Promoting Physical Activity in Local Communities: Understanding Health, Nutrition, and Physical Activity Needs in Winooski, VT

Introduction: Since the Winooski YMCA opened in March 2008, enrollment has been much lower than expected, with only 200 members enrolled by September 2008. One goal of the YMCA is to promote the health of the community by increasing involvement in physical activity in Winooski. Regular exercise is associated with enhanced health and decreased risk of diabetes, cardiovascular disease, as well as many cancers. In order to promote physical activity in the Winooski community, the YMCA set a goal to increase their enrollment to 500 members by December 2008.https://scholarworks.uvm.edu/comphp_gallery/1005/thumbnail.jp

The cost of mapping trachoma: Data from the Global Trachoma Mapping Project.

BACKGROUND: The Global Trachoma Mapping Project (GTMP) was implemented with the aim of completing the baseline map of trachoma globally. Over 2.6 million people were examined in 1,546 districts across 29 countries between December 2012 and January 2016. The aim of the analysis was to estimate the unit cost and to identify the key cost drivers of trachoma prevalence surveys conducted as part of GTMP. METHODOLOGY AND PRINCIPAL FINDINGS: In-country and global support costs were obtained using GTMP financial records. In-country expenditure was analysed for 1,164 districts across 17 countries. The mean survey cost was $13,113 per district [median:$11,675; IQR = $8,365-$14,618], $17,566 per evaluation unit [median:$15,839; IQR = $10,773-$19,915], $692 per cluster [median:$625; IQR = $452-$847] and $6.0 per person screened [median:$4.9; IQR = $3.7-$7.9]. Survey unit costs varied substantially across settings, and were driven by parameters such as geographic location, demographic characteristics, seasonal effects, and local operational constraints. Analysis by activities showed that fieldwork constituted the largest share of in-country survey costs (74%), followed by training of survey teams (11%). The main drivers of in-country survey costs were personnel (49%) and transportation (44%). Global support expenditure for all surveyed districts amounted to $5.1m, which included grant management, epidemiological support, and data stewardship. CONCLUSION: This study provides the most extensive analysis of the cost of conducting trachoma prevalence surveys to date. The findings can aid planning and budgeting for future trachoma surveys required to measure the impact of trachoma elimination activities. Furthermore, the results of this study can also be used as a cost basis for other disease mapping programmes, where disease or context-specific survey cost data are not available

Quality Assurance and Quality Control in the Global Trachoma Mapping Project.

In collaboration with the health ministries that we serve and other partners, we set out to complete the multiple-country Global Trachoma Mapping Project. To maximize the accuracy and reliability of its outputs, we needed in-built, practical mechanisms for quality assurance and quality control. This article describes how those mechanisms were created and deployed. Using expert opinion, computer simulation, working groups, field trials, progressively accumulated in-project experience, and external evaluations, we developed 1) criteria for where and where not to undertake population-based prevalence surveys for trachoma; 2) three iterations of a standardized training and certification system for field teams; 3) a customized Android phone-based data collection app; 4) comprehensive support systems; and 5) a secure end-to-end pipeline for data upload, storage, cleaning by objective data managers, analysis, health ministry review and approval, and online display. We are now supporting peer-reviewed publication. Our experience shows that it is possible to quality control and quality assure prevalence surveys in such a way as to maximize comparability of prevalence estimates between countries and permit high-speed, high-fidelity data processing and storage, while protecting the interests of health ministries

Community prevalence of SARS-CoV-2 in England from April to November, 2020: results from the ONS Coronavirus Infection Survey

Background: Decisions about the continued need for control measures to contain the spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) rely on accurate and up-to-date information about the number of people testing positive for SARS-CoV-2 and risk factors for testing positive. Existing surveillance systems are generally not based on population samples and are not longitudinal in design. Methods: Samples were collected from individuals aged 2 years and older living in private households in England that were randomly selected from address lists and previous Office for National Statistics surveys in repeated crosssectional household surveys with additional serial sampling and longitudinal follow-up. Participants completed a questionnaire and did nose and throat self-swabs. The percentage of individuals testing positive for SARS-CoV-2 RNA was estimated over time by use of dynamic multilevel regression and poststratification, to account for potential residual non-representativeness. Potential changes in risk factors for testing positive over time were also assessed. The study is registered with the ISRCTN Registry, ISRCTN21086382. Findings: Between April 26 and Nov 1, 2020, results were available from 1 191 170 samples from 280327 individuals; 5231 samples were positive overall, from 3923 individuals. The percentage of people testing positive for SARS-CoV-2 changed substantially over time, with an initial decrease between April 26 and June 28, 2020, from 0·40% (95% credible interval 0·29–0·54) to 0·06% (0·04–0·07), followed by low levels during July and August, 2020, before substantial increases at the end of August, 2020, with percentages testing positive above 1% from the end of October, 2020. Having a patient facing role and working outside your home were important risk factors for testing positive for SARS-CoV-2 at the end of the first wave (April 26 to June 28, 2020), but not in the second wave (from the end of August to Nov 1, 2020). Age (young adults, particularly those aged 17–24 years) was an important initial driver of increased positivity rates in the second wave. For example, the estimated percentage of individuals testing positive was more than six times higher in those aged 17–24 years than in those aged 70 years or older at the end of September, 2020. A substantial proportion of infections were in individuals not reporting symptoms around their positive test (45–68%, dependent on calendar time. Interpretation: Important risk factors for testing positive for SARS-CoV-2 varied substantially between the part of the first wave that was captured by the study (April to June, 2020) and the first part of the second wave of increased positivity rates (end of August to Nov 1, 2020), and a substantial proportion of infections were in individuals not reporting symptoms, indicating that continued monitoring for SARS-CoV-2 in the community will be important for managing the COVID-19 pandemic moving forwards

How does student activism drive cultural campus change in the UK and US regarding sexual violence on campus?

Using policy frameworks and author expertise to identify relevant literature, four academics and two student-activist-authors, critically review literature upon student activist responses to sexual violence on campus. We conclude, student activism is pivotal to campus cultural change. In the UK, we review how student activism challenges outdated policy; in the US, how this has elevated the issue to national policy agendas. We apply theoretical frameworks of policy windows, policy entrepreneurs, campus readiness models and embodied intersectional citizenship. This article recommends universities work collaboratively with student activists, rather than viewing collaboration as a reputational risk. Further, we recommend developing Campus Community Readiness Models to include measures of collaboration. We contend, student activism can incur costs. Connecting activists online may help manage the transience of student activism. Collaboration and connection with and between student activists may represent a cultural shift toward sustainability stages of readiness characterised by community ownership

Mind the gap:difference between Framingham heart age and real age increases with age in HIV-positive individuals-a clinical cohort study

OBJECTIVES: To measure the excess risk of cardiovascular disease (CVD) in HIV-positive individuals by comparing ‘heart age’ with real age and to estimate associations of patients’ characteristics with heart age deviation (heart age–real age). DESIGN: Clinical Cohort Study. SETTING: Bristol HIV clinic, Brecon Unit at Southmead Hospital, Bristol, UK. PARTICIPANTS: 749 HIV-positive adults who attended for care between 2008 and 2011. Median age was 42 years (IQR 35–49), 67% were male and 82% were treated with antiretroviral therapy. MAIN OUTCOME MEASURES: We calculated the Framingham 10-year risk of CVD and traced back to ‘heart age’, the age of an individual with the same score but ideal risk factor values. We estimated the relationship between heart age deviation and real age using fractional polynomial regression. We estimated crude and mutually adjusted associations of sex, age, CD4 count, viral load/treatment status and period of starting antiretroviral therapy with heart age deviation. RESULTS: The average heart age for a male aged 45 years was 48 years for a non-smoker and 60 years for a smoker. Heart age deviation increased with real age and at younger ages was smaller for females than males, although this reversed after 48 years. Compared to patients with CD4 count <500 cells/mm(3), heart age deviation was 2.4 (95% CI 0.7 to 4.0) and 4.3 (2.3 to 6.3) years higher for those with CD4 500–749 cells/mm(3) and ≥750 cells/mm(3), respectively. CONCLUSIONS: In HIV-positive individuals, the difference between heart age and real age increased with age and CD4 count and was very dependent on smoking status. Heart age could be a useful tool to communicate CVD risk to patients and the benefits of stopping smoking