119 research outputs found

    The role of education in development of an indigenous Mexican community : indigenous perspectives : a thesis presented in partial fulfilment of the requirements for the degree of Master of Philosophy in Development Studies at Massey University

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    This thesis is concerned with the role of formal education in development for indigenous peoples. To shed light on the complex relationship between education and development, it presents an in-depth exploration of the experiences, concerns and aspirations of members of one indigenous Mexican community concerning the issues of identity, development and schooling. It investigates how the people of this location, a Zapoteco village in the southern Mexican state of Oaxaca, see development for their community, and how formal education could best contribute to the achievement of these aspirations. Education is considered within the context of different social processes taking place in the community. Attention is focused on the perspectives of indigenous parents and young people, in accordance with a view of development which recognises the expertise of local people in analysing their situation, and respects their opinions and ideas as paramount to achieving appropriate development. Data from interviews with community members is analysed to reveal a number of themes running through respondents' opinions on culture, identity and development, and the interaction of formal education with these. Their ideas concerning education and cultural autonomy are considered in the light of educational and cultural theories sustained by research, and an analysis of the potential of formal education to contribute to the achievement of expressed development goals is presented. Development for most Tabae√Īos consisted on the one hand of cultural continuity, in terms of traditional livelihoods, forms of social organisation and language, and on the other of the acquisition of skills, knowledge and institutions that will allow for the economic, social and cultural development of the community and its individuals. Research and the experiences of indigenous communities elsewhere in the world suggest that education has the potential to support community development in both of these aspects. Tabae√Īos are beginning to take a more active role in formal education, and the existence of a solid and autochthonous foundation for participation and locally controlled development in the community offers grounds for cautious optimism regarding its ability to continue to define and achieve both the education and the development talked of by community members

    The clinical- and cost-effectiveness of functional electrical stimulation and ankle-foot orthoses for foot drop in Multiple Sclerosis: a multicentre randomized trial

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    Objective: To compare the clinical- and cost-effectiveness of ankle-foot orthoses (AFOs) and functional electrical stimulation (FES) over 12 months in people with Multiple Sclerosis with foot drop. Design: Multicentre, powered, non-blinded, randomized trial. Setting: Seven Multiple Sclerosis outpatient centres across Scotland. Subjects: Eighty-five treatment-na√Įve people with Multiple Sclerosis with persistent (>three months) foot drop. Interventions: Participants randomized to receive a custom-made, AFO (n = 43) or FES device (n = 42). Outcome measures: Assessed at 0, 3, 6 and 12 months; 5-minute self-selected walk test (primary), Timed 25 Foot Walk, oxygen cost of walking, Multiple Sclerosis Impact Scale-29, Multiple Sclerosis Walking Scale-12, Modified Fatigue Impact Scale, Euroqol five-dimension five-level questionnaire, Activities-specific Balance and Confidence Scale, Psychological Impact of Assistive Devices Score, and equipment and National Health Service staff time costs of interventions. Results: Groups were similar for age (AFO, 51.4 (11.2); FES, 50.4(10.4) years) and baseline walking speed (AFO, 0.62 (0.21); FES 0.73 (0.27) m/s). In all, 38% dropped out by 12 months (AFO, n = 21; FES, n = 11). Both groups walked faster at 12 months with device (P < 0.001; AFO, 0.73 (0.24); FES, 0.79 (0.24) m/s) but no difference between groups. Significantly higher Psychological Impact of Assistive Devices Scores were found for FES for Competence (P = 0.016; AFO, 0.85(1.05); FES, 1.53(1.05)), Adaptability (P = 0.001; AFO, 0.38(0.97); FES 1.53 (0.98)) and Self-Esteem (P = 0.006; AFO, 0.45 (0.67); FES 1 (0.68)). Effects were comparable for other measures. FES may offer value for money alternative to usual care. Conclusion: AFOs and FES have comparable effects on walking performance and patient-reported outcomes; however, high drop-outs introduces uncertainty

    Occupational Injustice and the Right to Play: A Systematic Review of Accessible Playgrounds for Children with Disabilities

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    Background: Playgrounds facilitate important opportunities for growth and development during childhood. These experiences are not afforded to children with disabilities due to environmental and societal barriers despite ADA regulations. The objective of this systematic review is to dentify and synthesize existing research on the relationship between key areas of development and accessible play settings for children aged 3-12 with disabilities, and provide occupational therapy practitioners (OTPs) with a body of evidence to inform evidence-based interventions and utilize in advocating for occupational justice. Methods: The following databases were searched on January 30, 2021: Academic Search Complete/EBSCO, CINAHL/EBSCO, Education Research Complete/EBSCO, ERIC, OTSeeker, and PubMed. Study Selection and Data Collection: This systematic review was conducted using PRISMA guidelines. Included studies were peer-reviewed, included children with disabilities aged 3-12, in an accessible play setting, and had outcomes related to areas of childhood development. Validated tools were used to determine risk of bias and quality of evidence. Results: Nine articles met inclusion criteria. This included one Level IIIB matched case-control study, four Level IV cross-sectional studies, three Level V qualitative studies, and one mixed-methods study with both Level IV and Level V evidence. Social participation, play participation, and motor skill development were negatively impacted in 8 of 9 studies despite playgrounds being labeled accessible. Conclusion: Children with disabilities have decreased engagement in activities that provide opportunities for play, social participation, and motor skill development. OTPs should address occupational injustice in the playground setting through developing programs to combat stigma, engaging in policy and playground design, and conducting longitudinal cohort studies. Through addressing play accessibility, OTPs could significantly reduce instances of play inequity. Creating interdisciplinary teams to address accessible playground design locally would allow OTPs the opportunity to make a lasting impact for the children in their community

    Effects of Age and Functional Status on the Relationship of Systolic Blood Pressure With Mortality in Mid and Late Life: The ARIC Study

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    Impaired functional status attenuates the relationship of systolic blood pressure (SBP) with mortality in older adults but has not been studied in middle-aged populations

    Factors Related to Differences in Retention among African Americans and White Participants in the Atherosclerosis Risk in Communities Study (ARIC) Prospective Cohort: 1987-2013

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    Background: Few studies have addressed retention of minorities, particularly African Americans, in longitudinal research. Our aim was to determine whether there was differ­ential retention between African Americans and Whites in the ARIC cohort and identify cardiovascular disease (CVD) risk factors and indicators of socioeconomic status (SES) as­sociated with these retention differences.Methods: 15,688 participants, 27% African American and 73% White, were included from baseline, 1987-1989, and classified as having died, lost or withdrew from study contact, or remained active in study calls through 2013. Life tables were created illustrating retention patterns stratified by race, from baseline through visit 5, 2011- 2013. Prevalence tables stratified by race, participation status, and center were cre­ated to examine CVD risk factors and SES at baseline and visit 5.Results: 54% of African Americans com­pared with 62% of Whites were still in follow-up by 2013. This difference was due to an 8% higher cumulative incidence of death among African Americans. Those who remained in follow-up had the lowest baseline CVD risk factors and better SES, followed by those who were lost/withdrew, then those who died. Whites had lower lev­els of most CVD risk factors and higher SES than African Americans overall at baseline and visit 5; though, the magnitude of visit 5 differences was less.Conclusions: In the ARIC cohort, reten­tion differed among African Americans and Whites, but related more to mortality dif­ferences than dropping-out. Additional re­search is needed to better characterize the factors contributing to minority participants’ recruitment and retention in longitudinal research.Ethn Dis. 2017;27(1):31-38; doi:10.18865/ed.27.1.31.</p

    The Importance of Mid-to-Late-Life Body Mass Index Trajectories on Late-Life Gait Speed

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    Background: Prior studies suggest being overweight may be protective against poor functional outcomes in older adults. Methods: Body mass index (BMI, kg/m2) was measured over 25 years across five visits (1987-2011) among Atherosclerosis Risk in Communities Study participants (baseline Visit 1 n = 15,720, aged 45-64 years). Gait speed was measured at Visit 5 ("late-life", aged ‚Č•65 years, n = 6,229). BMI trajectories were examined using clinical cutpoints and continuous mixed models to estimate effects of patterns of BMI change on gait speed, adjusting for demographics and comorbidities. Results: Mid-life BMI (baseline visit; 55% women; 27% black) was associated with late-life gait speed 25 years later; gait speeds were 94.3, 89.6, and 82.1 cm/s for participants with baseline normal BMI (<25), overweight (25 ‚ȧ BMI < 30), and obese (BMI ‚Č• 30) (p < .001). In longitudinal analyses, late-life gait speeds were 96.9, 88.8, and 81.3 cm/s for participants who maintained normal, overweight, and obese weight status, respectively, across 25 years (p < .01). Increasing BMI over 25 years was associated with poorer late-life gait speeds; a 1%/year BMI increase for a participant with a baseline BMI of 22.5 (final BMI 28.5) was associated with a 4.6-cm/s (95% confidence interval: -7.0, -1.8) slower late-life gait speed than a participant who maintained a baseline BMI of 22.5. Conclusion: Being overweight in older age was not protective of mobility function. Maintaining a normal BMI in mid- and late-life may help preserve late-life mobility

    Correlation between molar activity, injection mass and uptake of the PARP targeting radiotracer [F-18]olaparib in mouse models of glioma

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    Purpose Radiopharmaceuticals targeting poly(ADP-ribose) polymerase (PARP) have emerged as promising agents for cancer diagnosis and therapy. PARP enzymes are expressed in both cancerous and normal tissue. Hence, the injected mass, molar activity and potential pharmacological effects are important considerations for the use of radiolabelled PARP inhibitors for diagnostic and radionuclide therapeutic applications. Here, we performed a systematic evaluation by varying the molar activity of [F-18]olaparib and the injected mass of [F-Total]olaparib to investigate the effects on tumour and normal tissue uptake in two subcutaneous human glioblastoma xenograft models. Methods [F-18]Olaparib uptake was evaluated in the human glioblastoma models: in vitro on U251MG and U87MG cell lines, and in vivo on tumour xenograft-bearing mice, after administration of [F-Total]olaparib (varying injected mass: 0.04-8.0 mu g, and molar activity: 1-320 GBq/mu mol). Results Selective uptake of [F-18]olaparib was demonstrated in both models. Tumour uptake was found to be dependent on the injected mass of [F-Total]olaparib (mu g) but not the molar activity. An injected mass of 1 mu g resulted in the highest tumour uptake (up to 6.9 +/- 1.3%ID/g), independent of the molar activity. In comparison, both the lower and higher injected masses of [F-Total]olaparib resulted in lower relative tumour uptake (%ID/g; P 0.5 mu g). Conclusion Our findings show that the injected mass of [F-Total]olaparib has significant effects on tumour uptake. Moderate injected masses of PARP inhibitor-derived radiopharmaceuticals may lead to improved relative tumour uptake and tumour-to-background ratio for cancer diagnosis and radionuclide therapy

    Anger Proneness, Gender, and the Risk of Heart Failure

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    Evidence concerning the association of anger-proneness with incidence of heart failure is lacking

    Neural tube defects and maternal intake of micronutrients related to one-carbon metabolism or antioxidant activity

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    Maternal nutritional status has been evaluated to clarify its role in development of neural tube defects (NTDs). Maternal folate intake during pregnancy has been closely evaluated for its association with NTDs

    Impact of long-term measures of glucose and blood pressure on the retinal microvasculature

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    Retinopathy and retinal microvascular abnormalities are common in adult populations, yet few long-term predictors have been identified. We therefore examined the association between systolic blood pressure (SBP) and fasting plasma glucose, assessed over 18 years, with retinopathy and retinal vascular caliber in 2,066 Carotid MRI participants, an Atherosclerosis Risk in Communities ancillary study
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