from exposure to wildfire smoke and to identify susceptible populations. Methods: We reviewed the scientific literature for studies of wildfire smoke exposure on mortality and on respiratory, cardiovascular, mental, and perinatal health. Within those reviewed papers deemed to have minimal risk of bias, we assessed the coherence and consistency of findings. Discussion: Consistent evidence documents associations between wildfire smoke exposure and general respiratory health effects, specifically exacerbations of asthma and chronic obstructive pulmonary disease. Growing evidence suggests associations with increased risk of respiratory infections and all-cause mortality. Evidence for cardiovascular effects is mixed, but a few recent studies have reported associations for specific cardiovascular end points. Insufficient research exists to identify specific population subgroups that are more susceptible to wildfire smoke exposure. Conclusions: Consistent evidence from a large number of studies indicates that wildfire smoke exposure is associated with respiratory morbidity with growing evidence supporting an association with all-cause mortality. More research is needed to clarify which causes of mortality may be associated with wildfire smoke, whether cardiovascular outcomes are associated with wildfire smoke, and if certain populations are more susceptible. Citation: Reid CE, Brauer M, Johnston FH, Jerrett M, Balmes JR, Elliott CT. 2016. Critical review of health impacts of wildfire smoke exposure. Environ Health Perspect 124:1334–1343; http://dx.doi.org/10.1289/ehp.1409277 PMID:27082891

Experts' Perspectives Toward a Population Health Approach for Children With Medical Complexity.

PubMed

Barnert, Elizabeth S; Coller, Ryan J; Nelson, Bergen B; Thompson, Lindsey R; Chan, Vincent; Padilla, Cesar; Klitzner, Thomas S; Szilagyi, Moira; Chung, Paul J

2017-08-01

Because children with medical complexity (CMC) display very different health trajectories, needs, and resource utilization than other children, it is unclear how well traditional conceptions of population health apply to CMC. We sought to identify key health outcome domains for CMC as a step toward determining core health metrics for this distinct population of children. We conducted and analyzed interviews with 23 diverse national experts on CMC to better understand population health for CMC. Interviewees included child and family advocates, health and social service providers, and research, health systems, and policy leaders. We performed thematic content analyses to identify emergent themes regarding population health for CMC. Overall, interviewees conveyed that defining and measuring population health for CMC is an achievable, worthwhile goal. Qualitative themes from interviews included: 1) CMC share unifying characteristics that could serve as the basis for population health outcomes; 2) optimal health for CMC is child specific and dynamic; 3) health of CMC is intertwined with health of families; 4) social determinants of health are especially important for CMC; and 5) measuring population health for CMC faces serious conceptual and logistical challenges. Experts have taken initial steps in defining the population health of CMC. Population health for CMC involves a dynamic concept of health that is attuned to individual, health-related goals for each child. We propose a framework that can guide the identification and development of population health metrics for CMC. Copyright © 2017 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

Heterozygosity-fitness correlations among wild populations of European tree frog (Hyla arborea) detect fixation load.

PubMed

Luquet, E; David, P; Lena, J-P; Joly, P; Konecny, L; Dufresnes, C; Perrin, N; Plenet, S

2011-05-01

Quantifying the impacts of inbreeding and genetic drift on fitness traits in fragmented populations is becoming a major goal in conservation biology. Such impacts occur at different levels and involve different sets of loci. Genetic drift randomly fixes slightly deleterious alleles leading to different fixation load among populations. By contrast, inbreeding depression arises from highly deleterious alleles in segregation within a population and creates variation among individuals. A popular approach is to measure correlations between molecular variation and phenotypic performances. This approach has been mainly used at the individual level to detect inbreeding depression within populations and sometimes at the population level but without consideration about the genetic processes measured. For the first time, we used in this study a molecular approach considering both the interpopulation and intrapopulation level to discriminate the relative importance of inbreeding depression vs. fixation load in isolated and non-fragmented populations of European tree frog (Hyla arborea), complemented with interpopulational crosses. We demonstrated that the positive correlations observed between genetic heterozygosity and larval performances on merged data were mainly caused by co-variations in genetic diversity and fixation load among populations rather than by inbreeding depression and segregating deleterious alleles within populations. Such a method is highly relevant in a conservation perspective because, depending on how populations lose fitness (inbreeding vs. fixation load), specific management actions may be designed to improve the persistence of populations. © 2011 Blackwell Publishing Ltd.

Firefighter Hand Anthropometry and Structural Glove Sizing: A New Perspective

PubMed Central

Hsiao, Hongwei; Whitestone, Jennifer; Kau, Tsui-Ying; Hildreth, Brooke

2015-01-01

Objective We evaluated the current use and fit of structural firefighting gloves and developed an improved sizing scheme that better accommodates the U.S. firefighter population. Background Among surveys, 24% to 30% of men and 31% to 62% of women reported experiencing problems with the fit or bulkiness of their structural firefighting gloves. Method An age-, race/ethnicity-, and gender-stratified sample of 863 male and 88 female firefighters across the United States participated in the study. Fourteen hand dimensions relevant to glove design were measured. A cluster analysis of the hand dimensions was performed to explore options for an improved sizing scheme. Results The current national standard structural firefighting glove-sizing scheme underrepresents firefighter hand size range and shape variation. In addition, mismatch between existing sizing specifications and hand characteristics, such as hand dimensions, user selection of glove size, and the existing glove sizing specifications, is significant. An improved glove-sizing plan based on clusters of overall hand size and hand/finger breadth-to-length contrast has been developed. Conclusion This study presents the most up-to-date firefighter hand anthropometry and a new perspective on glove accommodation. The new seven-size system contains narrower variations (standard deviations) for almost all dimensions for each glove size than the current sizing practices. Application The proposed science-based sizing plan for structural firefighting gloves provides a step-forward perspective (i.e., including two women hand model–based sizes and two wide-palm sizes for men) for glove manufacturers to advance firefighter hand protection. PMID:26169309

Exploring the patient perspective of fatigue in adults with visual impairment: a qualitative study.

PubMed

Schakel, Wouter; Bode, Christina; van der Aa, Hilde P A; Hulshof, Carel T J; Bosmans, Judith E; van Rens, Gerardus H M B; van Nispen, Ruth M A

2017-08-03

Fatigue is an often mentioned symptom by patients with irreversible visual impairment. This study explored the patient perspective of fatigue in visually impaired adults with a focus on symptoms of fatigue, causes, consequences and coping strategies. Two large Dutch low vision multidisciplinary rehabilitation organisations. 16 visually impaired adults with severe symptoms of fatigue selected by purposive sampling. A qualitative study involving semistructured interviews. A total of four first-level codes were top-down predetermined in correspondence with the topics of the research question. Verbatim transcribed interviews were analysed with a combination of a deductive and inductive approach using open and axial coding. Participants often described the symptoms of fatigue as a mental, daily and physical experience. The most often mentioned causes of fatigue were a high cognitive load, the intensity and amount of activities, the high effort necessary to establish visual perception, difficulty with light intensity and negative cognitions. Fatigue had the greatest impact on the ability to carry out social roles and participation, emotional functioning and cognitive functioning. The most common coping strategies were relaxation, external support, socialising and physical exercise and the acceptance of fatigue. Our results indicate that low vision-related fatigue is mainly caused by population specific determinants that seem different from the fatigue experience described in studies with other patient populations. Fatigue may be central to the way patients react, adapt and compensate to the consequences of vision loss. These findings indicate a need for future research aimed at interventions specifically tailored to the unique aspects of fatigue related to vision loss. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

The danger within: the role of genetic, behavioural and ecological factors in population persistence of colour polymorphic species.

PubMed

Bolton, Peri E; Rollins, Lee A; Griffith, Simon C

2015-06-01

Polymorphic species have been the focus of important work in evolutionary biology. It has been suggested that colour polymorphic species have specific evolutionary and population dynamics that enable them to persist through environmental changes better than less variable species. We suggest that recent empirical and theoretical work indicates that polymorphic species may be more vulnerable to extinction than previously thought. This vulnerability arises because these species often have a number of correlated sexual, behavioural, life history and ecological traits, which can have a simple genetic underpinning. When exacerbated by environmental change, these alternate strategies can lead to conflict between morphs at the genomic and population levels, which can directly or indirectly affect population and evolutionary dynamics. In this perspective, we identify a number of ways in which the nature of the correlated traits, their underpinning genetic architecture, and the inevitable interactions between colour morphs can result in a reduction in population fitness. The principles illustrated here apply to all kinds of discrete polymorphism (e.g. behavioural syndromes), but we focus primarily on colour polymorphism because they are well studied. We urge further empirical investigation of the genetic architecture and interactions in polymorphic species to elucidate the impact on population fitness. © 2015 John Wiley & Sons Ltd.

Population structure and temporal maintenance of the multihost fungal pathogen Botrytis cinerea: causes and implications for disease management.

PubMed

Walker, Anne-Sophie; Gladieux, Pierre; Decognet, Véronique; Fermaud, Marc; Confais, Johann; Roudet, Jean; Bardin, Marc; Bout, Alexandre; Nicot, Philippe C; Poncet, Christine; Fournier, Elisabeth

2015-04-01

Understanding the causes of population subdivision is of fundamental importance, as studying barriers to gene flow between populations may reveal key aspects of the process of adaptive divergence and, for pathogens, may help forecasting disease emergence and implementing sound management strategies. Here, we investigated population subdivision in the multihost fungus Botrytis cinerea based on comprehensive multiyear sampling on different hosts in three French regions. Analyses revealed a weak association between population structure and geography, but a clear differentiation according to the host plant of origin. This was consistent with adaptation to hosts, but the distribution of inferred genetic clusters and the frequency of admixed individuals indicated a lack of strict host specificity. Differentiation between individuals collected in the greenhouse (on Solanum) and outdoor (on Vitis and Rubus) was stronger than that observed between individuals from the two outdoor hosts, probably reflecting an additional isolating effect associated with the cropping system. Three genetic clusters coexisted on Vitis but did not persist over time. Linkage disequilibrium analysis indicated that outdoor populations were regularly recombining, whereas clonality was predominant in the greenhouse. Our findings open up new perspectives for disease control by managing plant debris in outdoor conditions and reinforcing prophylactic measures indoor. © 2014 Society for Applied Microbiology and John Wiley & Sons Ltd.

Managing American Oystercatcher (Haematopus palliatus) population qrowth by targeting nesting season vital rates

USGS Publications Warehouse

Felton, Shilo K.; Hostetter, Nathan J.; Pollock, Kenneth H.; Simons, Theodore R.

2017-01-01

In populations of long-lived species, adult survival typically has a relatively high influence on population growth. From a management perspective, however, adult survival can be difficult to increase in some instances, so other component rates must be considered to reverse population declines. In North Carolina, USA, management to conserve the American Oystercatcher (Haematopus palliatus) targets component vital rates related to fecundity, specifically nest and chick survival. The effectiveness of such a management approach in North Carolina was assessed by creating a three-stage female-based deterministic matrix model. Isoclines were produced from the matrix model to evaluate minimum nest and chick survival rates necessary to reverse population decline, assuming all other vital rates remained stable at mean values. Assuming accurate vital rates, breeding populations within North Carolina appear to be declining. To reverse this decline, combined nest and chick survival would need to increase from 0.14 to ≤ 0.27, a rate that appears to be attainable based on historical estimates. Results are heavily dependent on assumptions of other vital rates, most notably adult survival, revealing the need for accurate estimates of all vital rates to inform management actions. This approach provides valuable insights for evaluating conservation goals for species of concern.

Reduced specificity in emotion judgment in people with autism spectrum disorder

PubMed Central

Wang, Shuo; Adolphs, Ralph

2017-01-01

There is a conflicting literature on facial emotion processing in autism spectrum disorder (ASD): both typical and atypical performance have been reported, and inconsistencies in the literature may stem from different processes examined (emotion judgment, face perception, fixations) as well as differences in participant populations. Here we conducted a detailed investigation of the ability to discriminate graded emotions shown in morphs of fear-happy faces, in a well-characterized high-functioning sample of participants with ASD and matched controls. Signal detection approaches were used in the analyses, and concurrent high-resolution eye-tracking was collected. Although people with ASD had typical thresholds for categorical fear and confidence judgments, their psychometric specificity to detect emotions across the entire range of intensities was reduced. However, fixation patterns onto the stimuli were typical and could not account for the reduced specificity of emotion judgment. Together, our results argue for a subtle and specific deficit in emotion perception in ASD that, from a signal detection perspective, is best understood as a reduced specificity due to increased noise in central processing of the face stimuli. PMID:28343960

Sex-specific predictors of inpatient rehabilitation outcomes after traumatic brain injury

PubMed Central

Chan, Vincy; Mollayeva, Tatyana; Ottenbacher, Kenneth J.; Colantonio, Angela

2016-01-01

Objective To identify sex-specific predictors of inpatient rehabilitation outcomes among patients with a traumatic brain injury (TBI) from a population based perspective. Design Retrospective cohort study Setting Ontario, Canada Participants Patients in inpatient rehabilitation for a TBI within one year of acute care discharge between 2008/09 and 2011/12 (N=1,730, 70% male, 30% female). Interventions None Main Outcome Measures Inpatient rehabilitation length of stay, total Functional Independence Measure (FIM™) score, and motor and cognitive FIM™ ratings at discharge. Results Sex, as a covariate in multivariable linear regression models, was not a significant predictor of rehabilitation outcomes. While many of the predictors examined were similar across males and females, sex-specific multivariable models identified some predictors of rehabilitation outcome that are specific for males and females; mechanism of injury (p<.0001) was a significant predictor of functional outcome only among females while comorbidities (p<.0001) was a significant predictor for males only. Conclusions Predictors of outcomes after inpatient rehabilitation differed by sex, providing evidence for a sex-specific approach in planning and resource allocation for inpatient rehabilitation services for patients with TBI. PMID:26836952

Sex-Specific Predictors of Inpatient Rehabilitation Outcomes After Traumatic Brain Injury.

PubMed

Chan, Vincy; Mollayeva, Tatyana; Ottenbacher, Kenneth J; Colantonio, Angela

2016-05-01

To identify sex-specific predictors of inpatient rehabilitation outcomes among patients with a traumatic brain injury (TBI) from a population-based perspective. Retrospective cohort study. Inpatient rehabilitation. Patients in inpatient rehabilitation for a TBI within 1 year of acute care discharge between 2008/2009 and 2011/2012 (N=1730, 70% men, 30% women). None. Inpatient rehabilitation length of stay, total FIM score, and motor and cognitive FIM ratings at discharge. Sex, as a covariate in multivariable linear regression models, was not a significant predictor of rehabilitation outcomes. Although many of the predictors examined were similar across men and women, sex-specific multivariable models identified some predictors of rehabilitation outcome that are specific for men and women; mechanism of injury (P<.0001) was a significant predictor of functional outcome only among women, whereas comorbidities (P<.0001) was a significant predictor for men only. Predictors of outcomes after inpatient rehabilitation differed by sex, providing evidence for a sex-specific approach in planning and resource allocation for inpatient rehabilitation services for patients with TBI. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

"I feel like I am surviving the health care system": understanding LGBTQ health in Nova Scotia, Canada.

PubMed

Colpitts, Emily; Gahagan, Jacqueline

2016-09-22

Currently, there is a dearth of baseline data on the health of lesbian, gay, bisexual, transgender, and queer (LGBTQ) populations in the province of Nova Scotia, Canada. Historically, LGBTQ health research has tended to focus on individual-level health risks associated with poor health outcomes among these populations, which has served to obscure the ways in which they maintain their own health and wellness across the life course. As such, there is an urgent need to shift the focus of LGBTQ health research towards strengths-based perspectives that explore the complex and resilient ways in which LGBTQ populations promote their health. This paper discusses the findings of our recent scoping review as well as the qualitative data to emerge from community consultations aimed at developing strengths-based approaches to understanding and advancing LGBTQ pathways to health across Nova Scotia. Our scoping review findings demonstrated the lack of strengths-based research on LGBTQ health in Nova Scotia. Specifically, the studies examined in our scoping review identified a number of health-promoting factors and a wide variety of measurement tools, some of which may prove useful for future strengths-based health research with LGBTQ populations. In addition, our community consultations revealed that many participants had negative experiences with health care systems and services in Nova Scotia. However, participants also shared a number of factors that contribute to LGBTQ health and suggestions for how LGBTQ pathways to health in Nova Scotia can be improved. There is an urgent need to conduct research on the health needs, lived experiences, and outcomes of LGBTQ populations in Nova Scotia to address gaps in our knowledge of their unique health needs. In moving forward, it is important that future health research take an intersectional, strengths-based perspective in an effort to highlight the factors that promote LGBTQ health and wellness across the life course, while taking into account the social determinants of health.

Estimating lifetime healthcare costs with morbidity data.

PubMed

Carreras, Marc; Ibern, Pere; Coderch, Jordi; Sánchez, Inma; Inoriza, Jose M

2013-10-25

In many developed countries, the economic crisis started in 2008 producing a serious contraction of the financial resources spent on healthcare. Identifying which individuals will require more resources and the moment in their lives these resources have to be allocated becomes essential. It is well known that a small number of individuals with complex healthcare needs consume a high percentage of health expenditures. Conversely, little is known on how morbidity evolves throughout life. The aim of this study is to introduce a longitudinal perspective to chronic disease management. Data used relate to the population of the county of Baix Empordà in Catalonia for the period 2004-2007 (average population was N = 88,858). The database included individual information on morbidity, resource consumption, costs and activity records. The population was classified using the Clinical Risk Groups (CRG) model. Future morbidity evolution was simulated under different assumptions using a stationary Markov chain. We obtained morbidity patterns for the lifetime and the distribution function of the random variable lifetime costs. Individual information on acute episodes, chronic conditions and multimorbidity patterns were included in the model. The probability of having a specific health status in the future (healthy, acute process or different combinations of chronic illness) and the distribution function of healthcare costs for the individual lifetime were obtained for the sample population. The mean lifetime cost for women was €111,936, a third higher than for men, at €81,566 (all amounts calculated in 2007 Euros). Healthy life expectancy at birth for females was 46.99, lower than for males (50.22). Females also spent 28.41 years of life suffering from some type of chronic disease, a longer period than men (21.9). Future morbidity and whole population costs can be reasonably predicted, combining stochastic microsimulation with a morbidity classification system. Potential ways of efficiency arose by introducing a time perspective to chronic disease management.

Estimating lifetime healthcare costs with morbidity data

PubMed Central

2013-01-01

Background In many developed countries, the economic crisis started in 2008 producing a serious contraction of the financial resources spent on healthcare. Identifying which individuals will require more resources and the moment in their lives these resources have to be allocated becomes essential. It is well known that a small number of individuals with complex healthcare needs consume a high percentage of health expenditures. Conversely, little is known on how morbidity evolves throughout life. The aim of this study is to introduce a longitudinal perspective to chronic disease management. Methods Data used relate to the population of the county of Baix Empordà in Catalonia for the period 2004–2007 (average population was N = 88,858). The database included individual information on morbidity, resource consumption, costs and activity records. The population was classified using the Clinical Risk Groups (CRG) model. Future morbidity evolution was simulated under different assumptions using a stationary Markov chain. We obtained morbidity patterns for the lifetime and the distribution function of the random variable lifetime costs. Individual information on acute episodes, chronic conditions and multimorbidity patterns were included in the model. Results The probability of having a specific health status in the future (healthy, acute process or different combinations of chronic illness) and the distribution function of healthcare costs for the individual lifetime were obtained for the sample population. The mean lifetime cost for women was €111,936, a third higher than for men, at €81,566 (all amounts calculated in 2007 Euros). Healthy life expectancy at birth for females was 46.99, lower than for males (50.22). Females also spent 28.41 years of life suffering from some type of chronic disease, a longer period than men (21.9). Conclusions Future morbidity and whole population costs can be reasonably predicted, combining stochastic microsimulation with a morbidity classification system. Potential ways of efficiency arose by introducing a time perspective to chronic disease management. PMID:24156613

Medicine, religion and ayahuasca in Catalonia. Considering ayahuasca networks from a medical anthropology perspective.

PubMed

Apud, Ismael; Romaní, Oriol

2017-01-01

Ayahuasca is a psychoactive beverage from the Amazon, traditionally used by indigenous and mestizo populations in the region. Widespread international use of the beverage began in the 1990s in both secular contexts and religious/spiritual networks. This article offers an analysis of these networks as health care systems in general and for the case of Spain and specifically Catalonia, describing the emergence and characteristics of their groups, and the therapeutic itineraries of some participants. The medical anthropology perspective we take enables us to reflect on the relationship between medicine and religion, and problematize the tensions between medicalization and medical pluralism. Closely linked to the process of medicalization, we also analyze prohibitionist drug policies and their tensions and conflicts with the use of ayahuasca in ritual and 'health care' contexts. The paper ends with a reflection on the problem of ayahuasca as 'medicine', since the connection between religion and medicine is a very difficult one to separate. Copyright © 2016 Elsevier B.V. All rights reserved.

Obesity and the Neurocognitive Basis of Food Reward and the Control of Intake12

PubMed Central

Ziauddeen, Hisham; Alonso-Alonso, Miguel; Hill, James O; Kelley, Michael; Khan, Naiman A

2015-01-01

With the rising prevalence of obesity, hedonic eating has become an important theme in obesity research. Hedonic eating is thought to be that driven by the reward of food consumption and not metabolic need, and this has focused attention on the brain reward system and how its dysregulation may cause overeating and obesity. Here, we begin by examining the brain reward system and the evidence for its dysregulation in human obesity. We then consider the issue of how individuals are able to control their hedonic eating in the present obesogenic environment and compare 2 contrasting perspectives on the control of hedonic eating, specifically, enhanced control of intake via higher cognitive control and loss of control over intake as captured by the food addiction model. We conclude by considering what these perspectives offer in terms of directions for future research and for potential interventions to improve control over food intake at the population and the individual levels. PMID:26178031

International comparison of experience-based health state values at the population level.

PubMed

Heijink, Richard; Reitmeir, Peter; Leidl, Reiner

2017-07-07

Decision makers need to know whether health state values, an important component of summary measures of health, are valid for their target population. A key outcome is the individuals' valuation of their current health. This experience-based perspective is increasingly used to derive health state values. This study is the first to compare such experience-based valuations at the population level across countries. We examined the relationship between respondents' self-rated health as measured by the EQ-VAS, and the different dimensions and levels of the EQ-5D-3 L. The dataset included almost 32,000 survey respondents from 15 countries. We estimated generalized linear models with logit link function, including country-specific models and pooled-data models with country effects. The results showed significant and meaningful differences in the valuation of health states and individual health dimensions between countries, even though similarities were present too. Between countries, coefficients correlated positively for the values of mobility, self-care and usual activities, but not for the values of pain and anxiety, thus underlining structural differences. The findings indicate that, ideally, population-specific experience-based value sets are developed and used for the calculation of health outcomes. Otherwise, sensitivity analyses are needed. Furthermore, transferring the results of foreign studies into the national context should be performed with caution. We recommend future studies to investigate the causes of differences in experience-based health state values through a single international study possibly complemented with qualitative research on the determinants of valuation.

Corruption, inequality and population perception of healthcare quality in Europe.

PubMed

Nikoloski, Zlatko; Mossialos, Elias

2013-11-11

Evaluating the quality of healthcare and patient safety using general population questionnaires is important from research and policy perspective. Using a special wave of the Eurobarometer survey, we analysed the general population's perception of health care quality and patient safety in a cross-country setting. We used ordered probit, ordinary least squares and probit analysis to estimate the determinants of health care quality, and ordered logit analysis to analyse the likelihood of being harmed by a specific medical procedure. The models used population weights as well as country-clustered standard errors. We found robust evidence for the impact of socio-demographic variables on the perception of quality of health care. More specifically, we found a non-linear impact of age on the perception of quality of health care and patient safety, as well as a negative impact of poverty on both perception of quality and patient safety. We also found robust evidence that countries with higher corruption levels were associated with worse perceptions of quality of health care. Finally, we found evidence that income inequality affects patients' perception vis-à-vis safety, thus feeding into the poverty/health care quality nexus. Socio-demographic factors and two macro variables (corruption and income inequality) explain the perception of quality of health care and likelihood of being harmed by adverse events. The results carry significant policy weight and could explain why targeting only the health care sector (without an overall reform of the public sector) could potentially be challenging.

Gambling and the Health of the Public: Adopting a Public Health Perspective.

PubMed

Korn, David A.; Shaffer, Howard J.

1999-01-01

During the last decade there has been an unprecedented expansion of legalized gambling throughout North America. Three primary forces appear to be motivating this growth: (1) the desire of governments to identify new sources of revenue without invoking new or higher taxes; (2) tourism entrepreneurs developing new destinations for entertainment and leisure; and (3) the rise of new technologies and forms of gambling (e.g., video lottery terminals, powerball mega-lotteries, and computer offshore gambling). Associated with this phenomenon, there has been an increase in the prevalence of problem and pathological gambling among the general adult population, as well as a sustained high level of gambling-related problems among youth. To date there has been little dialogue within the public health sector in particular, or among health care practitioners in general, about the potential health impact of gambling or gambling-related problems. This article encourages the adoption of a public health perspective towards gambling. More specifically, this discussion has four primary objectives:1. Create awareness among health professionals about gambling, its rapid expansion and its relationship with the health care system;2. Place gambling within a public health framework by examining it from several perspectives, including population health, human ecology and addictive behaviors;3. Outline the major public health issues about how gambling can affect individuals, families and communities;4. Propose an agenda for strengthening policy, prevention and treatment practices through greater public health involvement, using the framework of The Ottawa Charter for Health Promotion as a guide.By understanding gambling and its potential impacts on the public's health, policy makers and health practitioners can minimize gambling's negative impacts and appreciate its potential benefits.

China's floating population and the potential for HIV transmission: a social-behavioural perspective.

PubMed

Anderson, A F; Qingsi, Z; Hua, X; Jianfeng, B

2003-04-01

Historical, geo-economic and behavioural perspectives are used in an exploratory analysis of China's migrant or 'floating' population as a factor in the spread of HIV on the mainland. Participants in the interview format survey (N = 506) included in-transit individuals in Beijing, and peddlers, restaurant workers, and employment seekers in Shanghai. When viewed in light of various social dynamics, the convenience survey data suggest that elements within this migrant population, as well as their rurally located partners and spouses, may be at increased risk of acquiring the virus. Given the sheer size and broad movement of this population, it is contended that it may well be a 'tipping point' factor in AIDS prevention and control in China.

Regulatory challenges in the review of data from global clinical trials: the PMDA perspective.

PubMed

Asano, K; Tanaka, A; Sato, T; Uyama, Y

2013-08-01

Regulatory agencies face challenges in reviewing data from global clinical trials (GCTs) in the era of globalization of drug development. One major challenge is consideration of ethnic factors in evaluating GCT data so as to extrapolate foreign population data to one's own national population. Here, we present the Pharmaceuticals and Medical Devices Agency (PMDA) perspective in reviewing GCT data in new drug applications (NDAs) and discuss future challenges for new drug approval.

Cost-effectiveness of partially-hydrolyzed formula for prevention of atopic dermatitis in Australia.

PubMed

Su, John; Prescott, Susan; Sinn, John; Tang, Mimi; Smith, Peter; Heine, Ralf G; Spieldenner, Jörg; Iskedjian, Michael

2012-01-01

To perform an economic evaluation of a specific brand of partially hydrolyzed infant formula (PHF-W) in the prevention of atopic dermatitis (AD) among Australian infants. A cost-effectiveness analysis was undertaken from the perspectives of the Department of Health and Aging (DHA), of the family of the affected subject and of society as a whole in Australia, based on a decision-analytic model following a hypothetical representative cohort of Australian newborns who are not exclusively breastfed and who have a familial history of allergic disease (i.e., are deemed 'at risk'). Costs, consequences, and incremental cost-effectiveness ratios (ICER) were calculated for PHF-W vs standard cow's milk based infant formula (SF), and, in a secondary analysis, vs extensively hydrolyzed infant formula (EHF-Whey), when the latter was used for the prevention of AD. From a representative starting cohort of 87,724 'at risk' newborns in Australia in 2009, the expected ICERs for PHF-W vs SF were AU$496 from the perspective of the DHA and savings of AUD1739 and AU$1243 from the family and societal perspectives, respectively. When compared to EHF-Whey, PHF-W was associated with savings for the cohort of AU$5,183,474 and AU$6,736,513 from the DHA and societal perspectives. The generalizability and transferability of results to other settings, populations, or brands of infant formula should be made with caution. Whenever possible, a conservative approach directing bias against PHF-W rather than its comparators was applied in the base case analysis. Assumptions were verified in one-way and probabilistic sensitivity analyses, which confirmed the robustness of the model. PHF-W appears to be cost-effective when compared to SF from the DHA perspective, dominant over SF from the other perspectives, and dominant over EHF-Whey from all perspectives, in the prevention of AD in 'at risk' infants not exclusively breastfed, in Australia.

Extending life for people with a terminal illness: a moral right and an expensive death? Exploring societal perspectives.

PubMed

McHugh, Neil; Baker, Rachel M; Mason, Helen; Williamson, Laura; van Exel, Job; Deogaonkar, Rohan; Collins, Marissa; Donaldson, Cam

2015-03-07

Many publicly-funded health systems apply cost-benefit frameworks in response to the moral dilemma of how best to allocate scarce healthcare resources. However, implementation of recommendations based on costs and benefit calculations and subsequent challenges have led to 'special cases' with certain types of health benefits considered more valuable than others. Recent debate and research has focused on the relative value of life extensions for people with terminal illnesses. This research investigates societal perspectives in relation to this issue, in the UK. Q methodology was used to elicit societal perspectives from a purposively selected sample of data-rich respondents. Participants ranked 49 statements of opinion (developed for this study), onto a grid, according to level of agreement. These 'Q sorts' were followed by brief interviews. Factor analysis was used to identify shared points of view (patterns of similarity between individuals' Q sorts). Analysis produced a three factor solution. These rich, shared accounts can be broadly summarised as: i) 'A population perspective - value for money, no special cases', ii) 'Life is precious - valuing life-extension and patient choice', iii) 'Valuing wider benefits and opportunity cost - the quality of life and death'. From the factor descriptions it is clear that the main philosophical positions that have long dominated debates on the just allocation of resources have a basis in public opinion. The existence of certain moral positions in the views of society does not ethically imply, and pragmatically cannot mean, that all are translated into policy. Our findings highlight normative tensions and the importance of critically engaging with these normative issues (in addition to the current focus on a procedural justice approach to health policy). Future research should focus on i) the extent to which these perspectives are supported in society, ii) how respondents' perspectives relate to specific resource allocation questions, and iii) the characteristics of respondents associated with each perspective.

Research Gaps in the Use of Dairy Ingredients in Food Aid Products.

PubMed

DiRienzo, Douglas

2016-03-01

Nutritional interventions to help prevent stunting, particularly in the first 1000 days from conception to 2 years of a child's life, are a major focus of numerous food aid organizations worldwide. Dairy ingredients can play an important role in enhancing the nutritional value and effectiveness of food products used in food aid. This article addresses gaps in research on malnutrition from both a broad perspective and specific to dairy ingredients. Narrative review. From a broad perspective, there is a need for gaining a consensus by the research community and funders of research on best practices for protocol development, outcomes measured, and reporting of study outcomes. Identification of biomarkers and rapid screening methods and consistent application of their use would expedite future research. A better understanding of nutritional requirements for malnourished populations, including the effects of energy deficits and disease on those requirements, is needed. More specific to dairy ingredients, a key research question is: Does dairy protein or the package of nutrients provided by dairy ingredients have a unique impact on growth, and if so, how? Also, data on the optimal levels of dairy ingredients based on the effective cost of treatment are needed, particularly in the treatment and prevention of moderate acute malnutrition and during pregnancy. © The Author(s) 2016.

Cancer Prevention Among Adults Aged 45–64 Years

PubMed Central

Ory, Marcia G.; Anderson, Lynda A.; Friedman, Daniela B.; Pulczinski, Jairus C.; Eugene, Nola; Satariano, William A.

2015-01-01

As part of setting the stage for this supplement to the American Journal of Preventive Medicine, a life-course perspective is presented to assist in understanding the importance of cancer prevention for adults in midlife, a period roughly spanning 20 years between ages 45 and 64 years. Drawing on disciplinary perspectives from the social sciences and public health, several life-course themes are delineated in this article: how specific life transitions present unique opportunities for interventions to inform policy and practice that can improve population health outcomes; how interventions can be focused on those at particular life stages or on the entire life course; and how the onset and progression of chronic conditions such as cancer are dependent on a complex interplay of critical and sensitive periods, and trajectory and accumulation processes. A translational research framework is applied to help promote the movement of applied public health interventions for cancer prevention into practice. Also explored are differences that can affect people at midlife relative to other age cohorts. Specifically, cancer-related risks and care networks are examined, with examples of public health strategies that can be applied to cancer prevention and control. As a conclusion, select methodologic issues and next steps for advancing research and practice are identified. PMID:24512925

The Locus Preservation Hypothesis: Shared Linguistic Profiles across Developmental Disorders and the Resilient Part of the Human Language Faculty

PubMed Central

Leivada, Evelina; Kambanaros, Maria; Grohmann, Kleanthes K.

2017-01-01

Grammatical markers are not uniformly impaired across speakers of different languages, even when speakers share a diagnosis and the marker in question is grammaticalized in a similar way in these languages. The aim of this work is to demarcate, from a cross-linguistic perspective, the linguistic phenotype of three genetically heterogeneous developmental disorders: specific language impairment, Down syndrome, and autism spectrum disorder. After a systematic review of linguistic profiles targeting mainly English-, Greek-, Catalan-, and Spanish-speaking populations with developmental disorders (n = 880), shared loci of impairment are identified and certain domains of grammar are shown to be more vulnerable than others. The distribution of impaired loci is captured by the Locus Preservation Hypothesis which suggests that specific parts of the language faculty are immune to impairment across developmental disorders. Through the Locus Preservation Hypothesis, a classical chicken and egg question can be addressed: Do poor conceptual resources and memory limitations result in an atypical grammar or does a grammatical breakdown lead to conceptual and memory limitations? Overall, certain morphological markers reveal themselves as highly susceptible to impairment, while syntactic operations are preserved, granting support to the first scenario. The origin of resilient syntax is explained from a phylogenetic perspective in connection to the “syntax-before-phonology” hypothesis. PMID:29081756

Seal dynamics on the Swedish west coast: Scenarios of competition as Baltic grey seal intrude on harbour seal territory

NASA Astrophysics Data System (ADS)

Svensson, Carl Johan

2012-07-01

The Kattegat-Skagerrak region on the Swedish west coast is home to an abundant harbour seal population (Phoca vitulina) and a small scattered grey seal population (Halichoerus grypus). In addition, grey seal from the growing population in the Baltic Sea frequently migrate into the Kattegat-Skagerrak. Harbour seals on the west coast of Sweden show relatively high population growth (approximately 9%) compared to the Baltic grey seal in ice-free habitats (approximately 6%), which, in theory, makes harbour seal the stronger competitor of the two in this region. However, incidents of disease in harbour seals that lower population growth are becoming more frequent. These epidemics are primarily caused by the Phocine Distemper Virus (PDV), and may reduce population size with up to 70%. This study models the average development under potential scenarios of competing harbour- and Baltic grey seal populations using Leslie matrices and the Lotka-Volterra model of inter-specific competition. The model is parameterised with previously published data, and resource overlap is incorporated through density dependent pup survival. Using numerical methods short- and long-term abundances are simulated under weak, moderate and strong competition and for different frequencies of PDV epidemics. Results show that the harbour seals are resilient to competition while exerting a negative effect on grey seal abundance under moderate to strong competition. Hence Baltic grey seal benefit from weaker levels of competition. Under moderate and strong competition grey seal abundance is a direct function of the PDV frequency as this reduces the competitive strength of harbour seals. Theoretically this means that higher frequencies of PDV or other pathogens epidemics could facilitate an expansion of Baltic grey seal into Kattegat-Skagerrak. Independent of interaction strength and frequency of epidemics the projected changes to abundances are slow (50-100 years), and even in exceedingly stable populations very long time-series of population size estimates are necessary to determine interaction strength. From a management perspective, a more permanent grey seal population in Kattegat-Skagerrak is likely to increase the predation pressure on overfished regional cod populations, and also lead to higher prevalence of the cod parasite Pseudoterranova decipiens, which uses grey seal as end host. From a population ecology perspective, abundant Baltic grey seal in this region would facilitate the mixing of grey seals from the North Atlantic and the Baltic Sea, with unknown implications for the genetically divergent Baltic population.

Violent crime in San Antonio, Texas: an application of spatial epidemiological methods.

PubMed

Sparks, Corey S

2011-12-01

Violent crimes are rarely considered a public health problem or investigated using epidemiological methods. But patterns of violent crime and other health conditions are often affected by similar characteristics of the built environment. In this paper, methods and perspectives from spatial epidemiology are used in an analysis of violent crimes in San Antonio, TX. Bayesian statistical methods are used to examine the contextual influence of several aspects of the built environment. Additionally, spatial regression models using Bayesian model specifications are used to examine spatial patterns of violent crime risk. Results indicate that the determinants of violent crime depend on the model specification, but are primarily related to the built environment and neighborhood socioeconomic conditions. Results are discussed within the context of a rapidly growing urban area with a diverse population. Copyright © 2011 Elsevier Ltd. All rights reserved.

Provider perspectives on treatment decision-making in nephrotic syndrome.

PubMed

Hladunewich, Michelle A; Beanlands, Heather; Herreshoff, Emily; Troost, Jonathan P; Maione, Maria; Trachtman, Howard; Poulton, Caroline; Nachman, Patrick; Modes, Mary Margaret; Hailperin, Marilyn; Pitter, Renee; Gipson, Debbie S

2017-01-01

Managing patients with nephrotic syndrome (NS) remains difficult for the practicing nephrologist. This often young patient population is faced with a debilitating, relapsing and remitting disease with non-specific treatment options that are often poorly tolerated. Clinicians managing these complex patients must attempt to apply disease-specific evidence while considering the individual patient's clinical and personal situation. We conducted qualitative interviews to ascertain the provider perspectives of NS, treatment options and factors that influence recommendations for disease management, and administered a survey to assess both facilitators and barriers to the implementation of the Kidney Disease: Improving Global Outcomes (KDIGO) guidelines. When making treatment recommendations, providers considered characteristics of various treatments such as efficacy, side effects and evaluation of risk versus benefit, taking into account how the specific treatment fit with the individual patient. Time constraints and the complexity of explaining the intricacies of NS were noted as significant barriers to care. Although the availability of guidelines was deemed a facilitator to care, the value of the KDIGO guidelines was limited by the perception of poor quality of evidence. The complexity of NS and the scarcity of robust evidence to support treatment recommendations are common challenges reported by nephrologists. Future development and use of shared learning platforms may support the integration of best available evidence, patient/family preferences and exchange of information at a pace that is unconstrained by the outpatient clinic schedule. © The Author 2017. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.

The support of autonomy and the control of behavior.

PubMed

Deci, E L; Ryan, R M

1987-12-01

In this article we suggest that events and contexts relevant to the initiation and regulation of intentional behavior can function either to support autonomy (i.e., to promote choice) or to control behavior (i.e., to pressure one toward specific outcomes). Research herein reviewed indicates that this distinction is relevant to specific external events and to general interpersonal contexts as well as to specific internal events and to general personality orientations. That is, the distinction is relevant whether one's analysis focuses on social psychological variables or on personality variables. The research review details those contextual and person factors that tend to promote autonomy and those that tend to control. Furthermore, it shows that autonomy support has generally been associated with more intrinsic motivation, greater interest, less pressure and tension, more creativity, more cognitive flexibility, better conceptual learning, a more positive emotional tone, higher self-esteem, more trust, greater persistence of behavior change, and better physical and psychological health than has control. Also, these results have converged across different assessment procedures, different research methods, and different subject populations. On the basis of these results, we present an organismic perspective in which we argue that the regulation of intentional behavior varies along a continuum from autonomous (i.e., self-determined) to controlled. The relation of this organismic perspective to historical developments in empirical psychology is discussed, with a particular emphasis on its implications for the study of social psychology and personality.

Applying Theory across Settings, Behaviors and Populations: Translational Challenges and Opportunities

PubMed Central

Mermelstein, Robin J.; Revenson, Tracey A.

2013-01-01

Basic social psychological theories have much to contribute to our understanding of health problems and health-related behaviors and may provide potential avenues for intervention development. However, for these theories to have broader reach and applicability to the field of health psychology, more work needs to be done in integrating contexts into these theories and addressing more specifically their application across settings, behaviors, and populations. We argue that integration of these theories into a broader multi-disciplinary and multi-level ecological framework is needed to enhance their translation into real-world applications. To enhance this translation, we make several recommendations, including breaking down silos between disciplinary perspectives and enhancing bidirectional communication and translation; analyzing boundary conditions of theories; expanding research approaches to move outside the laboratory and maintain a focus on external validity; and conducting efficacy testing of theories with meaningful, relevant endpoints. PMID:23646843

The relevance of public health research for practice: A 30-year perspective.

PubMed

Diderichsen, Finn

2018-06-01

The Nordic context where public health responsibility is strongly devolved to municipalities raises specific demands on public health research. The demands for causal inference of disease aetiology and intervention efficacy is not different, but in addition there is a need for population health science that describes local prevalence, distribution and clustering of determinants. Knowledge of what interventions and policies work, for whom and under what conditions is essential, but instead of assuming context independence and demanding high external validity it is important to understand how contextual factors linked to groups and places modify both effects and implementation. More implementation studies are needed, but the infrastructure for that research in terms of theories and instruments for monitoring implementation is needed. Much of this was true also 30 years ago, but with increasing spending on both public health research and practice, the demands are increasing that major improvement of population health and health equity are actually achieved.

Applying theory across settings, behaviors, and populations: translational challenges and opportunities.

PubMed

Mermelstein, Robin J; Revenson, Tracey A

2013-05-01

Basic social psychological theories have much to contribute to our understanding of health problems and health-related behaviors and may provide potential avenues for intervention development. However, for these theories to have broader reach and applicability to the field of health psychology, more work needs to be done in integrating contexts into these theories and addressing more specifically their application across settings, behaviors, and populations. We argue that integration of these theories into a broader multidisciplinary and multilevel ecological framework is needed to enhance their translation into real-world applications. To enhance this translation, we make several recommendations, including breaking down silos between disciplinary perspectives and enhancing bidirectional communication and translation; analyzing boundary conditions of theories; expanding research approaches to move outside the laboratory and maintain a focus on external validity; and conducting efficacy testing of theories with meaningful, relevant endpoints. PsycINFO Database Record (c) 2013 APA, all rights reserved.

Chemical education experiences from the English language learner perspective

NASA Astrophysics Data System (ADS)

Flores, Annette

2011-12-01

The Rio Grande Valley (RGV) is a region populated by Spanish-speaking immigrants and their descendants producing a large English Language Learner (ELL) student population. ELLs have historically had low literacy rates and achievement levels when compared to their counterparts. In order to address this achievement gap, previous research efforts and curriculum interventions have focused on language acquisition as being the determining factor in ELL education, with little attention given to academic content acquisition. More current research efforts have transitioned into English language acquisition through academic content instruction; this present research study specifically focuses on ELL experiences in chemistry. Participants were high school chemistry students who identified as ELL or had recently exited out of ELL status. Students were interviewed to identify factors that attributed to their experiences in chemistry. Findings indicate code-switching as a key to learning chemistry in English but also the deterrent in English language acquisition.

Linking population, fertility, and family planning with adaptation to climate change: perspectives from Ethiopia.

PubMed

Rovin, Kimberly; Hardee, Karen; Kidanu, Aklilu

2013-09-01

Global climate change is felt disproportionately in the world's most economically disadvantaged countries. As adaption to an evolving climate becomes increasingly salient on national and global scales, it is important to assess how people at the local-level are already coping with changes. Understanding local responses to climate change is essential for helping countries to construct strategies to bolster resilience to current and future effects. This qualitative research investigated responses to climate change in Ethiopia; specifically, how communities react to and cope with climate variation, which groups are most vulnerable, and the role of family planning in increasing resilience. Participants were highly aware of changing climate effects, impacts of rapid population growth, and the need for increased access to voluntary family planning. Identification of family planning as an important adaptation strategy supports the inclusion of rights-based voluntary family planning and reproductive health into local and national climate change adaptation plans.

Neural Stem Cells: Historical Perspective and Future Prospects

PubMed Central

Breunig, Joshua J.; Haydar, Tarik F.; Rakic, Pasko

2011-01-01

How a single fertilized cell generates diverse neuronal populations has been a fundamental biological problem since the 19th century. Classical histological methods revealed that post-mitotic neurons are produced in a precise temporal and spatial order from germinal cells lining the cerebral ventricles. In the 20th century DNA labeling and histo- and immuno-histochemistry helped to distinguish the subtypes of dividing cells and delineate their locations in the ventricular and subventricular zones. Recently, genetic and cell biological methods have provided insights into sequential gene expression and molecular and cellular interactions that generate heterogeneous populations of NSCs leading to specific neuronal classes. This precisely regulated developmental process does not tolerate significant in vivo deviation, making replacement of adult neurons by NSCs during pathology a colossal challenge. In contrast, utilizing the trophic factors emanating from the NSC or their derivatives to slow down deterioration or prevent death of degenerating neurons may be a more feasible strategy. PMID:21609820

Hispanic fertility, immigration, and race in the twenty-first century

PubMed Central

Parrado, Emilio A.; Flippen, Chenoa A.

2012-01-01

In this paper we systematically describe the connection between immigration and fertility in light of the increasing nativist reaction to Hispanic groups. We follow a life-course perspective to directly link migration and fertility transitions. The analysis combines original qualitative and quantitative data collected in Durham/Chapel Hill, NC as well as national level information from the Current Population Survey. The qualitative data provides a person-centered approach to the connection between migration and fertility that we then extend in quantitative analyses. Results demonstrate that standard demographic measures that treat migration and fertility as separate processes considerably distort the childbearing experience of immigrant women, inflating fertility estimates for Hispanics as a whole. Once this connection is taken into consideration the fertility levels of Hispanic women are much lower than those reported with standard measures and the fertility-specific contribution of Hispanics to U.S. population growth is much reduced. PMID:23066430

The New Population Debate: Two Views on Population Growth and Economic Development. Population Trends and Public Policy, Number 7.

ERIC Educational Resources Information Center

King, Timothy; Kelley, Allen C.

Articles representing two views on the issue of rapid population growth and economic development are presented. Although the authors present different perspectives, they agree on many of the fundamentals. For example, both reject alarmism about impending "population explosions" and the use of population as a scapegoat for all Third World…

Biodegradation: Updating the concepts of control for microbial cleanup in contaminated aquifers.

PubMed

Meckenstock, Rainer U; Elsner, Martin; Griebler, Christian; Lueders, Tillmann; Stumpp, Christine; Aamand, Jens; Agathos, Spiros N; Albrechtsen, Hans-Jørgen; Bastiaens, Leen; Bjerg, Poul L; Boon, Nico; Dejonghe, Winnie; Huang, Wei E; Schmidt, Susanne I; Smolders, Erik; Sørensen, Sebastian R; Springael, Dirk; van Breukelen, Boris M

2015-06-16

Biodegradation is one of the most favored and sustainable means of removing organic pollutants from contaminated aquifers but the major steering factors are still surprisingly poorly understood. Growing evidence questions some of the established concepts for control of biodegradation. Here, we critically discuss classical concepts such as the thermodynamic redox zonation, or the use of steady state transport scenarios for assessing biodegradation rates. Furthermore, we discuss if the absence of specific degrader populations can explain poor biodegradation. We propose updated perspectives on the controls of biodegradation in contaminant plumes. These include the plume fringe concept, transport limitations, and transient conditions as currently underestimated processes affecting biodegradation.

Molecules to modeling: Toxoplasma gondii oocysts at the human–animal–environment interface

PubMed Central

VanWormer, Elizabeth; Fritz, Heather; Shapiro, Karen; Mazet, Jonna A.K.; Conrad, Patricia A.

2013-01-01

Environmental transmission of extremely resistant Toxoplasma gondii oocysts has resulted in infection of diverse species around the world, leading to severe disease and deaths in human and animal populations. This review explores T. gondii oocyst shedding, survival, and transmission, emphasizing the importance of linking laboratory and landscape from molecular characterization of oocysts to watershed-level models of oocyst loading and transport in terrestrial and aquatic systems. Building on discipline-specific studies, a One Health approach incorporating tools and perspectives from diverse fields and stakeholders has contributed to an advanced understanding of T. gondii and is addressing transmission at the rapidly changing human–animal–environment interface. PMID:23218130

[Identity construction in adolescents of migrant parents. Crosswise analysis of the identity process].

PubMed

Bouche-Florin, Laëtitia; Skandrani, Sara Marie; Moro, Marie Rose

2007-01-01

Adolescence is the specific stage during which psychological changes and identity searching are at the forefront of preoccupations. The identity construction proves to be particularly complex in a transcultural context. Starting from their clinical questioning, the authors propose a literature review of the process of identity construction in a population of adolescent children of migrant parents. This theoretical reflection is based on conceptualisations of this process in intercultural psychology, transcultural psychology and in the theory of dialogical self. Putting into perspective these different approaches and their interconnections will help better understand the reality of hybrid or half-breed identity during adolescence.

Power, discourse, and resistance: Poststructuralist influences in nursing.

PubMed

Holmes, Dave; Gagnon, Marilou

2018-01-01

Based on our respective research programs (psychiatry, forensic psychiatry, public health, HIV/AIDS, harm reduction) this article aims to use purposely non-conventional means to present the substantial contribution of poststructuralist perspectives to knowledge development in nursing science in general and in our current research in particular. More specifically, we call on the work of Michel Foucault and Deleuze & Guattari to politicize nursing science using examples from our empirical research programs with marginal and often highly marginalized populations. We discuss the concepts of power, discourse, and resistance to illustrate the essential contribution of poststructuralism to marginal, even "nomadic", nursing research. © 2017 John Wiley & Sons Ltd.

Market Access Advancements and Challenges in “Drug-Companion Diagnostic Test” Co-Development in Europe

PubMed Central

Akhmetov, Ildar; Ramaswamy, Rakshambikai; Akhmetov, Illias; Thimmaraju, Phani Kishore

2015-01-01

The pharma ecosphere is witnessing a measured transformation from the one-size-fits-all or blockbuster model of drugs to more informed and tailored personalized treatments that facilitate higher safety and efficacy for a relevant sub-population. However, with several breakthroughs still in a nascent stage, market access becomes a crucial factor for commercial success, especially when it comes to co-creating value for pertinent stakeholders. This article highlights diverse issues from stakeholder perspectives in Europe, specifically the ones which require immediate resolution. Furthermore, the article also discusses case studies articulating potential solutions for the issues discussed. PMID:26075972

A content analysis of peripheral arterial disease patient-reported outcome measures using the International Classification of Functioning, Disability and Health.

PubMed

Osborne, Candice Lee; Kauvar, David Seth

2017-10-17

The purpose of this study was to link, classify and describe the content of peripheral arterial disease (PAD)-specific patient-reported outcome measures using the International Classification of Functioning. The results were then analyzed to determine if these assessments provide clinicians and researchers with a comprehensive understanding of the lived experience of patients with PAD. Each meaningful concept in identified PAD assessments was linked to the International Classification of Functioning, Disability and Health to determine included and excluded content areas. An overall perspective was assigned to each assessment item. Inter-rater reliability was established using a kappa statistic. The body functions component is most frequently addressed overall followed by the activities and participation component. International Classification of Functioning chapter and category distribution vary greatly between assessments and no assessment comprehensively examines community participation and relationships. The majority of the assessment items are of the health status-disability and quality of life perspectives. The results of this study suggest the need for the development of a comprehensive PAD assessment that includes a more even distribution of International Classification of Functioning topics and subtopics. A more comprehensive assessment would better capture the lived experience of this patient population. Implications for Rehabilitation A better understanding of the data collected using the current peripheral arterial disease-specific patient-reported outcome measures may contribute to the development of more comprehensive assessment tools that will ultimately lead to improved patient care. This study contributes to the preliminary foundation for the development of a peripheral arterial disease International Classification of Functioning, Disability and Health Core Set. Clinicians and researchers interested in using peripheral arterial disease-specific patient-reported outcome measures for clinical and research purposes can better understand what topics are included and excluded in the collection and what perspectives are addressed.

Patient-reported outcomes to support medical product labeling claims: FDA perspective.

PubMed

Patrick, Donald L; Burke, Laurie B; Powers, John H; Scott, Jane A; Rock, Edwin P; Dawisha, Sahar; O'Neill, Robert; Kennedy, Dianne L

2007-01-01

This article concerns development and use of patient-reported outcomes (PROs) in clinical trials to evaluate medical products. A PRO is any report coming directly from patients, without interpretation by physicians or others, about how they function or feel in relation to a health condition and its therapy. PRO instruments are used to measure these patient reports. PROs provide a unique perspective on medical therapy, because some effects of a health condition and its therapy are known only to patients. Properly developed and evaluated PRO instruments also have the potential to provide more sensitive and specific measurements of the effects of medical therapies, thereby increasing the efficiency of clinical trials that attempt to measure the meaningful treatment benefits of those therapies. Poorly developed and evaluated instruments may provide misleading conclusions or data that cannot be used to support product labeling claims. We review selected major challenges from Food and Drug Administration's perspective in using PRO instruments, measures, and end points to support treatment benefit claims in product labeling. These challenges highlight the need for sponsors to formulate desired labeling claim(s) prospectively, to acquire and document information needed to support these claim(s), and to identify existing instruments or develop new and more appropriate PRO instruments for evaluating treatment benefit in the defined population in which they will seek claims.

Attending to scalar ethical issues in emerging approaches to environmental health research and practice.

PubMed

Buse, Chris G; Smith, Maxwell; Silva, Diego S

2018-06-04

Accelerated changes to the planet have created novel spaces to re-imagine the boundaries and foci of environmental health research. Climate change, mass species extinction, ocean acidification, biogeochemical disturbance, and other emergent environmental issues have precipitated new population health perspectives, including, but not limited to, one health, ecohealth, and planetary health. These perspectives, while nuanced, all attempt to reconcile broad global challenges with localized health impacts by attending to the reciprocal relationships between the health of ecosystems, animals, and humans. While such innovation is to be encouraged, we argue that a more comprehensive engagement with the ethics of these emerging fields of inquiry will add value in terms of the significance and impact of associated interventions. In this contribution, we highlight how the concept of spatial and temporal scale can be usefully deployed to shed light on a variety of ethical issues common to emerging environmental health perspectives, and that the potential of scalar analysis implicit to van Potter's conceptualization of bioethics has yet to be fully appreciated. Specifically, we identify how scale interacts with key ethical issues that require consideration and clarification by one health, ecohealth, and planetary health researchers and practitioners to enhance the effectiveness of research and practice, including justice and governance.

The full translational spectrum of prevention science: facilitating the transfer of knowledge to practices and policies that prevent behavioral health problems.

PubMed

Fishbein, Diana H; Ridenour, Ty A; Stahl, Mindy; Sussman, Steve

2016-03-01

A broad-span, six-stage translational prevention model is presented, extending from the basic sciences-taking a multi-level systems approach, including the neurobiological sciences-through to globalization. The application of a very wide perspective of translation research from basic scientific discovery to international policy change promises to elicit sustainable, population-level reductions in behavioral health disorders. To illustrate the conceptualization and actualization of a program of translational prevention research, we walk through each stage of research to practice and policy using an exemplar, callous-unemotional (CU) traits. Basic science has identified neurobiological, psychophysiological, behavioral, contextual, and experiential differences in this subgroup, and yet, these findings have not been applied to the development of more targeted intervention. As a result, there are currently no programs considered especially effective for CU traits, likely because they do not specifically target underlying mechanisms. To prevent/reduce the prevalence of conduct disorder, it is critical that we transfer existing knowledge to subsequent translational stages, including intervention development, implementation, and scaling. And eventually, once resulting programs have been rigorously evaluated, replicated, and adapted across cultural, ethnic, and gender groups, there is potential to institutionalize them as well as call attention to the special needs of this population. In this paper, we begin to consider what resources and changes in research perspectives are needed to move along this translational spectrum.

Long-lived keratin 15+ esophageal progenitor cells contribute to homeostasis and regeneration

PubMed Central

Giroux, Véronique; Lento, Ashley A.; Islam, Mirazul; Pitarresi, Jason R.; Kharbanda, Akriti; Hamilton, Kathryn E.; Whelan, Kelly A.; Long, Apple; Rhoades, Ben; Tang, Qiaosi; Nakagawa, Hiroshi; Lengner, Christopher J.; Bass, Adam J.; Wileyto, E. Paul; Klein-Szanto, Andres J.; Wang, Timothy C.; Rustgi, Anil K.

2017-01-01

The esophageal lumen is lined by a stratified squamous epithelium comprised of proliferative basal cells that differentiate while migrating toward the luminal surface and eventually desquamate. Rapid epithelial renewal occurs, but the specific cell of origin that supports this high proliferative demand remains unknown. Herein, we have described a long-lived progenitor cell population in the mouse esophageal epithelium that is characterized by expression of keratin 15 (Krt15). Genetic in vivo lineage tracing revealed that the Krt15 promoter marks a long-lived basal cell population able to self-renew, proliferate, and generate differentiated cells, consistent with a progenitor/stem cell population. Transcriptional profiling demonstrated that Krt15+ basal cells are molecularly distinct from Krt15– basal cells. Depletion of Krt15-derived cells resulted in decreased proliferation, thereby leading to atrophy of the esophageal epithelium. Further, Krt15+ cells were radioresistant and contributed to esophageal epithelial regeneration following radiation-induced injury. These results establish the presence of a long-lived and indispensable Krt15+ progenitor cell population that provides additional perspective on esophageal epithelial biology and the widely prevalent diseases that afflict this epithelium. PMID:28481227

Changing landscapes and the cosmopolitism of the eastern Colorado avifauna

USGS Publications Warehouse

Knopf, Fritz L.

1986-01-01

The avifauna of continental North America has changed dramatically since colonial times. Excessive hunting contributed, at least in part, to the extinction of birds such as the great auk (Pinguinus impennis) and passenger pigeon (Ectopistes migratorius), while more recently organochlorine insecticide residues have resulted in drastic reductions in numbers of brown pelicans (Pelecanus occidentalis) (Anderson et al. 1975) and other species. Generally, however, vertebrate populations change in direct response to changes in their habitats. For example, herring gulls (Larus argentatus) have increased in numners (Kadlec and Drury 1968) with urbanization of the New England coastline, in the same locations formerly occupied by the extinct heath hen (Tympanuchus cupido cupido). Also, passerine birds of forest interiors have declined in numbers with fragmentation of the eastern deciduous forest into small stands; this fragmentation has led to increases in numbers of edge species (Robbins 1979, Ambuel and Temple 1983). Even subtle community shifts can introduce new competitive processes that can augment population changes among species (Brittingham and Temple 1983). Such studies of broad-scale changes in vegetative communities and their influence on native wildlife species have fostered the recent topical emphasis on "conservation biology" (Soule and Wilcox 1980, Soule 1985) and "landscape ecology" (Burgess and Sharpe 1981, Harris 1984:25-43). As changes in landscapes are causing subtle (but potentially dramatic) changes in the distribution of native species, conservation biologists are finding that mere presence-absence data on populations, or even accurate information on reproductive success, is inadequate to evaluate management activities or environmental perturbations. The principles of "conservation genetics" are attracting interest in the management of natural preserves especially (Schonewald-Cox et al. 1983). Changing patterns in landscape complexion or genetic makeup of a population are difficult to detect locally. Contemporary issues in the conservation of native species demand regional and continental perspectives (Samson and Knopf 1982). Thus, management activities at specific sites are often viewed as short-sighted by planners and conservation critics. This paper illustrates how these contemporary theories can influence a local conservation perspective. That perspective is developed around historical processes that have led to cosmopolitism of the local avifauna on the Colorado Division of Wildlife's South Platte Wildlife Management Area (SPWMA) near Crook, Colorado.

The Employers' perspective on barriers and facilitators to employment of people with intellectual disability: A differential mixed-method approach.

PubMed

Kocman, Andreas; Fischer, Linda; Weber, Germain

2018-01-01

Obtaining employment is among the most important ambitions of people with intellectual disability. Progress towards comprehensive inclusive employment is hampered by numerous barriers. Limited research is available on these barriers and strategies to overcome them. A mixed method approach in a sample of 30 HR-managers was used to assess (i) differences in perceived barriers for employment of people with specific disabilities and mental disorders; (ii) barriers specific to employing people with intellectual disability; (iii) strategies to overcome these barriers. Employers perceive more barriers for hiring people with intellectual disability and mental disorders than for physical disabilities. Employment for this population is hampered by a perceived lack of skills and legal issues. Strategies perceived as beneficial are supplying information, changes in organizational strategies and legal changes. Employers' differentiated expectations and reservations towards hiring individuals with specific disabilities need to be taken into account to increase employment for people with intellectual disability. © 2017 John Wiley & Sons Ltd.

The role of egocentric and allocentric abilities in Alzheimer's disease: a systematic review.

PubMed

Serino, Silvia; Cipresso, Pietro; Morganti, Francesca; Riva, Giuseppe

2014-07-01

A great effort has been made to identify crucial cognitive markers that can be used to characterize the cognitive profile of Alzheimer's disease (AD). Because topographical disorientation is one of the earliest clinical manifestation of AD, an increasing number of studies have investigated the spatial deficits in this clinical population. In this systematic review, we specifically focused on experimental studies investigating allocentric and egocentric deficits to understand which spatial cognitive processes are differentially impaired in the different stages of the disease. First, our results highlighted that spatial deficits appear in the earliest stages of the disease. Second, a need for a more ecological assessment of spatial functions will be presented. Third, our analysis suggested that a prevalence of allocentric impairment exists. Specifically, two selected studies underlined that a more specific impairment is found in the translation between the egocentric and allocentric representations. In this perspective, the implications for future research and neurorehabilitative interventions will be discussed. Copyright © 2014 Elsevier B.V. All rights reserved.

When your face describes your memories: facial expressions during retrieval of autobiographical memories.

PubMed

El Haj, Mohamad; Daoudi, Mohamed; Gallouj, Karim; Moustafa, Ahmed A; Nandrino, Jean-Louis

2018-05-11

Thanks to the current advances in the software analysis of facial expressions, there is a burgeoning interest in understanding emotional facial expressions observed during the retrieval of autobiographical memories. This review describes the research on facial expressions during autobiographical retrieval showing distinct emotional facial expressions according to the characteristics of retrieved memoires. More specifically, this research demonstrates that the retrieval of emotional memories can trigger corresponding emotional facial expressions (e.g. positive memories may trigger positive facial expressions). Also, this study demonstrates the variations of facial expressions according to specificity, self-relevance, or past versus future direction of memory construction. Besides linking research on facial expressions during autobiographical retrieval to cognitive and affective characteristics of autobiographical memory in general, this review positions this research within the broader context research on the physiologic characteristics of autobiographical retrieval. We also provide several perspectives for clinical studies to investigate facial expressions in populations with deficits in autobiographical memory (e.g. whether autobiographical overgenerality in neurologic and psychiatric populations may trigger few emotional facial expressions). In sum, this review paper demonstrates how the evaluation of facial expressions during autobiographical retrieval may help understand the functioning and dysfunctioning of autobiographical memory.

The transcultural diabetes nutrition algorithm: a canadian perspective.

PubMed

Gougeon, Réjeanne; Sievenpiper, John L; Jenkins, David; Yale, Jean-François; Bell, Rhonda; Després, Jean-Pierre; Ransom, Thomas P P; Camelon, Kathryn; Dupre, John; Kendall, Cyril; Hegazi, Refaat A; Marchetti, Albert; Hamdy, Osama; Mechanick, Jeffrey I

2014-01-01

The Transcultural Diabetes Nutrition Algorithm (tDNA) is a clinical tool designed to facilitate implementation of therapeutic lifestyle recommendations for people with or at risk for type 2 diabetes. Cultural adaptation of evidence-based clinical practice guidelines (CPG) recommendations is essential to address varied patient populations within and among diverse regions worldwide. The Canadian version of tDNA supports and targets behavioural changes to improve nutritional quality and to promote regular daily physical activity consistent with Canadian Diabetes Association CPG, as well as channelling the concomitant management of obesity, hypertension, dyslipidemia, and dysglycaemia in primary care. Assessing glycaemic index (GI) (the ranking of foods by effects on postprandial blood glucose levels) and glycaemic load (GL) (the product of mean GI and the total carbohydrate content of a meal) will be a central part of the Canadian tDNA and complement nutrition therapy by facilitating glycaemic control using specific food selections. This component can also enhance other metabolic interventions, such as reducing the need for antihyperglycaemic medication and improving the effectiveness of weight loss programs. This tDNA strategy will be adapted to the cultural specificities of the Canadian population and incorporated into the tDNA validation methodology.

The Transcultural Diabetes Nutrition Algorithm: A Canadian Perspective

PubMed Central

Sievenpiper, John L.; Jenkins, David; Yale, Jean-François; Bell, Rhonda; Després, Jean-Pierre; Ransom, Thomas P. P.; Dupre, John; Kendall, Cyril; Hegazi, Refaat A.; Marchetti, Albert; Hamdy, Osama; Mechanick, Jeffrey I.

2014-01-01

The Transcultural Diabetes Nutrition Algorithm (tDNA) is a clinical tool designed to facilitate implementation of therapeutic lifestyle recommendations for people with or at risk for type 2 diabetes. Cultural adaptation of evidence-based clinical practice guidelines (CPG) recommendations is essential to address varied patient populations within and among diverse regions worldwide. The Canadian version of tDNA supports and targets behavioural changes to improve nutritional quality and to promote regular daily physical activity consistent with Canadian Diabetes Association CPG, as well as channelling the concomitant management of obesity, hypertension, dyslipidemia, and dysglycaemia in primary care. Assessing glycaemic index (GI) (the ranking of foods by effects on postprandial blood glucose levels) and glycaemic load (GL) (the product of mean GI and the total carbohydrate content of a meal) will be a central part of the Canadian tDNA and complement nutrition therapy by facilitating glycaemic control using specific food selections. This component can also enhance other metabolic interventions, such as reducing the need for antihyperglycaemic medication and improving the effectiveness of weight loss programs. This tDNA strategy will be adapted to the cultural specificities of the Canadian population and incorporated into the tDNA validation methodology. PMID:24550982

Religion and attitudes toward the environment: a comparison of Mormons and the general U.S. population

PubMed Central

Hunter, Lori M.; Toney, Michael B.

2011-01-01

Religion has been shown to influence attitudes toward an array of social issues. This manuscript focuses specifically on environmental issues, with empirical examination of the distinctiveness of contemporary Mormon environmental perspectives as contrasted with the general U.S. population. A belief in the importance of dominion over the environment is noted, by some, to be reflected in anti-environmental stance characterizing Mormon Culture Region political leaders and church members [Foltz, R. C. (2000). Mormon values and the Utah environment. Worldviews: Environment, Culture, Religion, 4, 1–19]. Yet, a set of highly regarded essays by a diverse group of Mormons, including some in church leadership positions, expresses strong personal commitments to environmental causes and point to Mormon teachings and doctrines promoting environmentalism (Williams, Smith, and Gibbs, 1998). We examine variation in environmental concern as expressed by Mormons in a local community survey undertaken in Logan, Utah, as contrasted with the nationally-representative General Social Survey (1993). We find substantial differences between Mormons and the national sample; While Mormons tended to express greater levels of environmental concern, they were less likely to have undertaken specific behaviors reflective of such concern. PMID:21909183

Anthropology and the study of menopause: evolutionary, developmental, and comparative perspectives.

PubMed

Sievert, Lynnette Leidy

2014-10-01

This work aims to consider how the discipline of anthropology contributes to the study of menopause through evolutionary, developmental, and comparative perspectives. This study was a review of skeletal and ethnographic evidence for menopause and postreproductive life in humans' distant past, hypotheses for the evolution of menopause and long postreproductive life, variation in age at menopause with focus on childhood environments, and the study of variation in symptom experience across populations. Longevity, rather than capacity for menopause, sets humans apart from other primates. Skeletal evidence demonstrates that some Neanderthals and archaic Homo sapiens lived to the age at menopause and that at least one third of women in traditional foraging populations live beyond menopause. The evolutionary reasons for why women experience a long postreproductive life continue to be debated. A developmental perspective suggests that early childhood may be a critical time for the environment to irreversibly influence the number of oocytes or rate of follicular atresia and, ultimately, age at menopause. A comparative perspective examines symptom experience at midlife through participant observation, qualitative interviews, and quantitative instruments to gain a holistic understanding of the meaning, experience, and sociocultural context of menopause. An evolutionary perspective suggests that menopause is not a recent phenomenon among humans. A developmental perspective focuses on the influence of early childhood on ovarian function. A comparative perspective expands clinical norms and provides knowledge about the range of human variations.

The non-specific effects of vaccines and other childhood interventions: the contribution of INDEPTH Health and Demographic Surveillance Systems.

PubMed

Sankoh, Osman; Welaga, Paul; Debpuur, Cornelius; Zandoh, Charles; Gyaase, Stephney; Poma, Mary Atta; Mutua, Martin Kavao; Hanifi, S M Manzoor Ahmed; Martins, Cesario; Nebie, Eric; Kagoné, Moubassira; Emina, Jacques B O; Aaby, Peter

2014-06-01

Most childhood interventions (vaccines, micronutrients) in low-income countries are justified by their assumed effect on child survival. However, usually the interventions have only been studied with respect to their disease/deficiency-specific effects and not for their overall effects on morbidity and mortality. In many situations, the population-based effects have been very different from the anticipated effects; for example, the measles-preventive high-titre measles vaccine was associated with 2-fold increased female mortality; BCG reduces neonatal mortality although children do not die of tuberculosis in the neonatal period; vitamin A may be associated with increased or reduced child mortality in different situations; effects of interventions may differ for boys and girls. The reasons for these and other contrasts between expectations and observations are likely to be that the immune system learns more than specific prevention from an intervention; such training may enhance or reduce susceptibility to unrelated infections. INDEPTH member centres have been in an ideal position to document such additional non-specific effects of interventions because they follow the total population long term. It is proposed that more INDEPTH member centres extend their routine data collection platform to better measure the use and effects of childhood interventions. In a longer perspective, INDEPTH may come to play a stronger role in defining health research issues of relevance to low-income countries. © The Author 2014; all rights reserved. Published by Oxford University Press on behalf of the International Epidemiological Association.

Exploring Health Implications of Disparities Associated with Food Insecurity Among Low-Income Populations.

PubMed

Canales, Mary K; Coffey, Nancy; Moore, Emily

2015-09-01

A focus group process, conducted by a community-academic partnership, qualitatively assessed food insecurity perspectives of parents and community staff assisting families with food assistance. Food insecurity was reported to affect all aspects of their life, increasing stress and reducing coping abilities. The Agency for Healthcare Research and Quality encourages research with priority populations, including low-income populations. This research supports the body of knowledge correlating relationships between poverty, food insecurity, and chronic health conditions. Perspectives of food-insecure people are often missing from policy and advocacy interventions. Nurses can use lessons learned and recommendations from this research to address food-insecurity-related health disparities. Copyright © 2015 Elsevier Inc. All rights reserved.

Population and Development: Perspective on a Teaching Challenge.

ERIC Educational Resources Information Center

Dawson, Leslie

1995-01-01

Through the World Institute's Curriculum, students can look at the world's two largest nations, China and India, to learn about population and gender equity issues. This article describes the use of recent data gathered by international agencies and population education in the classroom. (LZ)

Determinants of health and disability in ageing population: the COURAGE in Europe Project (collaborative research on ageing in Europe).

PubMed

Leonardi, Matilde; Chatterji, Somnath; Koskinen, Seppo; Ayuso-Mateos, Jose Luis; Haro, Josep Maria; Frisoni, Giovanni; Frattura, Lucilla; Martinuzzi, Andrea; Tobiasz-Adamczyk, Beata; Gmurek, Michal; Serrano, Ramon; Finocchiaro, Carla

2014-01-01

COURAGE in Europe was a 3-year project involving 12 partners from four European countries and the World Health Organization. It was inspired by the pressing need to integrate international studies on disability and ageing in light of an innovative perspective based on a validated data-collection protocol. COURAGE in Europe Project collected data on the determinants of health and disability in an ageing population, with specific tools for the evaluation of the role of the built environment and social networks on health, disability, quality of life and well-being. The main survey was conducted by partners in Finland, Poland and Spain where the survey has been administered to a sample of 10,800 persons, which was completed in March 2012. The newly developed and validated COURAGE Protocol for Ageing Studies has proven to be a valid tool for collecting comparable data in ageing population, and the COURAGE in Europe Project has created valid and reliable scientific evidence, demonstrating cross-country comparability, for disability and ageing research and policy development. It is therefore recommended that future studies exploring determinants of health and disability in ageing use the COURAGE-derived methodology. COURAGE in Europe Project collected data on the determinants of health and disability in an ageing population, with specific tools for the evaluation of the role of built environment and social networks on health, disability quality of life and well-being. The COURAGE Protocol for Ageing Studies has proven to be a valid tool for collecting comparable data in the ageing population. The COURAGE in Europe Consortium recommends that future studies exploring determinants of health and disability in ageing use COURAGE-derived methodology. Copyright © 2013 John Wiley & Sons, Ltd.

Cultural Competence in the Treatment of Addictions: Theory, Practice and Evidence.

PubMed

Gainsbury, Sally M

2017-07-01

Culturally and linguistically diverse (CALD) populations often have high rates of addictive disorders, but lower rates of treatment seeking and completion than the mainstream population. A significant barrier to treatment is the lack of culturally relevant and appropriate treatment. A literature review was conducted to identify relevant literature related to cultural competence in mental health services delivery and specifically treatment for addictive disorders. Several theoretical models of cultural competence in therapy have been developed, but the lack of rigorous research limits the empirical evidence available. Research indicates that culturally competent treatment practices including providing therapy and materials in the client's language, knowledge, understanding and appreciation for cultural perspectives and nuances, involving the wider family and community and training therapists can enhance client engagement, retention and treatment outcomes for substance use and gambling. Further methodologically rigorous research is needed to isolate the impact of cultural competence for the treatment of addictions and guide research to determine treatment efficacy within specific CALD populations. Training therapists and recruiting therapists and researchers from CALD communities is important to ensure an ongoing focus and improved outcomes for CALD populations due to the importance of engaging these populations with addiction treatment. Copyright © 2016 John Wiley & Sons, Ltd. Key Practitioner Message: The treatment needs of culturally diverse individuals with addictions are often not met. Theoretical models can guide therapists in incorporating cultural competence. Culturally targeted treatments increase recruitment, retention and treatment outcomes. Cultural competence includes matching clinicians and clients on linguistic and cultural backgrounds as well as being mindful of the impact of culture on client's experience of addiction problems. Few methodologically rigorous trials have been conducted to guide treatment practices and research needs to be incorporated into existing culturally relevant treatment services. Copyright © 2016 John Wiley & Sons, Ltd.

Phylogenetic perspective and the search for life on earth and elsewhere

NASA Technical Reports Server (NTRS)

Pace, Norman R.

1989-01-01

Any search for microbial life on Mars cannot rely upon cultivation of indigenous organisms. Only a minority of even terrestrial organisms that are observed in mixed, naturally-occurring microbial populations can be cultivated in the laboratory. Consequently, methods are being developed for analyzing the phylogenetic affiliations of the constituents of natural microbial populations without the need for their cultivation. This is more than an exercise in taxonomy, for the extent of phylogenetic relatedness between unknown and known organisms is some measure of the extent of their biochemical commonalities. In one approach, total DNA is isolated from natural microbial populations and 16S rRNA genes are shotgun cloned for rapid sequence determinations and phylogenetic analyses. A second approach employs oligodeoxynucleotide hybridization probes that bind to phylogenetic group-specific sequences in 16S rRNA. Since each actively growing cell contains about 104 ribosomes, the binding of the diagnostic probes to single cells can be visualized by radioactivity or fluorescence. The application of these methods and the use of in situ cultivation techniques is illustrated using submarine hydrothermal vent communities. Recommendations are made regarding planning toward future Mars missions.

Primary care: choices and opportunities for racial/ethnic minority populations in the USA and UK--a comparative analysis.

PubMed

Smith, M B

1999-08-01

This paper examines and compares the choices made and the opportunities provided by the United States and the United Kingdom in delivering primary care services to their racial/ethnic minority populations. While both nations agree that the most effective strategy for health service delivery to a diverse population lies in primary care, their approaches to obtaining this goal have been quite different. Sociological theories of functionalism and conflict perspective provide the analytical and organizing framework of the paper. Within this theoretical context, the health systems in place in each country are examined as an outgrowth of the larger socio-political, economic and cultural structures of the US and UK. Analysis of the advance of managed care in the US and the recent NHS reforms are also discussed in terms of lessons learned and the difficulties that lay ahead in order to ensure that these new developments contribute significantly to eliminating the disproportionately worse health status of racial ethnic minorities. Towards that goal the paper identifies opportunities for collaboration and specific recommendations for future action by both countries.

HIV, international travel and tourism: global issues and Pacific perspectives.

PubMed

Lewis, N D; Bailey, J

AIDS, like plagues throughout human history, has been blamed repeatedly on foreigners. This has heightened ramifications, from the personal to the geopolitical, in an era of escalating population movement and rapid international travel. By the end of 1990, the World Health Organization had estimated that the total number of AIDS cases worldwide was close to 1.3 million. Recent estimates suggest that by the year 2000, 38-100 million adults and over 10 million children will have been infected with HIV. Seventy-five to eighty-five percent of that number will be from the developing world. AIDS has rapidly become pandemic, with wide-ranging consequences for humankind. Human population movement is an important component in the natural history of AIDS. With respect to this, a central consideration is the relationship between AIDS and international travel, especially tourism. In this paper, after reviewing HIV in the Asia-Pacific region, we present the epidemiology of HIV in the Pacific Islands, discuss its impact with particular reference to population movement, and explore some of the specific challenges that the Pacific Island region faces.

Host specificity in parasitic plants—perspectives from mistletoes

PubMed Central

Okubamichael, Desale Y.; Griffiths, Megan E.; Ward, David

2016-01-01

Host specificity has been investigated for centuries in mistletoes, viruses, insects, parasitoids, lice and flukes, yet it is poorly understood. Reviewing the numerous studies on mistletoe host specificity may contribute to our understanding of these plants and put into context the dynamics at work in root parasitic plants and animal parasites. The mechanisms that determine host specificity in mistletoes are not as well documented and understood as those in other groups of parasites. To rectify this, we synthesized the available literature and analyzed data compiled from herbaria, published monographs and our own field studies in South Africa. As for other groups of parasites, multiple factors influence mistletoe host specificity. Initially, pollination affects gene flow. Subsequently, seed dispersal vectors (birds and marsupials), host abundance and compatibility (genetic, morphological, physiological and chemical), history and environmental conditions affect the interaction of mistletoes and their hosts and determine host specificity. Mistletoe–host network analyses and a geographic mosaic approach combined with long-term monitoring of reciprocal transplant experiments, genetic analyses of confined mistletoe populations and comparative phylogenetic studies could provide further insights to our understanding of host specificity. Some of these approaches have been used to study animal–plant interactions and could be adopted to test and evaluate host specificity in mistletoes at local and larger geographic scales. PMID:27658817

An international comparative family medicine study of the Transition Project data from the Netherlands, Malta and Serbia. Is family medicine an international discipline? Comparing diagnostic odds ratios across populations.

PubMed

Soler, Jean K; Okkes, Inge; Oskam, Sibo; van Boven, Kees; Zivotic, Predrag; Jevtic, Milan; Dobbs, Frank; Lamberts, Henk

2012-06-01

This is an international study of the epidemiology of family medicine (FM) in three practice populations from the Netherlands, Malta and Serbia. Diagnostic associations between common reasons for encounter (RfEs) and episodes titles are compared and similarities and differences are described and analysed. Participating family doctors (FDs) recorded details of all their patient contacts in an 'episode of care (EoC)' structure using the International Classification of Primary Care (ICPC). RfEs presented by the patient and episode titles (diagnostic labels of EoCs) were classified with ICPC. The relationships between RfEs and episode titles were studied with Bayesian methods. Distributions of diagnostic odds ratios (ORs) from the three population databases are presented and compared. ICPC, the RfE and the EoC data model are appropriate tools to study the process of diagnosis in FM. Distributions of diagnostic associations between RfEs and episode titles in the Transition Project international populations show remarkable similarities and congruencies in the process of diagnosis from both the RfE and the episode title perspectives. The congruence of diagnostic associations between populations supports the use of such data from one population to inform diagnostic decisions in another. Differences in the magnitude of such diagnostic associations are significant, and population-specific data are therefore desirable. We propose that both an international (common) and a local (health care system specific) content of FM exist and that the empirical distributions of diagnostic associations presented in this paper are a reflection of both these effects. We also observed that the frequency of exposure to such diagnostic challenges had a strong effect on the confidence intervals of diagnostic ORs reflecting these diagnostic associations. We propose that this constitutes evidence that expertise in FM is associated with frequency of exposure to diagnostic challenges.

Manipulating recall vantage perspective of intrusive memories in dysphoria.

PubMed

Williams, Alishia D; Moulds, Michelle L

2008-10-01

The current study attempted to experimentally manipulate mode of recall (field, observer perspective) in a sample of mildly dysphoric participants (N=134) who reported a distressing intrusive memory of negative autobiographical event. Specifically, the current study sought to ascertain whether shifting participants into a converse perspective would have differential effects on the reported experience of their memory. Results indicated that shifting participants from a field to an observer perspective resulted in decreased experiential ratings: specifically, reduced distress and vividness. Also, as anticipated, the converse shift in perspective (from observer to field) did not lead to a corresponding increase in experiential ratings, but did result in reduced ratings of observation and a trend was observed for decreased levels of detachment. The findings support the notion that recall perspective has a functional role in the regulation of intrusion-related distress and represents a cognitive avoidance mechanism.

In vitro gamete derivation from pluripotent stem cells: progress and perspective.

PubMed

Nagano, Makoto C

2007-04-01

Germ cells constitute a highly specialized cell population that is indispensable for the continuation and evolution of the species. Recently, several research groups have shown that these unique cells can be produced in vitro from pluripotent stem cells. Furthermore, live births of offspring using induced germ cells have been reported in one study. These results suggest that it may be possible to investigate germ cell development ex vivo and to establish novel reproductive technologies. To this end, it is critical to assess if gamete induction processes in vitro faithfully recapitulate normal germ cell development in vivo. Here, this issue is discussed with a focus on the germ line specification and the sex-specific development of pre- and postnatal germ cells. The aim of this paper is to concisely summarize the past progress and to present some future issues for the investigation into in vitro gamete production from pluripotent stem cells.

H3Africa: current perspectives

PubMed Central

Mulder, Nicola; Abimiku, Alash’le; Adebamowo, Sally N; de Vries, Jantina; Matimba, Alice; Olowoyo, Paul; Ramsay, Michele; Skelton, Michelle; Stein, Dan J

2018-01-01

Precision medicine is being enabled in high-income countries by the growing availability of health data, increasing knowledge of the genetic determinants of disease and variation in response to treatment (pharmacogenomics), and the decreasing costs of data generation, which promote routine application of genomic technologies in the health sector. However, there is uncertainty about the feasibility of applying precision medicine approaches in low- and middle-income countries, due to the lack of population-specific knowledge, skills, and resources. The Human Heredity and Health in Africa (H3Africa) initiative was established to drive new research into the genetic and environmental basis for human diseases of relevance to Africans as well as to build capacity for genomic research on the continent. Precision medicine requires this capacity, in addition to reference data on local populations, and skills to analyze and interpret genomic data from the bedside. The H3Africa consortium is collectively processing samples and data for over 70,000 participants across the continent, accompanied in most cases by rich clinical information on a variety of non-communicable and infectious diseases. These projects are increasingly providing novel insights into the genetic basis of diseases in indigenous populations, insights that have the potential to drive the development of new diagnostics and treatments. The consortium has also invested significant resources into establishing high-quality biorepositories in Africa, a bioinformatic network, and a strong training program that has developed skills in genomic data analysis and interpretation among bioinformaticians, wet-lab researchers, and health-care professionals. Here, we describe the current perspectives of the H3Africa consortium and how it can contribute to making precision medicine in Africa a reality. PMID:29692621

Building flexibility and managing complexity in community mental health: lessons learned in a large urban centre.

PubMed

Stergiopoulos, Vicky; Saab, Dima; Francombe Pridham, Kate; Aery, Anjana; Nakhost, Arash

2018-01-24

Across many jurisdictions, adults with complex mental health and social needs face challenges accessing appropriate supports due to system fragmentation and strict eligibility criteria of existing services. To support this underserviced population, Toronto's local health authority launched two novel community mental health models in 2014, inspired by Flexible Assertive Community Team principles. This study explores service user and provider perspectives on the acceptability of these services, and lessons learned during early implementation. We purposively sampled 49 stakeholders (staff, physicians, service users, health systems stakeholders) and conducted 17 semi-structured qualitative interviews and 5 focus groups between October 23, 2014 and March 2, 2015, exploring stakeholder perspectives on the newly launched team based models, as well as activities and strategies employed to support early implementation. Interviews and focus groups were audio recorded, transcribed verbatim and analyzed using thematic analysis. Findings revealed wide-ranging endorsement for the two team-based models' success in engaging the target population of adults with complex service needs. Implementation strengths included the broad recognition of existing service gaps, the use of interdisciplinary teams and experienced service providers, broad partnerships and collaboration among various service sectors, training and team building activities. Emerging challenges included lack of complementary support services such as suitable housing, organizational contexts reluctant to embrace change and risk associated with complexity, as well as limited service provider and organizational capacity to deliver evidence-based interventions. Findings identified implementation drivers at the practitioner, program, and system levels, specific to the implementation of community mental health interventions for adults with complex health and social needs. These can inform future efforts to address the health and support needs of this vulnerable population.

Antiviral agents for influenza: a comparison of cost-effectiveness data.

PubMed

Lynd, Larry D; Goeree, Ron; O'Brien, Bernie J

2005-01-01

The economic burden of influenza-related illness has been estimated to be 71.3-166 billion US dollars in the US, the majority of which is attributable to indirect costs as a result of lost productivity. There are currently four antiviral drugs available for the treatment of influenza: two ion channel blockers, amantadine and rimantadine; and two neuraminidase inhibitors, zanamivir and oseltamivir. The objective of this paper was to review the studies evaluating the cost effectiveness of currently available antiviral treatment and prophylaxis management strategies for influenza. Published studies that reported both costs and effectiveness of influenza management were extracted using MEDLINE, pre-MEDLINE and EMBASE. To facilitate a broad comparison, all costs were inflated to 2003 US dollars. Fifteen studies met the inclusion criteria of the review, with 14 analyses based on decision-analytic modelling and one economic analysis performed alongside a clinical trial. Management strategies included antiviral influenza prophylaxis or vaccination, empiric treatment of suspected disease, or antiviral treatment following rapid influenza testing. Study populations included healthy adults, adults at risk of influenza-related adverse outcomes, institutionalised and non-institutionalised elderly, and children. The comparator in all studies was standard care (i.e. over-the-counter medications only), and analyses were carried out from both the societal and payer perspectives. The only dominant strategy relative to standard care was vaccination of the institutionalised elderly. All other strategies in all populations were both more costly and more effective than standard care. Depending on the population and the perspective, the incremental cost-effectiveness ratios (ICERs) for antiviral treatment strategies ranged from 5000 US dollars/QALY for amantadine in test-and-treat studies to >400,000 US dollars/QALY for zanamivir or oseltamivir treatment in children. Sensitivity analysis in all studies consistently reported a strong influence of the population prevalence or diagnostic accuracy of influenza on the cost effectiveness of all strategies. Baseline influenza prevalence varied widely between studies, ranging from 15% to 68%. There was also a wide variation in the assumption about the disutility of influenza (ranging from -0.137 to -0.983 for the elderly requiring hospitalisation), which also impacted the cost effectiveness. Given the variation in the ICERs of antiviral treatment and prophylaxis, the uncertainty around many model parameters, and the dynamic nature of influenza from year to year, one can only conclude that antiviral treatment or prophylaxis for influenza is likely to be more cost effective in specific populations at specific times during the influenza season, and during influenza seasons when the population prevalence reaches epidemic levels or there is mismatch between the vaccine and the circulating virus.

Renewing Our Cultural Borderlands: Equitable Population Innovations for Communication (EPIC)

ERIC Educational Resources Information Center

Pillay, Mershen; Kathard, Harsha

2018-01-01

The professions of speech-language pathology and audiology provide valuable services for persons with communication, hearing, and feeding/swallowing disabilities. However, from a global perspective, mainstream practice discourses represent values from colonial perspectives (called Northern here). As such, they remain largely inaccessible to most…

Quality of care, quality of life, and attitudes toward disabilities: perspectives from a qualitative focus group study in Porto Alegre, Brazil.

PubMed

Mattevi, Betina S; Bredemeier, Juliana; Fam, Cláudia; Fleck, Marcelo P

2012-03-01

To explore the concepts of quality of life (QOL), quality of care (QOC), and attitudes toward disabilities in Porto Alegre, Brazil, from the perspective of people living with disabilities, including their relatives and caregivers. This was a qualitative study that interviewed a total of 23 participants in five focus groups, during May-August 2006. After an open discussion about QOL, the WHOQOL-Bref, a generic questionnaire for the assessment of QOL, was presented to participants. The study was performed simultaneously in 15 international centers. Analysis was based on Bardin's content analysis. Regarding QOL, important themes that emerged were: work, education, leisure, universal accessibility, integration in the society, and social inclusion. Concerning QOC, professional qualifications, disabilities-related training for health and education professionals, and access to health services were considered important. Regarding attitudes toward disabilities, the participants perceived the attitudes of others, especially of caregivers, to significantly impact the QOL of people with disabilities. People living with disabilities value many of the same themes considered important by the general public; however, several additional themes specific to disabilities and specific to these groups of participants emerged. This information highlights the importance of taking into account the unique perceptions and cultural traits of the target population when measuring QOL, QOC, and attitudes toward disabilities.

Decision-making capacity and competency in the elderly: a clinical and neuropsychological perspective.

PubMed

Moberg, Paul J; Rick, Jacqueline H

2008-01-01

With our ageing population, the number of older adults with cognitive impairment has also increased. There is both an acute and growing need for evidence-based assessments to identify their decision making capacity and competence. In the present article we (1) present definitions of decision-making capacity and competence, (2) review cognitive functions that are central to decision-making capacity as well as the methods and procedures commonly used to assess these domains, and (3) address the communication of assessment findings to patients and their loved ones. The importance of assessing decision-making capacity in the context of specific functions and of respecting the values and interests of older adults are emphasized.

[Consensus of Chinese experts on diagnosis of severe periodontitis and treatment principles of periodontitis in special population].

PubMed

2017-02-09

Today, there is greater awareness about periodontal diseases amongst Chinese dental clinicians. However, confusions regarding some clinical conditions have been remained in diagnosis and treatment of periodontal disease. Therefore, the Chinese Society of Periodontology undertook the formation of consensus in order to provide perspective to the dental clinicians and to help them in evaluation of the patient's risk factors, so as to make a better treatment decisions in their clinical practice. In the present consensus report, the diagnosis of severe chronic periodontitis at individual level and treatment recommendations of patients with systemic diseases and specific conditions, such as diabetes, hypertension, tumour, period of pregnancy, and the aged, were provided.

The relation between working memory components and ADHD symptoms from a developmental perspective.

PubMed

Tillman, Carin; Eninger, Lilianne; Forssman, Linda; Bohlin, Gunilla

2011-01-01

The objective was to examine the relations between attention deficit hyperactivity disorder (ADHD) symptoms and four working memory (WM) components (short-term memory and central executive in verbal and visuospatial domains) in 284 6-16-year-old children from the general population. The results showed that verbal and visuospatial short-term memory and verbal central executive uniquely contributed to inattention symptoms. Age interacted with verbal short-term memory in predicting inattention, with the relation being stronger in older children. These findings support the notion of ADHD as a developmental disorder, with changes in associated neuropsychological deficits across time. The results further indicate ADHD-related deficits in several specific WM components.

[Embryonic stem cells. Future perspectives].

PubMed

Groebner, M; David, R; Franz, W M

2006-05-01

Embryonic stem cells (ES cells) are able to differentiate into any cell type, and therefore represent an excellent source for cellular replacement therapies in the case of widespread diseases, for example heart failure, diabetes, Parkinson's disease and spinal cord injury. A major prerequisite for their efficient and safe clinical application is the availability of pure populations for direct cell transplantation or tissue engineering as well as the immunological compatibility of the transplanted cells. The expression of human surface markers under the control of cell type specific promoters represents a promising approach for the selection of cardiomyocytes and other cell types for therapeutic applications. The first human clinical trial using ES cells will start in the United States this year.

Children have type 2 diabetes too: an historical perspective.

PubMed

Dean, Heather J; Sellers, Elizabeth A C

2015-10-01

Prior to 1985, type 2 diabetes was a disease of adults. Simultaneously with the global epidemic of childhood obesity, type 2 diabetes has increased in children. Initially, the presentation of small case series of type 2 diabetes in children was met with skepticism. As the number and size of the case series grew and the first long-term outcomes of end-stage complications in young adults appeared in the literature, the international community took notice with guarded interest. Type 2 diabetes disproportionately affects the children of specific ethnic groups and from disadvantaged socioeconomic environments, especially Indigenous populations. The past decade has seen unprecedented intense global interest in the etiology, treatment, and prevention of type 2 diabetes in children.

[Perspectives and challenges to guarantee training and renewal in general internal medicine].

PubMed

Waeber, G; Cornuz, J; Gaspoz, J-M; Pécoud, A; Perrier, A

2009-01-28

Training new doctors in general internal medicine represents a challenge. This requires to define future needs, which result from interest that are not necessarily convergent between patients, doctors, insurers and politicians. Problems related to medical demography in Switzerland, with the ageing of the population, the increase in health care costs and the place of Switzerland within the European Community require the implementation of specific objectives to train new physicians in general internal medicine. The success of these opportunities depends on social factors, political choices and choices from physician's association. In this article we will approach these challenges by formulating some proposals--nonexhaustive--in order to guarantee sufficient renewal in general internal medicine.

Metamodels for Transdisciplinary Analysis of Wildlife Population Dynamics

PubMed Central

Lacy, Robert C.; Miller, Philip S.; Nyhus, Philip J.; Pollak, J. P.; Raboy, Becky E.; Zeigler, Sara L.

2013-01-01

Wildlife population models have been criticized for their narrow disciplinary perspective when analyzing complexity in coupled biological – physical – human systems. We describe a “metamodel” approach to species risk assessment when diverse threats act at different spatiotemporal scales, interact in non-linear ways, and are addressed by distinct disciplines. A metamodel links discrete, individual models that depict components of a complex system, governing the flow of information among models and the sequence of simulated events. Each model simulates processes specific to its disciplinary realm while being informed of changes in other metamodel components by accessing common descriptors of the system, populations, and individuals. Interactions among models are revealed as emergent properties of the system. We introduce a new metamodel platform, both to further explain key elements of the metamodel approach and as an example that we hope will facilitate the development of other platforms for implementing metamodels in population biology, species risk assessments, and conservation planning. We present two examples – one exploring the interactions of dispersal in metapopulations and the spread of infectious disease, the other examining predator-prey dynamics – to illustrate how metamodels can reveal complex processes and unexpected patterns when population dynamics are linked to additional extrinsic factors. Metamodels provide a flexible, extensible method for expanding population viability analyses beyond models of isolated population demographics into more complete representations of the external and intrinsic threats that must be understood and managed for species conservation. PMID:24349567

Primary care assessment from a male population perspective.

PubMed

Silva, Abiúde Nadabe E; Silva, Simone Albino da; Silva, Ana Roberta Vilarouca da; Araújo, Telma Maria Evangelista de; Rebouças, Cristiana Brasil Almeida; Nogueira, Lídya Tolstenko

2018-01-01

to evaluate the quality of primary health care from the perspective of the male population. a cross-sectional descriptive-evaluative study conducted at the family health units of Teresina, Piauí, Brazil, with the male population being interviewed through the Primary Care Assessment Tool (PCAT). 301 participants with mean age of 51.34 years, married, incomplete elementary school and monthly income between one and two minimum wages. The evaluation was positive for the following care domains: utilization, information system and longitudinality. The features access, comprehensiveness of care, service available and service provided, family centeredness and community orientation obtained a negative evaluation. the features of primary care are unsatisfactory, indicating the need to expand access to services offered and to qualify care for male users.

Conservation perspectives: Review of new science and primary threats to golden-winged warblers

Treesearch

Ronald W. Rohrbaugh; David A. Buehler; Sara Barker Swarthout; David I. King; Jeffrey L. Larkin; Kenneth V. Rosenberg; Amber M. Roth; Rachel Vallender; Tom Will

2016-01-01

In this penultimate chapter, we examine new perspectives on ecology of Golden-winged Warblers (Vermivora chrysoptera), review primary population- level threats, and offer conservation recommendations. Adequate forest cover and patchlevel habitat configuration are important for successful reproduction and to buffer against negative interactions with...

Forging University-Community Collaboration: The Agency Perspective on National Service.

ERIC Educational Resources Information Center

Tice, Carol H.

1994-01-01

With passage of the National and Community Service Trust Act of 1993, national service volunteers will be joining forces with community-based organizations to work with underserved populations, creating many challenges. The community agency perspective on some anticipated challenges, possible responses, and application of principles of good…

Second Home Owners, Locals and Their Perspectives on Rural Development

ERIC Educational Resources Information Center

Farstad, Maja; Rye, Johan Fredrik

2013-01-01

Dominating strands within the research literature on second homes explain social conflicts between rural hosting and visiting second home populations by describing their differing perspectives on rural development. Such presentations suggest that locals are likely to welcome new developments in order to enhance the economic viability of their…

Comparing Faculty and Student Perspectives of Graduate Teaching Assistants' Teaching

ERIC Educational Resources Information Center

Rodriques, Romola A. Bernard; Bond-Robinson, Janet

2006-01-01

Teaching involves strategic interactions and problem solving based on understanding of the situation, the discipline, and the population of students that one is teaching. The feedback from undergraduate students (UGs) and from faculty and other instructors coaching graduate teaching assistants (GTAs) in teaching provides outside perspectives, and…

Newcomer Pupils in Northern Ireland: A Pastoral Perspective

ERIC Educational Resources Information Center

Jones, Sharon Jayne

2015-01-01

Rapid changes in Northern Ireland's demographic, resulting in an increasingly multicultural and multilingual school population, are presenting new opportunities and challenges for schools in a region emerging from a troubled recent past. Reflecting on this from a pastoral perspective, this article focuses on the relationships between the school…

Employing the clinical service unit model.

PubMed

Harger, J; Gualtieri-Reed, T; Burton, W

2001-01-01

Duke University Hospital has instituted a decision tool that enables administrators and medical directors to manage from both the operational (departmental) perspective as well as from the patient population perspective. The tool automates routine reporting, aligns business information with a new, cross-functional management structure, and provides a focus for improvement opportunities.

A Critical Look at Perspectives of Access and Mission at High Latinx-Enrolling Urban Universities

ERIC Educational Resources Information Center

Zerquera, Desiree D.; Ballysingh, Tracy Arámbula; Templeton, Emerald

2017-01-01

This article examines administrators' perspectives related to embracing and fulfilling a diversity- and access-centered mission at urban-serving universities with high Latinx enrollment. Considering today's context of higher education--whereby access and opportunities for Latinx and other marginalized populations has become increasingly…

Utilization of Pasture and Forages by Ruminants: A Historical Perspective

USDA-ARS?s Scientific Manuscript database

Pastures, forages and grasslands dominate the landscape across the United States and support a large ruminant population that supplies the nation with value-added animal products. An historical perspective is presented of the innovations as they occurred in the Journal of Animal Science over the pas...

River networks as ecological corridors: A coherent ecohydrological perspective

NASA Astrophysics Data System (ADS)

Rinaldo, Andrea; Gatto, Marino; Rodriguez-Iturbe, Ignacio

2018-02-01

This paper draws together several lines of argument to suggest that an ecohydrological framework, i.e. laboratory, field and theoretical approaches focused on hydrologic controls on biota, has contributed substantially to our understanding of the function of river networks as ecological corridors. Such function proves relevant to: the spatial ecology of species; population dynamics and biological invasions; the spread of waterborne disease. As examples, we describe metacommunity predictions of fish diversity patterns in the Mississippi-Missouri basin, geomorphic controls imposed by the fluvial landscape on elevational gradients of species' richness, the zebra mussel invasion of the same Mississippi-Missouri river system, and the spread of proliferative kidney disease in salmonid fish. We conclude that spatial descriptions of ecological processes in the fluvial landscape, constrained by their specific hydrologic and ecological dynamics and by the ecosystem matrix for interactions, i.e. the directional dispersal embedded in fluvial and host/pathogen mobility networks, have already produced a remarkably broad range of significant results. Notable scientific and practical perspectives are thus open, in the authors' view, to future developments in ecohydrologic research.

Enhanced Patient-Centred Care: Physiotherapists' Perspectives on the Impact of International Clinical Internships on Canadian Practice.

PubMed

Mesaroli, Giulia; Bourgeois, Anne-Marie; McCurry, Ellen; Condren, Allison; Petropanagos, Peter; Fraser, Michelle; Nixon, Stephanie A

2015-01-01

To explore the perspectives of physiotherapists who participated in an international clinical internship (ICI) in low- or middle-income countries (LMICs) during their physiotherapy (PT) training in a Canadian PT programme regarding the ICI's impact on their PT practice in Canada. This qualitative descriptive study used in-depth semi-structured interviews. Data were organized using NVivo; inductive and deductive coding were used to analyze data and develop broader themes. The 13 practising Canadian physiotherapists interviewed described three enhanced capacities: (1) critical reflection on culture, values and practice; (2) communication skills; and (3) creativity and resourcefulness. These capacities were perceived to transfer to Canadian practice by enhancing participants' ability to deliver patient-centred care, specifically through an enhanced understanding of patients' values and social determinants of health, regardless of the Canadian setting or patient population. For PT students considering an ICI, the study findings provide insight into the perceived impact of ICIs on Canadian practice. For PT academic programmes, the findings can guide decisions on the extent of investment in ICIs as learning opportunities that will enhance practice in Canada.

Bipolar spectrum disorders. New perspectives.

PubMed Central

Piver, Andre; Yatham, Lakshmi N.; Lam, Raymond W.

2002-01-01

OBJECTIVE: To review new perspectives on diagnosis, clinical features, epidemiology, and treatment of bipolar II and related disorders. QUALITY OF EVIDENCE: Articles were identified by searching MEDLINE and ClinPSYCH from January 1994 to August 2001 using the key words bipolar disorder, type II or 2; hypomania; spectrum; or variants. Reference lists from articles were reviewed. Overall, the quality of evidence was not high; we found no randomized controlled trials that specifically addressed bipolar II or bipolar spectrum disorders (BSDs). MAIN MESSAGE: Characterized by elevated mood cycling with depression, BSDs appear to be much more common than previously thought, affecting up to 30% of primary care patients presenting with anxiety or depressive symptoms. Hypomania, the defining feature of bipolar II disorder, is often not detected. Collateral information, semistructured interviews, and brief screening instruments could improve diagnosis. Antidepressants should be used with caution. The newer mood stabilizers or combinations of mood stabilizers might be the treatments of choice in the future. CONCLUSION: Family physicians, as primary providers of mental health care, should try to recognize and treat BSDs more frequently. These disorders are becoming increasingly common in primary care populations. PMID:12053634

Developing Health-Related Indicators of Climate Change: Australian Stakeholder Perspectives.

PubMed

Navi, Maryam; Hansen, Alana; Nitschke, Monika; Hanson-Easey, Scott; Pisaniello, Dino

2017-05-22

Climate-related health indicators are potentially useful for tracking and predicting the adverse public health effects of climate change, identifying vulnerable populations, and monitoring interventions. However, there is a need to understand stakeholders' perspectives on the identification, development, and utility of such indicators. A qualitative approach was used, comprising semi-structured interviews with key informants and service providers from government and non-government stakeholder organizations in South Australia. Stakeholders saw a need for indicators that could enable the monitoring of health impacts and time trends, vulnerability to climate change, and those which could also be used as communication tools. Four key criteria for utility were identified, namely robust and credible indicators, specificity, data availability, and being able to be spatially represented. The variability of risk factors in different regions, lack of resources, and data and methodological issues were identified as the main barriers to indicator development. This study demonstrates a high level of stakeholder awareness of the health impacts of climate change, and the need for indicators that can inform policy makers regarding interventions.

Electroconvulsive therapy: a Canadian perspective.

PubMed

Smith, W E; Richman, A

1984-12-01

Recent ECT practices in Canada are reviewed from a historical perspective with respect to specific criticisms. Utilization is decreasing; utilization rates vary widely between Provinces and between regions; disproportionate numbers of females have been receiving ECT; a substantial group of patients diagnosed as neurotic and schizophrenic continue to receive ECT; criteria and guidelines for its use are not consistently applied. Expected rates of ECT used are estimated, based on theory and practice as well as on published data on the epidemiology of affective disorders. Data on actual Canadian usage are reviewed and compared with an estimated minimum ratio of 30-45+ cases per year of non bi-polar depression per 100,000 population requiring ECT. Results show that there may be a substantial number of patients in some Provinces for whom ECT is the best available treatment and who are not receiving it. There is some ethical concern associated with possible under-use of ECT as the best therapy available for certain patient groups. Clinical cases and patterns of care should be reviewed at the hospital level to determine how best to effect improvements in the use of this treatment.

Territorial and land-use rights perspectives on human-chimpanzee-elephant coexistence in West Africa (Guinea, Guinea-Bissau, Senegal, nineteenth to twenty-first centuries).

PubMed

Leblan, Vincent

2016-07-01

The first part of this article compares the distribution of chimpanzee and elephant populations in reaction to human territorial dynamics of West African trade in parts of nineteenth century Guinea, Guinea-Bissau and Senegal. It answers for this specific region the question of whether present-day situations of close chimpanzee-human spatial proximity are stable or only temporary phenomena in long-term processes of environmental change, and shows that conservation policies centred on either of these two "flagship" species carry radically different ecological, political and territorial implications. The second part shifts to local-level perspectives on human-chimpanzee relationships, emphasizing the land rights contentions and misunderstandings created by the implementation of protected areas at Bossou and in the Boké region of Guinea. These case studies help to look at acts of resistance and local interpretations of primate conservation policies as opportunities to reconsider what is being protected, for what purpose, as whose heritage, and to move towards new and more legitimate opportunities for the implementation of conservation policies.

Indoor Thermal Comfort, an Evolutionary Biology Perspective

DOE Office of Scientific and Technical Information (OSTI.GOV)

Stoops, John L.

2006-04-15

As is becoming increasingly clear, the human species evolvedin the East African savannah. Details of the precise evolutionary chainremain unresolved however it appears that the process lasted severalmillion years, culminating with the emergence of modern Homo sapiensroughly 200,000 years ago. Following that final evolutionary developmentmodern Homo sapiens relatively quickly populated the entire world.Clearly modern Homo sapiens is a successful, resourceful and adaptablespecies. In the developed societies, modern humans live an existence farremoved from our evolutionary ancestors. As we have learned over the lastcentury, this "new" lifestyle can often result in unintendedconsequences. Clearly, our modern access to food, shelter, transportationand healthcaremore » has resulted in greatly expanded expected lifespan butthis new lifestyle can also result in the emergence of different kinds ofdiseases and health problems. The environment in modern buildings haslittle resemblance to the environment of the savannah. We strive tocreate environments with little temperature, air movement and lightvariation. Building occupants often express great dissatisfaction withthese modern created environments and a significant fraction even developsomething akin to allergies to specific buildings (sick buildingsyndrome). Are the indoor environments we are creating fundamentallyunhealthy -- when examined from an evolutionary perspective?« less

English for Specific Purposes and Academic Literacies: Eclecticism in Academic Writing Pedagogy

ERIC Educational Resources Information Center

McGrath, Lisa; Kaufhold, Kathrin

2016-01-01

Academic Literacies and English for Specific Purposes perspectives on the teaching of academic writing tend to be positioned as dichotomous and ideologically incompatible. Nonetheless, recent studies have called for the integration of these two perspectives in the design of writing programmes in order to meet the needs of students in the…

Parents' Perspectives on Coping with Duchenne Muscular Dystrophy and Concomitant Specific Learning Disabilities

ERIC Educational Resources Information Center

Webb, Carol L.

2005-01-01

This study addresses parental perspectives and coping strategies related to Duchenne muscular dystrophy and specific learning disabilities. Data were collected through individual semi-structured in-depth interviews with fifteen sets of parents. Participants were selected based on variables such as age of children, number of children with both…

The perspectives of Caribbean high school students' experiences in American science classrooms

NASA Astrophysics Data System (ADS)

Ferguson, Renae Luenell

The purpose of this study was to describe the perspectives of Caribbean high school students' experiences in American science classrooms. Research suggests that psychological, cultural, and socioeconomic perspectives influence the science experiences of African Americans or Blacks; the result of which is under-representation (Lewis et al., 2000). Nonetheless, what is uncertain is if these and other perspectives are similar to the science experiences of Caribbeans who also are majority black by race and rank as the 3 rd largest immigrant population in America's schools (Suarez-Orozco, 2000). Questions guiding this study were: (1) What are the perspectives of Caribbean high school students' experiences in American science classrooms? (2) What can we learn from the perspectives of Caribbean high school students' science experiences that may address issues of participation and interest; consequently, influencing the overall performance of ethnic minorities in school science? Sociocultural theory provides the framework for the analysis of the study. Four Caribbean born students in an American high school participated in this naturalistic qualitative research. A constant comparative method was used to categorize and analyze the data and uncover meaningful patterns that emerged from the four interviews and written documents. Although there were similarities between African Americans' science experiences as documented in the literature and that of Caribbeans in this study, the Caribbean participants relied on prior native experiences to dictate their perspectives of their science experiences in America. According to Caribbean students, American science high schools classrooms utilize an objective style of assessments; are characterized by a lack of teacher support; allow behavioral problems in the classroom; and function through different communication styles than the native Caribbean science classroom environment. This study implies science educators should be sensitive to the sociocultural nuances of Caribbeans, as well as to all other students. Educators should also understand and value students' individual backgrounds, cultural patterns, and specific influences which impinge students in science and may result in underachievement. In addition, educators should not only discuss issues of under-representation in science but also they should begin to initiate the implementation of strategies addressed in this study in order to bring awareness and resolution to these pressing issues.

A review of methods to estimate cause-specific mortality in presence of competing risks

USGS Publications Warehouse

Heisey, Dennis M.; Patterson, Brent R.

2006-01-01

Estimating cause-specific mortality is often of central importance for understanding the dynamics of wildlife populations. Despite such importance, methodology for estimating and analyzing cause-specific mortality has received little attention in wildlife ecology during the past 20 years. The issue of analyzing cause-specific, mutually exclusive events in time is not unique to wildlife. In fact, this general problem has received substantial attention in human biomedical applications within the context of biostatistical survival analysis. Here, we consider cause-specific mortality from a modern biostatistical perspective. This requires carefully defining what we mean by cause-specific mortality and then providing an appropriate hazard-based representation as a competing risks problem. This leads to the general solution of cause-specific mortality as the cumulative incidence function (CIF). We describe the appropriate generalization of the fully nonparametric staggered-entry Kaplan–Meier survival estimator to cause-specific mortality via the nonparametric CIF estimator (NPCIFE), which in many situations offers an attractive alternative to the Heisey–Fuller estimator. An advantage of the NPCIFE is that it lends itself readily to risk factors analysis with standard software for Cox proportional hazards model. The competing risks–based approach also clarifies issues regarding another intuitive but erroneous "cause-specific mortality" estimator based on the Kaplan–Meier survival estimator and commonly seen in the life sciences literature.

[Impact of social disadvantages and time perspective on smoking cessation].

PubMed

Merson, Frédéric; Perriot, Jean

2012-02-01

Smoking addiction and tobacco dependence are related to social deprivation and time perspective. The objective of this study was to understand how these factors influenced the results of smoking cessation in order to optimize the care of this population. We included 200 patients from our outpatient clinic from March 1, 2009 to June 30, 2010. This study focused on the impact of social disadvantages and time perspective on smoking cessation. Time perspective was measured with the short version of the Zimbardo Time Perspective Inventory, social disadvantages with Epices scale. Information on each individual's characteristics, smoking addiction, and smoking cessation was collected. One hundred and ninety-two patients (of whom 45% were socially disadvantaged) participated. Socially disadvantaged people tend to lean towards dimensions "Past Negative" (P<0.0001), "Present Fatalistic" (P<0.0001) and are less likely to foresee themselves in the future (P<0.0002) compared with the rest of the population. Their decision to stop smoking reveals they are more motivated for financial reasons (P<0.0001) and their attempts more often end in failure (P=0.006). In addition, they have, more frequently, anxiodepressive problems (P<0.0001) and a higher level of nicotine dependence (P<0.0001). The results highlight the importance of taking into account the social disadvantages and time perspective in helping these addicted patients to stop smoking. Copyright © 2011. Published by Elsevier Masson SAS.

Left inferior-parietal lobe activity in perspective tasks: identity statements

PubMed Central

Arora, Aditi; Weiss, Benjamin; Schurz, Matthias; Aichhorn, Markus; Wieshofer, Rebecca C.; Perner, Josef

2015-01-01

We investigate the theory that the left inferior parietal lobe (IPL) is closely associated with tracking potential differences of perspective. Developmental studies find that perspective tasks are mastered at around 4 years of age. Our first study, meta-analyses of brain imaging studies shows that perspective tasks specifically activate a region in the left IPL and precuneus. These tasks include processing of false belief, visual perspective, and episodic memory. We test the location specificity theory in our second study with an unusual and novel kind of perspective task: identity statements. According to Frege's classical logical analysis, identity statements require appreciation of modes of presentation (perspectives). We show that identity statements, e.g., “the tour guide is also the driver” activate the left IPL in contrast to a control statements, “the tour guide has an apprentice.” This activation overlaps with the activations found in the meta-analysis. This finding is confirmed in a third study with different types of statements and different comparisons. All studies support the theory that the left IPL has as one of its overarching functions the tracking of perspective differences. We discuss how this function relates to the bottom-up attention function proposed for the bilateral IPL. PMID:26175677

Medical cannabis – the Canadian perspective

PubMed Central

Ko, Gordon D; Bober, Sara L; Mindra, Sean; Moreau, Jason M

2016-01-01

Cannabis has been widely used as a medicinal agent in Eastern medicine with earliest evidence in ancient Chinese practice dating back to 2700 BC. Over time, the use of medical cannabis has been increasingly adopted by Western medicine and is thus a rapidly emerging field that all pain physicians need to be aware of. Several randomized controlled trials have shown a significant and dose-dependent relationship between neuropathic pain relief and tetrahydrocannabinol – the principal psychoactive component of cannabis. Despite this, barriers exist to use from both the patient perspective (cost, addiction, social stigma, lack of understanding regarding safe administration) and the physician perspective (credibility, criminality, clinical evidence, patient addiction, and policy from the governing medical colleges). This review addresses these barriers and draws attention to key concerns in the Canadian medical system, providing updated treatment approaches to help clinicians work with their patients in achieving adequate pain control, reduced narcotic medication use, and enhanced quality of life. This review also includes case studies demonstrating the use of medical marijuana by patients with neuropathic low-back pain, neuropathic pain in fibromyalgia, and neuropathic pain in multiple sclerosis. While significant preclinical data have demonstrated the potential therapeutic benefits of cannabis for treating pain in osteoarthritis, rheumatoid arthritis, fibromyalgia, and cancer, further studies are needed with randomized controlled trials and larger study populations to identify the specific strains and concentrations that will work best with selected cohorts. PMID:27757048

Medical cannabis - the Canadian perspective.

PubMed

Ko, Gordon D; Bober, Sara L; Mindra, Sean; Moreau, Jason M

2016-01-01

Cannabis has been widely used as a medicinal agent in Eastern medicine with earliest evidence in ancient Chinese practice dating back to 2700 BC. Over time, the use of medical cannabis has been increasingly adopted by Western medicine and is thus a rapidly emerging field that all pain physicians need to be aware of. Several randomized controlled trials have shown a significant and dose-dependent relationship between neuropathic pain relief and tetrahydrocannabinol - the principal psychoactive component of cannabis. Despite this, barriers exist to use from both the patient perspective (cost, addiction, social stigma, lack of understanding regarding safe administration) and the physician perspective (credibility, criminality, clinical evidence, patient addiction, and policy from the governing medical colleges). This review addresses these barriers and draws attention to key concerns in the Canadian medical system, providing updated treatment approaches to help clinicians work with their patients in achieving adequate pain control, reduced narcotic medication use, and enhanced quality of life. This review also includes case studies demonstrating the use of medical marijuana by patients with neuropathic low-back pain, neuropathic pain in fibromyalgia, and neuropathic pain in multiple sclerosis. While significant preclinical data have demonstrated the potential therapeutic benefits of cannabis for treating pain in osteoarthritis, rheumatoid arthritis, fibromyalgia, and cancer, further studies are needed with randomized controlled trials and larger study populations to identify the specific strains and concentrations that will work best with selected cohorts.

Catholic Perspectives on Population Issues. Population Bulletin, Vol. 35, No. 6.

ERIC Educational Resources Information Center

Murphy, Francis X.

The bulletin investigates the major positions held by the Catholic Church toward population problems. Separate sections discuss the demographic debate, traditional church teaching, the birth control movement, the Vatican Council II and the Papal Birth Control Commission, Pope Paul's 1968 Encyclical against contraception, the 1980 Synod of Bishops,…

Taking Perspective: Context, Culture, and History

ERIC Educational Resources Information Center

Suárez-Orozco, Marcelo M.; Suárez-Orozco, Carola

2013-01-01

There are important lessons to be learned from taking a comparative perspective in considering migration. Comparative examination of immigration experiences provides a way to glean common denominators of adaptation while considering the specificity of sending and receiving contexts and cultures. Equally important is a historical perspective that…

Corruption, inequality and population perception of healthcare quality in Europe

PubMed Central

2013-01-01

Background Evaluating the quality of healthcare and patient safety using general population questionnaires is important from research and policy perspective. Using a special wave of the Eurobarometer survey, we analysed the general population’s perception of health care quality and patient safety in a cross-country setting. Methods We used ordered probit, ordinary least squares and probit analysis to estimate the determinants of health care quality, and ordered logit analysis to analyse the likelihood of being harmed by a specific medical procedure. The models used population weights as well as country-clustered standard errors. Results We found robust evidence for the impact of socio-demographic variables on the perception of quality of health care. More specifically, we found a non-linear impact of age on the perception of quality of health care and patient safety, as well as a negative impact of poverty on both perception of quality and patient safety. We also found robust evidence that countries with higher corruption levels were associated with worse perceptions of quality of health care. Finally, we found evidence that income inequality affects patients’ perception vis-à-vis safety, thus feeding into the poverty/health care quality nexus. Conclusions Socio-demographic factors and two macro variables (corruption and income inequality) explain the perception of quality of health care and likelihood of being harmed by adverse events. The results carry significant policy weight and could explain why targeting only the health care sector (without an overall reform of the public sector) could potentially be challenging. PMID:24215401

Applying anthropology to eliminate tobacco-related health disparities.

PubMed

Goldade, Kate; Burgess, Diana; Olayinka, Abimbola; Whembolua, Guy Lucien S; Okuyemi, Kolawole S

2012-06-01

Disparities in tobacco's harm persist. Declines in smoking among the general population have not been experienced to the same extent by vulnerable populations. Innovative strategies are required to diminish disparities in tobacco's harm. As novel tools, anthropological concepts and methods may be applied to improve the design and outcomes of tobacco cessation interventions. We reviewed over 60 articles published in peer-reviewed journals since 1995 for content on anthropology and smoking cessation. The specific questions framing the review were: (a) "How can lessons learned from anthropological studies of smoking improve the design and effectiveness of smoking cessation interventions?" (b) How can anthropology be applied to diminish disparities in smoking cessation? and (c) How can qualitative methods be used most effectively in smoking cessation intervention research? Three specific disciplinary tools were identified and examined: (a) culture, (b) reflexivity, and (c) qualitative methods. Examining culture as a dynamic influence and understanding the utilities of smoking in a particular group is a precursor to promoting cessation. Reflexivity enables a deeper understanding of how smokers perceive quitting and smoking beyond addiction and individual health consequences. Qualitative methods may be used to elicit in-depth perspectives on quitting, insights to inform existing community-based strategies for making behavior changes, and detailed preferences for cessation treatment or programs. Anthropological tools can be used to improve the effectiveness of intervention research studies targeting individuals from vulnerable groups. Synthesized applications of anthropological concepts can be used to facilitate translation of findings into clinical practice for providers addressing tobacco cessation in vulnerable populations.

The Health Needs of Young Women: Applying a Feminist Philosophical Lens to Nursing Science and Practice.

PubMed

Burton, Candace W

2016-01-01

Ongoing development of nursing science requires attention to the philosophical and theoretical bases upon which the science is built. A feminist theoretical perspective offers a useful lens for understanding the needs of both nurses and their clients. Adolescent and young adult women are an underserved and understudied population for whom nursing care can be especially beneficial. Considering the needs of this population from a philosophical perspective, through a feminist lens, is one effective means of developing nursing science approaches that contribute to and ultimately improve care for adolescent and young adult women.

The Health Needs of Young Women: Applying a feminist philosophical lens to nursing science and practice

PubMed Central

Burton, Candace W.

2016-01-01

Ongoing development of nursing science requires attention to the philosophical and theoretical basis upon which the science is built. A feminist theoretical perspective offers a useful lens for understanding the needs of both nurses and their clients. Adolescent and young adult women are an underserved and understudied population for whom nursing care can be especially beneficial. Considering the needs of this population from a philosophical perspective, through a feminist lens, is one effective means of developing nursing science approaches that contribute to and ultimately improve care for adolescent and young adult women. PMID:27149225

Emergent properties of interacting populations of spiking neurons.

PubMed

Cardanobile, Stefano; Rotter, Stefan

2011-01-01

Dynamic neuronal networks are a key paradigm of increasing importance in brain research, concerned with the functional analysis of biological neuronal networks and, at the same time, with the synthesis of artificial brain-like systems. In this context, neuronal network models serve as mathematical tools to understand the function of brains, but they might as well develop into future tools for enhancing certain functions of our nervous system. Here, we present and discuss our recent achievements in developing multiplicative point processes into a viable mathematical framework for spiking network modeling. The perspective is that the dynamic behavior of these neuronal networks is faithfully reflected by a set of non-linear rate equations, describing all interactions on the population level. These equations are similar in structure to Lotka-Volterra equations, well known by their use in modeling predator-prey relations in population biology, but abundant applications to economic theory have also been described. We present a number of biologically relevant examples for spiking network function, which can be studied with the help of the aforementioned correspondence between spike trains and specific systems of non-linear coupled ordinary differential equations. We claim that, enabled by the use of multiplicative point processes, we can make essential contributions to a more thorough understanding of the dynamical properties of interacting neuronal populations.

Clinical applications and implications of common and founder mutations in Indian subpopulations.

PubMed

Ankala, Arunkanth; Tamhankar, Parag M; Valencia, C Alexander; Rayam, Krishna K; Kumar, Manisha M; Hegde, Madhuri R

2015-01-01

South Asian Indians represent a sixth of the world's population and are a racially, geographically, and genetically diverse people. Their unique anthropological structure, prevailing caste system, and ancient religious practices have all impacted the genetic composition of most of the current-day Indian population. With the evolving socio-religious and economic activities of the subsects and castes, endogamous and consanguineous marriages became a commonplace. Consequently, the frequency of founder mutations and the burden of heritable genetic disorders rose significantly. Specifically, the incidence of certain autosomal-recessive disorders is relatively high in select Indian subpopulations and communities that share common recent ancestry. Although today clinical genetics and molecular diagnostic services are making inroads in India, the high costs associated with the technology and the tests often keep patients from an exact molecular diagnosis, making more customized and tailored tests, such as those interrogating the most common and founder mutations or those that cater to select sects within the population, highly attractive. These tests offer a quick first-hand affordable diagnostic and carrier screening tool. Here, we provide a comprehensive catalog of known common mutations and founder mutations in the Indian population and discuss them from a molecular, clinical, and historical perspective. © 2014 WILEY PERIODICALS, INC.

Environmental fluctuations restrict eco-evolutionary dynamics in predator-prey system.

PubMed

Hiltunen, Teppo; Ayan, Gökçe B; Becks, Lutz

2015-06-07

Environmental fluctuations, species interactions and rapid evolution are all predicted to affect community structure and their temporal dynamics. Although the effects of the abiotic environment and prey evolution on ecological community dynamics have been studied separately, these factors can also have interactive effects. Here we used bacteria-ciliate microcosm experiments to test for eco-evolutionary dynamics in fluctuating environments. Specifically, we followed population dynamics and a prey defence trait over time when populations were exposed to regular changes of bottom-up or top-down stressors, or combinations of these. We found that the rate of evolution of a defence trait was significantly lower in fluctuating compared with stable environments, and that the defence trait evolved to lower levels when two environmental stressors changed recurrently. The latter suggests that top-down and bottom-up changes can have additive effects constraining evolutionary response within populations. The differences in evolutionary trajectories are explained by fluctuations in population sizes of the prey and the predator, which continuously alter the supply of mutations in the prey and strength of selection through predation. Thus, it may be necessary to adopt an eco-evolutionary perspective on studies concerning the evolution of traits mediating species interactions. © 2015 The Author(s) Published by the Royal Society. All rights reserved.

Emergent Properties of Interacting Populations of Spiking Neurons

PubMed Central

Cardanobile, Stefano; Rotter, Stefan

2011-01-01

Dynamic neuronal networks are a key paradigm of increasing importance in brain research, concerned with the functional analysis of biological neuronal networks and, at the same time, with the synthesis of artificial brain-like systems. In this context, neuronal network models serve as mathematical tools to understand the function of brains, but they might as well develop into future tools for enhancing certain functions of our nervous system. Here, we present and discuss our recent achievements in developing multiplicative point processes into a viable mathematical framework for spiking network modeling. The perspective is that the dynamic behavior of these neuronal networks is faithfully reflected by a set of non-linear rate equations, describing all interactions on the population level. These equations are similar in structure to Lotka-Volterra equations, well known by their use in modeling predator-prey relations in population biology, but abundant applications to economic theory have also been described. We present a number of biologically relevant examples for spiking network function, which can be studied with the help of the aforementioned correspondence between spike trains and specific systems of non-linear coupled ordinary differential equations. We claim that, enabled by the use of multiplicative point processes, we can make essential contributions to a more thorough understanding of the dynamical properties of interacting neuronal populations. PMID:22207844

Epilepsy in India I: Epidemiology and public health

PubMed Central

Amudhan, Senthil; Gururaj, Gopalkrishna; Satishchandra, Parthasarathy

2015-01-01

Of the 70 million persons with epilepsy (PWE) worldwide, nearly 12 million PWE are expected to reside in India; which contributes to nearly one-sixth of the global burden. This paper (first of the two part series) provides an in-depth understanding of the epidemiological aspects of epilepsy in India for developing effective public health prevention and control programs. The overall prevalence (3.0-11.9 per 1,000 population) and incidence (0.2-0.6 per 1,000 population per year) data from recent studies in India on general population are comparable to the rates of high-income countries (HICs) despite marked variations in population characteristics and study methodologies. There is a differential distribution of epilepsy among various sociodemographic and economic groups with higher rates reported for the male gender, rural population, and low socioeconomic status. A changing pattern in the age-specific occurrence of epilepsy with preponderance towards the older age group is noticed due to sociodemographic and epidemiological transition. Neuroinfections, neurocysticercosis (NCC), and neurotrauma along with birth injuries have emerged as major risk factors for secondary epilepsy. Despite its varied etiology (unknown and known), majority of the epilepsy are manageable in nature. This paper emphasizes the need for focused and targeted programs based on a life-course perspective and calls for a stronger public health approach based on equity for prevention, control, and management of epilepsy in India. PMID:26425001

Nurse Perceptions of Pain in Pediatric Traumatic Brain Injury: A Pilot Study.

PubMed

McCaa, Robin

2017-01-01

Pain assessment in the pediatric population is challenging because of age, developmental stage, and patient cooperation. Cognitive impairment, impaired communication, and physical disability that may accompany traumatic brain injury (TBI) further complicate pain assessments. A pilot descriptive qualitative research study was conducted to investigate nurse perceptions of pain in pediatric patients diagnosed with TBI. Specifically, this study sought to answer the following questions: a) Is pain accurately assessed in this population? b) Is pain adequately treated in this population? and c) What obstacles exist, if any, to the assessment and treatment of pain? A convenience sample of three registered nurses employed in a pediatric neurosurgery setting participated in this study. Each nurse participated in one individual, semi-structured, face-to-face interview lasting approximately 30 minutes. Interviews were transcribed verbatim and analyzed for common themes. Common themes identified across all interviews were a) challenging assessments; b) limited, although effective, treatments; and c) communication as an area of opportunity for improvement. Implications for practice and policy include a need for more sensitive pain assessment tools to improve the objectivity and accuracy of pain assessment, clarification of care priorities and organization of care from clinical and management perspectives, and additional research in alternative pain treatments for this population. Findings from this study will guide the development of a larger, more comprehensive study, with the aim of improving practice and policy in pain management for this population.

Efficacy evaluation of managed population shift in Ukraine from zone of obligate (compulsory) resettlement as a measure of public radiation protection.

PubMed

Gunko, N V

2015-12-01

Evaluation of efficacy of the managed population transmigration from zone of obligate (compulsory) resettlement as a measure of civil protection after the Chernobyl NPP accident from the perspective of radiation biology. Legislative and statutory tutorial documents that regulate the managed population shift from radiologically contaminated territories of Ukraine and data from the Ukrainian State Service of Statistics on time limits and scopes of population transmigration from contaminated settlements were the informational back ground of the study. Data on retrospective and expected/anticipated radiation doses in population of settlements exposed to radiological contamination in Ukraine after the Chernobyl disaster summarized for the 1986-1997 peri od and up to 2055 were the information source for calculation of averted doses due to population shift. Battery of basic research empirical evidence review methods was applied under the calculation, systemic, and biomedical approach. Population shift from zone of obligate (compulsore) resettlement (hereafter referred to as Zone 2) to stop the radiation exposure as a tool of civil protection from emergency ionizing radiation after the Chernobyl NPP accident was scientifically substantiated and expedient from the perspective of radiation biology. Estimability of a managed population shift from "dose effect" perspective and "benefit/harm" principle is worse because of data absence on individual radiation doses to migrants in the country. Public shift in 1990 and 1991 was most effective from the viewpoint of level of averted lifetime dose. Due to transmigration the averted lifetime dose to the most vulnerable group of the Chernobyl disaster survivors i.e. children aged 0 years varied from 11.2 to 28.8 mSv (calculated for the Perejizdiv village council of Zhytomyr province). Since 2000 there was almost no public shift being not accomplished in the scheduled scope. Delay and incompleteness of transmigration have diminished the efficacy of this measure in the framework of radiological protection of population. N. V. Gunko.

Cost-effectiveness analysis of a vaccination program for the prevention of herpes zoster and post-herpetic neuralgia in adults aged 50 and over in Germany.

PubMed

Préaud, Emmanuelle; Uhart, Mathieu; Böhm, Katharina; Aidelsburger, Pamela; Anger, Delphine; Bianic, Florence; Largeron, Nathalie

2015-01-01

Herpes zoster (HZ; shingles) is a common viral disease that affects the nerves and surrounding skin causing a painful dermatomal rash and leading to debilitating complications such as, mainly, post-herpetic neuralgia (PHN). Currently, there is no effective treatment for HZ and PHN. The objective of this study was to assess the cost-effectiveness of a HZ vaccination program in Germany. An existing Markov Model was adapted to the German healthcare setting to compare a vaccination policy to no vaccination on a lifetime time-horizon, considering 2 scenarios: vaccinating people starting at the age of 50 or at the age of 60 years, from the perspective of the statutory health insurance (SHI) and the societal perspective. According to the perspective, vaccinating 20% of the 60+ German population resulted in 162,713 to 186,732 HZ and 31,657 to 35,793 PHN cases avoided. Corresponding incremental cost-effectiveness ratios (ICER) were 39,306 €/QALY from the SHI perspective and 37,417 €/QALY from a societal perspective. Results for the 50+ German population ranged from 336,468 to 394,575 HZ and from 48,637 to 56,087 PHN cases avoided from the societal perspective. Corresponding ICER were 39,782 €/QALY from a SHI perspective and 32,848 €/QALY from a societal perspective. Sensitivity analyses showed that results are mainly impacted by discount rates, utility values and use of alternative epidemiological data.The model indicated that a HZ vaccination policy in Germany leads to significant public health benefits and could be a cost-effective intervention. The results were robust and consistent with local and international existing literature.

Perinatal legislative policies and health outcomes.

PubMed

Lorch, Scott A

2017-10-01

Perinatal epidemiology examines the variation and determinants of pregnancy outcomes from a maternal and neonatal perspective. However, improving public and population health also requires the translation of this evidence base into substantive public policies. Assessing the impact of such public policies requires sufficient data to include potential confounding factors in the analysis, such as coexisting medical conditions and socioeconomic status, and appropriate statistical and epidemiological techniques. This review will explore policies addressing three areas of perinatal medicine-elective deliveries prior to 39 weeks' gestation; perinatal regionalization; and mandatory paid maternity leave policies-to illustrate the challenges when assessing the impact of specific policies at the patient and population level. Data support the use of these policies to improve perinatal health, but with weaker and less certain effect sizes when compared to the initial patient-level studies. Improved data collection and epidemiological techniques will allow for improved assessment of these policies and the identification of potential areas of improvement when translating patient-level studies into public policies. Copyright © 2017 Elsevier Inc. All rights reserved.

[Gynaecology and obstetrics in Basse-Normandy: demographic perspectives in 15 years].

PubMed

Mandon, M; Macé, J-M; Dreyfus, M; Berger, L

2015-01-01

The French population is growing and ageing. In this context, it is important to consider the future of gynecologists and obstetricians in Basse-Normandie. The aim of this study was to perform an overview of the demographics of practitioners and estimate the retirements. We also try to project the need of trainees for the next years. We conducted a demographic and workload survey among 142 practitioners and 35 trainees. We detailed retirements and arrivals of this population. By 2025, nearly two-thirds of practitioners in 2012 will retire, including 100% of medical gynecologists. Otherwise, there will be a lack of 1 to 2 practitioners per year. We also noted the tendance of feminization (86%) and the wish of a multi-practice in public hospital (86%). A reflection about the health planning will be necessary in order to answer the demographics difficulty in the region. We will have to take into account the future retirements and also the specific situations in each area. Copyright © 2013. Published by Elsevier Masson SAS.

Copy number variations and genetic admixtures in three Xinjiang ethnic minority groups

PubMed Central

Lou, Haiyi; Li, Shilin; Jin, Wenfei; Fu, Ruiqing; Lu, Dongsheng; Pan, Xinwei; Zhou, Huaigu; Ping, Yuan; Jin, Li; Xu, Shuhua

2015-01-01

Xinjiang is geographically located in central Asia, and it has played an important historical role in connecting eastern Eurasian (EEA) and western Eurasian (WEA) people. However, human population genomic studies in this region have been largely underrepresented, especially with respect to studies of copy number variations (CNVs). Here we constructed the first CNV map of the three major ethnic minority groups, the Uyghur, Kazakh and Kirgiz, using Affymetrix Genome-Wide Human SNP Array 6.0. We systematically compared the properties of CNVs we identified in the three groups with the data from representatives of EEA and WEA. The analyses indicated a typical genetic admixture pattern in all three groups with ancestries from both EEA and WEA. We also identified several CNV regions showing significant deviation of allele frequency from the expected genome-wide distribution, which might be associated with population-specific phenotypes. Our study provides the first genome-wide perspective on the CNVs of three major Xinjiang ethnic minority groups and has implications for both evolutionary and medical studies. PMID:25026903

Black-White variations in the lagged reciprocal relationship between religiosity and perceived control.

PubMed

Oates, Gary

2013-06-01

This national longitudinal data-based multi-population LISREL study, the most comprehensive assessment to date of racial variations in the (in)congruity between religiosity and perceived control, gauges variation among Black and White Americans in the lagged reciprocal relationship between religiosity dimensions and mastery. Racial variation in the reciprocal religiosity-perceived control relationship has hitherto gone un-addressed. Prior investigations have also typically utilised cross-sectional samples - often from regional or age-specific populations. The observed public religiosity-mastery relationship over time exhibits signs of mutual reinforcement among Blacks: public religiosity enhances Blacks' subsequent mastery, while prior mastery borderline-significantly enhances their public religiosity. The subjective religiosity-mastery relationship among Whites evinces a marginally countervailing pattern: Subjective religiosity diminishes Whites' mastery, while mastery borderline-significantly enhances their subjective religiosity. The inordinately positive public religiosity-effect on Blacks' mastery notably constitutes solid support for the " resource compensation " perspective on the impact of religiosity on mastery across dominant and subordinate groups.

Genetic information transfer promotes cooperation in bacteria

PubMed Central

Dimitriu, Tatiana; Lotton, Chantal; Bénard-Capelle, Julien; Misevic, Dusan; Brown, Sam P.; Lindner, Ariel B.; Taddei, François

2014-01-01

Many bacterial species are social, producing costly secreted “public good” molecules that enhance the growth of neighboring cells. The genes coding for these cooperative traits are often propagated via mobile genetic elements and can be virulence factors from a biomedical perspective. Here, we present an experimental framework that links genetic information exchange and the selection of cooperative traits. Using simulations and experiments based on a synthetic bacterial system to control public good secretion and plasmid conjugation, we demonstrate that horizontal gene transfer can favor cooperation. In a well-mixed environment, horizontal transfer brings a direct infectious advantage to any gene, regardless of its cooperation properties. However, in a structured population transfer selects specifically for cooperation by increasing the assortment among cooperative alleles. Conjugation allows cooperative alleles to overcome rarity thresholds and invade bacterial populations structured purely by stochastic dilution effects. Our results provide an explanation for the prevalence of cooperative genes on mobile elements, and suggest a previously unidentified benefit of horizontal gene transfer for bacteria. PMID:25024219

Complexity in cognitive assessment of elderly British minority ethnic groups: Cultural perspective.

PubMed

Khan, Farooq; Tadros, George

2014-07-01

To study the influence of cultural believes on the acceptance and accessibility of dementia services by patients from British Minority Ethnic (BME) groups. It is noted that non-White ethnic populations rely more on cultural and religious concepts as coping mechanisms to overcome carer stress. In British Punjabi families, ageing was seen as an accepted reason for withdrawal and isolation, and cognitive impairment was rarely identified. Illiteracy added another complexity, only 35% of older Asians in a UK city could speak English, 21% could read and write English, while 73% could read and write in their first language. False positive results using Mini Mental State Examination was found to be 6% of non-impaired white people and 42% of non-impaired black people. Cognitive assessment tests under-estimate the abilities in BME groups. Wide range of variations among white and non-White population were found, contributors are education, language, literacy and culture-specific references. © The Author(s) 2013 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Copy number variations and genetic admixtures in three Xinjiang ethnic minority groups.

PubMed

Lou, Haiyi; Li, Shilin; Jin, Wenfei; Fu, Ruiqing; Lu, Dongsheng; Pan, Xinwei; Zhou, Huaigu; Ping, Yuan; Jin, Li; Xu, Shuhua

2015-04-01

Xinjiang is geographically located in central Asia, and it has played an important historical role in connecting eastern Eurasian (EEA) and western Eurasian (WEA) people. However, human population genomic studies in this region have been largely underrepresented, especially with respect to studies of copy number variations (CNVs). Here we constructed the first CNV map of the three major ethnic minority groups, the Uyghur, Kazakh and Kirgiz, using Affymetrix Genome-Wide Human SNP Array 6.0. We systematically compared the properties of CNVs we identified in the three groups with the data from representatives of EEA and WEA. The analyses indicated a typical genetic admixture pattern in all three groups with ancestries from both EEA and WEA. We also identified several CNV regions showing significant deviation of allele frequency from the expected genome-wide distribution, which might be associated with population-specific phenotypes. Our study provides the first genome-wide perspective on the CNVs of three major Xinjiang ethnic minority groups and has implications for both evolutionary and medical studies.

Modeling quorum sensing trade-offs between bacterial cell density and system extension from open boundaries

NASA Astrophysics Data System (ADS)

Marenda, Mattia; Zanardo, Marina; Trovato, Antonio; Seno, Flavio; Squartini, Andrea

2016-12-01

Bacterial communities undergo collective behavioural switches upon producing and sensing diffusible signal molecules; a mechanism referred to as Quorum Sensing (QS). Exemplarily, biofilm organic matrices are built concertedly by bacteria in several environments. QS scope in bacterial ecology has been debated for over 20 years. Different perspectives counterpose the role of density reporter for populations to that of local environment diffusivity probe for individual cells. Here we devise a model system where tubes of different heights contain matrix-embedded producers and sensors. These tubes allow non-limiting signal diffusion from one open end, thereby showing that population spatial extension away from an open boundary can be a main critical factor in QS. Experimental data, successfully recapitulated by a comprehensive mathematical model, demonstrate how tube height can overtake the role of producer density in triggering sensor activation. The biotic degradation of the signal is found to play a major role and to be species-specific and entirely feedback-independent.

Modeling quorum sensing trade-offs between bacterial cell density and system extension from open boundaries.

PubMed

Marenda, Mattia; Zanardo, Marina; Trovato, Antonio; Seno, Flavio; Squartini, Andrea

2016-12-14

Bacterial communities undergo collective behavioural switches upon producing and sensing diffusible signal molecules; a mechanism referred to as Quorum Sensing (QS). Exemplarily, biofilm organic matrices are built concertedly by bacteria in several environments. QS scope in bacterial ecology has been debated for over 20 years. Different perspectives counterpose the role of density reporter for populations to that of local environment diffusivity probe for individual cells. Here we devise a model system where tubes of different heights contain matrix-embedded producers and sensors. These tubes allow non-limiting signal diffusion from one open end, thereby showing that population spatial extension away from an open boundary can be a main critical factor in QS. Experimental data, successfully recapitulated by a comprehensive mathematical model, demonstrate how tube height can overtake the role of producer density in triggering sensor activation. The biotic degradation of the signal is found to play a major role and to be species-specific and entirely feedback-independent.

An operational centre for managing major chemical industrial accidents.

PubMed

Kiranoudis, C T; Kourniotis, S P; Christolis, M; Markatos, N C; Zografos, K G; Giannouli, I M; Androutsopoulos, K N; Ziomas, I; Kosmidis, E; Simeonidis, P; Poupkou, N

2002-01-28

The most important characteristic of major chemical accidents, from a societal perspective, is their tendency to produce off-site effects. The extent and severity of the accident may significantly affect the population and the environment of the adjacent areas. Following an accident event, effort should be made to limit such effects. Management decisions should be based on rational and quantitative information based on the site specific circumstances and the possible consequences. To produce such information we have developed an operational centre for managing large-scale industrial accidents. Its architecture involves an integrated framework of geographical information system (GIS) and RDBMS technology systems equipped with interactive communication capabilities. The operational centre was developed for Windows 98 platforms, for the region of Thriasion Pedion of West Attica, where the concentration of industrial activity and storage of toxic chemical is immense within areas of high population density. An appropriate case study is given in order to illuminate the use and necessity of the operational centre.

Preservice Teachers' Perspective Transformations as Social Change Agents

ERIC Educational Resources Information Center

Woodrow, Kelli; Caruana, Vicki

2017-01-01

In this article, we investigate whether, and in what ways, the learning experiences in a capstone course in reflective teaching impact the perspective transformations (PT) of preservice teachers toward a diverse K-12 student population and the plans of preservice teachers to take future action as change agents. Using an adaptation of the Learning…

Debunking the Pocahontas Paradox: The Need for a Humanistic Perspective.

ERIC Educational Resources Information Center

Portman, Tarrell Awe Agahe; Herring, Roger D.

2001-01-01

Historical and contemporary stereotypes of Native American Indian women have resulted in inaccurate and insensitive images. Mass media, movies, and printed materials continue to portray Native American Indian women as either princesses or savages. The purpose of this article is to provide a more humanistic perspective of this population. (Contains…

Developing Pre-Requisites for Empathy: Increasing Awareness of Self, the Body and the Perspectives of Others

ERIC Educational Resources Information Center

McNaughton, Susan Maree

2016-01-01

Empathy is an important affective attribute for graduates entering future practice with diverse populations. Self- and bodily awareness and the ability to take others' perspectives are essential for developing, maintaining and encouraging the cognitive, affective and motivational elements of empathy. This paper presents a thematic analysis of…

Critical Race Theory and Research on Asian Americans and Pacific Islanders in Higher Education

ERIC Educational Resources Information Center

Teranishi, Robert T.; Behringer, Laurie B.; Grey, Emily A.; Parker, Tara L.

2009-01-01

In this article, the authors offer critical race theory (CRT) as an alternative theoretical perspective that permits the examination and transcendence of conceptual blockages, while simultaneously offering alternative perspectives on higher education policy and practice and the Asian American and Pacific Islander (AAPI) student population. The…

Science Teaching Beliefs and Reported Approaches within a Research University: Perspectives from Faculty, Graduate Students, and Undergraduates

ERIC Educational Resources Information Center

Marbach-Ad, Gili; Ziemer, Kathryn Schaefer; Orgler, Michal; Thompson, Katerina V.

2014-01-01

This study explores and compares the perspectives of three populations (faculty members, graduate students, and undergraduates) toward science teaching in the College of Chemical and Life Sciences at a research-intensive university. In particular, we investigate the role of faculty professional development in reforming undergraduate science…

The Reconstruction of Parenting after Migration: A Perspective from Cultural Translation

ERIC Educational Resources Information Center

de Haan, Mariette

2011-01-01

Migration induces complex processes of human transformation that are usually not reflected in theories that describe these changes. In most theories regarding these transformations, the implicit assumption is that immigrants undergo a transition to the culture of the mainstream population according to a modernization perspective. Based on a review…

Quality in Higher Education: United Arab Emirates Perspective

ERIC Educational Resources Information Center

Soomro, Tariq Rahim; Ahmad, Reyaz

2012-01-01

Quality in higher education is the major concern among researchers. Managing quality in higher education in a multicultural population with different approaches is not only challenging but an uphill task. This paper will focus on quality concern in higher education keeping in view, the United Arab Emirates (UAE) perspectives. A model to maintain…

Freedom and Responsibility: The Aesthetics of Free Musical Improvisation and Its Educational Implications--A View from Bakhtin

ERIC Educational Resources Information Center

Kanellopoulos, Panagiotis A.

2011-01-01

This paper aims to examine how specific aspects of Bakhtin's theoretical perspective might inform our understanding of improvisation. Moreover, it outlines the possible educational implications of such a perspective. Specifically, a sketch of a Bakhtinian conception of improvisation is proposed, a sketch which emphasizes the cultivation of an…

Host specificity in parasitic plants-perspectives from mistletoes.

PubMed

Okubamichael, Desale Y; Griffiths, Megan E; Ward, David

2016-01-01

Host specificity has been investigated for centuries in mistletoes, viruses, insects, parasitoids, lice and flukes, yet it is poorly understood. Reviewing the numerous studies on mistletoe host specificity may contribute to our understanding of these plants and put into context the dynamics at work in root parasitic plants and animal parasites. The mechanisms that determine host specificity in mistletoes are not as well documented and understood as those in other groups of parasites. To rectify this, we synthesized the available literature and analyzed data compiled from herbaria, published monographs and our own field studies in South Africa. As for other groups of parasites, multiple factors influence mistletoe host specificity. Initially, pollination affects gene flow. Subsequently, seed dispersal vectors (birds and marsupials), host abundance and compatibility (genetic, morphological, physiological and chemical), history and environmental conditions affect the interaction of mistletoes and their hosts and determine host specificity. Mistletoe-host network analyses and a geographic mosaic approach combined with long-term monitoring of reciprocal transplant experiments, genetic analyses of confined mistletoe populations and comparative phylogenetic studies could provide further insights to our understanding of host specificity. Some of these approaches have been used to study animal-plant interactions and could be adopted to test and evaluate host specificity in mistletoes at local and larger geographic scales. © The Authors 2016. Published by Oxford University Press on behalf of the Annals of Botany Company.

The education of physicians: a CDC perspective.

PubMed

Koo, Denise; Thacker, Stephen B

2008-04-01

The Centers for Disease Control and Prevention (CDC) strongly supports integrating population health perspectives into the education of physicians. Physicians with critical-thinking skills, a commitment to the health of a community, and a systems-based approach are critical partners for the agency in its mission to protect and promote the public's health. To cultivate such physicians, integrating population health concepts solely into undergraduate medical education would be inadequate. A multipronged approach that establishes and maintains population health concepts with physicians at all stages of their education is needed: before medical school, during medical school, during residency and fellowship, and in research and practice (particularly for faculty who train the next generation). The authors describe relevant, CDC-conducted or CDC-supported activities that support such physician education during all these stages. Based in part on recent, cutting-edge trends assimilating community health particularly into primary care residencies, the authors also offer ideas for new ways that CDC can participate in the development of physicians who are truly competent at both medicine and population health in an integrated fashion -- physicians who focus on and care for individual patients but who also take a broader population or community perspective and can act effectively in either arena. Physicians who take such a systems approach -- who view and understand medicine and public health as a continuum rather than as distinct arenas -- are sorely needed to help solve the current health system crisis and to contribute to improving health in other ways.

The Exercise–Affect–Adherence Pathway: An Evolutionary Perspective

PubMed Central

Lee, Harold H.; Emerson, Jessica A.; Williams, David M.

2016-01-01

The low rates of regular exercise and overall physical activity (PA) in the general population represent a significant public health challenge. Previous research suggests that, for many people, exercise leads to a negative affective response and, in turn, reduced likelihood of future exercise. The purpose of this paper is to examine this exercise–affect–adherence relationship from an evolutionary perspective. Specifically, we argue that low rates of physical exercise in the general population are a function of the evolved human tendency to avoid unnecessary physical exertion. This innate tendency evolved because it allowed our evolutionary ancestors to conserve energy for physical activities that had immediate adaptive utility such as pursuing prey, escaping predators, and engaging in social and reproductive behaviors. The commonly observed negative affective response to exercise is an evolved proximate psychological mechanism through which humans avoid unnecessary energy expenditure. The fact that the human tendencies toward negative affective response to and avoidance of unnecessary physical activities are innate does not mean that they are unchangeable. Indeed, it is only because of human-engineered changes in our environmental conditions (i.e., it is no longer necessary for us to work for our food) that our predisposition to avoid unnecessary physical exertion has become a liability. Thus, it is well within our capabilities to reengineer our environments to once again make PA necessary or, at least, to serve an immediate functional purpose. We propose a two-pronged approach to PA promotion based on this evolutionary functional perspective: first, to promote exercise and other physical activities that are perceived to have an immediate purpose, and second, to instill greater perceived purpose for a wider range of physical activities. We posit that these strategies are more likely to result in more positive (or less negative) affective responses to exercise, better adherence to exercise programs, and higher rates of overall PA. PMID:27610096

The cost effectiveness of ivabradine in the treatment of chronic heart failure from the U.K. National Health Service perspective.

PubMed

Griffiths, A; Paracha, N; Davies, A; Branscombe, N; Cowie, M R; Sculpher, M

2014-07-01

Ivabradine, a specific heart rate lowering therapy, has been shown in a randomised placebo-controlled study, Systolic HF Treatment with the If Inhibitor Ivabradine Trial (SHIfT), to significantly reduce the composite end point of cardiovascular death and hospitalisation for worsening heart failure (HF) in patients with systolic HF who are in sinus rhythm and with a heart rate ≥70 bpm, when added to optimised medical therapy (HR: 0.82, 95% CI 0.75 to 0.90, p<0.0001). We assessed the cost effectiveness of ivabradine, from a UK National Health Service perspective, based on the results of SHIfT. A Markov model estimated the cost effectiveness of ivabradine compared with standard care for two cohorts of patients with HF (heart rate ≥75 bpm in line with the EU labelled indication; and heart rate ≥70 bpm in line with the SHIfT study population). Modelled outcomes included death, hospitalisation, quality of life and New York Heart Association class. Total costs and quality adjusted life years (QALYs) for ivabradine and standard care were estimated over a lifetime horizon. The incremental cost per additional QALY for ivabradine plus standard care versus standard care has been estimated as £8498 for heart rate ≥75 bpm and £13 764 for heart rate ≥70 bpm. Ivabradine is expected to have a 95% chance of being cost-effective in the EU licensed population using the current National Institute for Health and Care Excellence cost effectiveness threshold of £20 000 per QALY. These results were robust in sensitivity analyses. This economic evaluation suggests that the use of ivabradine is likely to be cost-effective in eligible patients with HF from a UK National Health Service perspective. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

The Cost Effectiveness of Nalmefene for Reduction of Alcohol Consumption in Alcohol-Dependent Patients with High or Very High Drinking-Risk Levels from a UK Societal Perspective.

PubMed

Brodtkorb, Thor-Henrik; Bell, Melissa; Irving, Adam H; Laramée, Philippe

2016-02-01

To evaluate costs and health outcomes of nalmefene plus psychosocial support, compared with psychosocial intervention alone, for reducing alcohol consumption in alcohol-dependent patients, specifically focusing on societal costs related to productivity losses and crime. A Markov model was constructed to model costs and health outcomes of the treatments over 5 years. Analyses were conducted for nalmefene's licensed population: adults with both alcohol dependence and high or very high drinking-risk levels (DRLs) who do not require immediate detoxification and who have high or very high DRLs after initial assessment. The main outcome measure was cost per quality-adjusted life-year (QALY) gained as assessed from a UK societal perspective. Alcohol-attributable productivity loss, crime and health events occurring at different levels of alcohol consumption were taken from published risk-relation studies. Health-related and societal costs were drawn from public data and the literature. Data on the treatment effect, as well as baseline characteristics of the modelled population and utilities, came from three pivotal phase 3 trials of nalmefene. Nalmefene plus psychosocial support was dominant compared with psychosocial intervention alone, resulting in QALYs gained and reduced societal costs. Sensitivity analyses showed that this conclusion was robust. Nalmefene plus psychosocial support led to per-patient reduced costs of £3324 and £2483, due to reduced productivity losses and crime events, respectively. Nalmefene is cost effective from a UK societal perspective, resulting in greater QALY gains and lower costs compared with psychosocial support alone. Nalmefene demonstrates considerable public benefits by reducing alcohol-attributable productivity losses and crime events in adults with both alcohol dependence and high or very high DRLs who do not require immediate detoxification and who have high or very high DRLs after initial assessment.

Early recovery following lower limb arthroplasty: Qualitative interviews with patients undergoing elective hip and knee replacement surgery. Initial phase in the development of a patient-reported outcome measure.

PubMed

Strickland, Louise H; Kelly, Laura; Hamilton, Thomas W; Murray, David W; Pandit, Hemant G; Jenkinson, Crispin

2017-09-27

To explore the patients' perspective of surgery and early recovery when undergoing lower limb (hip or knee) arthroplasty. Lower limb arthroplasty is a commonly performed procedure for symptomatic arthritis, which has not responded to conservative medical treatment. Each patient's perspective of the surgical process and early recovery period impacts on their quality of life. Open, semistructured qualitative interviews were used to allow for a deeper understanding of the patient perspective when undergoing a hip or knee arthroplasty. Following ethical approval, 30 patients were interviewed between August and November 2016 during the perioperative period while undergoing an elective hip or knee arthroplasty (n = 30). The interviews were performed between the day of surgery and a nine-week postoperative clinic appointment. Data were analysed using an in-depth narrative thematic analysis method. NVivo qualitative data analysis software was used. Seven main themes evolved from the interviews: "improving function and mobility", "pain", "experiences of health care", "support from others", "involvement and understanding of care decisions", "behaviour and coping" and "fatigue and sleeping". The early postoperative recovery period is of vital importance to all surgical patients. This is no different for the orthopaedic patient. However, identifying key self-reported areas of importance from patients can guide clinical focus for healthcare professionals. To have specific patient-reported information regarding key areas of importance during the perioperative phase is invaluable when caring for the orthopaedic surgical patient. It gives insight and understanding in to this increasing population group. This study has also served as a starting point in the development of a questionnaire which could be used to assess interventions in the lower limb arthroplasty population. These results will influence both items and content of the questionnaire. © 2017 John Wiley & Sons Ltd.

Enhanced primary mental healthcare for Indigenous Australians: service implementation strategies and perspectives of providers.

PubMed

Reifels, Lennart; Nicholas, Angela; Fletcher, Justine; Bassilios, Bridget; King, Kylie; Ewen, Shaun; Pirkis, Jane

2018-01-01

Improving access to culturally appropriate mental healthcare has been recognised as a key strategy to address the often greater burden of mental health issues experienced by Indigenous populations. We present data from the evaluation of a national attempt at improving access to culturally appropriate mental healthcare for Indigenous Australians through a mainstream primary mental healthcare program, the Access to Allied Psychological Services program, whilst specifically focusing on the implementation strategies and perspectives of service providers. We conducted semi-structured interviews with 31 service providers (primary care agency staff, referrers, and mental health professionals) that were analysed thematically and descriptively. Agency-level implementation strategies to enhance service access and cultural appropriateness included: the conduct of local service needs assessments; Indigenous stakeholder consultation and partnership development; establishment of clinical governance frameworks; workforce recruitment, clinical/cultural training and supervision; stakeholder and referrer education; and service co-location at Indigenous health organisations. Dedicated provider-level strategies to ensure the cultural appropriateness of services were primarily aimed at the context and process of delivery (involving, flexible referral pathways, suitable locations, adaptation of client engagement and service feedback processes) and, to a lesser extent, the nature and content of interventions (provision of culturally adapted therapy). This study offers insights into key factors underpinning the successful national service implementation approach. Study findings highlight that concerted national attempts to enhance mainstream primary mental healthcare for Indigenous people are critically dependent on effective local agency- and provider-level strategies to optimise the integration, adaptation and broader utility of these services within local Indigenous community and healthcare service contexts. Despite the explicit provider focus, this study was limited by a lack of Indigenous stakeholder perspectives. Key study findings are of direct relevance to inform the future implementation and delivery of culturally appropriate primary mental healthcare programs for Indigenous populations in Australia and internationally.

From ecology to base pairs: nursing and genetic science.

PubMed

Williams, J K; Tripp-Reimer, T

2001-07-01

With the mapping of the human genome has come the opportunity for nursing research to explore topics of concern to the maintenance, restoration, and attainment of genetic-related health. Initially, nursing research on genetic topics originated primarily from physical anthropology and from a clinical, disease-focused perspective. Nursing research subsequently focused on psychosocial aspects of genetic conditions for individuals and their family members. As findings emerge from current human genome discovery, new programs of genetic nursing research are originating from a biobehavioral interface, ranging from the investigations of the influence of specific molecular changes on gene function to social/ethical issues of human health and disease. These initiatives reflect nursing's response to discoveries of gene mutations related to phenotypic expression in both clinical and community-based populations. Genetic research programs are needed that integrate or adapt theoretical and methodological advances in epidemiology, family systems, anthropology, and ethics with those from nursing. Research programs must address not only populations with a specific disease but also community-based genetic health care issues. As genetic health care practice evolves, so will opportunities for research by nurses who can apply genetic concepts and interventions to improve the health of the public. This article presents an analysis of the evolution of genetic nursing research and challengesfor the future.

Growing pains: How risk perception and risk communication research can help to manage the challenges of global population growth.

PubMed

Dawson, Ian G J; Johnson, Johnnie E V

2014-08-01

In 2011, the global human population reached 7 billion and medium variant projections indicate that it will exceed 9 billion before 2045. Theoretical and empirical perspectives suggest that this growth could lead to an increase in the likelihood of adverse events (e.g., food shortages, climate change, etc.) and/or the severity of adverse events (e.g., famines, natural disasters, etc.). Several scholars have posited that the size to which the global population grows and the extent to which this growth increases the likelihood of adverse outcomes will largely be shaped by individuals' decisions (in households, organizations, governments, etc.). In light of the strong relationship between perceived risk and decision behaviors, it is surprising that there remains a dearth of empirical research that specifically examines the perceived risks of population growth and how these perceptions might influence related decisions. In an attempt to motivate this important strand of research, this article examines the major risks that may be exacerbated by global population growth and draws upon empirical work concerning the perception and communication of risk to identify potential directions for future research. The article also considers how individuals might perceive both the risks and benefits of population growth and be helped to better understand and address the related issues. The answers to these questions could help humanity better manage the emerging consequences of its continuing success in increasing infant survival and adult longevity. © 2014 Society for Risk Analysis.

Syntactic Versus Memory Accounts of the Sentence Comprehension Deficits of Specific Language Impairment: Looking Back, Looking Ahead.

PubMed

Montgomery, James W; Gillam, Ronald B; Evans, Julia L

2016-12-01

Compared with same-age typically developing peers, school-age children with specific language impairment (SLI) exhibit significant deficits in spoken sentence comprehension. They also demonstrate a range of memory limitations. Whether these 2 deficit areas are related is unclear. The present review article aims to (a) review 2 main theoretical accounts of SLI sentence comprehension and various studies supporting each and (b) offer a new, broader, more integrated memory-based framework to guide future SLI research, as we believe the available evidence favors a memory-based perspective of SLI comprehension limitations. We reviewed the literature on the sentence comprehension abilities of English-speaking children with SLI from 2 theoretical perspectives. The sentence comprehension limitations of children with SLI appear to be more fully captured by a memory-based perspective than by a syntax-specific deficit perspective. Although a memory-based view appears to be the better account of SLI sentence comprehension deficits, this view requires refinement and expansion. Current memory-based perspectives of adult sentence comprehension, with proper modification, offer SLI investigators new, more integrated memory frameworks within which to study and better understand the sentence comprehension abilities of children with SLI.

Syntactic Versus Memory Accounts of the Sentence Comprehension Deficits of Specific Language Impairment: Looking Back, Looking Ahead

PubMed Central

Gillam, Ronald B.; Evans, Julia L.

2016-01-01

Purpose Compared with same-age typically developing peers, school-age children with specific language impairment (SLI) exhibit significant deficits in spoken sentence comprehension. They also demonstrate a range of memory limitations. Whether these 2 deficit areas are related is unclear. The present review article aims to (a) review 2 main theoretical accounts of SLI sentence comprehension and various studies supporting each and (b) offer a new, broader, more integrated memory-based framework to guide future SLI research, as we believe the available evidence favors a memory-based perspective of SLI comprehension limitations. Method We reviewed the literature on the sentence comprehension abilities of English-speaking children with SLI from 2 theoretical perspectives. Results The sentence comprehension limitations of children with SLI appear to be more fully captured by a memory-based perspective than by a syntax-specific deficit perspective. Conclusions Although a memory-based view appears to be the better account of SLI sentence comprehension deficits, this view requires refinement and expansion. Current memory-based perspectives of adult sentence comprehension, with proper modification, offer SLI investigators new, more integrated memory frameworks within which to study and better understand the sentence comprehension abilities of children with SLI. PMID:27973643

Evolution of educational inequalities in site-specific cancer mortality among Belgian men between the 1990s and 2000s using a "fundamental cause" perspective.

PubMed

Vanthomme, Katrien; Vandenheede, Hadewijch; Hagedoorn, Paulien; Gadeyne, Sylvie

2017-07-05

According to the "fundamental cause" theory, emerging knowledge on health-enhancing behaviours and technologies results in health disparities. This study aims to assess (trends in) educational inequalities in site-specific cancer mortality in Belgian men in the 1990s and the 2000s using this framework. Data were derived from record linkage between the Belgian censuses of 1991 and 2001 and register data on mortality. The study population comprised all Belgian men aged 50-79 years during follow-up. Both absolute and relative inequality measures have been calculated. Despite an overall downward trend in cancer mortality, educational differences are observed for the majority of cancer sites in the 2000s. Generally, inequalities are largest for mortality from preventable cancers. Trends over time in inequalities are rather stable compared with the 1990s. Educational differences in site-specific cancer mortality persist in the 2000s in Belgium, mainly for cancers related to behavioural change and medical interventions. Policy efforts focussing on behavioural change and healthcare utilization remain crucial in order to tackle these increasing inequalities.

Challenges and opportunities in patient-specific, motion-managed and PET/CT-guided radiation therapy of lung cancer: review and perspective

PubMed Central

2012-01-01

The increasing interest in combined positron emission tomography (PET) and computed tomography (CT) to guide lung cancer radiation therapy planning has been well documented. Motion management strategies during treatment simulation PET/CT imaging and treatment delivery have been proposed to improve the precision and accuracy of radiotherapy. In light of these research advances, why has translation of motion-managed PET/CT to clinical radiotherapy been slow and infrequent? Solutions to this problem are as complex as they are numerous, driven by large inter-patient variability in tumor motion trajectories across a highly heterogeneous population. Such variation dictates a comprehensive and patient-specific incorporation of motion management strategies into PET/CT-guided radiotherapy rather than a one-size-fits-all tactic. This review summarizes challenges and opportunities for clinical translation of advances in PET/CT-guided radiotherapy, as well as in respiratory motion-managed radiotherapy of lung cancer. These two concepts are then integrated into proposed patient-specific workflows that span classification schemes, PET/CT image formation, treatment planning, and adaptive image-guided radiotherapy delivery techniques. PMID:23369522

CCTC and the Process for Reauthorization of Bilingual Teacher Preparation Standards: A Critical-Historical Perspective

ERIC Educational Resources Information Center

Cadiero-Kaplan, Karen; Berta-Avila, Margarita; Flores, Juan

2007-01-01

California and the rest of the United Sates are undergoing significant challenges in providing educational opportunities for an increasingly diverse population. These challenges include inadequate literacy and numeracy skills among large segments of the student and adult populations; an ongoing shift in the demographic profile of the population,…

Population Growth and Policies in Mega-Cities. Sao Paulo.

ERIC Educational Resources Information Center

United Nations New York, NY. Dept. of Economic and Social Information and Policy Analysis.

This document is one in a series of studies that focus on the population policies and plans of a number of mega-cities in developing countries. The object of the series is to examine the formulation, implementation, and evaluation of the population policies of mega-cities from a broad perspective, emphasizing the reciprocal links between…

A hospital-specific template for benchmarking its cost and quality.

PubMed

Silber, Jeffrey H; Rosenbaum, Paul R; Ross, Richard N; Ludwig, Justin M; Wang, Wei; Niknam, Bijan A; Saynisch, Philip A; Even-Shoshan, Orit; Kelz, Rachel R; Fleisher, Lee A

2014-10-01

Develop an improved method for auditing hospital cost and quality tailored to a specific hospital's patient population. Medicare claims in general, gynecologic and urologic surgery, and orthopedics from Illinois, New York, and Texas between 2004 and 2006. A template of 300 representative patients from a single index hospital was constructed and used to match 300 patients at 43 hospitals that had a minimum of 500 patients over a 3-year study period. From each of 43 hospitals we chose 300 patients most resembling the template using multivariate matching. We found close matches on procedures and patient characteristics, far more balanced than would be expected in a randomized trial. There were little to no differences between the index hospital's template and the 43 hospitals on most patient characteristics yet large and significant differences in mortality, failure-to-rescue, and cost. Matching can produce fair, directly standardized audits. From the perspective of the index hospital, "hospital-specific" template matching provides the fairness of direct standardization with the specific institutional relevance of indirect standardization. Using this approach, hospitals will be better able to examine their performance, and better determine why they are achieving the results they observe. © Health Research and Educational Trust.

The emergence of human-evolutionary medical genomics

PubMed Central

Crespi, Bernard J

2011-01-01

In this review, I describe how evolutionary genomics is uniquely suited to spearhead advances in understanding human disease risk, owing to the privileged position of genes as fundamental causes of phenotypic variation, and the ability of population genetic and phylogenetic methods to robustly infer processes of natural selection, drift, and mutation from genetic variation at the levels of family, population, species, and clade. I first provide an overview of models for the origins and maintenance of genetically based disease risk in humans. I then discuss how analyses of genetic disease risk can be dovetailed with studies of positive and balancing selection, to evaluate the degree to which the ‘genes that make us human’ also represent the genes that mediate risk of polygenic disease. Finally, I present four basic principles for the nascent field of human evolutionary medical genomics, each of which represents a process that is nonintuitive from a proximate perspective. Joint consideration of these principles compels novel forms of interdisciplinary analyses, most notably studies that (i) analyze tradeoffs at the level of molecular genetics, and (ii) identify genetic variants that are derived in the human lineage or in specific populations, and then compare individuals with derived versus ancestral alleles. PMID:25567974

A note on measuring apprehension about writing.

PubMed

Rechtien, J G; Dizinno, G

1997-06-01

Having revised Daly and Miller's 1975 unidimensional Writing Apprehension Test, Riffe and Stacks in 1992 proposed eight multidimensional factors derived from responses to 56 items in their Mass Communication Writing Apprehension Measure, administered to communication students to identify the various dimensions of apprehension about writing shared with business writers and specific to their major. The current authors administered the questionnaire at the beginning of an academic year to 419 freshmen from all undergraduate schools and majors at a private liberal arts university. It was hypothesized that the factors found among the homogeneous population of communication majors would not be replicated among the more heterogeneous student population. The hypothesis was partially upheld. Seven factors were identified. Two duplicated most items found by Riffe and Stacks (1992), four added items, and one was new. The results of this study suggest that, although the general population of students differs from students in mass communication, as Riffe and Stacks remarked, the groups also share similar content in their writing apprehension, that writing apprehension is multidimensional, that caution must be exercised when administering any instrument for the diagnostic and counseling purposes suggested by Riffe and Stacks, and that writing apprehension should also be investigated from the perspective of locus of control.

Interdisciplinary modeling and analysis to reduce loss of life from tsunamis

NASA Astrophysics Data System (ADS)

Wood, N. J.

2016-12-01

Recent disasters have demonstrated the significant loss of life and community impacts that can occur from tsunamis. Minimizing future losses requires an integrated understanding of the range of potential tsunami threats, how individuals are specifically vulnerable to these threats, what is currently in place to improve their chances of survival, and what risk-reduction efforts could be implemented. This presentation will provide a holistic perspective of USGS research enabled by recent advances in geospatial modeling to assess and communicate population vulnerability to tsunamis and the range of possible interventions to reduce it. Integrated research includes efforts to characterize the magnitude and demography of at-risk individuals in tsunami-hazard zones, their evacuation potential based on landscape conditions, nature-based mitigation to improve evacuation potential, evacuation pathways and population demand at assembly areas, siting considerations for vertical-evacuation refuges, community implications of multiple evacuation zones, car-based evacuation modeling for distant tsunamis, and projected changes in population exposure to tsunamis over time. Collectively, this interdisciplinary research supports emergency managers in their efforts to implement targeted risk-reduction efforts based on local conditions and needs, instead of generic regional strategies that only focus on hazard attributes.

Within Host Evolution Selects for a Dominant Genotype of Mycobacterium tuberculosis while T Cells Increase Pathogen Genetic Diversity.

PubMed

Copin, Richard; Wang, Xueying; Louie, Eddie; Escuyer, Vincent; Coscolla, Mireia; Gagneux, Sebastien; Palmer, Guy H; Ernst, Joel D

2016-12-01

Molecular epidemiological assessments, drug treatment optimization, and development of immunological interventions all depend on understanding pathogen adaptation and genetic variation, which differ for specific pathogens. Mycobacterium tuberculosis is an exceptionally successful human pathogen, yet beyond knowledge that this bacterium has low overall genomic variation but acquires drug resistance mutations, little is known of the factors that drive its population genomic characteristics. Here, we compared the genetic diversity of the bacteria that established infection to the bacterial populations obtained from infected tissues during murine M. tuberculosis pulmonary infection and human disseminated M. bovis BCG infection. We found that new mutations accumulate during in vitro culture, but that in vivo, purifying selection against new mutations dominates, indicating that M. tuberculosis follows a dominant lineage model of evolution. Comparing bacterial populations passaged in T cell-deficient and immunocompetent mice, we found that the presence of T cells is associated with an increase in the diversity of the M. tuberculosis genome. Together, our findings put M. tuberculosis genetic evolution in a new perspective and clarify the impact of T cells on sequence diversity of M. tuberculosis.

Specific to Whose Body? Perspective-Taking and the Spatial Mapping of Valence

PubMed Central

Kominsky, Jonathan F.; Casasanto, Daniel

2013-01-01

People tend to associate the abstract concepts of “good” and “bad” with their fluent and disfluent sides of space, as determined by their natural handedness or by experimental manipulation (Casasanto, 2011). Here we investigated influences of spatial perspective taking on the spatialization of “good” and “bad.” In the first experiment, participants indicated where a schematically drawn cartoon character would locate “good” and “bad” stimuli. Right-handers tended to assign “good” to the right and “bad” to the left side of egocentric space when the character shared their spatial perspective, but when the character was rotated 180° this spatial mapping was reversed: good was assigned to the character’s right side, not the participant’s. The tendency to spatialize valence from the character’s perspective was stronger in the second experiment, when participants were shown a full-featured photograph of the character. In a third experiment, most participants not only spatialized “good” and “bad” from the character’s perspective, they also based their judgments on a salient attribute of the character’s body (an injured hand) rather than their own body. Taking another’s spatial perspective encourages people to compute space-valence mappings using an allocentric frame of reference, based on the fluency with which the other person could perform motor actions with their right or left hand. When people reason from their own spatial perspective, their judgments depend, in part, on the specifics of their bodies; when people reason from someone else’s perspective, their judgments may depend on the specifics of the other person’s body, instead. PMID:23717296

[A framework to support action in population mental health].

PubMed

Mantoura, Pascale; Roberge, Marie-Claude; Fournier, Louise

In Quebec, like elsewhere in the world, we are witnessing a growing concern for the population's mental health and for the importance of concentrating efforts on prevention and promotion. In this context, public health actors are invited to adopt a leadership role in advancing mental health promotion and mental disorder prevention goals, and establish the required partnerships with actors from the health and social services and from other sectors who are indispensable to the population mental health agenda. In Canada, public heath actors are not yet sufficiently supported in this role. They express the need to access structuring frameworks which can clarify their action in mental health. This article first presents the momentum for change at the policy level within the field of mental health. A framework to support population mental health action is then presented. The framework identifies the various dimensions underlying the promotion of population mental health as well as the reduction of mental health inequalities. The article finally illustrates how the application of a populational (the application of a populational responsibility perspective) responsibility perspective, as it is defined in the context of Quebec, facilitates the implementation of the various elements of this framework. In the end, public health actors are better equipped to situate their practice in favour of the population's mental health.

Prioritizing the 21st Century Superintendent's Skill Set and Knowledge Base from the School Board Leadership Perspective

ERIC Educational Resources Information Center

Shaw, Teri L.

2014-01-01

The purpose of this study was to identify the extent that specific research based skill sets and areas of knowledge emerged as highly important, moderately important, and less important from the perspective of school board leadership as it pertains to 21st century superintendents. The study further disaggregated the data by specific school…

Human Ecology: Persistence and Change.

ERIC Educational Resources Information Center

Hawley, Amos H.

1981-01-01

Demonstrates the relevance of ecology to sociological research and discusses some of the theoretical perspectives embodied in ecology. Examines ecology's emphasis upon the population rather than the individual as the unit of observation and on organizations as products of the interaction of population and environment. (DB)

Ethical issues in using Twitter for population-level depression monitoring: a qualitative study.

PubMed

Mikal, Jude; Hurst, Samantha; Conway, Mike

2016-04-14

Recently, significant research effort has focused on using Twitter (and other social media) to investigate mental health at the population-level. While there has been influential work in developing ethical guidelines for Internet discussion forum-based research in public health, there is currently limited work focused on addressing ethical problems in Twitter-based public health research, and less still that considers these issues from users' own perspectives. In this work, we aim to investigate public attitudes towards utilizing public domain Twitter data for population-level mental health monitoring using a qualitative methodology. The study explores user perspectives in a series of five, 2-h focus group interviews. Following a semi-structured protocol, 26 Twitter users with and without a diagnosed history of depression discussed general Twitter use, along with privacy expectations, and ethical issues in using social media for health monitoring, with a particular focus on mental health monitoring. Transcripts were then transcribed, redacted, and coded using a constant comparative approach. While participants expressed a wide range of opinions, there was an overall trend towards a relatively positive view of using public domain Twitter data as a resource for population level mental health monitoring, provided that results are appropriately aggregated. Results are divided into five sections: (1) a profile of respondents' Twitter use patterns and use variability; (2) users' privacy expectations, including expectations regarding data reach and permanence; (3) attitudes towards social media based population-level health monitoring in general, and attitudes towards mental health monitoring in particular; (4) attitudes towards individual versus population-level health monitoring; and (5) users' own recommendations for the appropriate regulation of population-level mental health monitoring. Focus group data reveal a wide range of attitudes towards the use of public-domain social media "big data" in population health research, from enthusiasm, through acceptance, to opposition. Study results highlight new perspectives in the discussion of ethical use of public data, particularly with respect to consent, privacy, and oversight.

The Temporal Perspective in Higher Education Learners: Comparisons between Online and Onsite Learning

ERIC Educational Resources Information Center

Romero, Margarida; Usart, Mireia

2014-01-01

Higher Education increases flexibility with online learning solutions. Nevertheless, dropout rates in online university are large. Among the reasons, one aspect deserving further study is students' Time Perspective (TP), which has been studied in onsite HE. It is necessary to know the TP profile of the growing population of online students, and…

Successful Practices for Immigrant Parent Involvement: An Ontario Perspective

ERIC Educational Resources Information Center

Ladky, Mary; Peterson, Shelley Stagg

2008-01-01

This article brings together the perspectives of 21 immigrant parents who speak eight different languages and have been in Canada less than six years with those of 61 teachers and 32 principals who work in schools with English as a second language (ESL) populations of 20% or greater who have been recognized for successfully involving immigrant…

The Dynamics of Mobile Learning Utilization in Vocational Education: Frame Model Perspective Review

ERIC Educational Resources Information Center

Mahande, Ridwan Daud; Susanto, Adhi; Surjono, Herman Dwi

2017-01-01

This study aimed to describe the dynamics of content aspects, user aspects and social aspects of mobile learning utilization (m-learning) in vocational education from the FRAME Model perspective review. This study was quantitative descriptive research. The population in this study was teachers and students of state vocational school and private…

Independent Living and Attendant Care in Sweden: A Consumer Perspective. Monograph Number Thirty-Four.

ERIC Educational Resources Information Center

Ratzka, Adolf D.

The monograph presents, from the disabled consumer's perspective, a description and critique of independent living and attendant care services in Sweden. First, a brief description of Swedish welfare policy as it applies to the population as a whole is presented. Next, services available to people with disabilities are described with emphasis on…

Framing Health Messages for Adolescents: Should We Use Objective Time Periods, Temporal Benchmarks, or Both?

ERIC Educational Resources Information Center

McKay, Michael T.; Cole, Jon C.; Sumnall, Harry R.; Goudie, Andrew J.

2012-01-01

Time perspective is a cognitive-motivational construct, which has been shown to be related to decision-making, motivation and adjustment. The majority of research into time perspective has been conducted in college students and/or general population samples. Focus groups were held as part of a larger investigation into the relationship between…

Occupational stress in the multicultural workplace.

PubMed

Pasca, Romana; Wagner, Shannon L

2011-08-01

Occupational stress is a well researched topic leading to the development of strong, viable models of workplace stress. However, there is a gap in the literature with respect to the applicability of this research to specific cultural groups, in particular those of immigrant status. The present paper reviews the extant literature regarding occupational stress from a multicultural perspective, evaluates the usefulness for existing models in the multicultural context, and discusses current issues with respect to increasing multiculturalism in the work environment. The authors conclude that workforce diversity is emerging as a pressing issue of organizational life and consequently, that future research needs to continue investigating whether current knowledge regarding workplace stress is fitting with the multicultural diversity of the present-day working population.

Childhood obesity policy: implications for African American girls and a nursing ecological model.

PubMed

Reed, Monique

2013-01-01

In the United States there is a prevalence of obesity among ethnic groups, especially African American girls. The author in this column examines through an ecological lens selected American federal, state, and city policies and program interventions aimed at reducing obesity. Specifically, the eating behavior of African American girls is discussed as a population subset for which significant gaps are present in current obesity policy and implementation. Policy recommendations should include parents as research has shown a significant relationship in the eating behaviors of African American girls and their parents. Opportunities for nurses in practice and research to test the effectiveness of family and community level policy and program initiatives that address the ecological perspectives of the adolescent environment are discussed.

High Density or Urban Sprawl: What Works Best in Biology?

PubMed

Oreopoulos, John; Gray-Owen, Scott D; Yip, Christopher M

2017-02-28

With new approaches in imaging-from new tools or reagents to processing algorithms-come unique opportunities and challenges to our understanding of biological processes, structures, and dynamics. Although innovations in super-resolution imaging are affording novel perspectives into how molecules structurally associate and localize in response to, or in order to initiate, specific signaling events in the cell, questions arise as to how to interpret these observations in the context of biological function. Just as each neighborhood in a city has its own unique vibe, culture, and indeed density, recent work has shown that membrane receptor behavior and action is governed by their localization and association state. There is tremendous potential in developing strategies for tracking how the populations of these molecular neighborhoods change dynamically.

Prostate Cancer Epigenome

PubMed Central

Chinaranagari, Swathi; Sharma, Pankaj; Bowen, Nathan J.; Chaudhary, Jaideep

2018-01-01

Prostate cancer is a major health burden within the ever-increasingly aging US population. The molecular mechanisms involved in prostate cancer are diverse and heterogeneous. In this context, epigenetic changes, both global and gene specific, are now an emerging alternate mechanism in disease initiation and progression. The three major risk factors in prostate cancer: age, geographic ancestry, and environment are all influenced by epigenetics and additional significant insight is required to gain an understanding of the underlying mechanisms. The androgen receptor and its downstream effector pathways, central to prostate cancer initiation and progression, are subject to a multitude of epigenetic alterations. In this review we focus on the global perspective of epigenetics and the use of recent next-generation sequencing platforms to interrogate epigenetic changes in the prostate cancer genome. PMID:25421658

Prostate cancer epigenome.

PubMed

Chinaranagari, Swathi; Sharma, Pankaj; Bowen, Nathan J; Chaudhary, Jaideep

2015-01-01

Prostate cancer is a major health burden within the ever-increasingly aging US population. The molecular mechanisms involved in prostate cancer are diverse and heterogeneous. In this context, epigenetic changes, both global and gene specific, are now an emerging alternate mechanism in disease initiation and progression. The three major risk factors in prostate cancer: age, geographic ancestry, and environment are all influenced by epigenetics and additional significant insight is required to gain an understanding of the underlying mechanisms. The androgen receptor and its downstream effector pathways, central to prostate cancer initiation and progression, are subject to a multitude of epigenetic alterations. In this review we focus on the global perspective of epigenetics and the use of recent next-generation sequencing platforms to interrogate epigenetic changes in the prostate cancer genome.

A geometric morphometric study of regional differences in the ontogeny of the modern human facial skeleton.

PubMed

Vioarsdóttir, Una Strand; O'Higgins, Paul; Stringer, Chris

2002-09-01

This study examines interpopulation variations in the facial skeleton of 10 modern human populations and places these in an ontogenetic perspective. It aims to establish the extent to which the distinctive features of adult representatives of these populations are present in the early post natal period and to what extent population differences in ontogenetic scaling and allometric trajectories contribute to distinct facial forms. The analyses utilize configurations of facial landmarks and are carried out using geometric morphometric methods. The results of this study show that modern human populations can be distinguished based on facial shape alone, irrespective of age or sex, indicating the early presence of differences. Additionally, some populations have statistically distinct facial ontogenetic trajectories that lead to the development of further differences later in ontogeny. We conclude that population-specific facial morphologies develop principally through distinctions in facial shape probably already present at birth and further accentuated and modified to variable degrees during growth. These findings raise interesting questions regarding the plasticity of facial growth patterns in modern humans. Further, they have important implications in relation to the study of growth in the face of fossil hominins and in relation to the possibility of developing effective discriminant functions for the identification of population affinities of immature facial skeletal material. Such tools would be of value in archaeological, forensic and anthropological applications. The findings of this study underline the need to examine more deeply, and in more detail, the ontogenetic basis of other causes of craniometric variation, such as sexual dimorphism and hominin species differentiation.

[Tuberculosis among the socially vulnerable populations; perspectives from human security concept].

PubMed

Ishikawa, Nobukatsu

2009-07-01

Tuberculosis (TB) has been and will continue to be the disease of the poor and the socially vulnerable. Current TB epidemiology in Japan shows increasing proportion of TB among the economically and socially poor or vulnerable populations. Though there is no universally recognized set of the definitions, the economically poor who are covered under the social security services including the homeless, foreign migrants, or the aged over 80 years may be considered as consisting the "socially vulnerable population" for TB in Japan. TB among the socially vulnerable has several characteristics, for example, patients are often detected with severe conditions due to delayed diagnosis, and have high defaulter rate during treatment, which causes immature death, or drug-resistant disease. Stop TB Strategy by WHO, responding to the Millennium Development Goals, proposes a new approach which focuses on empowering the patients and the community. Observations from various studies show that DOTS contributes to empowering the patients and the communities. Further effort will be needed to reorient TB programs towards the perspective of patients' empowerment. Solely relying on static analyses of TB among the socially vulnerable has its limitations. Dynamic approach, which utilizes human security concepts such as empowerment and patients' perspective, will be required not only to control TB among the socially vulnerable population but also to holistically tackle the problem of TB for Japan.

Bedtime procrastination: A self-regulation perspective on sleep insufficiency in the general population.

PubMed

Kroese, Floor M; Evers, Catharine; Adriaanse, Marieke A; de Ridder, Denise T D

2016-05-01

Getting insufficient sleep has serious consequences in terms of mental and physical health. The current study is the first to approach insufficient sleep from a self-regulation perspective by investigating the phenomenon of bedtime procrastination: going to bed later than intended, without having external reasons for doing so. Data from a representative sample of Dutch adults (N = 2431) revealed that a large proportion of the general population experiences getting insufficient sleep and regularly goes to bed later than they would like to. Most importantly, a relationship between self-regulation and experienced insufficient sleep was found, which was mediated by bedtime procrastination. © The Author(s) 2014.

Marketing active transportation to school to improve children's health: Utilizing parental perspectives from an inner-city environment.

PubMed

Royne, Marla B; Ivey, Stephanie S; Levy, Marian; Fox, Alexa K; Roakes, Susan L

2016-01-01

Thirty years ago, nearly half of the children in the United States walked or rode their bikes to school. Today, less than 15% of children actively commute to school. With the growing obesity epidemic, encouraging children to walk or bike to school has become a national priority. This research examines factors that influence parental decisions allowing their children to walk to school in an urban environment to identify effective marketing and communication strategies to reach those parents. Results indicate differences in parental perspectives across populations; suggestions for effectively marketing the Safe Routes to School program to minority populations are provided.

The failure of academic epidemiology: witness for the prosecution.

PubMed

Shy, C M

1997-03-15

Academic epidemiology has failed to develop the scientific methods and the knowledge base to support the fundamental public health mission of preventing disease and promoting health through organized community efforts. As a basic science of public health, epidemiology should attempt to understand health and disease from a community and ecologic perspective as a consequence of how society is organized and behaves, what impact social and economic forces have on disease incidence rates, and what community actions will be effective in altering incidence rates. However, as taught in most textbooks and as widely practiced by academicians, epidemiology has become a biomedical discipline focused on the distribution and determinants of disease in groups of individuals who happen to have some common characteristics, exposures, or diseases. The ecology of human health has not been addressed, and the societal context in which disease occurs has been either disregarded or deliberately abstracted from consideration. By essentially assuming that risk factors for disease in individuals can be summed to understand the causes of disease in populations, academic epidemiology has limited itself to a narrow biomedical perspective, thereby committing the bio-medical fallacy of inferring that disease in populations can be understood by studying risk factors for disease in individuals. Epidemiology should be redefined as a study of the distribution and societal determinants of the health status of populations. This definition provides a stronger link to be the primary mission of public health and places an appropriate emphasis on the social, economic, environmental, and cultural determinants of population health. Epidemiology must cross the boundaries of other population sciences and add to its scope a macro-epidemiology, a study of causes from a truly population perspective, considering health and disease within the context of the total human environment.

Patient and provider perspectives on Bedsider.org, an online contraceptive information tool, in a low income, racially diverse clinic population.

PubMed

Gressel, Gregory M; Lundsberg, Lisbet S; Illuzzi, Jessica L; Danton, Cheryl M; Sheth, Sangini S; Xu, Xiao; Gariepy, Aileen

2014-12-01

To explore patient and provider perspectives regarding a new Web-based contraceptive support tool. We conducted a qualitative study at an urban Medicaid-based clinic among sexually active women interested in starting a new contraceptive method, clinic providers and staff. All participants were given the opportunity to explore Bedsider, an online contraceptive support tool developed for sexually active women ages 18-29 by the National Campaign to Prevent Teen and Unplanned Pregnancy and endorsed by the American Congress of Obstetricians and Gynecologists. Focus groups were conducted separately among patient participants and clinic providers/staff using open-ended structured interview guides to identify specific themes and key concepts related to use of this tool in an urban clinic setting. Patient participants were very receptive to this online contraceptive support tool, describing it as trustworthy, accessible and empowering. In contrast, clinic providers and staff had concerns regarding the Website's legitimacy, accessibility, ability to empower patients and applicability, which limited their willingness to recommend its use to patients. Contrasting opinions regarding Bedsider may point to a potential disconnect between how providers and patients view contraception information tools. Further qualitative and quantitative studies are needed to explore women's perspectives on contraceptive education and counseling and providers' understanding of these perspectives. This study identifies a contrast between how patients and providers in an urban clinic setting perceive a Web-based contraceptive tool. Given a potential patient-provider discrepancy in preferred methods and approaches to contraceptive counseling, additional research is needed to enhance this important arena of women's health care. Copyright © 2014 Elsevier Inc. All rights reserved.

The Relation between Feedback Perceptions and the Supervisor-Student Relationship in Master's Thesis Projects

ERIC Educational Resources Information Center

de Kleijn, Renske A. M.; Meijer, Paulien C.; Pilot, Albert; Brekelmans, Mieke

2014-01-01

Research supervision can be investigated from social-emotional and cognitive perspectives, but most studies include only one perspective. This study aims to understand the interplay between a social-emotional (supervisor-student relationship) and cognitive (feedback) perspective on the outcomes of master's thesis supervision in specific, by…

What the Teaching Perspectives of Cooperating Teachers Tell US about Their Advisory Practices

ERIC Educational Resources Information Center

Clarke, A.; Jarvis-Selinger, S.

2005-01-01

This study drew upon the recently developed Teaching Perspectives Inventory (TPI) to compare and contrast the teaching perspectives of cooperating teachers against a range of demographic data specific to cooperating teachers. The outcomes indicate, among other things, that a high percentage of cooperating teachers base their pedagogical…

Ethical Perspectives, Reactions to Other's Moral Behavior, and Consequent Moral Action.

ERIC Educational Resources Information Center

Pope, William R.; Forsyth, Donelson R.

In analyzing various moral and legal philosophies, two perspectives emerge, absolute moral rules/higher law, and situationally-specific moral rules/legal positivism. From these two perspectives, four types of individuals emerge in accordance with their degree of adherence to ideological tenets: (1) situationists (high on idealism and relativism);…

Comprehensive elements of a physiotherapy exercise programme in haemophilia--a global perspective.

PubMed

Blamey, G; Forsyth, A; Zourikian, N; Short, L; Jankovic, N; De Kleijn, P; Flannery, T

2010-07-01

Exercise programmes for people with haemophilia are usually designed and implemented to help manage the recovery after a haemarthrosis or a muscle bleed, or as a tool to help prevent bleeding episodes from occurring. In this article, we have identified individual components of exercise that are often applied as separate entities, but may also need to be implemented in concert for optimized impact. Although it may be necessary on occasion to bias an exercise programme towards one component over the others, it is important to recognize that the various elements of exercise are not mutually exclusive. Decreased flexibility, strength and proprioception, will result in an impairment of balance and a loss of function. Programme design should whenever possible be guided by proven methodology in terms of how each component is incorporated, and more specifically how long to perform the exercise for and how many repetitions should be performed. We recognize, however, that this is not always possible and that there is significant value in drawing from the experience of clinicians with specialized training in the management of haemophilia. In this study, both perspectives are presented, providing reference-based reviews of the mechanics of the various elements of exercise as well as the expert opinions of the authors. Research that has been completed using patients with conditions other than haemophilia may or may not have a direct application with the bleeding disorders population, but the programme design based on principles of tissue healing in addition to disease specific knowledge should be encouraged.

Maximising the Use of Evidence: Exploring the Intersection between Population Health Intervention Research and Knowledge Translation from a Canadian Perspective

ERIC Educational Resources Information Center

Hobin, Erin P.; Hayward, Sarah; Riley, Barbara; Di Ruggiero, Erica; Birdsell, Judy

2012-01-01

Population and public health research has been shifting from describing factors that shape health to an interrogation of the processes and outcomes underpinning policy and programme interventions. This shift has given rise to acknowledging population health intervention research (PHIR) as a distinct field of study in Canada. Given that PHIR aims…

A retrospective perspective: evaluating population changes by repeating historic bird surveys

Treesearch

Lawrence D. Igl; Douglas H. Johnson

2005-01-01

Acquiring an accurate picture of the changes in bird populations often involves a trade-off between the time and effort required to complete the surveys and the number of years spent surveying the bird populations. An alternative approach to long-term monitoring efforts is to collect current data and contrast those with data collected earlier in a similar fashion on...

Changes in Student Populations and Average Test Scores of Dutch Primary Schools

ERIC Educational Resources Information Center

Luyten, Hans; de Wolf, Inge

2011-01-01

This article focuses on the relation between student population characteristics and average test scores per school in the final grade of primary education from a dynamic perspective. Aggregated data of over 5,000 Dutch primary schools covering a 6-year period were used to study the relation between changes in school populations and shifts in mean…

On Adopting Solutions to Improve Population Health: Do We Have the Political Will?

ERIC Educational Resources Information Center

Galea, Sandro

2016-01-01

In this column, Sandro Galea addresses what would be required to identify and implement solutions that can improve the health of populations. Galea suggests that two perspectives need to inform solutions that might prove successful. First, solutions that aim to improve the health of populations need to be grounded in clarity of purpose, aiming to…

Population Profiles; A Series of 14 Units, Plus Extras, for the Study of Demography. Numbers 8 and 9.

ERIC Educational Resources Information Center

Lee, Everett S.; Bouvier, Leon F.

"Growth and Future of Cities" and "The Nation's Minorities" are units eight and nine, respectively from the fourteen-units series Population Profiles. The former initiates its consideration of our urban future with two divergent points of view on population distribution. Those views are brought into perspective by an historical investigation of…

The biology of small, introduced populations, with special reference to biological control

PubMed Central

Fauvergue, Xavier; Vercken, Elodie; Malausa, Thibaut; Hufbauer, Ruth A

2012-01-01

Populations are introduced into novel environments in different contexts, one being the biological control of pests. Despite intense efforts, less than half introduced biological control agents establish. Among the possible approaches to improve biological control, one is to better understand the processes that underpin introductions and contribute to ecological and evolutionary success. In this perspective, we first review the demographic and genetic processes at play in small populations, be they stochastic or deterministic. We discuss the theoretical outcomes of these different processes with respect to individual fitness, population growth rate, and establishment probability. Predicted outcomes differ subtly in some cases, but enough so that the evaluating results of introductions have the potential to reveal which processes play important roles in introduced populations. Second, we attempt to link the theory we have discussed with empirical data from biological control introductions. A main result is that there are few available data, but we nonetheless report on an increasing number of well-designed, theory-driven, experimental approaches. Combining demography and genetics from both theoretical and empirical perspectives highlights novel and exciting avenues for research on the biology of small, introduced populations, and great potential for improving both our understanding and practice of biological control. PMID:22949919

Expanding the universe of universal coverage: the population health argument for increasing coverage for immigrants.

PubMed

Nandi, Arijit; Loue, Sana; Galea, Sandro

2009-12-01

As the US recession deepens, furthering the debate about healthcare reform is now even more important than ever. Few plans aimed at facilitating universal coverage make any mention of increasing access for uninsured non-citizens living in the US, many of whom are legally restricted from certain types of coverage. We conducted a critical review of the public health literature concerning the health status and access to health services among immigrant populations in the US. Using examples from infectious and chronic disease epidemiology, we argue that access to health services is at the intersection of the health of uninsured immigrants and the general population and that extending access to healthcare to all residents of the US, including undocumented immigrants, is beneficial from a population health perspective. Furthermore, from a health economics perspective, increasing access to care for immigrant populations may actually reduce net costs by increasing primary prevention and reducing the emphasis on emergency care for preventable conditions. It is unlikely that proposals for universal coverage will accomplish their objectives of improving population health and reducing social disparities in health if they do not address the substantial proportion of uninsured non-citizens living in the US.

Australian engineering educators' attitudes towards Aboriginal cultures and perspectives

NASA Astrophysics Data System (ADS)

Goldfinch, Thomas; Prpic, Juliana Kaya; Jolly, Lesley; Leigh, Elyssebeth; Kennedy, Jade

2017-07-01

In Australia, representation of Aboriginal populations within the engineering profession is very low despite participation targets set by Government departments, professional bodies and Universities. Progressing the Aboriginal inclusion agenda within Australian Engineering Education requires a clearer understanding of engineering educators' preparedness for increased numbers of students from this non-traditional cohort. This research stems from a recently completed project that explored Aboriginal perspectives in engineering education and proposed a model for embedding perspectives in curricula. Nine engineering academics were interviewed to explore attitudes towards Aboriginal perspectives in engineering and the viability of the proposed model. Results of the interviews indicate efforts to embed Aboriginal perspectives are starting from a small base of knowledge and experience. Individuals' motivations and values indicate that there is significant support for improving this, but that efforts can be hampered by conceptions of Aboriginal perspectives that do not consider how Aboriginal knowledges may change engineering itself.

Key Data on Adolescence.

ERIC Educational Resources Information Center

Coleman, John

In order to counteract widespread stereotyping of adolescents and to provide a historical perspective on the lives of youth in Great Britain, this report compiles statistical data in six areas regarding adolescents and youth. Chapter 1, "Population, Families and Households," presents information on the population of the United Kingdom…

Are Statisticians Cold-Blooded Bosses? A New Perspective on the "Old" Concept of Statistical Population

ERIC Educational Resources Information Center

Lu, Yonggang; Henning, Kevin S. S.

2013-01-01

Spurred by recent writings regarding statistical pragmatism, we propose a simple, practical approach to introducing students to a new style of statistical thinking that models nature through the lens of data-generating processes, not populations. (Contains 5 figures.)

Management of aggressive B cell NHLs in the AYA population: an adult versus pediatric perspective.

PubMed

Dunleavy, Kieron; Gross, Thomas G

2018-06-12

The adolescents and young adult (AYA) population represent a group where mature B-cell lymphomas constitute a significant proportion of the overall malignancies that occur. Among these are aggressive B-cell non-Hodgkin lymphomas (NHLs) which are predominantly diffuse large B-cell lymphoma (DLBCL), primary mediastinal B-cell lymphoma (PMBCL) and Burkitt lymphoma (BL). For the most part, there is remarkable divide in how pediatric/adolescent patients (under the age of 18 years) with lymphoma are treated versus their young adult counterparts and molecular data are lacking, especially in pediatric and AYA series. The outcome for AYA patients with cancers has historically been inferior to that of children or older adults, highlighting the necessity to focus on this population. This review discusses the pediatric versus adult perspective in terms of how these diseases are understood and approached and emphasizes the importance of collaborative efforts in both developing consensus for treatment of this population and planning future research endeavors. Copyright © 2018 American Society of Hematology.

Changes in visual perspective influence brain activity patterns during cognitive perspective-taking of other people's pain.

PubMed

Vistoli, Damien; Achim, Amélie M; Lavoie, Marie-Audrey; Jackson, Philip L

2016-05-01

Empathy refers to our capacity to share and understand the emotional states of others. It relies on two main processes according to existing models: an effortless affective sharing process based on neural resonance and a more effortful cognitive perspective-taking process enabling the ability to imagine and understand how others feel in specific situations. Until now, studies have focused on factors influencing the affective sharing process but little is known about those influencing the cognitive perspective-taking process and the related brain activations during vicarious pain. In the present fMRI study, we used the well-known physical pain observation task to examine whether the visual perspective can influence, in a bottom-up way, the brain regions involved in taking others' cognitive perspective to attribute their level of pain. We used a pseudo-dynamic version of this classic task which features hands in painful or neutral daily life situations while orthogonally manipulating: (1) the visual perspective with which hands were presented (first-person versus third-person conditions) and (2) the explicit instructions to imagine oneself or an unknown person in those situations (Self versus Other conditions). The cognitive perspective-taking process was investigated by comparing Other and Self conditions. When examined across both visual perspectives, this comparison showed no supra-threshold activation. Instead, the Other versus Self comparison led to a specific recruitment of the bilateral temporo-parietal junction when hands were presented according to a first-person (but not third-person) visual perspective. The present findings identify the visual perspective as a factor that modulates the neural activations related to cognitive perspective-taking during vicarious pain and show that this complex cognitive process can be influenced by perceptual stages of information processing. Copyright © 2016 Elsevier Ltd. All rights reserved.

Parental Perspectives during the Transition to Adulthood of Adolescents with a History of Specific Language Impairment (SLI)

ERIC Educational Resources Information Center

Conti-Ramsden, Gina; Botting, Nicola; Durkin, Kevin

2008-01-01

Purpose: This is the 2nd article of a companion set (the 1st article being on language and independence). It presents research examining parental perspectives on aspects of impairment in their offspring involving families rearing children with specific language impairment (SLI). Method: The same sample as that of the 1st study participated in this…

New Perspectives on the Diagnosis of Allergy to Anisakis spp.

PubMed

Moneo, Ignacio; Carballeda-Sangiao, Noelia; González-Muñoz, Miguel

2017-05-01

To compare the prevalence of sensitization in different countries based on specific IgE values and to evaluate the use of isolated native or recombinant allergens for diagnosis. Isolated allergens help in the diagnosis of truly sensitized patients avoiding false positives due to cross-reactions. Their use is therefore highly recommended, especially when used as a combination of several relevant allergens. The use of purified allergens allows an accurate diagnosis and this has led to three important findings: (1) in addition to the digestive route of sensitization, occupational and non-digestive exposure seems to be clinically relevant. (2) The parasite appears as an important agent for chronic urticaria. And (3) in endemic countries, the amount of highly sensitized subjects in the general population could be as high as 7%. Adequate information to asymptomatic patients on fish consumption habits would avoid new contacts with parasite allergens and decrease their specific IgE levels and consequently the appearance of acute or chronic episodes induced by the parasite.

"Knowing That You're Not the Only One": Perspectives on Group-Based Cognitive-Behavioral Therapy for Adherence and Depression (CBT-AD) in Adults With Type 1 Diabetes.

PubMed

Esbitt, Sabrina A; Batchelder, Abigail W; Tanenbaum, Molly L; Shreck, Erica; Gonzalez, Jeffrey S

2015-08-01

Depression and illness-specific distress are more common among adults with Type 1 diabetes (T1DM) than the general population and have been associated with poorer control of blood glucose and increased risk for serious diabetes-related complications. Treatment nonadherence has also been associated with depressive symptoms and diabetes-related distress, and has repeatedly been suggested as an important modifiable behavioral pathway linking depression and diabetes outcomes. The present study reports on the feasibility and acceptability of a pilot intervention using group-based cognitive-behavioral therapy to improve treatment adherence among adults with T1DM and elevated levels of diabetes-related distress or depressive symptoms. We describe the components of the intervention and utilize qualitative data along with descriptive outcome data. Our findings suggest that participation in the group was acceptable and associated with reductions in depressive symptoms and diabetes-specific distress. Challenges to feasibility and future directions are discussed.

Androgens and Androgen Derivatives: Science, Myths, and Theories: Explored From a Special Operations Perspective.

PubMed

Givens, Melissa L; Deuster, Patricia

2015-01-01

Androgen use outside of legitimate medical therapy is a perceived concern that is drawing attention across military and specifically Special Operations Forces (SOF) communities. For leadership and the medical community to properly address the issue and relate to those individuals who are using or considering use, it will be crucial to understand the scope of the problem. Limited data suggest that the prevalence of androgen use may be increasing, and inferences made from the scientific literature suggest that SOF may be a population of concern. While risks of androgen use are well known, there are little data specific to military performance that can be applied to a rigorous risk:benefit analysis, allowing myths and poorly supported theories to perpetuate within the community. Further efforts to define the potential benefits balanced against the short- and long-term risks should be undertaken. Providers within the SOF community should arm themselves with information to engage androgen users and leadership in meaningful discussion regarding androgen use. 2015.

The shared and specific relationships between exposure to potentially traumatic events and transdiagnostic dimensions of psychopathology.

PubMed

Sunderland, Matthew; Carragher, Natacha; Chapman, Cath; Mills, Katherine; Teesson, Maree; Lockwood, Emma; Forbes, David; Slade, Tim

2016-03-01

The experience of traumatic events has been linked to the development of psychopathology. Changing perspectives on psychopathology have resulted in the hypothesis that broad dimensional constructs account for the majority of variance across putatively distinct disorders. As such, traumatic events may be associated with several disorders due to their relationship with these broad dimensions rather than any direct disorder-specific relationship. The current study used data from 8871 Australians to test this hypothesis. Two broad dimensions accounted for the majority of relationships between traumatic events and mental and substance use disorders. Direct relationships remained between post-traumatic stress disorder and six categories of traumatic events in the total population and between drug dependence and accidents/disasters for males only. These results have strong implications for how psychopathology is conceptualized and offer some evidence that traumatic events are associated with an increased likelihood of experiencing psychopathology in general. Copyright © 2016 Elsevier Ltd. All rights reserved.

Population groups: indexing, coverage, and retrieval effectiveness of ethnically related health care issues in health sciences databases.

PubMed Central

Efthimiadis, E N; Afifi, M

1996-01-01

OBJECTIVES: This study examined methods of accessing (for indexing and retrieval purposes) medical research on population groups in the major abstracting and indexing services of the health sciences literature. DESIGN: The study of diseases in specific population groups is facilitated by the indexing of both diseases and populations in a database. The MEDLINE, PsycINFO, and Embase databases were selected for the study. The published thesauri for these databases were examined to establish the vocabulary in use. Indexing terms were identified and examined as to their representation in the current literature. Terms were clustered further into groups thought to reflect an end user's perspective and to facilitate subsequent analysis. The medical literature contained in the three online databases was searched with both controlled vocabulary and natural language terms. RESULTS: The three thesauri revealed shallow pre-coordinated hierarchical structures, rather difficult-to-use terms for post-coordination, and a blurring of cultural, genetic, and racial facets of populations. Post-coordination is difficult because of the system-oriented terminology, which is intended mostly for information professionals. The terminology unintentionally restricts access by the end users who lack the knowledge needed to use the thesauri effectively for information retrieval. CONCLUSIONS: Population groups are not represented adequately in the index languages of health sciences databases. Users of these databases need to be alerted to the difficulties that may be encountered in searching for information on population groups. Information and health professionals may not be able to access the literature if they are not familiar with the indexing policies on population groups. Consequently, the study points to a problem that needs to be addressed, through either the redesign of existing systems or the design of new ones to meet the goals of Healthy People 2000 and beyond. PMID:8883987

Can invasions occur without change? A comparison of G-matrices and selection in the peach-potato aphid, Myzus persicae

PubMed Central

Bacigalupe, Leonardo D; Barrientos, Karin; Beckerman, Andrew P; Carter, Mauricio J; Figueroa, Christian C; Foster, Stephen P; Moore, Allen J; Silva, Andrea X; Nespolo, Roberto F

2013-01-01

Most evolutionary research on biological invasions has focused on changes seen between the native and invaded range for a particular species. However, it is likely that species that live in human-modified habitats in their native range might have evolved specific adaptations to those environments, which increase the likelihood of establishment and spread in similar human-altered environments. From a quantitative genetic perspective, this hypothesis suggests that both native and introduced populations should reside at or near the same adaptive peak. Therefore, we should observe no overall changes in the G (genetic variance–covariance) matrices between native and introduced ranges, and stabilizing selection on fitness-related traits in all populations. We tested these predictions comparing three populations of the worldwide pest Myzus persicae from the Middle East (native range) and the UK and Chile (separately introduced ranges). In general, our results provide mixed support for this idea, but further comparisons of other species are needed. In particular, we found that there has been some limited evolution in the studied traits, with the Middle East population differing from the UK and Chilean populations. This was reflected in the structure of the G-matrices, in which Chile differed from both UK and Middle East populations. Furthermore, the amount of genetic variation was massively reduced in Chile in comparison with UK and Middle East populations. Finally, we found no detectable selection on any trait in the three populations, but clones from the introduced ranges started to reproduce later, were smaller, had smaller offspring, and had lower reproductive fitness than clones from the native range. PMID:24455140

Promoting LGBT health and wellbeing through inclusive policy development

PubMed Central

Mulé, Nick J; Ross, Lori E; Deeprose, Barry; Jackson, Beth E; Daley, Andrea; Travers, Anna; Moore, Dick

2009-01-01

In this paper we argue the importance of including gender and sexually diverse populations in policy development towards a more inclusive form of health promotion. We emphasize the need to address the broad health and wellbeing issues and needs of LGBT people, rather than exclusively using an illness-based focus such as HIV/AIDS. We critically examine the limitations of population health, the social determinants of health (SDOH), and public health goals, in light of the lack of recognition of gender and sexually diverse individuals and communities. By first acknowledging the unique health and social care needs of LGBT people, then employing anti-oppressive, critical and intersectional analyses we offer recommendations for how to make population health perspectives, public health goals, and the design of public health promotion policy more inclusive of gender and sexual diversity. In health promotion research and practice, representation matters. It matters which populations are being targeted for health promotion interventions and for what purposes, and it matters which populations are being overlooked. In Canada, current health promotion policy is informed by population health and social determinants of health (SDOH) perspectives, as demonstrated by Public Health Goals for Canada. With Canada's multicultural makeup comes the challenge of ensuring that diverse populations are equitably and effectively recognized in public health and health promotion policy. PMID:19442315

Promoting LGBT health and wellbeing through inclusive policy development.

PubMed

Mulé, Nick J; Ross, Lori E; Deeprose, Barry; Jackson, Beth E; Daley, Andrea; Travers, Anna; Moore, Dick

2009-05-15

In this paper we argue the importance of including gender and sexually diverse populations in policy development towards a more inclusive form of health promotion. We emphasize the need to address the broad health and wellbeing issues and needs of LGBT people, rather than exclusively using an illness-based focus such as HIV/AIDS. We critically examine the limitations of population health, the social determinants of health (SDOH), and public health goals, in light of the lack of recognition of gender and sexually diverse individuals and communities. By first acknowledging the unique health and social care needs of LGBT people, then employing anti-oppressive, critical and intersectional analyses we offer recommendations for how to make population health perspectives, public health goals, and the design of public health promotion policy more inclusive of gender and sexual diversity. In health promotion research and practice, representation matters. It matters which populations are being targeted for health promotion interventions and for what purposes, and it matters which populations are being overlooked. In Canada, current health promotion policy is informed by population health and social determinants of health (SDOH) perspectives, as demonstrated by Public Health Goals for Canada. With Canada's multicultural makeup comes the challenge of ensuring that diverse populations are equitably and effectively recognized in public health and health promotion policy.

The evolution of syntax: an exaptationist perspective.

PubMed

Fitch, W Tecumseh

2011-01-01

The evolution of language required elaboration of a number of independent mechanisms in the hominin lineage, including systems involved in signaling, semantics, and syntax. Two perspectives on the evolution of syntax can be contrasted. The "continuist" perspective seeks the evolutionary roots of complex human syntax in simpler combinatory systems used in animal communication systems, such as iteration and sequencing. The "exaptationist" perspective posits evolutionary change of function, so that systems today used for linguistic communication might previously have served quite different functions in earlier hominids. I argue that abundant biological evidence supports an exaptationist perspective, in general, and that it must be taken seriously when considering language evolution. When applied to syntax, this suggests that core computational components used today in language could have originally served non-linguistic functions such as motor control, non-verbal thought, or spatial reasoning. I outline three specific exaptationist hypotheses for spoken language. These three hypotheses each posit a change of functionality in a precursor circuit, and its transformation into a neural circuit or region specifically involved in language today. Hypothesis 1 suggests that the precursor mechanism for intentional vocal control, specifically direct cortical control over the larynx, was manual motor control subserved by the cortico-spinal tract. The second is that the arcuate fasciculus, which today connects syntactic and lexical regions, had its origin in intracortical connections subserving vocal imitation. The third is that the specialized components of Broca's area, specifically BA 45, had their origins in non-linguistic motor control, and specifically hierarchical planning of action. I conclude by illustrating the importance of both homology (studied via primates) and convergence (typically analyzed in birds) for testing such evolutionary hypotheses.

Perspectives of Using Internet on the Scientific Research among the Postgraduate Students at the University of Khartoum-Sudan

ERIC Educational Resources Information Center

Al Hassan, Esam Idress K.

2015-01-01

The purpose of this study was to identify the perspectives of using Internet on the scientific research among the Postgraduate Students at the University of Khartoum. The researcher used the descriptive analytical method, the population consisted of all Postgraduate students at the University of Khartoum (Master & Ph.D.), registered during the…

Deaf Students as a Linguistic and Cultural Minority: Shifting Perspectives and Implications for Teaching and Learning

ERIC Educational Resources Information Center

Higgins, Michael; Lieberman, Amy M.

2016-01-01

Deaf children have traditionally been perceived and educated as a special needs population. Over the past several decades, many factors have converged to enable a shift in perspective to one in which deaf children are viewed as a cultural and linguistic minority, and the education of deaf children is approached from a bilingual framework. This…

Assessing Mental Health Needs of Rural Schools in South Texas: Counselors' Perspectives

ERIC Educational Resources Information Center

Bain, Steve F.; Rueda, Breeze; Mata-Villarreal, Jennifer; Mundy, Marie-Anne

2011-01-01

Texas continues to fall short of the necessary mental health resources for those communities and populations in rural counties. The purpose of this article was to review the mental health resource needs of rural schools in South Texas. The study focused primarily on the perspectives of the school counselors in the identified districts. Funded by a…

The Relationship between Transformational Leadership and Organizational Commitment in Nonprofit Long Term Care Organizations: The Direct Care Worker Perspective

ERIC Educational Resources Information Center

Porter, Jeanette A.

2015-01-01

The United States population is rapidly aging, and retaining direct care workers (DCWs) will continue to be a workforce concern for the industry in addressing the demand for long term care services. To date, scant literature exists that addresses the DCW perspective of leadership behaviors and their influence on organizational commitment. To…

Perspectives : anecdotal, historical and critical commentaries on genetics

Treesearch

Bryan K. Epperson

1999-01-01

The purpose of this article is to give a personal perspective of the person of Gustave Malecot and a conceptual account of his contributions to the field of population genetics. Some essential biographical information is given, but more important are some insights he himself gave into his early career. I was privileged to have him share these insights with me over the...

The Education of Gifted and Talented Children from a Federal Perspective.

ERIC Educational Resources Information Center

Zettel, Jeffrey J.

The author describes the federal role in the education of gifted and talented children both from a social and a political perspective. The history of federal involvment with the gifted/talented population is depicted within a context of four time periods: the years prior to 1951; the period from 1951 to 1959; the decade from 1960 to 1970; and the…

Wall lizards display conspicuous signals to conspecifics and reduce detection by avian predators

PubMed Central

Stevens, Martin

2014-01-01

Visual signals are often under conflicting selection to be hidden from predators while being conspicuous to mates and rivals. Here, we investigated whether 3 different island populations of Aegean wall lizards (Podarcis erhardii) with variable coloration among diverse island habitats exhibit simultaneous camouflage and sexual signals. We examined whether signals appear better tuned to conspecific vision as opposed to that of avian predators, and whether background-matching camouflage and sexual signals are partitioned to specific body regions. This could facilitate both covert sexual signaling and camouflage according to the viewing perspectives of predators and conspecifics. We found that lizards typically appeared twice as conspicuous to conspecifics than to avian predators against the same visual background, largely due to lizards’ enhanced sensitivity to ultraviolet, suggesting that P. erhardii signals are tuned to conspecific vision to reduce detection by predators. Males were more conspicuous than females to both predators and conspecifics. In 2 populations, male backs were relatively more camouflaged to predators compared to signaling flanks, whereas in females, exposed and concealed surfaces were camouflaged to predators and generally did not differ in background matching. These findings indicate that lizard coloration evolves under the competing demands of natural and sexual selection to promote signals that are visible to conspecifics while being less perceptible to avian predators. They also elucidate how interactions between natural and sexual selection influence signal detectability and partitioning to different body regions, highlighting the importance of considering receiver vision, viewing perspectives, and signaling environments in studies of signal evolution. PMID:25419083

Is There an Enabling Environment for Nutrition-Sensitive Agriculture in South Asia? Stakeholder Perspectives from India, Bangladesh, and Pakistan.

PubMed

van den Bold, Mara; Kohli, Neha; Gillespie, Stuart; Zuberi, Samar; Rajeesh, Sangeetha; Chakraborty, Barnali

2015-06-01

Almost half of all children in South Asia are stunted. Although agriculture has the potential to be a strong driver of undernutrition reduction and serves as the main source of livelihood for over half of South Asia's population, its potential to reduce undernutrition is currently not being realized. The Leveraging Agriculture for Nutrition in South Asia (LANSA) research consortium seeks to understand how agriculture and agrifood systems can be better designed to improve nutrition in South Asia. In 2013 and 2014, LANSA carried out interviews with stakeholders influential in, and/or knowledgeable of, agriculture-nutrition policy in India, Pakistan, and Bangladesh, to gain a better understanding of the institutional and political factors surrounding the nutrition sensitivity of agriculture in the region. Semistructured interviews were carried out in India, Bangladesh, and Pakistan with a total of 56 stakeholders representing international organizations, research, government, civil society, donors, and the private sector. The findings point to mixed perspectives on countries' policy sensitivity toward nutrition. There was consensus among stakeholders on the importance of political commitment to nutrition, improving nutrition literacy, strengthening capacities, and improving the use of financial resources. Although there are different ways in which South Asian agriculture can improve its impact on nutrition, sensitizing key influencers to the importance of nutrition for the health of a country's population appears as a critical issue. This should in turn serve as the premise for political commitment, intersectoral coordination to implement nutrition-relevant policies, adequately resourced nutrition-specific and nutrition-sensitive programs, and sufficient capacities at all levels. © The Author(s) 2015.

Barriers to providing maternity care to women with physical disabilities: Perspectives from health care practitioners.

PubMed

Mitra, Monika; Smith, Lauren D; Smeltzer, Suzanne C; Long-Bellil, Linda M; Sammet Moring, Nechama; Iezzoni, Lisa I

2017-07-01

Women with physical disabilities are known to experience disparities in maternity care access and quality, and communication gaps with maternity care providers, however there is little research exploring the maternity care experiences of women with physical disabilities from the perspective of their health care practitioners. This study explored health care practitioners' experiences and needs around providing perinatal care to women with physical disabilities in order to identify potential drivers of these disparities. We conducted semi-structured telephone interviews with 14 health care practitioners in the United States who provide maternity care to women with physical disabilities, as identified by affiliation with disability-related organizations, publications and snowball sampling. Descriptive coding and content analysis techniques were used to develop an iterative code book related to barriers to caring for this population. Public health theory regarding levels of barriers was applied to generate broad barrier categories, which were then analyzed using content analysis. Participant-reported barriers to providing optimal maternity care to women with physical disabilities were grouped into four levels: practitioner level (e.g., unwillingness to provide care), clinical practice level (e.g., accessible office equipment like adjustable exam tables), system level (e.g., time limits, reimbursement policies), and barriers relating to lack of scientific evidence (e.g., lack of disability-specific clinical data). Participants endorsed barriers to providing optimal maternity care to women with physical disabilities. Our findings highlight the needs for maternity care practice guidelines for women with physical disabilities, and for training and education regarding the maternity care needs of this population. Copyright © 2016 Elsevier Inc. All rights reserved.

Clinical characterization of the pre-ictal state in the pediatric population: A caretaker's perspective.

PubMed

Patel, Puja; Ferastraoaru, Victor; Gold, Dov; Lipnick, Andrew; Jehle, Rana; Haut, Sheryl R

2017-05-01

The unpredictability of seizures causes distress to patients with epilepsy and their caretakers. To date, no studies have explored seizure prediction specifically in the pediatric population. If the period of time preceding a seizure can be reliably identified, either by child or caretaker, there may be a role for pre-emptive interventions. The aim of this study was to investigate caretaker seizure prediction. A questionnaire was distributed to caretakers of patients with epilepsy. The patients were 0-21years old and experienced ≥1 seizure within the past year. We excluded patients with non-epileptic seizures or daily seizures. One hundred and fifty of 240 questionnaires met criteria. Of these, 32 (21.6%) caretakers indicated a positive report of seizure prediction. Age of seizure onset was earlier in the positive predictive group (3.3±3.3years) than in the non-predictor group (5.3±4.8years) (p=0.01). The most common pre-ictal symptoms reported were being tired, hazy look, and sleepiness. A total of 76.6% of caretakers reported at least one seizure precipitant. The prevalence of positive caretaker seizure prediction in this study is similar to that of seizure self-prediction in adult studies. These findings will be used to design prospective online or electronic diary studies to further investigate the caretaker's, as well as children's, perspectives on seizure prediction. We anticipate that this investigation may lead to novel treatments during times of high seizure risk. Copyright © 2017 Elsevier Inc. All rights reserved.

Understanding catastrophizing from a misdirected problem-solving perspective.

PubMed

Flink, Ida K; Boersma, Katja; MacDonald, Shane; Linton, Steven J

2012-05-01

The aim is to explore pain catastrophizing from a problem-solving perspective. The links between catastrophizing, problem framing, and problem-solving behaviour are examined through two possible models of mediation as inferred by two contemporary and complementary theoretical models, the misdirected problem solving model (Eccleston & Crombez, 2007) and the fear-anxiety-avoidance model (Asmundson, Norton, & Vlaeyen, 2004). In this prospective study, a general population sample (n= 173) with perceived problems with spinal pain filled out questionnaires twice; catastrophizing and problem framing were assessed on the first occasion and health care seeking (as a proxy for medically oriented problem solving) was assessed 7 months later. Two different approaches were used to explore whether the data supported any of the proposed models of mediation. First, multiple regressions were used according to traditional recommendations for mediation analyses. Second, a bootstrapping method (n= 1000 bootstrap resamples) was used to explore the significance of the indirect effects in both possible models of mediation. The results verified the concepts included in the misdirected problem solving model. However, the direction of the relations was more in line with the fear-anxiety-avoidance model. More specifically, the mediation analyses provided support for viewing catastrophizing as a mediator of the relation between biomedical problem framing and medically oriented problem-solving behaviour. These findings provide support for viewing catastrophizing from a problem-solving perspective and imply a need to examine and address problem framing and catastrophizing in back pain patients. ©2011 The British Psychological Society.

Unique challenges of hospice for patients with heart failure: A qualitative study of hospice clinicians.

PubMed

Lum, Hillary D; Jones, Jacqueline; Lahoff, Dana; Allen, Larry A; Bekelman, David B; Kutner, Jean S; Matlock, Daniel D

2015-09-01

Patients with heart failure have end-of-life care needs that may benefit from hospice care. The goal of this descriptive study was to understand hospice clinicians' perspectives on the unique aspects of caring for patients with heart failure to inform approaches to improving end-of-life care. This qualitative study explored experiences, observations, and perspectives of hospice clinicians regarding hospice care for patients with heart failure. Thirteen hospice clinicians from a variety of professional disciplines and clinical roles, diverse geographic regions, and varying lengths of time working in hospice participated in semistructured interviews. Through team-based, iterative qualitative analysis, we identified 3 major themes. Hospice clinicians identified 3 themes regarding care for patients with heart failure. First, care for patients with heart failure involves clinical complexity and a tailored approach to cardiac medications and advanced cardiac technologies. Second, hospice clinicians describe the difficulty patients with heart failure have in trusting hospice care due to patient optimism, prognostic uncertainty, and reliance on prehospice health care providers. Third, hospice clinicians described opportunities to improve heart failure-specific hospice care, highlighting the desire for collaboration with referring cardiologists. From a hospice clinician perspective, caring for patients with heart failure is unique compared with other hospice populations. This study suggests potential opportunities for hospice clinicians and referring providers who seek to collaborate to improve care for patients with heart failure during the transition to hospice care. Published by Elsevier Inc.

Humans display a reduced set of consistent behavioral phenotypes in dyadic games.

PubMed

Poncela-Casasnovas, Julia; Gutiérrez-Roig, Mario; Gracia-Lázaro, Carlos; Vicens, Julian; Gómez-Gardeñes, Jesús; Perelló, Josep; Moreno, Yamir; Duch, Jordi; Sánchez, Angel

2016-08-01

Socially relevant situations that involve strategic interactions are widespread among animals and humans alike. To study these situations, theoretical and experimental research has adopted a game theoretical perspective, generating valuable insights about human behavior. However, most of the results reported so far have been obtained from a population perspective and considered one specific conflicting situation at a time. This makes it difficult to extract conclusions about the consistency of individuals' behavior when facing different situations and to define a comprehensive classification of the strategies underlying the observed behaviors. We present the results of a lab-in-the-field experiment in which subjects face four different dyadic games, with the aim of establishing general behavioral rules dictating individuals' actions. By analyzing our data with an unsupervised clustering algorithm, we find that all the subjects conform, with a large degree of consistency, to a limited number of behavioral phenotypes (envious, optimist, pessimist, and trustful), with only a small fraction of undefined subjects. We also discuss the possible connections to existing interpretations based on a priori theoretical approaches. Our findings provide a relevant contribution to the experimental and theoretical efforts toward the identification of basic behavioral phenotypes in a wider set of contexts without aprioristic assumptions regarding the rules or strategies behind actions. From this perspective, our work contributes to a fact-based approach to the study of human behavior in strategic situations, which could be applied to simulating societies, policy-making scenario building, and even a variety of business applications.

Applying Anthropology to Eliminate Tobacco-Related Health Disparities

PubMed Central

Burgess, Diana; Olayinka, Abimbola; Whembolua, Guy Lucien S.; Okuyemi, Kolawole S.

2012-01-01

Introduction: Disparities in tobacco’s harm persist. Declines in smoking among the general population have not been experienced to the same extent by vulnerable populations. Innovative strategies are required to diminish disparities in tobacco’s harm. As novel tools, anthropological concepts and methods may be applied to improve the design and outcomes of tobacco cessation interventions. Methods: We reviewed over 60 articles published in peer-reviewed journals since 1995 for content on anthropology and smoking cessation. The specific questions framing the review were: (a) “How can lessons learned from anthropological studies of smoking improve the design and effectiveness of smoking cessation interventions?” (b) How can anthropology be applied to diminish disparities in smoking cessation? and (c) How can qualitative methods be used most effectively in smoking cessation intervention research? Results: Three specific disciplinary tools were identified and examined: (a) culture, (b) reflexivity, and (c) qualitative methods. Examining culture as a dynamic influence and understanding the utilities of smoking in a particular group is a precursor to promoting cessation. Reflexivity enables a deeper understanding of how smokers perceive quitting and smoking beyond addiction and individual health consequences. Qualitative methods may be used to elicit in-depth perspectives on quitting, insights to inform existing community-based strategies for making behavior changes, and detailed preferences for cessation treatment or programs. Conclusions: Anthropological tools can be used to improve the effectiveness of intervention research studies targeting individuals from vulnerable groups. Synthesized applications of anthropological concepts can be used to facilitate translation of findings into clinical practice for providers addressing tobacco cessation in vulnerable populations. PMID:22271609

Time perspective and weight management behaviors in newly diagnosed Type 2 diabetes: a mediational analysis.

PubMed

Hall, Peter A; Fong, Geoffrey T; Cheng, Alice Y

2012-12-01

The primary objective of the current study was to examine the extent to which domain-specific time perspective predicts weight management behaviors (dietary behavior and physical activity) among those newly diagnosed with Type 2 diabetes. A secondary objective was to test potential mediators of the hypothesized effect (behavioral intention, self-efficacy and control beliefs). A total of 204 adults newly diagnosed (≤6 months) with Type 2 diabetes participated in the study, which included a baseline assessment of domain-general and domain-specific time perspective, as well as strength of intention to perform two weight-management behaviors (dietary choice and physical activity); both weight-management behaviors were assessed again at 6 month follow-up. Hierarchical multiple regression analyses revealed a prospective association between domain-specific time perspective and uptake of weight management behaviors. Individuals with newly diagnosed T2DM possessing a future-oriented time perspective reported making less frequent fatty food choices and greater increases in physical activity over the 6-month follow-up interval. These effects were selectively mediated by intention strength, and not competing social cognitive variables. For both behaviors, the total effects and meditational models were robust to adjustments for demographics, body composition and disease variables. A future-oriented time perspective is prospectively associated with superior uptake of weight management behaviors among those with newly diagnosed Type 2 diabetes. The facilitating effect of future-oriented thinking appears to occur via enhanced strength of intentions to perform weight management behaviors.

Homeless youths' interpersonal perspectives of health care providers.

PubMed

Hudson, Angela L; Nyamathi, Adeline; Sweat, Jeff

2008-12-01

In the United States, youth run away from home due to poor interpersonal relationships with parents or guardians; often times, they have been the recipients of parental neglect or abuse. As youth become increasingly entrenched in street-based living and problem substance use, their ability to rehabilitate their lives is incumbent upon trusting and engaging relationships with adult service providers. A total of 54 substance-using homeless youth (18-25 years) participated in focus groups to provide their perspectives on encounters and interpersonal relationships with health care providers. Participants were recruited from shelters in Hollywood, California, and from a drop-in shelter in Santa Monica, California. Four themes related to interpersonal barriers to care from service providers were identified: authoritative communication, one-way communication, disrespect, and empathy. Participants appreciate care providers who convey information in a helpful, meaningful manner and prefer providers who can, themselves, share similar life experiences. Implications point to the need for agencies and services specifically tailored to homeless, drug-using youth. These agencies should employ care providers who are trained to understand the developmental needs and histories of runaway youth. For proper reintegration of this vulnerable population into mainstream society, the narratives of these youth underscore the necessity of targeted services.

Healthy Ageing in People with Intellectual Disabilities from Managers' Perspective: A Qualitative Study.

PubMed

Johansson, Maria; Björne, Petra; Runesson, Ingrid; Ahlström, Gerd

2017-08-18

An increasing number of people with intellectual disability (ID) are reaching older ages today although they experience more health problems than the older population without ID. Leaders in intellectual disability services can greatly influence the conditions for a healthy ageing, and the aim of the present study was to explore healthy ageing in this group from the perspective of the leaders. Interviews with 20 leaders were subjected to qualitative content analysis. The findings gave rise to the overall theme ageing in dependence, which emerged from the following six categories: Supporting self-determination; Inaccessible activities after retirement; Signs of decline; Increased and specific needs for support and care; A non-question of gender; Aspects concerning the end of life and death. A prerequisite for healthy ageing in the case of people with ID is, according to the leaders, that they can live the life according to their preferences and make independent choices whilst at the same time receiving adequate support. With the shrinking of their social network after retirement, they become increasingly dependent on staff and leaders in the group home, who need to know what healthy ageing implies.

The development and evaluation of written medicines information for type 2 diabetes.

PubMed

Lee, D Y L; Armour, C; Krass, I

2007-12-01

Written Medicines Information (WMI) is regarded as a key component in diabetes consumer education. In Australia, there is a paucity of WMI that specifically tailors to the extensive array of medicines used for the lifelong management of Type 2 diabetes. This research project aimed to employ a novel framework, the 'Consumer Involvement Cycle', to investigate consumer perspectives and needs of medicines information for Type 2 diabetes and develop appropriate WMI for the Type 2 diabetes population. The Consumer Involvement Cycle involved people with Type 2 diabetes and health professionals (HPs) working in partnership to design a series of WMI, incorporating a range of consumer-conceived ideas and concepts with professional evaluation from an expert panel of reviewing HPs. A total of 12 leaflets were developed. The Flesch-Kincaid Grade Level Score for the leaflets was approximately 8.0, which is considered to be 'fairly easy', in other words easily understood by a large proportion of the general public. The Consumer Involvement Cycle was validated as a useful framework in developing and evaluating appropriate consumer information. Consumer perspectives should be sought and well incorporated throughout the process of designing and assessing educational materials intended for consumer use.

Exploring Pathways to Trust: A Tribal Perspective on Data Sharing

PubMed Central

James, Rosalina; Tsosie, Rebecca; Sahota, Puneet; Parker, Myra; Dillard, Denise; Sylvester, Ileen; Lewis, John; Klejka, Joseph; Muzquiz, LeeAnna; Olsen, Polly; Whitener, Ron; Burke, Wylie

2014-01-01

National Institutes of Health data-sharing policies aim to maximize public benefit derived from genetic studies by increasing research efficiency and the use of a pooled data resource for future studies. While broad access to data may lead to benefits for populations underrepresented in genetic studies, such as indigenous groups, tribes have ownership interest in their data. The Northwest-Alaska Pharmacogenetic Research Network, a partnership involving tribal organizations and universities conducting basic and translational pharmacogenetic research, convened a meeting to discuss the collection, management, and secondary use of research data, and of the processes surrounding access to data stored in federal repositories. This article reports on tribal perspectives that emerged from the dialogue and discusses the implications of tribal government sovereign status on research agreements and data-sharing negotiations. There is strong tribal support for efficient research processes that expedite the benefits from collaborative research, but there is also a need for data sharing procedures that take into account tribal sovereignty and appropriate oversight of research ¬ such as tribally-based research review processes and review of draft manuscripts. We also note specific ways in which accountability could be encouraged by National Institutes of Health as part of the research process. PMID:24830328

Revealing the distinct folding phases of an RNA three-helix junction.

PubMed

Plumridge, Alex; Katz, Andrea M; Calvey, George D; Elber, Ron; Kirmizialtin, Serdal; Pollack, Lois

2018-05-14

Remarkable new insight has emerged into the biological role of RNA in cells. RNA folding and dynamics enable many of these newly discovered functions, calling for an understanding of RNA self-assembly and conformational dynamics. Because RNAs pass through multiple structures as they fold, an ensemble perspective is required to visualize the flow through fleetingly populated sets of states. Here, we combine microfluidic mixing technology and small angle X-ray scattering (SAXS) to measure the Mg-induced folding of a small RNA domain, the tP5abc three helix junction. Our measurements are interpreted using ensemble optimization to select atomically detailed structures that recapitulate each experimental curve. Structural ensembles, derived at key stages in both time-resolved studies and equilibrium titrations, reproduce the features of known intermediates, and more importantly, offer a powerful new structural perspective on the time-progression of folding. Distinct collapse phases along the pathway appear to be orchestrated by specific interactions with Mg ions. These key interactions subsequently direct motions of the backbone that position the partners of tertiary contacts for later bonding, and demonstrate a remarkable synergy between Mg and RNA across numerous time-scales.

Healthy Ageing in People with Intellectual Disabilities from Managers’ Perspective: A Qualitative Study

PubMed Central

Björne, Petra; Runesson, Ingrid

2017-01-01

An increasing number of people with intellectual disability (ID) are reaching older ages today although they experience more health problems than the older population without ID. Leaders in intellectual disability services can greatly influence the conditions for a healthy ageing, and the aim of the present study was to explore healthy ageing in this group from the perspective of the leaders. Interviews with 20 leaders were subjected to qualitative content analysis. The findings gave rise to the overall theme ageing in dependence, which emerged from the following six categories: Supporting self-determination; Inaccessible activities after retirement; Signs of decline; Increased and specific needs for support and care; A non-question of gender; Aspects concerning the end of life and death. A prerequisite for healthy ageing in the case of people with ID is, according to the leaders, that they can live the life according to their preferences and make independent choices whilst at the same time receiving adequate support. With the shrinking of their social network after retirement, they become increasingly dependent on staff and leaders in the group home, who need to know what healthy ageing implies. PMID:28820435

Clan, Language, and Migration History Has Shaped Genetic Diversity in Haida and Tlingit Populations From Southeast Alaska

PubMed Central

Schurr, Theodore G.; Dulik, Matthew C.; Owings, Amanda C.; Zhadanov, Sergey I.; Gaieski, Jill B.; Vilar, Miguel G.; Ramos, Judy; Moss, Mary Beth; Natkong, Francis

2013-01-01

The linguistically distinctive Haida and Tlingit tribes of Southeast Alaska are known for their rich material culture, complex social organization, and elaborate ritual practices. However, much less is known about these tribes from a population genetic perspective. For this reason, we analyzed mtDNA and Y-chromosome variation in Haida and Tlingit populations to elucidate several key issues pertaining to the history of this region. These included the genetic relationships of Haida and Tlingit to other indigenous groups in Alaska and Canada; the relationship between linguistic and genetic data for populations assigned to the Na-Dene linguistic family, specifically, the inclusion of Haida with Athapaskan, Eyak, and Tlingit in the language family; the possible influence of matrilineal clan structure on patterns of genetic variation in Haida and Tlingit populations; and the impact of European entry into the region on the genetic diversity of these indigenous communities. Our analysis indicates that, while sharing a “northern” genetic profile, the Haida and the Tlingit are genetically distinctive from each other. In addition, Tlingit groups themselves differ across their geographic range, in part due to interactions of Tlingit tribes with Athapaskan and Eyak groups to the north. The data also reveal a strong influence of maternal clan identity on mtDNA variation in these groups, as well as the significant influence of non-native males on Y-chromosome diversity. These results yield new details about the histories of the Haida and Tlingit tribes in this region. PMID:22549307

Neutral Theory: From Complex Population History to Natural Selection and Sociocultural Phenomena in Human Populations.

PubMed

Austerlitz, Frédéric; Heyer, Evelyne

2018-06-01

Here, we present a synthetic view on how Kimura's Neutral theory has helped us gaining insight on the different evolutionary forces that shape human evolution. We put this perspective in the frame of recent emerging challenges: the use of whole genome data for reconstructing population histories, natural selection on complex polygenic traits, and integrating cultural processes in human evolution.

Gustave Malecot and the Transition from Classical to Modern Population Genetics

PubMed Central

NAGYLAKI, T.

1989-01-01

The contributions of Gustave Malecot to theoretical population genetics are described, discussed, and put into perspective relative to earlier and later work. In this context, certain aspects of the theory of inbreeding, the correlation between relatives, the evolution of finite panmictic populations, and (in more depth) spatial variation are reviewed. A brief biographical sketch of Malecot is also presented. PMID:2670664

Writing Because I Want to, Not Because I Have to: Young Gifted Writers' Perspectives on the Factors that "Matter" in Developing Expertise

ERIC Educational Resources Information Center

Garrett, Lynda; Moltzen, Roger

2011-01-01

The study reported on here sought to better understand the development of writing talent from the perspectives of a group of gifted adolescent female writers. Recent shifts in how giftedness and talent are conceptualized has led to an increased focus on domain-specific abilities and the importance of understanding how specific talents can be…

Challenges in sexual and reproductive health of Roma people who live in settlements in Serbia.

PubMed

Sedlecky, Katarina; Rašević, Mirjana

2015-04-01

To investigate the differences in sexual and reproductive health (SRH) between Roma women of reproductive age who live in settlements and the general population of women of the same age in Serbia who do not live in settlements. The Multiple Indicator Cluster Survey 4 (MICS4) was administered to Roma and Serbian women and the results were compared between the two groups. In order to get a qualitative perspective, a specifically designed, short open-ended questionnaire about Roma women was given to Roma Health Mediators (RHMs). Roma women have a higher total fertility rate and adolescent birth rate, and early marriage is much more common among them. Differences are less clear regarding antenatal care and assistance during delivery from skilled personnel. Roma women more frequently rely on traditional contraception, and are less likely to use modern contraceptives than the general female population. Problems in the socio-economic sphere, poor school enrolment and maintenance of traditional patterns in Roma people living in settlements contribute to the disparities observed. Although data on the SRH of the general population of women in Serbia are far from being satisfactory, those for women who live in Roma settlements are much worse. Political actions aimed at the empowerment of Roma women in the spheres of education, employment and health promotion have been implemented with the hope that they might improve the SRH of this vulnerable population group.

Lifetime Incidence of CKD Stages 3–5 in the United States

PubMed Central

Grams, Morgan E.; Chow, Eric K.H.; Segev, Dorry L.; Coresh, Josef

2013-01-01

Background Lifetime risk estimates of chronic kidney disease (CKD) can motivate preventative behaviors at the individual level and forecast disease burden and health care utilization at the population level. Study Design Markov Monte Carlo model simulation study. Setting & Population Current U.S. black and white population. Model, Perspective, & Timeframe Markov models simulating kidney disease development, using an individual perspective and lifetime horizon. Outcomes Age-, sex- and race-specific residual lifetime risks of CKD stages 3a+ (eGFR<60 ml/min/1.73m2), 3b+ (eGFR<45 ml/min/1.73 m2), and 4+ (eGFR<30 ml/min/1.73m2), and end stage renal disease (ESRD). Measurements State transition probabilities of developing CKD and of dying prior to its development were modeled using: 1) mortality rates from National Vital Statistics Report, 2) mortality risk estimates from a 2-million person meta-analysis, and 3) CKD prevalence from National Health and Nutrition Examination Surveys. Incidence, prevalence, and mortality related to ESRD were supplied by the US Renal Disease System. Results At birth, the overall lifetime risks of CKD stages 3a+, 3b+, 4+, and ESRD were 59.1%, 33.6%, 11.5%, and 3.6%, respectively. Women experienced greater CKD risk yet lower ESRD risk than men; blacks of both sexes had markedly higher CKD stage 4+ and ESRD risk (lifetime risks for white men, white women, black men, and black women, respectively: 53.6%, 64.9%, 51.8%, and 63.6% [CKD stage 3a+]; 29.0%, 36.7%, 33.7%, and 40.2% [CKD stage 3b+]; 9.3%, 11.4%, 15.8%, and 18.5% [CKD stage 4+]; and 3.3%, 2.2%, 8.5%, and 7.8% [ESRD]). Risk of CKD increased with age, with approximately one-half of CKD stage 3a+ cases developing after 70 years of age. Limitations CKD incidence estimates were modeled from prevalence in the U.S. population. Conclusions In the U.S., the lifetime risk of developing CKD stage 3a+ is high, underscoring the importance of primary prevention and effective therapy to reduce CKD-related morbidity and mortality. PMID:23566637

A Paleozoological Perspective on White-Tailed Deer ( Odocoileus virginianus texana) Population Density and Body Size in Central Texas

NASA Astrophysics Data System (ADS)

Wolverton, Steve; Kennedy, James H.; Cornelius, John D.

2007-04-01

Archaeological and paleontological datasets are used in conservation to add time-depth to ecology. In central Texas, several top carnivores including prehistoric Native American hunters have been extirpated or have had their historic ranges restricted, which has resulted in pest-level white-tailed deer ( Odocoileus virginianus texana) populations in some areas. Differences in body size of deer between prehistory and modernity are expected, given that a lack of predation likely has increased intraspecific competition for forage among deer, resulting in smaller body size today. In fact, modern deer from settings without harvest pressure are significantly smaller than those from harvested areas and from prehistoric deer. From a natural history perspective, this research highlights potential evolutionary causes and effects of top-predator removal on deer populations and related components of biological communities in central Texas.

An Ecological Perspective of Latina/o College Student Ethnicity

ERIC Educational Resources Information Center

Geertz Gonzalez, Roger

2017-01-01

Although Latinos are the largest minority population in the United States and the largest minority population on American campuses, there is little research concerning Latino college student ethnic identity. This study incorporates an ecological model to examine the levels of influence of different settings and backgrounds of Latino college…

Better Reporting of Population Issues.

ERIC Educational Resources Information Center

Population Education in Asia and the Pacific Newsletter and Forum, 1990

1990-01-01

Presented are the focus and the annotated issues from a workshop on new perspectives in population education for 19 Pacific Island journalists, both print and broadcast, from government and nongovernment agencies. The regional workshop was jointly organized by UNESCO and the South Pacific Commission during February 1990, in Auckland, New Zealand.…

Cross-Cultural Perspectives in Counseling: Mental Health Conceptions in Malaysia.

ERIC Educational Resources Information Center

Mohamed, Othman

The general societal pattern in Malaysia is reflected by the distinct multi-racial composition of the population, comprised of Malays, Chinese, and Indians. In Malaysia, ethnicity determines the varied differences in the socio-cultural and religious diversity of the population. Organized modern medical services have existed in Malaysia since…

Is Pseudoscymnus tsugae the solution to the hemlock woolly adelgid problem?: An early perspective

Treesearch

Mark S. McClure; Carole A. S-J. Cheah; Timothy C. Tigner

2000-01-01

Hemlock woolly adelgid, Adelges tsugae Annand (Homoptera: Adelgidae) is native to Japan where it is an innocuous inhabitant of Tsuga diversifolia Masters and T. sieboldii Carriere. Native populations of this insect are regulated by host resistance and natural enemies. However, introduced populations in eastern...

In Search of Culturally Appropriate Autism Interventions: Perspectives of Latino Caregivers

ERIC Educational Resources Information Center

DuBay, Michaela; Watson, Linda R.; Zhang, Wanqing

2018-01-01

Most evidence-based autism spectrum disorder (ASD) interventions are tested with primarily White, mid-upper class, English-speaking populations, despite the increase in Latino children with ASD in early intervention programs throughout the United States. Unfortunately, interventions that are incongruent with a target population's culture may be…

The Texas saltwater angler population: a longitudinal perspective (1989-2005)

Treesearch

Yung-Ping (Emilio) Tseng; Robert B. Ditton

2007-01-01

This paper focuses on selected human dimensions indicators of the Texas recreational fishery using the Index of Qualitative Variation (IQV) and Spearman Rank-Order Correlation Coefficient. Minority (Hispanic, Spanish, and females) participation and the overall participation rate in saltwater fishing did not keep pace with a dramatic population...

Underserved Gifted Populations: Responding to Their Needs and Abilities. Perspectives on Creativity Research.

ERIC Educational Resources Information Center

Smutny, Joan Franklin, Ed.

Twenty-five papers address issues of the underserved gifted, including environmental influences, multicultural and global factors, special learning problems, and the highly gifted and creatively gifted. The papers are: "Twenty-five Teaching Strategies that Promote Learning Success for Underserved Gifted Populations" (Jerry Flack); "The Invisible…

What is a representative brain? Neuroscience meets population science.

PubMed

Falk, Emily B; Hyde, Luke W; Mitchell, Colter; Faul, Jessica; Gonzalez, Richard; Heitzeg, Mary M; Keating, Daniel P; Langa, Kenneth M; Martz, Meghan E; Maslowsky, Julie; Morrison, Frederick J; Noll, Douglas C; Patrick, Megan E; Pfeffer, Fabian T; Reuter-Lorenz, Patricia A; Thomason, Moriah E; Davis-Kean, Pamela; Monk, Christopher S; Schulenberg, John

2013-10-29

The last decades of neuroscience research have produced immense progress in the methods available to understand brain structure and function. Social, cognitive, clinical, affective, economic, communication, and developmental neurosciences have begun to map the relationships between neuro-psychological processes and behavioral outcomes, yielding a new understanding of human behavior and promising interventions. However, a limitation of this fast moving research is that most findings are based on small samples of convenience. Furthermore, our understanding of individual differences may be distorted by unrepresentative samples, undermining findings regarding brain-behavior mechanisms. These limitations are issues that social demographers, epidemiologists, and other population scientists have tackled, with solutions that can be applied to neuroscience. By contrast, nearly all social science disciplines, including social demography, sociology, political science, economics, communication science, and psychology, make assumptions about processes that involve the brain, but have incorporated neural measures to differing, and often limited, degrees; many still treat the brain as a black box. In this article, we describe and promote a perspective--population neuroscience--that leverages interdisciplinary expertise to (i) emphasize the importance of sampling to more clearly define the relevant populations and sampling strategies needed when using neuroscience methods to address such questions; and (ii) deepen understanding of mechanisms within population science by providing insight regarding underlying neural mechanisms. Doing so will increase our confidence in the generalizability of the findings. We provide examples to illustrate the population neuroscience approach for specific types of research questions and discuss the potential for theoretical and applied advances from this approach across areas.

Integrating Individual-Based Indices of Contaminant Effects

DOE PAGES

Rowe, Christopher L.; Hopkins, William A.; Congdon, Justin D.

2001-01-01

Habitat contamination can alter numerous biological processes in individual organisms. Examining multiple individual-level responses in an integrative fashion is necessary to understand how individual health or fitness reflects environmental contamination. Here we provide an example of such an integrated perspective based upon recent studies of an amphibian (the bullfrog, Rana catesbeiana) that experiences several, disparate changes when larval development occurs in a trace element�contaminated habitat. First, we present an overview of studies focused on specific responses of individuals collected from, or transplanted into, a habitat contaminated by coal combustion residues (CCR). These studies have reported morphological, behavioral, and physiological modificationsmore » to individuals chronically interacting with sediments in the CCR-contaminated site. Morphological abnormalities in the oral and tail regions in contaminant-exposed individuals influenced other properties such as grazing, growth, and swimming performance. Behavioral changes in swimming activities and responses to stimuli appear to influence predation risk in the contaminant-exposed population. Significant changes in bioenergetics in the contaminated habitat, evident as abnormally high energetic expenditures for survival (maintenance) costs, may ultimately influence production pathways (growth, energy storage) in individuals. We then present a conceptual model to examine how interactions among the affected systems (morphological, behavioral, physiological) may ultimately bring about more severe effects than would be predicted if the responses were considered in isolation. A complex interplay among simultaneously occurring biological changes emerges in which multiple, sublethal effects ultimately can translate into reductions in larval or juvenile survival, and thus reduced recruitment of juveniles into the population. In systems where individuals are exposed to low concentrations of contaminants for long periods of time, research focused on one or few sublethal responses could substantially underestimate overall effects on individuals. We suggest that investigators adopt a more integrated perspective on contaminant-induced biological changes so that studies of individual-based effects can be better integrated into analyses of mechanisms of population change.« less

Cultural aspects of adjustment to coronary heart disease in Chinese-Australians: a review of the literature.

PubMed

Daly, John; Davidson, Patricia; Chang, Esther; Hancock, Karen; Rees, David; Thompson, David R

2002-08-01

The burden of illness associated with Coronary Heart Disease (CHD) has determined this as a key focus for research at a basic science, individual and population level. Although considerable research has been conducted on specific aspects of the experience of CHD, such as anxiety or depression, there is a lack of research investigating the global aspects of the illness experience from the individual's perspective. Furthermore, there is a paucity of research examining the cross-cultural experiences of patients from Non-English Speaking Backgrounds (NESB). Given the multicultural nature of Australian society, and that health and illness are culturally constructed experiences (Manderson 1990), it is important to include the perspectives of people from minority cultures in health related research in order to provide culturally sensitive and appropriate health care and information during an illness. Further, the potential to prevent and modulate the course of CHD, by strategies such as smoking cessation and lipid management, mandate a health promotion agenda based on equity and access for all members of society. This article discusses cultural aspects of CHD in relation to nursing and allied health care during the recovery phase of an acute cardiac event. It reviews the research that has been conducted in this area, focusing on the Chinese-Australian population. The CINAHL, MEDLINE, FAMILY (Australian Family and Society Abstracts Database), PsychINFO, and Multicultural Australian and immigration Studies (MAIS) databases were searched, identifying literature published from 1982. Keywords used were Chin* (Chinese, China), Asia* (Asia, Asian), experience, adjustment, psychological, heart, coronary, cardiac, health and services. Reports not written in English were excluded. Australian Government reports were also searched, as well as hand searching of nursing and medical textbooks. These searches resulted in over 1000 articles. However, only around 50 were relevant for this review. Chinese-Australians are one of the fastest growing populations in Australia, and are at increased risk of CHD upon settling to Australia. Recommendations for future research and for the practice of nursing are provided.

Comparative and demographic analysis of orangutan genomes

PubMed Central

Locke, Devin P.; Hillier, LaDeana W.; Warren, Wesley C.; Worley, Kim C.; Nazareth, Lynne V.; Muzny, Donna M.; Yang, Shiaw-Pyng; Wang, Zhengyuan; Chinwalla, Asif T.; Minx, Pat; Mitreva, Makedonka; Cook, Lisa; Delehaunty, Kim D.; Fronick, Catrina; Schmidt, Heather; Fulton, Lucinda A.; Fulton, Robert S.; Nelson, Joanne O.; Magrini, Vincent; Pohl, Craig; Graves, Tina A.; Markovic, Chris; Cree, Andy; Dinh, Huyen H.; Hume, Jennifer; Kovar, Christie L.; Fowler, Gerald R.; Lunter, Gerton; Meader, Stephen; Heger, Andreas; Ponting, Chris P.; Marques-Bonet, Tomas; Alkan, Can; Chen, Lin; Cheng, Ze; Kidd, Jeffrey M.; Eichler, Evan E.; White, Simon; Searle, Stephen; Vilella, Albert J.; Chen, Yuan; Flicek, Paul; Ma, Jian; Raney, Brian; Suh, Bernard; Burhans, Richard; Herrero, Javier; Haussler, David; Faria, Rui; Fernando, Olga; Darré, Fleur; Farré, Domènec; Gazave, Elodie; Oliva, Meritxell; Navarro, Arcadi; Roberto, Roberta; Capozzi, Oronzo; Archidiacono, Nicoletta; Valle, Giuliano Della; Purgato, Stefania; Rocchi, Mariano; Konkel, Miriam K.; Walker, Jerilyn A.; Ullmer, Brygg; Batzer, Mark A.; Smit, Arian F. A.; Hubley, Robert; Casola, Claudio; Schrider, Daniel R.; Hahn, Matthew W.; Quesada, Victor; Puente, Xose S.; Ordoñez, Gonzalo R.; López-Otín, Carlos; Vinar, Tomas; Brejova, Brona; Ratan, Aakrosh; Harris, Robert S.; Miller, Webb; Kosiol, Carolin; Lawson, Heather A.; Taliwal, Vikas; Martins, André L.; Siepel, Adam; RoyChoudhury, Arindam; Ma, Xin; Degenhardt, Jeremiah; Bustamante, Carlos D.; Gutenkunst, Ryan N.; Mailund, Thomas; Dutheil, Julien Y.; Hobolth, Asger; Schierup, Mikkel H.; Chemnick, Leona; Ryder, Oliver A.; Yoshinaga, Yuko; de Jong, Pieter J.; Weinstock, George M.; Rogers, Jeffrey; Mardis, Elaine R.; Gibbs, Richard A.; Wilson, Richard K.

2011-01-01

“Orangutan” is derived from the Malay term “man of the forest” and aptly describes the Southeast Asian great apes native to Sumatra and Borneo. The orangutan species, Pongo abelii (Sumatran) and Pongo pygmaeus (Bornean), are the most phylogenetically distant great apes from humans, thereby providing an informative perspective on hominid evolution. Here we present a Sumatran orangutan draft genome assembly and short read sequence data from five Sumatran and five Bornean orangutan genomes. Our analyses reveal that, compared to other primates, the orangutan genome has many unique features. Structural evolution of the orangutan genome has proceeded much more slowly than other great apes, evidenced by fewer rearrangements, less segmental duplication, a lower rate of gene family turnover and surprisingly quiescent Alu repeats, which have played a major role in restructuring other primate genomes. We also describe the first primate polymorphic neocentromere, found in both Pongo species, emphasizing the gradual evolution of orangutan genome structure. Orangutans have extremely low energy usage for a eutherian mammal1, far lower than their hominid relatives. Adding their genome to the repertoire of sequenced primates illuminates new signals of positive selection in several pathways including glycolipid metabolism. From the population perspective, both Pongo species are deeply diverse; however, Sumatran individuals possess greater diversity than their Bornean counterparts, and more species-specific variation. Our estimate of Bornean/Sumatran speciation time, 400k years ago (ya), is more recent than most previous studies and underscores the complexity of the orangutan speciation process. Despite a smaller modern census population size, the Sumatran effective population size (Ne) expanded exponentially relative to the ancestral Ne after the split, while Bornean Ne declined over the same period. Overall, the resources and analyses presented here offer new opportunities in evolutionary genomics, insights into hominid biology, and an extensive database of variation for conservation efforts. PMID:21270892

Geometric, Kinematic and Radiometric Aspects of Image-Based Measurements

NASA Technical Reports Server (NTRS)

Liu, Tianshu

2002-01-01

This paper discusses theoretical foundations of quantitative image-based measurements for extracting and reconstructing geometric, kinematic and dynamic properties of observed objects. New results are obtained by using a combination of methods in perspective geometry, differential geometry. radiometry, kinematics and dynamics. Specific topics include perspective projection transformation. perspective developable conical surface, perspective projection under surface constraint, perspective invariants, the point correspondence problem. motion fields of curves and surfaces. and motion equations of image intensity. The methods given in this paper arc useful for determining morphology and motion fields of deformable bodies such as elastic bodies. viscoelastic mediums and fluids.

ELECTIONS: Perspectives on Activities and Challenges Across the Nation

DTIC Science & Technology

2001-10-01

GAO United States General Accounting OfficeReport to Congressional RequestersOctober 2001 ELECTIONS Perspectives on Activities and Challenges ...Perspectives on Activities and Challenges Across the Nation Contract Number Grant Number Program Element Number Author(s) Project Number Task...administration of elections and the election process as of November 2000. Specifically, this report describes in detail the operations and challenges associated

An Exploratory Study Investigating the Impact of a University Module That Aims to Challenge Students' Perspectives on Ageing and Older Adults

ERIC Educational Resources Information Center

Brown, Alison

2016-01-01

This study aimed to assess if a module on an undergraduate degree programme had challenged students' perspectives on ageing and older adults. Courses on gerontology are on the increase within the UK to support increasingly ageing populations, with agendas to promote ethical care and to challenge the incidence of elderly abuse. Research…

Interprofessional Graduate Students' Perspectives on Caring for Vulnerable Populations.

PubMed

Wright, Patricia Moyle; Hanson, Mary Jane S

The purpose of this focus group study was to explore graduate students' clinical experiences with vulnerable populations, perceived barriers to care, and ethical issues related to caring for disenfranchised groups. Furthermore, based on their experiences, the students were asked to share suggestions for curricular changes that could enhance care for vulnerable populations through interdisciplinary collaboration and multidisciplinary projects. The responses of the participants add to what is known about the care of vulnerable populations, offering a first-hand description of students' preparation for work with vulnerable populations and the interdisciplinary team.

Assessment and comparison of culturally based explanations for mental disorder among Singaporean Chinese youth.

PubMed

Mathews, Mathew

2011-01-01

Culture is important to how populations understand the cause of mental disorder, a variable that has implications for treatment-seeking behaviour. Asian populations underutilize professional mental health treatment partly because of their endorsement of supernatural causation models to explain mental disorders, beliefs that stem from their religious backgrounds. This study sought to understand the dimensions of explanatory models used by three groups of Singaporean Chinese youth (n = 842)--Christian, Chinese religionist, no religion--and examined their responses to an instrument that combined explanations from psychological and organic perspectives on mental disorder with approaches from Asian and Western religious traditions. Factor analysis revealed five factors. Two were psychological corresponding to the humanistic and cognitive-behavioural perspectives respectively. Another two, which were supernatural in nature, dealt with karmaic beliefs popular among Asian religionists and more classical religious explanations common in monotheistic religions. The remaining factor was deemed a physiological model although it incorporated an item that made it consistent with an Asian organic model. While groups differed in their endorsement of supernatural explanations, psychological perspectives had the strongest endorsement among this population. Regression analysis showed that individuals who endorsed supernatural explanations more strongly tended to have no exposure to psychology courses and heightened religiosity.

Music improves verbal memory encoding while decreasing prefrontal cortex activity: an fNIRS study.

PubMed

Ferreri, Laura; Aucouturier, Jean-Julien; Muthalib, Makii; Bigand, Emmanuel; Bugaiska, Aurelia

2013-01-01

Listening to music engages the whole brain, thus stimulating cognitive performance in a range of non-purely musical activities such as language and memory tasks. This article addresses an ongoing debate on the link between music and memory for words. While evidence on healthy and clinical populations suggests that music listening can improve verbal memory in a variety of situations, it is still unclear what specific memory process is affected and how. This study was designed to explore the hypothesis that music specifically benefits the encoding part of verbal memory tasks, by providing a richer context for encoding and therefore less demand on the dorsolateral prefrontal cortex (DLPFC). Twenty-two healthy young adults were subjected to functional near-infrared spectroscopy (fNIRS) imaging of their bilateral DLPFC while encoding words in the presence of either a music or a silent background. Behavioral data confirmed the facilitating effect of music background during encoding on subsequent item recognition. fNIRS results revealed significantly greater activation of the left hemisphere during encoding (in line with the HERA model of memory lateralization) and a sustained, bilateral decrease of activity in the DLPFC in the music condition compared to silence. These findings suggest that music modulates the role played by the DLPFC during verbal encoding, and open perspectives for applications to clinical populations with prefrontal impairments, such as elderly adults or Alzheimer's patients.

Methodology of quality improvement projects for the Texas Medicare population.

PubMed

Pendergrass, P W; Abel, R L; Bing, M; Vaughn, R; McCauley, C

1998-07-01

The Texas Medical Foundation, the quality improvement organization for the state of Texas, develops local quality improvement projects for the Medicare population. These projects are developed as part of the Health Care Quality Improvement Program undertaken by the Health Care Financing Administration. The goal of a local quality improvement project is to collaborate with providers to identify and reduce the incidence of unintentional variations in the delivery of care that negatively impact outcomes. Two factors are critical to the success of a quality improvement project. First, as opposed to peer review that is based on implicit criteria, quality improvement must be based on explicit criteria. These criteria represent key steps in the delivery of care that have been shown to improve outcomes for a specific disease. Second, quality improvement must be performed in partnership with the health care community. As such, the health care community must play an integral role in the design and evaluation of a quality improvement project and in the design and implementation of the resulting quality improvement plan. Specifically, this article provides a historical perspective for the transition from peer review to quality improvement. It discusses key steps used in developing and implementing local quality improvement projects including topic selection, quality indicator development, collaborator recruitment, and measurement of performance/improvement. Two Texas Medical Foundation projects are described to highlight the current methodology and to illustrate the impact of quality improvement projects.

Measuring biomarkers in wastewater as a new source of epidemiological information: Current state and future perspectives.

PubMed

Gracia-Lor, Emma; Castiglioni, Sara; Bade, Richard; Been, Frederic; Castrignanò, Erika; Covaci, Adrian; González-Mariño, Iria; Hapeshi, Evroula; Kasprzyk-Hordern, Barbara; Kinyua, Juliet; Lai, Foon Yin; Letzel, Thomas; Lopardo, Luigi; Meyer, Markus R; O'Brien, Jake; Ramin, Pedram; Rousis, Nikolaos I; Rydevik, Axel; Ryu, Yeonsuk; Santos, Miguel M; Senta, Ivan; Thomaidis, Nikolaos S; Veloutsou, Sofia; Yang, Zhugen; Zuccato, Ettore; Bijlsma, Lubertus

2017-02-01

The information obtained from the chemical analysis of specific human excretion products (biomarkers) in urban wastewater can be used to estimate the exposure or consumption of the population under investigation to a defined substance. A proper biomarker can provide relevant information about lifestyle habits, health and wellbeing, but its selection is not an easy task as it should fulfil several specific requirements in order to be successfully employed. This paper aims to summarize the current knowledge related to the most relevant biomarkers used so far. In addition, some potential wastewater biomarkers that could be used for future applications were evaluated. For this purpose, representative chemical classes have been chosen and grouped in four main categories: (i) those that provide estimates of lifestyle factors and substance use, (ii) those used to estimate the exposure to toxicants present in the environment and food, (iii) those that have the potential to provide information about public health and illness and (iv) those used to estimate the population size. To facilitate the evaluation of the eligibility of a compound as a biomarker, information, when available, on stability in urine and wastewater and pharmacokinetic data (i.e. metabolism and urinary excretion profile) has been reviewed. Finally, several needs and recommendations for future research are proposed. Copyright © 2016 Elsevier Ltd. All rights reserved.

Music improves verbal memory encoding while decreasing prefrontal cortex activity: an fNIRS study

PubMed Central

Ferreri, Laura; Aucouturier, Jean-Julien; Muthalib, Makii; Bigand, Emmanuel; Bugaiska, Aurelia

2013-01-01

Listening to music engages the whole brain, thus stimulating cognitive performance in a range of non-purely musical activities such as language and memory tasks. This article addresses an ongoing debate on the link between music and memory for words. While evidence on healthy and clinical populations suggests that music listening can improve verbal memory in a variety of situations, it is still unclear what specific memory process is affected and how. This study was designed to explore the hypothesis that music specifically benefits the encoding part of verbal memory tasks, by providing a richer context for encoding and therefore less demand on the dorsolateral prefrontal cortex (DLPFC). Twenty-two healthy young adults were subjected to functional near-infrared spectroscopy (fNIRS) imaging of their bilateral DLPFC while encoding words in the presence of either a music or a silent background. Behavioral data confirmed the facilitating effect of music background during encoding on subsequent item recognition. fNIRS results revealed significantly greater activation of the left hemisphere during encoding (in line with the HERA model of memory lateralization) and a sustained, bilateral decrease of activity in the DLPFC in the music condition compared to silence. These findings suggest that music modulates the role played by the DLPFC during verbal encoding, and open perspectives for applications to clinical populations with prefrontal impairments, such as elderly adults or Alzheimer’s patients. PMID:24339807

From local perception to global perspective

NASA Astrophysics Data System (ADS)

Lehner, Flavio; Stocker, Thomas F.

2015-08-01

Recent sociological studies show that over short time periods the large day-to-day, month-to-month or year-to-year variations in weather at a specific location can influence and potentially bias our perception of climate change, a more long-term and global phenomenon. By weighting local temperature anomalies with the number of people that experience them and considering longer time periods, we illustrate that the share of the world population exposed to warmer-than-normal temperatures has steadily increased during the past few decades. Therefore, warming is experienced by an increasing number of individuals, counter to what might be simply inferred from global mean temperature anomalies. This behaviour is well-captured by current climate models, offering an opportunity to increase confidence in future projections of climate change irrespective of the personal local perception of weather.

Lesbians' and bisexual women's definition of health.

PubMed

Fogel, Sarah C; Calman, Leslie; Magrini, D

2012-01-01

Health is an abstract term used to describe the state of the human body, a mental state or the likelihood of longevity. Throughout history, many definitions have been provided by agencies and healthcare professionals. Although the meaning of health has a long and well-examined history, there remains a gap in the literature surrounding the meaning of health to specific populations of people. The purpose of this article is to present an analysis of the meaning of health from the perspective of lesbians and bisexual women. A content analysis was performed on the definition of health as reported by 189 sexual minority women. The conclusions from this study strongly suggest that health interventions for lesbian and bisexual women focus on what women want to achieve, rather than on what individual behavior should be.

Understanding retirement: the promise of life-span developmental frameworks.

PubMed

Löckenhoff, Corinna E

2012-09-01

The impending retirement of large population cohorts creates a pressing need for practical interventions to optimize outcomes at the individual and societal level. This necessitates comprehensive theoretical models that acknowledge the multi-layered nature of the retirement process and shed light on the dynamic mechanisms that drive longitudinal patterns of adjustment. The present commentary highlights ways in which contemporary life-span developmental frameworks can inform retirement research, drawing on the specific examples of Bronfenbrenner's Ecological Model, Baltes and Baltes Selective Optimization with Compensation Framework, Schulz and Heckhausen's Motivational Theory of Life-Span Development, and Carstensen's Socioemotional Selectivity Theory. Ultimately, a life-span developmental perspective on retirement offers not only new interpretations of known phenomena but may also help to identify novel directions for future research as well as promising pathways for interventions.

Impact of social factors on labour discrimination of disabled women.

PubMed

Mondéjar-Jiménez, José; Vargas-Vargas, Manuel; Meseguer-Santamaría, María-Leticia; Mondéjar-Jiménez, Juan-Antonio

2009-01-01

Disabled women suffer from a double labour discrimination due to their gender and their disability. In rural areas, in addition, they also suffer from a lack of specific services, the isolation of the disabled associations, problems with public transport, the dispersion of population centres, and a limited access to information that could improve their chances of entering the labour market. The current work adopts a constructivist perspective on disability and offers a preliminary examination of the influence of social factors, such as the rural or urban nature of the disabled women's place of residence, the assistance they receive from their family or outside the family, the quantity of information they receive about the labour market, and their educational level, on the activity and employment status of this group of people.

Lessons learned about psychosocial responses to disaster and mass trauma: an international perspective

PubMed Central

Reifels, Lennart; Pietrantoni, Luca; Prati, Gabriele; Kim, Yoshiharu; Kilpatrick, Dean G.; Dyb, Grete; Halpern, James; Olff, Miranda; Brewin, Chris R.; O'Donnell, Meaghan

2013-01-01

At the 13th meeting of the European Society for Traumatic Stress Studies in 2013, a symposium was held that brought together international researchers and clinicians who were involved in psychosocial responses to disaster. A total of six disasters that occurred in five countries were presented and discussed. Lessons learned from these disasters included the need to: (1) tailor the psychosocial response to the specific disaster, (2) provide multi-dimensional psychosocial care, (3) target at-risk population groups, (4) proactively address barriers in access to care, (5) recognise the social dimensions and sources of resilience, (6) extend the roles for mental health professionals, (7) efficiently coordinate and integrate disaster response services, and (8) integrate research and evaluation into disaster response planning. PMID:24371515

Behavioral features of CHARGE syndrome: parents' perspectives of three children with CHARGE syndrome.

PubMed

Lauger, Kimberly; Cornelius, Nancy; Keedy, Wendy

2005-03-15

As the population first diagnosed with CHARGE Syndrome has aged, information has emerged about specific behavioral features of this syndrome. Once the medical features are managed, it is the behavioral features that interfere with our children's ability to form reciprocal relationships, to gain formal communication skills, to make the educational gains they are cognitively capable of, and to ultimately care for themselves. In telling the informal case studies of our children, we hope their behavioral commonalities, in spite of their medical and educational differences, will be apparent as well as the complexity of the multiple types of behavior observed. We remain hopeful that answers can be found that will help our children and our families cope with this very debilitating feature of CHARGE. Copyright (c) 2005 Wiley-Liss, Inc.

Ecology, ethics, and professional environmental practice: The Yucca Mountain, Nevada, project as a case study

DOE Office of Scientific and Technical Information (OSTI.GOV)

Malone, C.R.

1995-09-01

The US Department of Energy (DOE) is proposing to develop a geologic repository for disposing of high-level nuclear waste at Yucca Mountain, Nevada. In this commentary, the ecology program for the DOE`s Yucca Mountain Project is discussed from the perspective of state-of-the-art ecosystem analysis, environmental ethics, and standards of professional practice. Specifically at issue is the need by the Yucca Mountain ecology program to adopt an ecosystem approach that encompasses the current strategy based on population biology and community ecology alone. The premise here is that an ecosystem approach is essential for assessing the long-term potential environmental impacts at Yuccamore » Mountain in light of the thermal effects expected to be associated with heat from radioactive decay.« less

The success of failed Homo sapiens dispersals out of Africa and into Asia.

PubMed

Rabett, Ryan J

2018-02-01

The evidence for an early dispersal of Homo sapiens from Africa into the Levant during Marine Isotope Stage 5 (MIS-5) 126-74 ka (thousand years ago) was characterized for many years as an 'abortive' expansion: a precursor to a sustained dispersal from which all extant human populations can be traced. Recent archaeological and genetic data from both western and eastern parts of Eurasia and from Australia are starting to challenge that interpretation. This Perspective reviews the current evidence for a scenario where the MIS-5 dispersal encompassed a much greater geographic distribution and temporal duration. The implications of this for tracking and understanding early human dispersal in Southeast Asia specifically are considered, and the validity of measuring dispersal success only through genetic continuity into the present is examined.

Aptamers: novel diagnostic and therapeutic tools for diabetes mellitus and metabolic diseases.

PubMed

Hu, Jingping; Ye, Mao; Zhou, Zhiguang

2017-03-01

Diabetes mellitus is one of the most common chronic diseases that threatens human health in worldwide populations. Despite enormous efforts invested in the study of diabetes mellitus, the development of precise diagnoses and treatments for this disease remains difficult due to the limitations of current techniques. Therefore, new methods are currently being developed. Aptamers are oligonucleotides that bind to specific target molecules and have been widely applied as diagnostic and therapeutic tools. In recent years, aptamers have been utilized in the study of diabetes mellitus and metabolic diseases. In this review, we highlight recent developments and new perspectives on aptamers in the field of diabetes mellitus and other metabolic diseases. Aptamers could potentially provide the means for efficient diagnoses and therapies against diabetes mellitus.

[Population and economics in Quintana Roo state: some considerations from recent experience].

PubMed

Aguilar Barajas, I

1995-01-01

"This article focuses on the explosive population growth in Quintana Roo [Mexico] during the last few years and its...implications [for] the local economy. First, the article briefly describes population structure, emphasizing some migratory and socioeconomic aspects. Next it considers the status sectoral and regional production structure, which [emphasize] the strong dependence on tourism and its concentration in Cancun. In the conclusions population and economic aspects entwine, providing a more comprehensive developmental perspective." (SUMMARY IN ENG) excerpt

Concise Review: Stem Cell Population Biology: Insights from Hematopoiesis.

PubMed

MacLean, Adam L; Lo Celso, Cristina; Stumpf, Michael P H

2017-01-01

Stem cells are fundamental to human life and offer great therapeutic potential, yet their biology remains incompletely-or in cases even poorly-understood. The field of stem cell biology has grown substantially in recent years due to a combination of experimental and theoretical contributions: the experimental branch of this work provides data in an ever-increasing number of dimensions, while the theoretical branch seeks to determine suitable models of the fundamental stem cell processes that these data describe. The application of population dynamics to biology is amongst the oldest applications of mathematics to biology, and the population dynamics perspective continues to offer much today. Here we describe the impact that such a perspective has made in the field of stem cell biology. Using hematopoietic stem cells as our model system, we discuss the approaches that have been used to study their key properties, such as capacity for self-renewal, differentiation, and cell fate lineage choice. We will also discuss the relevance of population dynamics in models of stem cells and cancer, where competition naturally emerges as an influential factor on the temporal evolution of cell populations. Stem Cells 2017;35:80-88. © 2016 AlphaMed Press.

Incidence and 30-day case fatality rate of first-ever stroke in urban Nigeria: the prospective community based Epidemiology of Stroke in Lagos (EPISIL) phase II results.

PubMed

Danesi, Mustapha A; Okubadejo, Njideka U; Ojini, Frank I; Ojo, Oluwadamilola O

2013-08-15

Stroke is a leading cause of death worldwide and a major contributor to global disease burden. Although epidemiologic information from a community perspective is important in determining the magnitude of the burden in specific regions, and directing equitable distribution of health resources, data on the incidence of stroke in developing countries in Africa are scarce. To determine the current incidence rate and short-term (30-day) case fatality rate (CFR) of stroke in urban Nigeria, and provide age-adjusted and gender-specific incidence rates to enable comparison with global populations. The study was a prospective community-based stroke registry enrolling hospitalized and non-hospitalized first-ever in a lifetime stroke cases presenting at all health facilities (hospitals, homeopathic caregivers, physiotherapy clinics) located in the designated community. Pre-hospitalization deaths due to stroke were not included in our study. The study was conducted between January 1st and December 31st 2007 in Surulere Local Government Area of Lagos State, south western Nigeria, a mixed-income urban locality with a population of approximately 750,000 based on data from the National Population Commission. Stroke was defined using the World Health Organization (WHO) clinical criteria. Case fatality at 30-days post stroke was determined at follow-up on 160 hospitalized stroke cases. 189 first-ever strokes, comprised of 112 men and 77 women (mean±SD age 58.5±13.5 years) were documented, giving a crude incidence rate of 25.2 per 100,000 per year (95% confidence interval 21.6- 28.8). The gender-specific rates were 28.3/100,000 and 21.3/100,000 for males and females respectively. The age-adjusted incidence rate was 54.08 per 100,000 per year (adjusted to the WHO New World Population). Hospitalization rate was 84.6%, while the CFR (hospitalized) was 16.2%. The stroke incidence in this urban sub-Saharan African community remains lower than that in emerging and developed economies, although the age- and gender-related trends and CFR are comparable to that in developed countries. Copyright © 2013 Elsevier B.V. All rights reserved.

Chemical exchange in biomacromolecules: Past, present, and future

PubMed Central

Palmer, Arthur G.

2014-01-01

The perspective reviews quantitative investigations of chemical exchange phenomena in proteins and other biological macromolecules using NMR spectroscopy, particularly relaxation dispersion methods. The emphasis is on techniques and applications that quantify the populations, interconversion kinetics, and structural features of sparsely populated conformational states in equilibrium with a highly populated ground state. Applications to folding, mol ecular recognition, catalysis, and allostery by proteins and nucleic acids are highlighted. PMID:24656076

Medicare utilization, screening, and costs among participants in the Southeastern Diabetes Initiative: A population-based evaluation.

PubMed

Van Houtven, Courtney H; Greiner, Melissa A; Heidenfelder, Brooke; Spratt, Susan E; Granger, Bradi B; Dunham, Ashley A; Qualls, Laura G; Curtis, Lesley H

2018-04-01

Type 2 diabetes mellitus imposes significant burdens on patients and health care systems. Population-level interventions are being implemented to reach large numbers of patients at risk of or diagnosed with diabetes. We describe a population-based evaluation of the Southeastern Diabetes Initiative (SEDI) from the perspective of a payer, the Centers for Medicare & Medicaid Services (CMS). The purpose of this paper is to describe the population-based evaluation approach of the SEDI intervention from a Medicare utilization and cost perspective. We measured associations between the SEDI intervention and receipt of diabetes screening (i.e., HbA1c test, eye exam, lipid profile), health care resource use, and costs among intervention enrollees, compared with a control cohort of Medicare beneficiaries in geographically adjacent counties. The intervention cohort had slightly lower 1-year screening in 2 of 3 domains (4% for HbA1c; 9% for lipid profiles) in the post-intervention period, compared with the control cohort. The SEDI intervention cohort did not have different Medicare utilization or total Medicare costs in the post-intervention period from surrounding control counties. Our analytic approach may be useful to others evaluating CMS demonstration projects in which population-level health is targeted for improvement in a well-defined clinical population. Published by Elsevier Ltd.

Wealth, equity and health care: a critique of a "population health" perspective on the determinants of health. Critical Social Science Group.

PubMed

Poland, B; Coburn, D; Robertson, A; Eakin, J

1998-04-01

In this paper we examine the recent ascendancy of a "population health" perspective on the "determinants of health" in health policy circles as conceptualized by health economists and social epidemiologists such as Evans and Stoddart [Evans and Stoddart (1990) Producing health, consuming health care. Social Science & Medicine 31(12), 1347 1363]. Their view, that the financing of health care systems may actually be deleterious for the health status of populations by drawing attention away from the (economic) determinants of health, has arguably become the "core" of the discourse of "population health". While applauding the efforts of these and other members of the Canadian Institute for Advanced Research for "pushing the envelope", we nevertheless have misgivings about their conceptualization of both the "problem" and its "solutions", as well as about the implications of their perspective for policy. From our critique, we build an alternative point of view based on a political economy perspective. We point out that Evans and Stoddart's evidence is open to alternative interpretations--and, in fact, that their conclusions regarding the importance of wealth creation do not directly reflect the evidence presented, and are indicative of an oversimplified link between wealth and health. Their view also lacks an explicit substantive theory of society and of social change, and provides convenient cover for those who wish to dismantle the welfare state in the name of deficit reduction. Our alternative to the "provider dominance" theory of Evans and Stoddart and colleagues stresses that the factors or forces producing health status, which Evans and Stoddart describe, are contained within a larger whole (advanced industrial capitalism) which gives the parts their character and shapes their interrelationships. We contend that this alternative view better explains both how we arrived at a situation in which health care systems are as costly or extensive as they are, and suggests different policy avenues to those enunciated by Evans, Stoddart and their confrères.

Bioethical Issues in Conducting Pediatric Dentistry Clinical Research.

PubMed

Garrocho-Rangel, Arturo; Cerda-Cristerna, Bernardino; Pozos-Guillen, Amaury

Pediatric clinical research on new drugs and biomaterials involves children in order to create valid and generalizable knowledge. Research on vulnerable populations, such as children, is necessary but only admissible when researchers strictly follow methodological and ethical standards, together with the respect to human rights; and very especially when the investigation cannot be conducted with other population or when the potential benefits are specifically for that age group. Clinical research in Pediatric Dentistry is not an exception. The aim of the present article was to provide the bioethical principles (with respect to the child/parents' autonomy, benefit/risk analysis, and distributive justice), and recommendations, including informed consent, research ethics committees, conflict of interest, and the "equipoise" concept. Current and future worldwide oral health research in children and adolescents must be conducted incorporating their perspectives in the decision-making process as completely as possible. This concept must be carefully considered when a dental clinical study research is going to be planned and conducted, especially in the case of randomized controlled trials, in which children will be recruited as participants.

Speciation dynamics in the SE Asian tropics: Putting a time perspective on the phylogeny and biogeography of Sundaland tree squirrels, Sundasciurus.

PubMed

den Tex, Robert-Jan; Thorington, Richard; Maldonado, Jesus E; Leonard, Jennifer A

2010-05-01

Tropical rainforests are well known for their extraordinarily high levels of biodiversity. The origin of this species richness is still debated. For instance, the museum hypothesis states that over evolutionary time more and more species will accumulate with relatively few extinctions. In contrast, the Pleistocene diversification model argues that during the last 2 million years, climatic factors (glaciations) caused environmental changes that drove isolation and vicariant speciation events. In this study, we construct a molecular phylogeny of the Sundaland (Malay Peninsula, Sumata, Borneo, Palawan) and Greater Mindanao (Mindanao, Samar, Leyte) tree squirrels (genus Sundasciurus). Our results show that most speciation events in this forest dependent taxon occurred before the Pleistocene and that even the timing of intra-specific splits among populations from different landmasses are relatively old. Additionally, we found unexpectedly high divergence within and between highland populations of S. tenuis on Sumatra and the Malay Peninsula, highlighting the importance of Pliocene events in both speciation and within species divergences in this region. Copyright 2010 Elsevier Inc. All rights reserved.

Modeling microenvironmental regulation of glioblastoma stem cells: a biomaterials perspective

NASA Astrophysics Data System (ADS)

Heffernan, John M.; Sirianni, Rachael W.

2018-02-01

Following diagnosis of a glioblastoma (GBM) brain tumor, surgical resection, chemotherapy and radiation together yield a median patient survival of only 15 months. Importantly, standard treatments fail to address the dynamic regulation of the brain tumor microenvironment that actively supports tumor progression and treatment resistance. It is becoming increasingly recognized that specialized niches within the tumor microenvironment maintain a population of highly malignant glioblastoma stem-like cells (GSCs). GSCs are resistant to traditional chemotherapy and radiation therapy, suggesting that they may be responsible for the near universal rates of tumor recurrence and associated morbidity in GBM. Thus, disrupting microenvironmental support for GSCs could be critical to developing more effective GBM therapies. Three-dimensional (3D) culture models of the tumor microenvironment are powerful tools for identifying key biochemical and biophysical inputs that impact malignant behaviors. Such systems have been used effectively to identify conditions that regulate GSC proliferation, invasion, stem-specific phenotypes, and treatment resistance. Considering the significant role that GSC microenvironments play in regulating this tumorigenic sub-population, these models may be essential for uncovering mechanisms that limit GSCs malignancy.

Wealth inequality and health: a political economy perspective.

PubMed

Nowatzki, Nadine R

2012-01-01

Despite a plethora of studies on income inequality and health, researchers have been unable to make any firm conclusions as a result of methodological and theoretical limitations. Within this body of research, there has been a call for studies of wealth inequality and health. Wealth is far more unequally distributed than income and is conceptually unique from income. This paper discusses the results of bivariate cross-sectional analyses of the relationship between wealth inequality (Gini coefficient) and population health (life expectancy and infant mortality) in 14 wealthy countries. The results confirm that wealth inequality is associated with poor population health. Both unweighted and weighted correlations between wealth inequality and health are strong and significant, even after controlling for a variety of potential aggregate-level confounders, including gross domestic product per capita, and after excluding the United States, the most unequal country. The results are strongest for female life expectancy and infant mortality. The author outlines potential pathways through which wealth inequality might affect health, using specific countries to illustrate. The article concludes with policy recommendations that could contribute to a more equitable distribution of wealth and, ultimately, decreased health disparities.

Moving beyond behaviour: advancing HIV risk prevention epistemologies and interventions (A report on the state of the literature).

PubMed

Phillips, Alton F; Pirkle, Catherine M

2011-01-01

This paper is based on an extensive literature review of academic, policy and 'grey' literatures on the intersections of culture and the global HIV/AIDS pandemic commissioned by UNESCO. It highlights that the review exposed a dominant conceptual perspective that poorly captures structures of vulnerability, particularly structures that expose entire populations to risk in relatively uniform ways. Stemming from this, the review revealed a series of specific topical areas in need of further research including masculinities, transactional sex, infrastructural deficits in health and education, fragile states and global governance. For each of these topical areas the authors demonstrate the relationship to the conceptual limitation, summarise relevant research in this area, and provide evidence of applicability to public health interventions. In pursuit of more effective interventions, this paper draws attention to some of the conceptual limitations of current approaches to understanding the pandemic, and calls for interventions that move beyond individual behaviours to address structures that shape individual behaviour and make entire populations more vulnerable to HIV.

Anthropogenic fire drives the evolution of seed traits

PubMed Central

Gómez-González, Susana; Torres-Díaz, Cristian; Bustos-Schindler, Carlos; Gianoli, Ernesto

2011-01-01

Fire is a major disturbance affecting ecosystems worldwide. Phylogenetic studies have shown that the evolution of seed persistence (fire resistance) is associated with fire frequency or severity. However, the existence of specific seed traits resulting from natural selection mediated by fire remains a key question in plant evolution. We evaluated the role of fire in the evolution of seed traits from a microevolutionary perspective, using as a study system a native forb from the Chilean matorral, where fire is a novel, anthropogenic disturbance. We show that anthropogenic fires are shaping the evolution of seed traits such as pubescence and shape. Among-population variation in seed pubescence, shape, and pericarp thickness was strongly associated with fire frequency, and within a population, fire selected those plants with more pubescent seeds, thicker pericarps, and less rounded seeds. Seed pubescence and shape were shown to be heritable traits. Our findings provide insights into the understanding of the evolution of seed traits in fire-prone environments and demonstrate that human-made fires can be driving evolutionary changes in plant species from ecosystems where fires do not occur naturally. PMID:22065739

The DOE/DHHS memorandum of understanding: The DOE perspective

DOE Office of Scientific and Technical Information (OSTI.GOV)

Goldsmith, R.

1991-01-01

On March 27, 1990, Secretary James D. Watkins established an Office of Health under the Assistant Secretary for Environment, Safety and Health. All epidemiologic activities throughout the department were consolidated into this office as part of an Office of Epidemiology and Health Surveillance (OEHS) with specific responsibilities for occupational and community health surveillance. The mission and functions of the OEHS include the conduct of epidemiologic studies at US Department of Energy (DOE) facilities, nearby communities, and other populations. These studies comprise retrospective mortality studies of DOE contractor workers, hypothesis-generating studies related to the potential health effects of energy production andmore » use, ecologic studies of off-site populations, quick-response investigations of suspected disease clusters, and others as needed. In addition, OEHS is responsible for providing procedures, technical support, and other resources for the conduct of DOE-sponsored epidemiologic research studies to be managed outside of DOE, including analytic studies to be managed by the Department of Health and Human Service (HHS) under a memorandum of understanding (MOU), dose-reconstruction studies, and studies related to DOE facilities to be conducted through state health departments.« less

The Roman state and genetic pacification.

PubMed

Frost, Peter

2010-07-23

Over the last 10,000 years, the human genome has changed at an accelerating rate. The change seems to reflect adaptations to new social environments, including the rise of the State and its monopoly on violence. State societies punish young men who act violently on their own initiative. In contrast, non-State societies usually reward such behavior with success, including reproductive success. Thus, given the moderate to high heritability of male aggressiveness, the State tends to remove violent predispositions from the gene pool while favoring tendencies toward peacefulness and submission. This perspective is applied here to the Roman state, specifically its long-term effort to pacify the general population. By imperial times, this effort had succeeded so well that the Romans saw themselves as being inherently less violent than the "barbarians" beyond their borders. By creating a pacified and submissive population, the empire also became conducive to the spread of Christianity--a religion of peace and submission. In sum, the Roman state imposed a behavioral change that would over time alter the mix of genotypes, thus facilitating a subsequent ideological change.

Voluntary Vaccination through Self-organizing Behaviors on Locally-mixed Social Networks.

PubMed

Shi, Benyun; Qiu, Hongjun; Niu, Wenfang; Ren, Yizhi; Ding, Hong; Chen, Dan

2017-06-01

Voluntary vaccination reflects how individuals weigh the risk of infection and the cost of vaccination against the spread of vaccine-preventable diseases, such as smallpox and measles. In a homogeneously mixing population, the infection risk of an individual depends largely on the proportion of vaccinated individuals due to the effects of herd immunity. While in a structured population, the infection risk can also be affected by the structure of individuals' social network. In this paper, we focus on studying individuals' self-organizing behaviors under the circumstance of voluntary vaccination in different types of social networks. Specifically, we assume that each individual together with his/her neighbors forms a local well-mixed environment, where individuals meet equally often as long as they have a common neighbor. We carry out simulations on four types of locally-mixed social networks to investigate the network effects on voluntary vaccination. Furthermore, we also evaluate individuals' vaccinating decisions through interacting with their "neighbors of neighbors". The results and findings of this paper provide a new perspective for vaccination policy-making by taking into consideration human responses in complex social networks.

Anthropogenic fire drives the evolution of seed traits.

PubMed

Gómez-González, Susana; Torres-Díaz, Cristian; Bustos-Schindler, Carlos; Gianoli, Ernesto

2011-11-15

Fire is a major disturbance affecting ecosystems worldwide. Phylogenetic studies have shown that the evolution of seed persistence (fire resistance) is associated with fire frequency or severity. However, the existence of specific seed traits resulting from natural selection mediated by fire remains a key question in plant evolution. We evaluated the role of fire in the evolution of seed traits from a microevolutionary perspective, using as a study system a native forb from the Chilean matorral, where fire is a novel, anthropogenic disturbance. We show that anthropogenic fires are shaping the evolution of seed traits such as pubescence and shape. Among-population variation in seed pubescence, shape, and pericarp thickness was strongly associated with fire frequency, and within a population, fire selected those plants with more pubescent seeds, thicker pericarps, and less rounded seeds. Seed pubescence and shape were shown to be heritable traits. Our findings provide insights into the understanding of the evolution of seed traits in fire-prone environments and demonstrate that human-made fires can be driving evolutionary changes in plant species from ecosystems where fires do not occur naturally.

Smooth Muscle Cell Genome Browser: Enabling the Identification of Novel Serum Response Factor Target Genes

PubMed Central

Lee, Moon Young; Park, Chanjae; Berent, Robyn M.; Park, Paul J.; Fuchs, Robert; Syn, Hannah; Chin, Albert; Townsend, Jared; Benson, Craig C.; Redelman, Doug; Shen, Tsai-wei; Park, Jong Kun; Miano, Joseph M.; Sanders, Kenton M.; Ro, Seungil

2015-01-01

Genome-scale expression data on the absolute numbers of gene isoforms offers essential clues in cellular functions and biological processes. Smooth muscle cells (SMCs) perform a unique contractile function through expression of specific genes controlled by serum response factor (SRF), a transcription factor that binds to DNA sites known as the CArG boxes. To identify SRF-regulated genes specifically expressed in SMCs, we isolated SMC populations from mouse small intestine and colon, obtained their transcriptomes, and constructed an interactive SMC genome and CArGome browser. To our knowledge, this is the first online resource that provides a comprehensive library of all genetic transcripts expressed in primary SMCs. The browser also serves as the first genome-wide map of SRF binding sites. The browser analysis revealed novel SMC-specific transcriptional variants and SRF target genes, which provided new and unique insights into the cellular and biological functions of the cells in gastrointestinal (GI) physiology. The SRF target genes in SMCs, which were discovered in silico, were confirmed by proteomic analysis of SMC-specific Srf knockout mice. Our genome browser offers a new perspective into the alternative expression of genes in the context of SRF binding sites in SMCs and provides a valuable reference for future functional studies. PMID:26241044

Fractionating the unitary notion of dissociation: disembodied but not embodied dissociative experiences are associated with exocentric perspective-taking

PubMed Central

Braithwaite, Jason J.; James, Kelly; Dewe, Hayley; Medford, Nick; Takahashi, Chie; Kessler, Klaus

2013-01-01

It has been argued that hallucinations which appear to involve shifts in egocentric perspective (e.g., the out-of-body experience, OBE) reflect specific biases in exocentric perspective-taking processes. Via a newly devised perspective-taking task, we examined whether such biases in perspective-taking were present in relation to specific dissociative anomalous body experiences (ABE) – namely the OBE. Participants also completed the Cambridge Depersonalization Scale (CDS; Sierra and Berrios, 2000) which provided measures of additional embodied ABE (unreality of self) and measures of derealization (unreality of surroundings). There were no reliable differences in the level of ABE, emotional numbing, and anomalies in sensory recall reported between the OBE and control group as measured by the corresponding CDS subscales. In contrast, the OBE group did provide significantly elevated measures of derealization (“alienation from surroundings” CDS subscale) relative to the control group. At the same time we also found that the OBE group was significantly more efficient at completing all aspects of the perspective-taking task relative to controls. Collectively, the current findings support fractionating the typically unitary notion of dissociation by proposing a distinction between embodied dissociative experiences and disembodied dissociative experiences – with only the latter being associated with exocentric perspective-taking mechanisms. Our findings – obtained with an ecologically valid task and a homogeneous OBE group – also call for a re-evaluation of the relationship between OBEs and perspective-taking in terms of facilitated disembodied experiences. PMID:24198776

Enhancing the incorporation of the patient's voice in drug development and evaluation.

PubMed

Chalasani, Meghana; Vaidya, Pujita; Mullin, Theresa

2018-01-01

People living with a condition are uniquely positioned to inform the understanding of the therapeutic context for drug development and evaluation. In 2012, the U.S. Food and Drug Administration (FDA) established the Patient-Focused Drug Development (PFDD) initiative to more systematically obtain the patient perspective on specific diseases and their currently available treatments. PFDD meetings are unique among FDA public meetings, with a format designed to engage patients and elicit their perspectives on two topic areas: (1) the most significant symptoms of their condition and the impact of the condition on daily life; and, (2) their current approaches to treatment. FDA has conducted 24 disease-specific PFDD meetings to date. The lessons learned from PFDD meetings range from experiences common across rare diseases to more disease specific experiences that matter most to patients. FDA recognizes that FDA-led PFDD meetings alone cannot address the gaps in information on the patient perspective. Patient-focused drug development is an ongoing effort and FDA looks forward to the next steps in advancing the science and the utilization of patient input throughout drug development and evaluation. The U.S. Food and Drug Administration (FDA) has multiple mechanisms for its regulators and staff to interact with patients -- but none quite like its novel Patient-Focused Drug Development (PFDD) initiative. FDA established the PFDD initiative to more systematically obtain the patient perspective on specific diseases and their currently available treatments. Since the initiative's inception in 2012, FDA has held 24 PFDD meetings, covering a range of disease areas and hearing directly from thousands of patients and caregivers. FDA's PFDD meetings have also provided key stakeholders, including patient advocates, researchers, drug developers, healthcare providers, and other government officials, an opportunity to hear the patient's voice. The lessons learned include but are not limited to specific experiences that matter most to patients, patient perspectives on meaningful treatment benefits and how patients want to be engaged in the drug development process. FDA recognizes that FDA-led PFDD meetings alone cannot address the gaps in information on the patient perspective. Further enhancing the incorporation of the patient's voice in drug development and evaluation continues to be a priority for FDA.

The consequences of chronic cannabis smoking in vulnerable adolescents.

PubMed

Iede, Montaha Al; Nunn, Kenneth; Milne, Bronwyn; Fitzgerald, Dominic A

2017-09-01

Cannabis, like the mythic shape-shifter, presents in various guises, morphing with the perspective and context of the observer. Arguments about cannabis are confused by a myriad of debates-medical, social, ethical and political-as if a single conceptual umbrella can capture the variety and granularity of marijuana-related issues. This paper responds to marijuana use as it is commonly practised by youth in Australia. It has little to say about synthetic cannabinoids, specific medicinal cannabinoids, or medicinal properties of marijuana. We address those adolescents genetically and environmentally vulnerable to mental illness, with specific emphasis on indigenous and neurodevelopmentally impaired young people who show patterns of usage and response very different to adults and more resilient members of the population. Specifically, the practice of mixing tobacco with marijuana by aboriginal youth, and the resultant coalition of dependencies, will likely presage a rise in pulmonary and central nervous system pathology over the coming decades. Aboriginal youth begin using earlier, persist longer, and take greater quantities of cannabis than non-indigenous youth. This paper recommends practical interventions to reduce the multiple health consequences of chronic cannabis use in young people, especially indigenous young people. Copyright © 2016. Published by Elsevier Ltd.

The economic burden of diabetes to French national health insurance: a new cost-of-illness method based on a combined medicalized and incremental approach.

PubMed

de Lagasnerie, Grégoire; Aguadé, Anne-Sophie; Denis, Pierre; Fagot-Campagna, Anne; Gastaldi-Menager, Christelle

2018-03-01

A better understanding of the economic burden of diabetes constitutes a major public health challenge in order to design new ways to curb diabetes health care expenditure. The aim of this study was to develop a new cost-of-illness method in order to assess the specific and nonspecific costs of diabetes from a public payer perspective. Using medical and administrative data from the major French national health insurance system covering about 59 million individuals in 2012, we identified people with diabetes and then estimated the economic burden of diabetes. Various methods were used: (a) global cost of patients with diabetes, (b) cost of treatment directly related to diabetes (i.e., 'medicalized approach'), (c) incremental regression-based approach, (d) incremental matched-control approach, and (e) a novel combination of the 'medicalized approach' and the 'incremental matched-control' approach. We identified 3 million individuals with diabetes (5% of the population). The total expenditure of this population amounted to €19 billion, representing 15% of total expenditure reimbursed to the entire population. Of the total expenditure, €10 billion (52%) was considered to be attributable to diabetes care: €2.3 billion (23% of €10 billion) was directly attributable, and €7.7 billion was attributable to additional reimbursed expenditure indirectly related to diabetes (77%). Inpatient care represented the major part of the expenditure attributable to diabetes care (22%) together with drugs (20%) and medical auxiliaries (15%). Antidiabetic drugs represented an expenditure of about €1.1 billion, accounting for 49% of all diabetes-specific expenditure. This study shows the economic impact of the assumption concerning definition of costs on evaluation of the economic burden of diabetes. The proposed new cost-of-illness method provides specific insight for policy-makers to enhance diabetes management and assess the opportunity costs of diabetes complications' management programs.

Observer perspective imagery with stuttering.

PubMed

Lowe, Robyn; Menzies, Ross; Packman, Ann; O'Brian, Sue; Onslow, Mark

2015-01-01

Adults who stutter are at risk of developing a range of psychological conditions. Social anxiety disorder is the most common anxiety disorder associated with stuttering. Observer perspective imagery is one cognitive process involved in the maintenance of some anxiety disorders. This involves viewing images as if looking at the self from the perspective of another. In contrast, the field perspective involves looking out from the self at the surrounding environment. The purpose of this study was to assess the presence of observer perspective imagery with stuttering. The authors administered the Hackmann, Surawy and Clark (1998) semi-structured interview to 30 adults who stutter and 30 controls. Group images and impressions were compared for frequency, perspective recalled and emotional valence. The stuttering group was significantly more likely than controls to recall images and impressions from an observer rather than a field perspective for anxious situations. It is possible the present results could reflect the same attentional processing bias that occurs with anxiety disorders in the non-stuttering population. These preliminary results provide an explanation for the persistence of conditions such as social anxiety disorder with stuttering. Clinical implications are discussed.

Has the world really survived the population bomb? (Commentary on "how the world survived the population bomb: lessons from 50 years of extraordinary demographic history").

PubMed

Becker, Stan

2013-12-01

In his PAA presidential address and corresponding article in Demography, David Lam (Demography 48:1231-1262, 2011) documented the extraordinary progress of humankind-vis-à-vis poverty alleviation, increased schooling, and reductions in mortality and fertility-since 1960 and noted that he expects further improvements by 2050. However, although Lam briefly covered the problems of global warming and pollution, he did not address several other major environmental problems that are closely related to the rapid human population growth in recent decades and to the progress he described. This commentary highlights some of these problems to provide a more balanced perspective on the situation of the world. Specifically, humans currently are using resources at an unsustainable level. Groundwater depletion and overuse of river water are major problems on multiple continents. Fossil fuel resources and several minerals are being depleted. Other major problems include deforestation, with the annual forest clearing globally estimated to be an area the size of New York State; and species extinction, with rates estimated to be 100 to 1,000 times higher than background rates. Principles of ecological economics are presented that allow an integration of ecology and economic development and better potential for preservation of the world for future generations.

Is breastfeeding fair? Tensions in feminist perspectives on breastfeeding and the family.

PubMed

McCarter-Spaulding, Deborah

2008-05-01

Breastfeeding is widely acknowledged to have health benefits for mothers and infants. Because it is sex-specific, it challenges the feminist principle of gender-neutral childbearing. Various feminist theories addressing breastfeeding from the perspective of gender ideology, cultural feminism, and history are reviewed and contrasted. Employment and race disparities are addressed within feminist contexts. Feminist health activism is suggested as a unifying perspective.

Conflicts and Contestations. Rural Populations' Perspectives on the Second Homes Phenomenon

ERIC Educational Resources Information Center

Rye, Johan Fredrik

2011-01-01

In response to demands to restructure and diversify their economies, many rural communities have welcomed the expanding phenomenon of second homes. However, while the second home owners bring new resources to the host communities, the literature also suggests that large second home populations in rural communities provide fertile ground for a…

Aboriginal Students' Perspectives on the Factors Influencing High School Completion

ERIC Educational Resources Information Center

MacIver, Marion

2012-01-01

The Canadian education system is failing its Aboriginal students as evidenced by the significant proportion not completing high school. The Aboriginal population has experienced a significantly greater proportion of people living in poverty and higher rates of unemployment than has the non-Aboriginal population. These factors can be linked to the…

Allostatic Load: Single Parents, Stress-Related Health Issues, and Social Care

ERIC Educational Resources Information Center

Johner, Randy L.

2007-01-01

This article explores the possible relationships between allostatic load (AL) and stress-related health issues in the low-income single-parent population, using both a population health perspective (PHP) and a biological framework. A PHP identifies associations among such factors as gender, income, employment, and social support and their…

Service Learning for At-Risk Student Populations: The Contextual Dynamism of Implementation

ERIC Educational Resources Information Center

Akin, Jacob T.; Vesely, Randall S.

2016-01-01

The central purpose of this article is to explore research, issues, and perspectives on the implementation of service learning programs to improve student achievement in at-risk student populations. The implementation of service learning programs takes place within multiple contexts and across several terrains. The complexities of implementing…

Pedagogical Mentorship, Indigenous Settings, and Rural Education: Perspectives from Guatemalan Teachers

ERIC Educational Resources Information Center

de la Garza, Katy

2014-01-01

Rural and Indigenous populations have the lowest educational achievement indicators and teachers with the least years of training. Global education movements have led to an increase in access to schooling by rural and Indigenous populations but high drop-out rates persist and education policies, curricular contents, and teacher trainings have…

Landscape genomics: A brief perspective [Chapter 9

Treesearch

Michael K. Schwartz; Gordon Luikart; Kevin S. McKelvey; Samuel A. Cushman

2010-01-01

Landscape genetics is the amalgamation of population genetics and landscape ecology (see Manel et al. 2003; Storfer et al. 2007). In Chapter 17, we discuss landscape genetics and provide two examples of applications in the area of modeling population connectivity and inferring fragmentation. These examples, like virtually all extant landscape genetic analyses, were...

Identity Formation and Self-Esteem Issues in the Male Transvestite: A Humanistic Perspective.

ERIC Educational Resources Information Center

Bordan, Terry; De Ricco, Marc

1997-01-01

Explores identity formation issues associated with low self-esteem in the transvestite population. Research showed significantly higher self-esteem for non-cross-dressers (N=27) than for cross-dressers (N=27). Focuses on relevant counseling issues when working with the transvestite population and proposes a humanistic and non-pathological…

Perspectives on Population in AP® Human Geography

ERIC Educational Resources Information Center

Lu, Max; Keller, Kenneth

2016-01-01

A study of human geography begins with the human population. In fact, demographic topics frequently relate to other units in the AP Human Geography course. The three main concepts elaborated upon in this article are (1) the demographic transition model, (2) Malthusian theory and its critics, and (3) pronatalist and antinatalist policies that might…

Effectiveness of Teacher Training: Voices of Teachers Serving High-Needs Populations of Students

ERIC Educational Resources Information Center

Varela, Daniella G.; Maxwell, Gerri M.

2015-01-01

This study explores the effectiveness of educator preparation programs from the perspective of three female Hispanic veteran teachers serving high-needs populations of students. The study strives to contribute to research on minimum proposed standards for teacher preparation programs in Texas. Through a process of coding data from the informant…

Digital Literacy Practices among Youth Populations: A Review of the Literature

ERIC Educational Resources Information Center

Blummer, Barbara

2008-01-01

Digital literacy includes a range of abilities from basic computing skills to the creation of multimodal texts. This literature review examines eleven articles that track the digital literacy practices of youth populations or individuals between the ages of 12 and 17. It describes the practices of these individuals through three perspectives,…

Researching Students with Disabilities: The Importance of Critical Perspectives

ERIC Educational Resources Information Center

Vaccaro, Annemarie; Kimball, Ezekiel W.; Wells, Ryan S.; Ostiguy, Benjamin J.

2014-01-01

In this chapter, the authors critically review the current state of quantitative research on college students with disabilities and examine the exclusion of this marginalized population from much of our research. They propose ways to conduct research that more fully accounts for this diverse and important college population. The authors argue that…

An Epidemiological Perspective on the Cause of Running Injuries.

ERIC Educational Resources Information Center

Powell, Kenneth E.; And Others

1986-01-01

Case reports do not consider the population which is injured and therefore are inappropriate for finding causal relationships. A review of three epidemiological studies, which take the population into account, showed that the only reasonably well-established cause of running injuries is the number of miles run per week. (Author/MT)

Weed Management in 2050: Perspective on the Future of Weed Science

USDA-ARS?s Scientific Manuscript database

The discipline of weed science is at a critical juncture. Decades of efficient chemical weed control has led to a rise in the number of herbicide resistant weed populations, with few new herbicides and increasing farm labor scarcity available to counter this trend. At the same time, world population...

Let's fight for the gender perspective.

PubMed

Lindahl, K

1994-01-01

The author, a representative of the Swedish National Preparatory Committee for the Cairo International Conference on Population and Development (ICPD), urges that each question and proposed action be considered within the framework of a gender and human rights perspective. The starting point for all discussions of population policies should be the individual rather than global population targets. Social and economic empowerment of women is essential to the success of development programs. If population growth is to match available resources, life-styles, production, and consumption strategies must be modified. In terms of sexual and reproductive health, the socioeconomic and cultural factors that impact on the decision to accept contraception must be considered. Safe methods of contraception and legal abortion must be available, and the sexual health issue should be broadened to include consideration of the sexual violence faced by many women and children. In addition, the fact the adolescents are sexually active must be accepted if unwanted pregnancies, deaths through unsafe abortion, and the transmission of sexually transmitted diseases are to be reduced. Support for contraceptive use is a necessary, but insufficient, precondition for women's health; essential is a more holistic approach.

Academic Careers and the Valuation of Academics. A Discursive Perspective on Status Categories and Academic Salaries in France as Compared to the U.S., Germany and Great Britain

ERIC Educational Resources Information Center

Angermuller, Johannes

2017-01-01

Academic careers are social processes which involve many members of large populations over long periods of time. This paper outlines a discursive perspective which looks into how academics are categorized in academic systems. From a discursive view, academic careers are organized by categories which can define who academics are (subjectivation)…

Xenotransplantation-theological-ethical considerations in an interdisciplinary symposium.

PubMed

Sautermeister, Jochen; Mathieu, Richard; Bogner, Veronika

2015-01-01

Unlike allotransplantation, reflections on xenotransplantation are infrequent in theological literature. However, xenotransplantation poses questions specifically concerning ethical and theological aspects that are imperative to address, such as personal identity between the poles of body, soul, and mind, the relationship between humans and animals, as well as challenges regarding specific issues of medical and social ethics. This study summarizes the lectures of the symposium on "Xenotransplantation-a challenge to theological ethics," which took place in Munich from September 30 until October 2, 2013, and analyses the implications of xenotransplantation from the perspectives of Christian theological ethics, biblical theology, and systematic theology. Furthermore, the issue of xenotransplantation is addressed from the perspectives of Judaism and Islam. Beyond these theological deliberations, the metaphorical and religious meaning of the human heart, which may have an impact on the societal acceptability of xenotransplantation, as well as the Christian notion of compassion regarding animals, is analyzed from the perspective of historical sciences. According to the perspectives of Christianity, Judaism, and Islam, there are no specifically religious fundamental and generally binding reasons to prohibit xenotransplantation as a means of treating grave and life-threatening organ insufficiencies. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Outcome instruments to assess scoliosis surgery.

PubMed

Bagó, Juan; Climent, Jose Ma; Pérez-Grueso, Francisco J S; Pellisé, Ferran

2013-03-01

To review and summarize the current knowledge regarding the outcome measures used to evaluate scoliosis surgery. Literature review. Outcome instruments should be tested to ensure that they have adequate metric characteristics: content and construct validity, reliability, and responsiveness. In the evaluation of scoliosis, generic instruments to assess health-related quality of life (HRQL) have been used, such as the SF-36 questionnaire and the EuroQol5D instrument. Nonetheless, it is preferable to use disease-specific instruments for this purpose, such as the SRS-22 Patient Questionnaire and the quality of life profile for spinal deformities (QLPSD). More recently, these generic and disease-specific instruments have been complemented with the use of super-specific instruments; i.e., those assessing a single aspect of the condition or specific populations with the condition. The patients' perception of their trunk deformity and body image has received particular attention, and several instruments are available to evaluate these aspects, such as the Walter-Reed Visual Assessment Scale (WRVAS), the Spinal Appearance Questionnaire (SAQ), and the Trunk Appearance Perception Scale (TAPS). The impacts of brace use can also be measured with specific scales, including the Bad Sobernheim Stress Questionnaire (BSSQ) and the Brace Questionnaire (BrQ). The available instruments to evaluate the treatment for non-idiopathic scoliosis have not been sufficiently validated and analyzed. Evaluation of scoliosis treatment should include the patient's perspective, which can be obtained with the use of patient-reported outcome measures.

Cost-effectiveness of quadrivalent influenza vaccine in Hong Kong - A decision analysis.

PubMed

You, Joyce H S; Ming, Wai-Kit; Chan, Paul K S

2015-01-01

Trivalent influenza vaccine (TIV) selects one of the 2 co-circulating influenza B lineages whereas quadrivalent influenza vaccine (QIV) includes both lineages. We examined potential cost-effectiveness of QIV versus TIV from perspectives of healthcare provider and society of Hong Kong. A decision tree was designed to simulate the outcomes of QIV vs. TIV in 6 age groups: 0-4 years, 5-9 years, 10-14 years, 15-64 years, 65-79 y and ≥80 years. Direct cost alone, direct and indirect costs, and quality-adjusted life-years (QALYs) loss due to TIV-unmatched influenza B infection were simulated for each study arm. Outcome measure was incremental cost per QALY (ICER). In base-case analysis, QIV was more effective than TIV in all-age population with additional direct cost per QALY (ICER-direct cost) and additional total cost per QALY (ICER-total cost) of USD 22,603 and USD 12,558, respectively. Age-stratified analysis showed that QIV was cost-effective in age groups 6 months to 9 y and ≥80 years from provider's perspective, and it was cost-effective in all age group except 15-64 y from societal perspective. Percentage of TIV-unmatched influenza B in circulation and additional vaccine cost of QIV were key influential factors. From perspectives of healthcare provider and society, QIV was the preferred option in 52.77% and 66.94% of 10,000 Monte Carlo simulations, respectively. QIV appears to be cost-effective in Hong Kong population, except for age group 15-64 years, from societal perspective. From healthcare provider's perspective, QIV seems to be cost-effective in very young (6 months-9 years) and older (≥80 years) age groups.

Research Participation as Work: Comparing the Perspectives of Researchers and Economically Marginalized Populations

PubMed Central

Page, Kimberly

2012-01-01

We examined the historical and regulatory framework of research with human participants in the United States, and described some possible unintended consequences of this framework in the context of paying young injection drug users for their time participating in behavioral and medical research. We drew upon our own experiences while conducting a long-running epidemiological study of hepatitis C virus infection. We found that existing ethical and regulatory framings of research participation may lead to injustices from the perspectives of research participants. We propose considering research participation as a specialized form of work and the use of community advisory boards to facilitate discussion about appropriate compensation for research participation among economically marginalized populations. PMID:22594754

Chemical-specific screening criteria for interpretation of biomonitoring data for volatile organic compounds (VOCs)--application of steady-state PBPK model solutions.

PubMed

Aylward, Lesa L; Kirman, Chris R; Blount, Ben C; Hays, Sean M

2010-10-01

The National Health and Nutrition Examination Survey (NHANES) generates population-representative biomonitoring data for many chemicals including volatile organic compounds (VOCs) in blood. However, no health or risk-based screening values are available to evaluate these data from a health safety perspective or to use in prioritizing among chemicals for possible risk management actions. We gathered existing risk assessment-based chronic exposure reference values such as reference doses (RfDs), reference concentrations (RfCs), tolerable daily intakes (TDIs), cancer slope factors, etc. and key pharmacokinetic model parameters for 47 VOCs. Using steady-state solutions to a generic physiologically-based pharmacokinetic (PBPK) model structure, we estimated chemical-specific steady-state venous blood concentrations across chemicals associated with unit oral and inhalation exposure rates and with chronic exposure at the identified exposure reference values. The geometric means of the slopes relating modeled steady-state blood concentrations to steady-state exposure to a unit oral dose or unit inhalation concentration among 38 compounds with available pharmacokinetic parameters were 12.0 microg/L per mg/kg-d (geometric standard deviation [GSD] of 3.2) and 3.2 microg/L per mg/m(3) (GSD=1.7), respectively. Chemical-specific blood concentration screening values based on non-cancer reference values for both oral and inhalation exposure range from 0.0005 to 100 microg/L; blood concentrations associated with cancer risk-specific doses at the 1E-05 risk level ranged from 5E-06 to 6E-02 microg/L. The distribution of modeled steady-state blood concentrations associated with unit exposure levels across VOCs may provide a basis for estimating blood concentration screening values for VOCs that lack chemical-specific pharmacokinetic data. The screening blood concentrations presented here provide a tool for risk assessment-based evaluation of population biomonitoring data for VOCs and are most appropriately applied to central tendency estimates for such datasets. Copyright (c) 2010 Elsevier Inc. All rights reserved.

Study protocol of cost-effectiveness and cost-utility of a biopsychosocial multidisciplinary intervention in the evolution of non-specific sub-acute low back pain in the working population: cluster randomised trial

PubMed Central

2011-01-01

Background Low back pain (LBP), with high incidence and prevalence rate, is one of the most common reasons to consult the health system and is responsible for a significant amount of sick leave, leading to high health and social costs. The objective of the study is to assess the cost-effectiveness and cost-utility analysis of a multidisciplinary biopsychosocial educational group intervention (MBEGI) of non-specific sub-acute LBP in comparison with the usual care in the working population recruited in primary healthcare centres. Methods/design The study design is a cost-effectiveness and cost-utility analysis of a MBEGI in comparison with the usual care of non-specific sub-acute LBP. Measures on effectiveness and costs of both interventions will be obtained from a cluster randomised controlled clinical trial carried out in 38 Catalan primary health care centres, enrolling 932 patients between 18 and 65 years old with a diagnosis of non-specific sub-acute LBP. Effectiveness measures are: pharmaceutical treatments, work sick leave (% and duration in days), Roland Morris disability, McGill pain intensity, Fear Avoidance Beliefs (FAB) and Golberg Questionnaires. Utility measures will be calculated from the SF-12. The analysis will be performed from a social perspective. The temporal horizon is at 3 months (change to chronic LBP) and 12 months (evaluate the outcomes at long term). Assessment of outcomes will be blinded and will follow the intention-to-treat principle. Discussion We hope to demonstrate the cost-effectiveness and cost-utility of MBEGI, see an improvement in the patients' quality of life, achieve a reduction in the duration of episodes and the chronicity of non-specific low back pain, and be able to report a decrease in the social costs. If the intervention is cost-effectiveness and cost-utility, it could be applied to Primary Health Care Centres. Trial registration ISRCTN: ISRCTN58719694 PMID:21859489

Estimating State-Specific Contributions to PM2.5- and O3-Related Health Burden from Residential Combustion and Electricity Generating Unit Emissions in the United States.

PubMed

Penn, Stefani L; Arunachalam, Saravanan; Woody, Matthew; Heiger-Bernays, Wendy; Tripodis, Yorghos; Levy, Jonathan I

2017-03-01

Residential combustion (RC) and electricity generating unit (EGU) emissions adversely impact air quality and human health by increasing ambient concentrations of fine particulate matter (PM 2.5 ) and ozone (O 3 ). Studies to date have not isolated contributing emissions by state of origin (source-state), which is necessary for policy makers to determine efficient strategies to decrease health impacts. In this study, we aimed to estimate health impacts (premature mortalities) attributable to PM 2.5 and O 3 from RC and EGU emissions by precursor species, source sector, and source-state in the continental United States for 2005. We used the Community Multiscale Air Quality model employing the decoupled direct method to quantify changes in air quality and epidemiological evidence to determine concentration-response functions to calculate associated health impacts. We estimated 21,000 premature mortalities per year from EGU emissions, driven by sulfur dioxide emissions forming PM 2.5 . More than half of EGU health impacts are attributable to emissions from eight states with significant coal combustion and large downwind populations. We estimate 10,000 premature mortalities per year from RC emissions, driven by primary PM 2.5 emissions. States with large populations and significant residential wood combustion dominate RC health impacts. Annual mortality risk per thousand tons of precursor emissions (health damage functions) varied significantly across source-states for both source sectors and all precursor pollutants. Our findings reinforce the importance of pollutant-specific, location-specific, and source-specific models of health impacts in design of health-risk minimizing emissions control policies. Citation: Penn SL, Arunachalam S, Woody M, Heiger-Bernays W, Tripodis Y, Levy JI. 2017. Estimating state-specific contributions to PM 2.5 - and O 3 -related health burden from residential combustion and electricity generating unit emissions in the United States. Environ Health Perspect 125:324-332; http://dx.doi.org/10.1289/EHP550.

Feminist poststructuralism: a methodological paradigm for examining clinical decision-making.

PubMed

Arslanian-Engoren, Cynthia

2002-03-01

To present the philosophical framework of feminist poststructuralism, discuss its use as an innovative research approach and its implications for nursing knowledge development and practice. This perspective examines the construction of meaning, power relationships, and the importance of language as it affects contemporary healthcare decisions. It seeks to identify and expose biases that marginalize the healthcare needs of women and contribute to healthcare disparities for this population. Additionally, a feminist poststructuralist perspective seeks to develop new knowledge for understanding gender differences. A feminist poststructuralist perspective represents an alternative paradigm for studying the phenomenon of clinical decision-making. An empirical application example of a feminist poststructuralist perspective is provided. This exemplar investigated emergency department registered nurses' triage decisions for men and women with symptoms suggestive of coronary heart disease.

Epidemiological and economic burden of Clostridium difficile in the United States: estimates from a modeling approach.

PubMed

Desai, Kamal; Gupta, Swati B; Dubberke, Erik R; Prabhu, Vimalanand S; Browne, Chantelle; Mast, T Christopher

2016-06-18

Despite a large increase in Clostridium difficile infection (CDI) severity, morbidity and mortality in the US since the early 2000s, CDI burden estimates have had limited generalizability and comparability due to widely varying clinical settings, populations, or study designs. A decision-analytic model incorporating key input parameters important in CDI epidemiology was developed to estimate the annual number of initial and recurrent CDI cases, attributable and all-cause deaths, economic burden in the general population, and specific number of high-risk patients in different healthcare settings and the community in the US. Economic burden was calculated adopting a societal perspective using a bottom-up approach that identified healthcare resources consumed in the management of CDI. Annually, a total of 606,058 (439,237 initial and 166,821 recurrent) episodes of CDI were predicted in 2014: 34.3 % arose from community exposure. Over 44,500 CDI-attributable deaths in 2014 were estimated to occur. High-risk susceptible individuals representing 5 % of the total hospital population accounted for 23 % of hospitalized CDI patients. The economic cost of CDI was $5.4 billion ($4.7 billion (86.7 %) in healthcare settings; $725 million (13.3 %) in the community), mostly due to hospitalization. A modeling framework provides more comprehensive and detailed national-level estimates of CDI cases, recurrences, deaths and cost in different patient groups than currently available from separate individual studies. As new treatments for CDI are developed, this model can provide reliable estimates to better focus healthcare resources to those specific age-groups, risk-groups, and care settings in the US where they are most needed. (Trial Identifier ClinicaTrials.gov: NCT01241552).

Self-reported versus measured height and weight in Hispanic and non-Hispanic menopausal women.

PubMed

Griebeler, Marcio L; Levis, Silvina; Beringer, Laura Muñoz; Chacra, Walid; Gómez-Marín, Orlando

2011-04-01

Height and weight information is commonly used in clinical trials and in making therapeutic decisions in medical practice. In both settings, the data are often obtained by self-report. If erroneous, this practice could lead to inaccuracies in estimating renal function and medication doses or to inaccurate outcomes of research studies. Previous publications have reported lack of reliability of self-reported weight and height in the general population but have not addressed age-specific and ethnicity-specific subgroups in the U.S. population. The inaccuracy of self-reported weight and height could be particularly significant in times of considerable changes in body weight, such as at menopause, which is often associated with weight gain. We assessed the validity of self-reported height and weight in 428 women within the first 5 years of menopause, 70.6% of whom were Hispanic. Participants overestimated their height by 2.2±3.5 cm (mean±standard deviation [SD]) and underestimated their weight by 1.5±2.9 kg. As a group, based on self-reported measures, 33.3% were misclassified with respect to body mass index (BMI) category, and the difference between measured BMI and self-reported BMI was similar between Hispanic white and non-Hispanic white women, positively related to measured weight, and inversely related to measured height, years from menopause, and multiple parity. From the public health perspective, inaccurate self-report could lead to a considerable underestimation of the current obesity prevalence rates. In our study population, the prevalence of obesity (BMI ≥30 kg/m(2)) was 6.3% based on self-reported values and 18% based on measured height and weight, representing a 3-fold underestimation.

Self-Reported Versus Measured Height and Weight in Hispanic and Non-Hispanic Menopausal Women

PubMed Central

Griebeler, Marcio L.; Beringer, Laura Muñoz; Chacra, Walid; Gómez-Marín, Orlando

2011-01-01

Abstract Background Height and weight information is commonly used in clinical trials and in making therapeutic decisions in medical practice. In both settings, the data are often obtained by self-report. If erroneous, this practice could lead to inaccuracies in estimating renal function and medication doses or to inaccurate outcomes of research studies. Previous publications have reported lack of reliability of self-reported weight and height in the general population but have not addressed age-specific and ethnicity-specific subgroups in the U.S. population. The inaccuracy of self-reported weight and height could be particularly significant in times of considerable changes in body weight, such as at menopause, which is often associated with weight gain. Methods We assessed the validity of self-reported height and weight in 428 women within the first 5 years of menopause, 70.6% of whom were Hispanic. Results Participants overestimated their height by 2.2±3.5 cm (mean±standard deviation [SD]) and underestimated their weight by 1.5±2.9 kg. As a group, based on self-reported measures, 33.3% were misclassified with respect to body mass index (BMI) category, and the difference between measured BMI and self-reported BMI was similar between Hispanic white and non-Hispanic white women, positively related to measured weight, and inversely related to measured height, years from menopause, and multiple parity. Conclusions From the public health perspective, inaccurate self-report could lead to a considerable underestimation of the current obesity prevalence rates. In our study population, the prevalence of obesity (BMI ≥30 kg/m2) was 6.3% based on self-reported values and 18% based on measured height and weight, representing a 3-fold underestimation. PMID:21413893

Treating Medicaid patients with hepatitis C: clinical and economic impact.

PubMed

Younossi, Zobair; Gordon, Stuart C; Ahmed, Aijaz; Dieterich, Douglas; Saab, Sammy; Beckerman, Rachel

2017-02-01

To estimate change in chronic hepatitis C virus (HCV) disease and the economic burden associated with comprehensive treatment of the chronic HCV-infected Medicaid population. Decision-analytic Markov model. Treatment-naïve patients with genotype 1 chronic HCV were followed over a lifetime horizon from the third-party payer perspective. Patients entered the model insured under Medicaid and were treated under state-specific restrictions by Metavir fibrosis stage (base case) or all treated (all-patient strategy) with an approved all-oral regimen (ledipasvir/sofosbuvir [LDV/SOF] for 8 weeks or 12 weeks, depending on cirrhosis status, viral load, and state-specific LDV/SOF restrictions). Untreated patients were assumed to age into Medicare at 65 years, where they were treated with LDV/SOF without restriction by fibrotic stage. The sustained virologic response (SVR) rate of the current Medicaid LDV/SOF restriction strategy was 75.2% versus 95.9% if all LDV/SOF-eligible patients were treated under Medicaid. Treating all eligible Medicaid patients with LDV/SOF, regardless of fibrotic stage, was projected to result in 36,752 fewer cases of cirrhosis; 1739 fewer liver transplants; 8169 fewer cases of hepatocellular carcinoma; 16,173 fewer HCV-related deaths; 0.84 additional life-years per patient; and 1.03 additional quality-adjusted life-years per patient. Treating all Medicaid patients with chronic HCV using LDV/SOF resulted in a 39.4% ($3.8 billion) savings and decreased the proportion of total costs attributable to downstream costs of care to 18.3%. A "treat all" strategy in a Medicaid population resulted in superior SVRs, substantial reductions in downstream negative clinical outcomes, and considerable cost savings. Current restrictive state policies regarding HCV treatment in Medicaid populations must be reassessed in light of these data.

First translational 'Think Tank' on cerebrovascular disease, cognitive impairment and dementia.

PubMed

Barone, Frank C; Gustafson, Deborah; Crystal, Howard A; Moreno, Herman; Adamski, Mateusz G; Arai, Ken; Baird, Alison E; Balucani, Clotilde; Brickman, Adam M; Cechetto, David; Gorelick, Philip; Biessels, Geert Jan; Kiliaan, Amanda; Launer, Lenore; Schneider, Julie; Sorond, Farzaneh A; Whitmer, Rachel; Wright, Clinton; Zhang, Zheng Gang

2016-02-13

As the human population continues to age, an increasing number of people will exhibit significant deficits in cognitive function and dementia. It is now recognized that cerebrovascular, metabolic and neurodegenerative diseases all play major roles in the evolution of cognitive impairment and dementia. Thus with our more recent recognition of these relationships and our need to understand and more positively impact on this world health problem, "The Leo and Anne Albert Charitable Trust" (Gene Pranzo, Trustee with significant support from Susan Brogan, Meeting Planner) provided generous support for this inaugural international workshop that was held from April 13-16, 2015 at the beautiful Ritz Carlton Golf Resort in North Naples, Florida. Researchers from SUNY Downstate Medical Center, Brooklyn, NY organized the event by selecting the present group of translationally inclined preclinical, clinical and population scientists focused on cerebrovascular disease (CVD) risk and its progression to vascular cognitive impairment (VCI) and dementia. Participants at the workshop addressed important issues related to aging, cognition and dementia by: (1) sharing new data, information and perspectives that intersect vascular, metabolic and neurodegenerative diseases, (2) discussing gaps in translating population risk, clinical and preclinical information to the progression of cognitive loss, and (3) debating new approaches and methods to fill these gaps that can translate into future therapeutic interventions. Participants agreed on topics for group discussion prior to the meeting and focused on specific translational goals that included promoting better understanding of dementia mechanisms, the identification of potential therapeutic targets for intervention, and discussed/debated the potential utility of diagnostic/prognostic markers. Below summarizes the new data-presentations, concepts, novel directions and specific discussion topics addressed by this international translational team at our "First Leo and Anne Albert Charitable Trust 'Think Tank' VCI workshop".

Factors associated with voice disorders among the elderly: a systematic review.

PubMed

Gois, Amanda Cibelly Brito; Pernambuco, Leandro de Araújo; Lima, Kenio Costa de

2017-12-26

During the aging process, natural modifications occur in the larynx and the structures involved in phonation which explain the specific characteristics found in the voices of elderly persons. When, at any moment, a voice fails and there is interference with communication, a voice disorder has occurred. This can generate disadvantages in communicative efficiency and have a negative impact on quality of life, compromising mechanisms of socialization, the maintenance of autonomy, and the sense of well-being. Nevertheless, there appears to be little clarity about which factors are associated with voice disorders in this population, especially from an epidemiological perspective. The present study is a literature review to identify factors associated with voice disorders among the elderly described in population-based studies. A systematic review of electronic databases was carried out. The methodological quality of the studies was analyzed with the Strengthening the Reporting of Observational Studies in Epidemiology guidelines. The research was conducted independently by two researchers. Although two articles met the eligibility criteria, none fulfilled all the criteria for the evaluation of methodological quality. According to the two studies selected for this review, factors associated with voice disorders among the elderly included both physical and psychosocial aspects. However, the methodological discrepancies between the studies, particularly in relation to sample selection and the instruments used indicate great variability and compromise the reliability of the results. Further prevalence studies and investigations of factors associated with voice disorders in the elderly from an epidemiological perspective, and which involve different cultures, should be carried out. Copyright © 2017 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

Barriers and facilitators to cultural competence in rehabilitation services: a scoping review.

PubMed

Grandpierre, Viviane; Milloy, Victoria; Sikora, Lindsey; Fitzpatrick, Elizabeth; Thomas, Roanne; Potter, Beth

2018-01-15

There is an important need to evaluate whether rehabilitation services effectively address the needs of minority culture populations with North America's increasingly diverse population. The objective of this paper was therefore to review and assess the state of knowledge of barriers and facilitators to cultural competence in rehabilitation services. Our scoping review focused on cultural competence in rehabilitation services. Rehabilitation services included in this review were: audiology, speech-language pathology, physiotherapy, and occupational therapy. A search strategy was developed to identify relevant articles published from inception of databases until April 2015. Titles and abstracts were screened by two independent reviewers according to specific eligibility criteria with the use of a liberal-accelerated approach. Full-text articles meeting inclusion criteria were then screened. Key study characteristics were abstracted by the first reviewer, and findings were verified by the second reviewer. After duplicates were removed, 4303 citations were screened. Included articles suggest that studies on cultural competence occur most frequently in occupational therapy (n = 17), followed by speech language pathology (n = 11), physiotherapy (n = 6), and finally audiology (n = 1). Primary barriers in rehabilitation services include language barriers, limited resources, and cultural barriers. Primary facilitators include cultural awareness amongst practitioners, cultural awareness in services, and explanations of health care systems. To our knowledge, this review is the first to summarize barriers and facilitators to cultural competence in rehabilitation fields. Insufficient studies were found to draw any conclusions with regards to audiological services. Minimal perspectives based on patient/caregiver experiences in all rehabilitation fields underscore a research gap. Future studies should aim to explore both patient/caregiver and practitioner perspectives as such data can help inform culturally competent practices.

Effective heart disease prevention: lessons from a qualitative study of user perspectives in Bangladeshi, Indian and Pakistani communities.

PubMed

Netto, G; McCloughan, L; Bhatnagar, A

2007-03-01

Coronary heart disease (CHD) has a high mortality, incidence and prevalence among Indian, Pakistani and Bangladeshi communities in the UK, indicating the need for effective heart disease prevention initiatives for these communities. This paper considers how service user perspectives can be used to develop effective, culturally focused CHD prevention interventions for these target groups by addressing identified barriers, including deeply held cultural beliefs. A qualitative research study, using a longitudinal action research approach. This was a community-based study in Edinburgh. Six focus group discussions--two for each community--were organized with participants from these communities at the beginning of the project. A further six focus group discussions for the same communities were organized six months later. Over the period examined, participants reported varying changes in levels of knowledge relating to the nature, causes and symptoms of CHD. Some participants reported taking slight to significant steps to reduce or prevent heart disease, while others did not. The project was viewed as helpful in increasing knowledge about CHD and preventive measures and encouraging healthier lifestyles. However, persistent barriers to change were also identified, requiring changes to the project that involved not only matching intervention materials and messages to observable, superficial characteristics of the target population, but more fundamental changes that address the cultural, social, historical, environmental and psychological forces that influence health behaviour. CHD prevention initiatives need to identify and respond to deep-rooted influences on health-behaviour in 'at-risk' groups, in addition to superficial characteristics of the target populations. It is important for specific prevention initiatives to be linked into wider CHD frameworks to ensure transferability of learning and integration within wider service provision.

The Fiscal Consequences Attributed to Changes in Morbidity and Mortality Linked to Investments in Health Care: A Government Perspective Analytic Framework.

PubMed

Connolly, Mark P; Kotsopoulos, Nikolaos; Postma, Maarten J; Bhatt, Aomesh

2017-02-01

Governments have an enormous economic and political stake in the health of their populations. Population health is not only fundamental to economic growth but also affects short-term and long-term government expenditure on health care, disability, and other social programs and influences direct and indirect tax receipts. Fiscal transfers between citizen and state are mostly ignored in conventional welfare economics analyses based on the hypothesis that there are no winners or losers through transference of wealth. However, from the government perspective, this position is flawed, as disability costs and lost taxes attributed to poor health and reduced productive output represent real costs that pose budgetary and growth implications. To address the value of health and health care investments for government, we have developed a fiscal health analytic framework that captures how changes in morbidity and mortality influence tax revenue and transfer costs (e.g., disability, allowances, ongoing health costs). The framework can be used to evaluate the marginal impact of discrete investments or a mix of interventions in health care to inform governmental budgetary consequences. In this context, the framework can be considered as a fiscal budget impact and/or cost-benefit analysis model that accounts for how morbidity and mortality linked to specific programs represent both ongoing costs and tax revenue for government. Mathematical models identical to those used in cost-effectiveness analyses can be employed in fiscal analysis to reflect how disease progression influences public accounts (e.g., tax revenue and transfers). Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Migrant and Refugee Patient Perspectives on Travel and Tuberculosis along the Thailand-Myanmar Border: A Qualitative Study.

PubMed

Tschirhart, Naomi; Sein, Tabitha; Nosten, Francois; Foster, Angel M

2016-01-01

The Thailand-Myanmar border separates two very different health systems. The healthcare system in eastern Myanmar remains underdeveloped as a result of decades of instability. Comparatively, Tak province, Thailand has more healthcare resources. In this Thai border province government hospitals and non-governmental organizations provide tuberculosis (TB) treatment to migrants and refugees. Our overall study aimed to explore accessibility of TB treatment, TB surveillance and health system responsiveness specific to migrant and refugee populations in Tak province. In this paper, we focus on the perspectives of migrant and refugee TB patients with respect to travel and treatment in Tak province. In 2014 we conducted focus group discussions with 61 TB, Tuberculosis and Human Immunodeficiency Virus co-infection, and multidrug-resistant TB patients in Tak province. We analyzed the data for content and themes and documented individual travel trajectories. Migrants are travelling with active TB within the country and between Thailand and Myanmar. Migrants primarily travelled to obtain treatment but two participants reported travelling home to seek family care in Myanmar before returning to Thailand for treatment. Travel, while expensive and arduous, is an adaptive strategy that migrants use to access healthcare. Migrant's need for travel points to larger difficulties associated with healthcare access in the border region. Long distance travel with an infectious disease can be seen as an indicator that local healthcare is not available or affordable. These findings suggest that public health officials from both sides of the border should discuss the factors that contribute to travel with active TB and explore potential solutions to mitigate disease transmission in migrant populations.

Psychology of Working Narratives of STEM Career Exploration for Non-dominant Youth

NASA Astrophysics Data System (ADS)

Mark, Sheron L.

2016-12-01

Science, technology, engineering, and mathematics (STEM) is a domain of knowledge, skills, and practices that is pervasive and of critical importance in our highly technological, rapidly advancing, and increasingly connected world; however, non-dominant youth, namely from non-White, lower-income, non-English-speaking, and immigrant backgrounds, are disproportionately underrepresented in STEM careers in the USA. Professional STEM career participation can be especially valuable for non-dominant populations as these careers are high quality, in-demand, and can afford one social mobility and economic stability. It is, therefore, important that we understand the ways in which non-dominant youth explore STEM careers such that we can further support and expand these. As such, this exploratory study has applied a career development perspective known as a Psychology of Working (PoW; Blustein in The psychology of working: a new perspective for career development, counseling, and public policy, Lawrence Erlbaum Associates, Mahwah, 2006) which is aptly suited to interpreting the career narratives of diverse, non-dominant populations in order to understand the unique STEM career exploration experiences of a group of non-dominant youth. The PoW framework has been modified in response to the developmental context of the youth, specifically, a focus on career expectations as opposed to career experiences, as well as their formal and informal educational experiences, including a National Science Foundation grant-funded STEM program, in which all of the participants were involved. From this study, an understanding has been gained of a number of different universal human needs that, when addressed, were influential on these youth's STEM career exploration. In particular, social connectedness via STEM career mentorship was identified as most impactful for these youth.

Chinese and Vietnamese adult male smokers' perspectives regarding facilitators of tobacco cessation behavior.

PubMed

Spigner, Clarence; Yip, Mei-Po; Huang, Bu; Tu, Shin Ping

2007-01-01

National surveys show a low prevalence of tobacco cigarette smoking within the Asian American/Pacific Islander population. However, smoking rates loom higher when data is disaggregated by ethnicity and gender. Nevertheless, few data are available on how smokers in this population quit smoking. The aim of this study was to collect first-hand perspectives from adult male Chinese and Vietnamese current and former smokers who were patients at a community clinic in Seattle, Washington, in order to understand the facilitators toward smoking cessation and the methods that they might use to quit smoking. A telephone survey was administered to age-eligible male Chinese and Vietnamese clinic patients who were current or former smokers. A total of 196 Chinese and 198 Vietnamese (N=394) adult male current and former smokers were contacted from a pool culled from the clinic database. Descriptive analysis using SPSS software revealed ethnicity-specific differences between current and former smokers regarding influences on smoking cessation behavior as well as uptake and endorsement of cessation methods. Family encouragement and physician recommendations were significant facilitators on the cessation process. Will power and self-determination were frequently mentioned by both Vietnamese and Chinese smokers as helpful methods to quit smoking. Vietnamese smokers were more resourceful than Chinese smokers in their use of smoking cessation methods. Even with access to cessation classes at a health clinic, half of current smokers indicated that they had no intention to quit. Such attitudes underscore the need for promotion of effective smoking cessation programs as well as successful strategies for reaching smokers. These conclusions are particularly important for Chinese smokers, who were comparatively less resourceful in their use of smoking cessation methods. Future studies should explore integrating the concept of will power with current mainstream state-of-the-art smoking cessation programs.

Migrant and Refugee Patient Perspectives on Travel and Tuberculosis along the Thailand-Myanmar Border: A Qualitative Study

PubMed Central

Sein, Tabitha; Nosten, Francois; Foster, Angel M.

2016-01-01

Background The Thailand-Myanmar border separates two very different health systems. The healthcare system in eastern Myanmar remains underdeveloped as a result of decades of instability. Comparatively, Tak province, Thailand has more healthcare resources. In this Thai border province government hospitals and non-governmental organizations provide tuberculosis (TB) treatment to migrants and refugees. Objectives Our overall study aimed to explore accessibility of TB treatment, TB surveillance and health system responsiveness specific to migrant and refugee populations in Tak province. In this paper, we focus on the perspectives of migrant and refugee TB patients with respect to travel and treatment in Tak province. Methods In 2014 we conducted focus group discussions with 61 TB, Tuberculosis and Human Immunodeficiency Virus co-infection, and multidrug-resistant TB patients in Tak province. We analyzed the data for content and themes and documented individual travel trajectories. Results and Discussion Migrants are travelling with active TB within the country and between Thailand and Myanmar. Migrants primarily travelled to obtain treatment but two participants reported travelling home to seek family care in Myanmar before returning to Thailand for treatment. Travel, while expensive and arduous, is an adaptive strategy that migrants use to access healthcare. Conclusions Migrant’s need for travel points to larger difficulties associated with healthcare access in the border region. Long distance travel with an infectious disease can be seen as an indicator that local healthcare is not available or affordable. These findings suggest that public health officials from both sides of the border should discuss the factors that contribute to travel with active TB and explore potential solutions to mitigate disease transmission in migrant populations. PMID:27509036

Provider perspectives on essential functions for care management in the collaborative treatment of hypertension: the P.A.R.T.N.E.R. framework.

PubMed

Hussain, Tanvir; Allen, Allyssa; Halbert, Jennifer; Anderson, Cheryl A M; Boonyasai, Romsai Tony; Cooper, Lisa A

2015-04-01

Care management has become a widespread strategy for improving chronic illness care. However, primary care provider (PCP) participation in programs has been poor. Because the success of care management relies on provider engagement, understanding provider perspectives is necessary. Our goal was to identify care management functions most valuable to PCPs in hypertension treatment. Six focus groups were conducted to discuss current challenges in hypertension care and identify specific functions of care management that would improve care. The study included 39 PCPs (participation rate: 83 %) representing six clinics, two of which care for large African American populations and four that are in underserved locations, in the greater Baltimore metropolitan area. This was a qualitative analysis of focus groups, using grounded theory and iterative coding. Providers desired achieving blood pressure control more rapidly. Collaborating with care managers who obtain ongoing patient data would allow treatment plans to be tailored to the changing life conditions of patients. The P.A.R.T.N.E.R. framework summarizes the care management functions that providers reported were necessary for effective collaboration: Partner with patients, providers, and the community; Arrange follow-up care; Resolve barriers to adherence; Track treatment response and progress; Navigate the health care system with patients; Educate patients & Engage patients in self-management; Relay information between patients and/or provider(s). The P.A.R.T.N.E.R. framework is the first to offer a checklist of care management functions that may promote successful collaboration with PCPs. Future research should examine the validity of this framework in various settings and for diverse patient populations affected by chronic diseases.

Cost-effectiveness of vitamin D and calcium supplementation in the treatment of elderly women and men with osteoporosis.

PubMed

Hiligsmann, Mickaël; Ben Sedrine, Wafa; Bruyère, Olivier; Evers, Silvia M; Rabenda, Véronique; Reginster, Jean-Yves

2015-02-01

The supplementation with vitamin D and calcium has been recommended for elderly, specifically those with increased risk of fractures older than 65 years. This study aims to assess the cost-effectiveness of vitamin D and calcium supplementation in elderly women and men with osteoporosis and therefore to assess if this recommendation is justified in terms of cost-effectiveness. A validated model for economic evaluations in osteoporosis was used to estimate the cost per quality-adjusted life-year (QALY) gained of vitamin D/calcium supplementation compared with no treatment. The model was populated with cost and epidemiological data from a Belgian health-care perspective. Analyses were conducted in women and men with a diagnosis of osteoporosis (i.e. bone mineral density T-score ≤-2.5). A literature search was conducted to describe the efficacy of vitamin D and calcium in terms of fracture risk reduction. The cost per QALY gained of vitamin D/calcium supplementation was estimated at €40 578 and €23 477 in women and men aged 60 years, respectively. These values decreased to €7912 and €10 250 at the age of 70 years and vitamin D and calcium supplementation was cost-saving at the age of 80 years, meaning that treatment cost was less than the costs of treating osteoporotic fractures of the no-treatment group. This study suggests that vitamin D and calcium supplementation is cost-effective for women and men with osteoporosis aged over 60 years. From an economic perspective, vitamin D and calcium should therefore be administrated in these populations including those also taking other osteoporotic treatments. © The Author 2014. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

Nursing Intensive-Care Satisfaction Scale [NICSS]: Development and validation of a patient-centred instrument.

PubMed

Romero-García, Marta; de la Cueva-Ariza, Laura; Benito-Aracil, Llucia; Lluch-Canut, Teresa; Trujols-Albet, Joan; Martínez-Momblan, Maria Antonia; Juvé-Udina, Maria-Eulàlia; Delgado-Hito, Pilar

2018-06-01

The aim of this study was to develop and validate the Nursing Intensive-Care Satisfaction Scale to measures satisfaction with nursing care from the critical care patient's perspective. Instruments that measure satisfaction with nursing cares have been designed and validated without taking the patient's perspective into consideration. Despite the benefits and advances in measuring satisfaction with nursing care, none instrument is specifically designed to assess satisfaction in intensive care units. Instrument development. The population were all discharged patients (January 2013 - January 2015) from three Intensive Care Units of a third level hospital (N = 200). All assessment instruments were given to discharged patients and 48 hours later, to analyse the temporal stability, only the questionnaire was given again. The validation process of the scale included the analysis of internal consistency, temporal stability; validity of construct through a confirmatory factor analysis; and criterion validity. Reliability was 0.95. The intraclass correlation coefficient for the total scale was 0.83 indicating a good temporal stability. Construct validity showed an acceptable fit and factorial structure with four factors, in accordance with the theoretical model, being Consequences factor the best correlated with other factors. Criterion validity, presented a correlation between low and high (range: 0.42-0.68). The scale has been designed and validated incorporating the perspective of critical care patients. Thanks to its reliability and validity, this questionnaire can be used both in research and in clinical practice. The scale offers a possibility to assess and develop interventions to improve patient satisfaction with nursing care. © 2018 John Wiley & Sons Ltd.

Achievement Goal Orientations and Identity Formation Styles

ERIC Educational Resources Information Center

Kaplan, Avi; Flum, Hanoch

2010-01-01

The present article points to shared underlying theoretical assumptions and central processes of a prominent academic motivation perspective--achievement goal theory--and recent process perspectives in the identity formation literature, and more specifically, identity formation styles. The review highlights the shared definition of achievement…

Migrant and minority family members in the intensive care unit. A review of the literature

PubMed Central

Quindemil, KettyElena; Anderson, Kathryn Hoehn; Mayer, Hanna

2013-01-01

Statistics show that people with migrant and minority background as patients are significant in numbers in the intensive care unit. This also puts family members in the perspective of nursing because family members are an inherent part of the intensive care unit. Family-centered care is perhaps most applicable to vulnerable populations like migrant family in the intensive care unit to meet family member’s needs. But very little is known about the situation of migrant and minority family members in the intensive care unit. The aim of the study was to explore the state of the science regarding family-centered care in the intensive care unit of patients with migration background in general and with a possible focus on major migrant populations in Austria—Former Yugoslavian und Turkish origin. A literature review investigated research articles that contained information on migrant and minority family members in the intensive care unit. Key points in the relevant articles were identified and categorized into themes with an explanation of findings at the end. Seventeen articles fulfilled the inclusion criteria. No article was found regarding groups of major migrant population groups in Austria. The included articles uncovered five predominant themes: importance of cultural norms, communication, family dynamics, universal caring, and nursing/provider deficit in culturally competent care. In order to provide adequate nursing care a more cohesive body of information on more specific geographic and cultural populations is recommended. Because of the complete lack of research regarding migrant families of Former Yugoslavian and Turkish origin into Austria, an exploration of this population is recommended. PMID:24860716

Extinction debt as a driver of amphibian declines: An example with imperiled flatwoods salamanders

USGS Publications Warehouse

Semiltsch, Raymond D; Walls, Susan; Barichivich, William J.; O'Donnell, Katherine

2017-01-01

A comprehensive view of population declines and their underlying causes is necessary to reverse species loss. Historically, in many cases, a narrow view may have allowed species declines to continue, virtually undetected, for long periods of time (perhaps even decades). We suggest that extinction debt is likely responsible for numerous (perhaps most) amphibian declines and that this perspective should be incorporated into the structure of amphibian research and management. Extinction debt, originally proposed to explain changes in species richness following environmental disturbance, also may refer to the proportion of populations of an individual species that is expected to eventually be lost because of habitat change. A conservation framework to address extinction debt focuses research on threats at the individual, population, and metapopulation levels. This approach will help enhance, restore, and protect specific processes and habitats at the proper scale by directing management to the most vulnerable level and stage of a species. We illustrate this approach using Flatwoods Salamanders, Ambystoma cingulatumand Ambystoma bishopi, which occurred historically throughout the Coastal Plain of the southeastern United States but have experienced a greater than 85% loss of populations in recent years. Reversal of these losses is possible only if conservation and recovery efforts encompass individual, population, and metapopulation levels. We illustrate our framework by outlining actions that could be taken at each of these levels to help guide conservation and management of amphibians with complex life cycles and provide options for how to prioritize conservation actions in the face of logistical and budgetary shortfalls.

[Demography perspectives and forecasts of the demand for electricity].

PubMed

Roy, L; Guimond, E

1995-01-01

"Demographic perspectives form an integral part in the development of electric load forecasts. These forecasts in turn are used to justify the addition and repair of generating facilities that will supply power in the coming decades. The goal of this article is to present how demographic perspectives are incorporated into the electric load forecasting in Quebec. The first part presents the methods, hypotheses and results of population and household projections used by Hydro-Quebec in updating its latest development plan. The second section demonstrates applications of such demographic projections for forecasting the electric load, with a focus on the residential sector." (SUMMARY IN ENG AND SPA) excerpt

Educational attainment and life expectancy: a perspective from the NIH Office of Behavioral and Social Sciences Research.

PubMed

Spittel, Michael L; Riley, William T; Kaplan, Robert M

2015-02-01

The NIH Office of Behavioral and Social Sciences Research (OBSSR) furthers the mission of the NIH by stimulating behavioral and social sciences research throughout NIH and integrating these areas of research more fully into the NIH health research enterprise, thereby improving our understanding, treatment, and prevention of disease. OBSSR accomplishes this mission through several strategic priorities: (1) supporting the next generation of basic behavioral and social sciences research, (2) facilitating interdisciplinary research, (3) promoting a multi-level systems perspective of health and behavior, and (4) encouraging a problem-focused perspective on population health. Published by Elsevier Ltd.

Roy's specific life values and the philosophical assumption of humanism.

PubMed

Hanna, Debra R

2013-01-01

Roy's philosophical assumption of humanism, which is shaped by the veritivity assumption, is considered in terms of her specific life values and in contrast to the contemporary view of humanism. Like veritivity, Roy's philosophical assumption of humanism unites a theocentric focus with anthropological values. Roy's perspective enriches the mainly secular, anthropocentric assumption. In this manuscript, the basis for Roy's perspective of humanism will be discussed so that readers will be able to use the Roy adaptation model in an authentic manner.

Equitable Perspectives: First-Year ESL Teachers' Expectations of, and Pedagogy for, Culturally and Linguistically Diverse Students

ERIC Educational Resources Information Center

Collazo, Judith

2017-01-01

As the American public school population has transformed from monolithic to multicultural, our teaching population has not (NCES, 2013). Thus, vast inequities in the US public schools for CLD students, compounded by a hierarchy of privilege and lowered teacher expectations, suppress the achievement and identities of culturally and linguistically…

Increasing Educational Attainment and Aspiration in an Underserved Community: The Perspective of Urban-Community Leaders

ERIC Educational Resources Information Center

Person, Dawn; Garcia, Yvonne; Fujimoto, Eugene; Nguyen, Kayla; Saunders, Katherine; Hoffman, John

2014-01-01

Latino students are significantly underrepresented in higher education. As the largest and fastest growing racial/ethnic population in the US, this is cause for national concern. Additionally, this rapid population growth is a call for community and school leaders from underserved communities to assess their service areas and focus on…

Welfare Systems, Aging and Work: An OECD Perspective.

ERIC Educational Resources Information Center

Visco, Ignazio

One of the major structural changes facing European economies is the adjustment to an older and more slowly growing population. Aging and lower fertility rates will result in a smaller proportion of the population being in the working age, especially after the year 2010. Estimates are that by 2030 there could be only 2 employed persons for every…

Historical perspective on the reintroduction of the fisher and American marten in Michigan and Wisconsin

Treesearch

Bronwyn W. Williams; Jonathan H. Gilbert; Patrick A. Zollner

2007-01-01

Management of mustelid species such as fishers and martens requires an understanding of the history of local populations. This is particularly true in areas where populations were extirpated and restored through reintroduction efforts. During the late 19th and 20th centuries, fishers (Martes pennanti) and American martens (Martes americana...

Teaching about a Growing World with a Good Book and a Geographic Perspective

ERIC Educational Resources Information Center

Hinde, Elizabeth R.

2012-01-01

Despite wars, natural disasters, fears of epidemics and pandemics, and other catastrophic events that are vividly featured in media outlets, the world's population continues to rise. In fact, the world recently passed another demographic milestone: a human population of 7 billion people. The number of people on Earth has tripled since around 1930,…

Expectations, Motivations, and Barriers to Professional Development: Perspectives from Adjunct Instructors Teaching Online

ERIC Educational Resources Information Center

Dailey-Hebert, Amber; Mandernach, B. Jean; Donnelli-Sallee, Emily; Norris, Virgil Rusty

2014-01-01

Adjunct instructors are the fastest growing population of faculty in the academy; and, given the current economic condition and its impact on institutions of higher learning, the proportion of adjunct faculty is likely to increase (Gappa, Austin & Trice, 2007; NCES, 2011). Yet the adjunct population continues to remain disconnected from the…

Specific deficit analyses in motor performance and quality of life of pediatric cancer patients--a cross-sectional pilot study.

PubMed

Beulertz, Julia; Bloch, Wilhelm; Prokop, Aram; Baumann, Freerk T

2013-05-01

Although survival rates in childhood cancer have distinctly improved, pediatric cancer patients often experience various disease- and treatment-related side effects with long-term consequences. Despite current studies investigating inactivity and limitations in physical functioning and quality of life in pediatric cancer patients, only little information regarding specific deficits in physical functioning and quality of life has been available until now. No study has yet analyzed these parameters from a global perspective and then identified specific deficits in a mixed childhood cancer population. Within this cross-sectional pilot study, motor performance and quality of life of 26 pediatric cancer patients were assessed after inpatient medical treatment, using standardized motor test batteries (MOT 4-6; DMT 6-18) and a quality of life questionnaire (KINDL®). Reference data have been mainly provided by the German "Children and Young People Health Survey" (KiGGS). Patients achieved lower motor performance scores (p = .000) (more than 27% below the average of healthy peers). Specific deficits were identified in motor speed and motor control (4-6 years), as well as in endurance, strength and coordination under time pressure (6-17 years). In terms of quality of life, no significant differences were examined compared to healthy children of the same age. The results of this study confirm that children with oncological diseases frequently have specific motor problems. Future research in pediatric oncology must investigate the impact of targeted, individualized exercise interventions addressing these specific deficits.

The dynamics of health in wild field vole populations: a haematological perspective

PubMed Central

Beldomenico, Pablo M.; Telfer, Sandra; Gebert, Stephanie; Lukomski, Lukasz; Bennett, Malcolm; Begon, Michael

2010-01-01

Summary Pathogens have been proposed as potentially important drivers of population dynamics, but while a few studies have investigated the impact of specific pathogens, the wealth of information provided by general indices of health has hardly been exploited. By evaluating haematological parameters in wild populations, our knowledge of the dynamics of health and infection may be better understood. Here, haematological dynamics in natural populations of field voles are investigated to determine environmental and host factors associated with indicators of inflammatory response (counts of monocytes and neutrophils) and of condition: measures of immunological investment (lymphocyte counts) and aerobic capacity (red blood cell counts). Individuals from three field vole populations were sampled monthly for 2 years. Comparisons with individuals kept under controlled conditions facilitated interpretation of field data. Mixed effects models were developed for each cell type to evaluate separately the effects of various factors on post-juvenile voles and mature breeding females. There were three well-characterized ‘physiological’ seasons. The immunological investment appeared lowest in winter (lowest lymphocyte counts), but red blood cells were at their highest levels and indices of inflammatory response at their lowest. Spring was characterized by a fall in red blood cell counts and peaks in indicators of inflammatory response. During the course of summer—autumn, red blood cell counts recovered, the immunological investment increased and the indicators of inflammatory response decreased. Poor body condition appeared to affect the inflammatory response (lower neutrophil and monocyte peaks) and the immunological investment (lower lymphocyte counts), providing evidence that the capacity to fight infection is dependent upon host condition. Breeding early in the year was most likely in females in better condition (high lymphocyte and red blood cell counts). All the haematological parameters were affected adversely by high population densities. PMID:18564292

The Population History of Endogenous Retroviruses in Mule Deer (Odocoileus hemionus)

PubMed Central

2014-01-01

Mobile elements are powerful agents of genomic evolution and can be exceptionally informative markers for investigating species and population-level evolutionary history. While several studies have utilized retrotransposon-based insertional polymorphisms to resolve phylogenies, few population studies exist outside of humans. Endogenous retroviruses are LTR-retrotransposons derived from retroviruses that have become stably integrated in the host genome during past infections and transmitted vertically to subsequent generations. They offer valuable insight into host-virus co-evolution and a unique perspective on host evolutionary history because they integrate into the genome at a discrete point in time. We examined the evolutionary history of a cervid endogenous gammaretrovirus (CrERVγ) in mule deer (Odocoileus hemionus). We sequenced 14 CrERV proviruses (CrERV-in1 to -in14), and examined the prevalence and distribution of 13 proviruses in 262 deer among 15 populations from Montana, Wyoming, and Utah. CrERV absence in white-tailed deer (O. virginianus), identical 5′ and 3′ long terminal repeat (LTR) sequences, insertional polymorphism, and CrERV divergence time estimates indicated that most endogenization events occurred within the last 200000 years. Population structure inferred from CrERVs (F ST = 0.008) and microsatellites (θ = 0.01) was low, but significant, with Utah, northwestern Montana, and a Helena herd being particularly differentiated. Clustering analyses indicated regional structuring, and non-contiguous clustering could often be explained by known translocations. Cluster ensemble results indicated spatial localization of viruses, specifically in deer from northeastern and western Montana. This study demonstrates the utility of endogenous retroviruses to elucidate and provide novel insight into both ERV evolutionary history and the history of contemporary host populations. PMID:24336966

The population history of endogenous retroviruses in mule deer (Odocoileus heminous)

USGS Publications Warehouse

Kamath, Pauline L.; Elleder, Daniel; Bao, Le; Cross, Paul C.; Powell, John H.; Poss, Mary

2013-01-01

Mobile elements are powerful agents of genomic evolution and can be exceptionally informative markers for investigating species and population-level evolutionary history. While several studies have utilized retrotransposon-based insertional polymorphisms to resolve phylogenies, few population studies exist outside of humans. Endogenous retroviruses are LTR-retrotransposons derived from retroviruses that have become stably integrated in the host genome during past infections and transmitted vertically to subsequent generations. They offer valuable insight into host-virus co-evolution and a unique perspective on host evolutionary history because they integrate into the genome at a discrete point in time. We examined the evolutionary history of a cervid endogenous gammaretrovirus (CrERVγ) in mule deer (Odocoileus hemionus). We sequenced 14 CrERV proviruses (CrERV-in1 to -in14), and examined the prevalence and distribution of 13 proviruses in 262 deer among 15 populations from Montana, Wyoming, and Utah. CrERV absence in white-tailed deer (O. virginianus), identical 5′ and 3′ long terminal repeat (LTR) sequences, insertional polymorphism, and CrERV divergence time estimates indicated that most endogenization events occurred within the last 200000 years. Population structure inferred from CrERVs (F ST = 0.008) and microsatellites (θ = 0.01) was low, but significant, with Utah, northwestern Montana, and a Helena herd being particularly differentiated. Clustering analyses indicated regional structuring, and non-contiguous clustering could often be explained by known translocations. Cluster ensemble results indicated spatial localization of viruses, specifically in deer from northeastern and western Montana. This study demonstrates the utility of endogenous retroviruses to elucidate and provide novel insight into both ERV evolutionary history and the history of contemporary host populations.

Evaluation of the 10th Grade Computerized Mathematics Curriculum from the Perspective of the Teachers and Educational Supervisors in the Southern Region in Jordan

ERIC Educational Resources Information Center

Al-Tarawneh, Sabri Hassan; Al-Qadi, Haitham Mamdouh

2016-01-01

This study aimed at evaluating the 10th grade computerized mathematics curriculum from the perspective of the teachers and supervisors in the southern region in Jordan. The study population consisted of all the teachers who teach the 10th grade in the southern region, with the total of (309) teachers and (20) supervisors. The sample consisted of…

[Transition from Millennium Development Goals to Sustainable Development Goals from the perspective of the social determinants of health and health equity].

PubMed

Urbina-Fuentes, Manue; Jasso-Gutiérrez, Luis; Schiavon-Ermani, Raffaela; Lozano, Rafael; Finkelman, Jacobo

2017-01-01

The United Nations Declaration of 2000 agreed on eight millennium development goals (MDGs) to be met in 2015. The results show that poverty continues through population growth and advances in both rich and poor countries are threatened by economic crises and inequities in geographic areas and population groups within countries. In a globalized world with great social and economic inequalities, from the perspective of the social determinants of health (SDH), the relevance of the new 17 sustainable development goals (SDGs) is greater. Faced with the health challenges in our country to achieve SDGs, the symposium "The transition from MDGs to SDGs from the perspective of SDH and health equity" was presented at the XLIV Congress of the National Academy of Medicine. The presentations dealt with five important aspects of the transition in Mexico: background and context; the current state of the MDGs in childhood; the impact on gender equity and adolescent fertility; the health system and the theme of environmental health and were presented by Dr. Raffaela Schiavon, Jacobo Finkelman, Luis Jasso and Rafael Lozano.

Toward youth self-report of health and quality of life in population monitoring.

PubMed

Topolski, Tari D; Edwards, Todd C; Patrick, Donald L

2004-01-01

This paper addresses population monitoring of youth health and quality of life, including the concepts used, methodological and practical criteria for indicators, and existing surveys and measures. Current population surveys of youth generally focus on poor health, such as disability or health-risk behaviors. Although these are important end points, indicators of illness or risk do not reflect the health or life perspective of the majority of youth who do not experience health problems. The measures used to monitor youth health should be appropriate and sensitive to future needs and capture the perspectives of youths. Two potential concepts for this "scorecard" are self-perceived health and quality of life, which have been shown to be useful in adults. For youth, the quality of life framework seems particularly relevant as it incorporates both positive and negative aspects of health and well-being and also captures salient aspects of health other than physical health, such as sense of self, social relationships, environment and culture, and life satisfaction.

Challenges in Transgender Healthcare: The Pathology Perspective

PubMed Central

Gupta, Sarika; Imborek, Katherine L.; Krasowski, Matthew D.

2016-01-01

Background: The transgender community is one of the most marginalized sections of our society. The literature is scarce regarding the pathology and laboratory medicine challenges associated with caring for transgender patients. Objective: To summarize the available gender-transitioning options and to discuss healthcare challenges, from a pathology/laboratory medicine perspective, in the care of transgender patients. Method: We reviewed the current terminology and epidemiology relevant to the transgender population in preparing our analysis. Conclusions: The main transgender healthcare challenges in pathology/laboratory medicine practice include the inflexibility of electronic medical records in documenting affirmed gender, unfamiliarity among medical and laboratory professional with the needs of and terminology related to the transgender population, lack of reference ranges for laboratory tests, unclear guidelines regarding gender classification for blood donation eligibility criteria, and paucity of experience in handling and interpreting surgical and cytologic specimens from gender-transitioning individuals. Directed efforts to overcome these shortcomings, coupled with a more welcoming posture, are essential to achieving the highest standards of care for the transgender population. PMID:27287942

Rural youth violence: it is a public health concern!

PubMed

Kulig, Judith C; Nahachewsky, Deana; Hall, Barry L; Kalischuk, Ruth Grant

2005-01-01

Youth violence is a significant issue for public health because of the potential for long-term impacts on individuals, families and communities. Limited exposure to violence is seen as a component of healthy living. However, there is limited understanding of violence from a public health perspective within rural communities. Rural refers to those communities with a population less than 10,000 outside the main commuting zone of a large urban area. Population health approaches, including the social determinants of health, are well supported by public health officials. Generating information about rural youth violence from a Canadian perspective would add to our understanding of these social determinants while providing guidance for policy and program development. Current understandings of youth violence are limited to an urban, and oftentimes, American perspective. An ongoing two-phase Canadian study on rural youth violence included qualitative interviews with 52 youth and the completion of a questionnaire that had been developed from the qualitative responses. The questionnaire has been completed by a larger sample of rural youth. The findings generated from this ongoing study will be useful in linking violence with social factors that impact health and thereby guide population health programs and policies. In this way, the role of public health to develop policies and implement programs will be directly influenced by evidence while addressing an ongoing public health concern.

Sport, and use of anabolic androgenic steroids among Icelandic high school students: a critical test of three perspectives.

PubMed

Thorlindsson, Thorolfur; Halldorsson, Vidar

2010-12-20

This study investigates the use of anabolic androgenic steroids (AAS) among a national representative sample of high school students in Iceland. We test several hypotheses drawn from three perspectives. The first perspective focuses on the use of AAS as an individual phenomenon motivated by the desire to succeed in sport. The second perspective views the use of AAS as shaped by norms and values embedded in social relationships of formally organized sport. The third perspective suggests that factors outside sport, which have been shown to correlate with the use of other substances, predict the use of AAS. We use logistic regression and predicted probabilities to analyze data from a national representative survey of 11,031 Icelandic high school students. Our results indicated that the use of AAS is not significantly related to participation in formally organized sports. However, it positively relates to fitness and physical training in informal contexts. We found a relatively strong relationship between the use of AAS and the use of illicit substances and a moderate relationship between AAS use and alcohol and tobacco consumption. We also found a significant negative relationship between AAS use and school integration and school achievement, and a significant positive relationship between AAS use and school anomie. The relation between AAS use and family-related variables was weaker. Finally, we found that the relationship between sport participation, physical exercise, and AAS use varies across levels of anomie and integration. Our findings suggest that the use of AAS and especially illegal substances should be considered more as a social and a health problem rather than a sport specific issue. We found that high school students participating in fitness and informal training outside of formally organized sport clubs are the main risk group and should be the target of prevention efforts. However, this should not be done at the expense of general risk factors that affect AAS and other substances used by the general population. Finally, we suggest that prevention efforts should target both groups and individuals.

Cognitive and emotional processing of pleasant and unpleasant experiences in major depression: A matter of vantage point?

PubMed

Pfaltz, Monique C; Wu, Gwyneth W Y; Liu, Guanyu; Tankersley, Amelia P; Stilley, Ashley M; Plichta, Michael M; McNally, Richard J

2017-03-01

In nonclinical populations, adopting a third-person perspective as opposed to a first-person perspective while analyzing negative emotional experiences fosters understanding of these experiences and reduces negative emotional reactivity. We assessed whether this generalizes to people with major depression (MD). Additionally, we assessed whether the emotion-reducing effects of adopting a third-person perspective also occur when subjects with MD and HC subjects analyze positive experiences. Seventy-two MD subjects and 82 HC subjects analyzed a happy and a negative experience from either a first-person or a third-person perspective. Unexpectedly, we found no emotion-reducing effects of third-person perspective in either group thinking about negative events. However, across groups, third-person perspective was associated with less recounting of negative experiences and with a clearer, more coherent understanding of them. Negative affect decreased and positive affect increased in both groups analyzing happy experiences. In MD subjects, decreases in depressive affect were stronger for the third-person perspective. In both groups, positive affect increased and negative affect decreased more strongly for the third-person perspective. While reflecting on their positive memory, MD subjects adopted their assigned perspective for a shorter amount of time (70%) than HC subjects (78%). However, percentage of time participants adopted their assigned perspective was unrelated to the significant effects we found. Both people suffering from MD and healthy individuals may benefit from processing pleasant experiences, especially when adopting a self-distant perspective. Copyright © 2016 Elsevier Ltd. All rights reserved.

Beyond Box Checking: Toward Sound Environmental Justice Analyses for Informed Decision-Making and Meaningful Tribal Consultation

NASA Astrophysics Data System (ADS)

Emanuel, R. E.; Rivers, L., III; Blank, G. B.

2017-12-01

Environmental justice analyses are mandatory components of federal environmental reviews in the United States. They are intended to help regulators and developers identify and address disproportionate impacts on poor and/or minority populations. In many cases, however, environmental justice analyses are treated as "box checking" exercises that employ weak or flawed designs unable to detect disparate impacts on vulnerable populations. We use a recent example of an environmental review led by the Federal Energy Regulatory Commission to demonstrate how flawed analyses mask disproportionate impacts on poor and/or minority populations. In this case, regulators conducted a flawed environmental justice analysis for the proposed Atlantic Coast Pipeline concluding no disproportionate impacts on vulnerable populations. We reanalyze data from the project's environmental impact statement and provide a more accurate assessment of impacts on Native Americans in North Carolina. Specifically, we show that Native Americans make up a disproportionately large fraction of residents along the proposed pipeline route (13.2%) compared to their representation in the affected counties (6.2%) or in the state at large (1.2%). We discuss implications of the original, flawed analysis for tribes representing nearly 30,000 Native Americans along the project route, and we discuss efforts by affected tribes to have their unique perspectives incorporated into the decision-making process. We conclude with general recommendations for designing environmental justice analyses that serve as useful tools to guide environmental decision-making and consultation with affected groups.

A Cross-Cultural Study of Task Specificity in Creativity

ERIC Educational Resources Information Center

Storme, Martin; Lubart, Todd; Myszkowski, Nils; Cheung, Ping Chung; Tong, Toby; Lau, Sing

2017-01-01

This study provides new evidence concerning task specificity in creativity--examining through a cross-cultural perspective the extent to which performance in graphic versus verbal creativity tasks (domain specificity) and in divergent versus convergent creativity tasks (process specificity) are correlated. The relations between different…