Multilevel correlates of household anthropometric typologies in Colombian mothers and their infants

Background. The aim of this study was to establish the association of maternal, family, and contextual correlates of anthropometric typologies at the household level in Colombia using 2005 Demographic Health Survey (DHS/ENDS) data.Methods. Household-level information from mothers 18-49 years old and their children less than 5 years old was included. Stunting and overweight were assessed for each child. Mothers were classified according to their body mass index. Four anthropometric typologies at the household level were constructed: normal, underweight, overweight, and dual burden. Four three-level [households (n = 8598) nested within municipalities (n = 226), nested within states (n = 32)] hierarchical polytomous logistic models were developed. Household log-odds of belonging to one of the four anthropometric categories, holding 'normal' as the reference group, were obtained.Results. This study found that anthropometric typologies were associated with maternal and family characteristics of maternal age, parity, maternal education, and wealth index. Higher municipal living conditions index was associated with a lower likelihood of underweight typology and a higher likelihood of overweight typology. Higher population density was associated with a lower likelihood of overweight typology.Conclusion. Distal and proximal determinants of the various anthropometric typologies at the household level should be taken into account when framing policies and designing interventions to reduce malnutrition in Colombia. Copyright © The Author(s) 2018

Graphene Electrochemistry: Fundamentals through to Electroanalytical Applications

Graphene is reported to possess a range of unique and highly desired properties and consequently has potential to revolutionise the field of electrochemistry if diligently employed as a new-generation electrode material. Graphene potentially represents the world’s thinnest electrode material, but there are experimental parameters to be overcome: the first problem is how to electrically wire/connect to the graphene sample(s) as to obtain the reported benefits; the second issue is how to reduce aggregation of graphene sheets back to their lowest energy conformation, that is, graphite, due to the strong π–π interactions between the graphene sheets; the third and final limitation is that various fabrication routes produce graphene to differing qualities, a factor that must be considered when exploring its fundamental electrochemical properties and electroanalytical implementation. This thesis reports on the fundamental electrochemical characterisation and resultant electroanalytical applicability of utilising graphene as a novel electrode material. The thesis consists of four key contributions, each developing on the knowledge gained from the previous. Chapters 1 through to 3 give an overview of the relevant fundamental electrochemical concepts with which this thesis is concerned. Chapter 4 provides a ‘snap-shot’ of the state of the graphene literature from 2010 (upon the commencement of this work), from which successive chapters follow the chronological development and investigation of graphene as produced through a variety of synthesis methods, gradually building a complete picture and understanding of the electrochemistry of graphene and the implications of its properties towards the fabrication and implementation of graphene as an electroanalytical sensor substrate. IV | P a g e Chapter 5 details the relevant experimental information and the full physicochemical characterisation of the various graphene materials utilised within this work. Chapters 6 and 7 utilise graphenes that are fabricated via a ‘top-down’ approach, which is most commonly employed in the literature, where in order to ‘connect to’ the graphene a liquid suspension is immobilised onto a suitable electrode surface. Chapter 6 uses surfactant-modified graphene and investigates, for the first time, the influence that such surfactants have on the observed electrochemistry. Chapter 7 uses pristine graphene in solution and considers; the aspects of various ‘coverages’ of graphene, the supporting electrode substrate, and how the formation of few and multiple layered graphene structures can influence the observed response. These parameters are overlooked within the current literature. Chapter 8 utilises graphene that is fabricated via a ‘bottom-up’ Chemical Vapour Deposition approach, which gives rise to high quality single layer graphene domains that, once efficiently ‘housed’ in order to connect to the graphene, allow the electrochemical exploration of monolayer graphene to be realised and be compared to quasi-graphene and defect abundant graphene structures for the first time. This approach allows the structure of graphene to be correlated with that of the electrochemical response for the first time. Critically, this work unambiguously demonstrates that the electrochemical response is edge plane like defect dependent. The final part of this thesis (Chapter 9) utilises a range of modified graphenes including novel three-dimensional (3D) structures (a graphene foam and graphene paste) and functionalised graphene (graphene/graphitic oxide), with the effects of said modifications explored towards the fundamental electrochemical and electroanalytical properties obtained. The first part of this chapter reports the electrochemistry of a novel freestanding 3D graphene V | P a g e foam and, for the first time, critically compares this to a freestanding 3D carbon foam alternative. It is demonstrated that the graphene foam gives rise to beneficial voltammetric responses in non-aqueous media, namely ionic liquids. This chapter also explores the use of a graphene paste electrode and demonstrates that the voltammetric response is no better than that of a graphite based paste electrode. Last, the use of graphene/graphitic oxide as an electrode material is explored and shown to give rise to unique voltammetric signatures, which are coverage dependant and can be utilised as a means of characterising the successful production of graphene through the reduction of graphene/graphitic oxide (as commonly utilised within the current electrochemical literature). Furthermore, it is shown that the unique voltammetry observed at graphene/graphitic oxide modified electrodes can be used beneficially for electrocatalytic processes. This thesis demonstrates that, within the graphene electrochemical literature, control experiments are often an overlooked comparison, which are needed for the electrochemical response of graphene to be understood and before the benefits of graphene can be claimed in such instances where superiority is ‘demonstrated’

Long-term evaluation of a course on evidence-based public health in the U.S. and Europe

The evidence-based public health course equips public health professionals with skills and tools for applying evidence-based frameworks and processes in public health practice. To date, training has included participants from all the 50 U.S. states, 2 U.S. territories, and multiple other countries besides the U.S. This study pooled follow-up efforts (5 surveys, with 723 course participants, 2005-2019) to explore the benefits, application, and barriers to applying the evidence-based public health course content. All analyses were completed in 2020. The most common benefits (reported by \u3e80% of all participants) were identifying ways to apply knowledge in their work, acquiring new knowledge, and becoming a better leader who promotes evidence-based approaches. Participants most frequently applied course content to searching the scientific literature (72.9%) and least frequently to writing grants (42.7%). Lack of funds for continued training (35.3%), not having enough time to implement evidence-based public health approaches (33.8%), and not having coworkers trained in evidence-based public health (33.1%) were common barriers to applying the content from the course. Mean scores were calculated for benefits, application, and barriers to explore subgroup differences. European participants generally reported higher benefits from the course (mean difference=0.12, 95% CI=0.00, 0.23) and higher frequency of application of the course content to their job (mean difference=0.17, 95% CI=0.06, 0.28) than U.S. participants. Participants from later cohorts (2012-2019) reported more overall barriers to applying course content in their work (mean difference=0.15, 95% CI=0.05, 0.24). The evidence-based public health course represents an important strategy for increasing the capacity (individual skills) for evidence-based processes within public health practice. Organization-level methods are also needed to scale up and sustain capacity-building efforts

Evaluating a train-the-trainer approach for improving capacity for evidence-based decision making in public health

BACKGROUND: Evidence-based public health gives public health practitioners the tools they need to make choices based on the best and most current evidence. An evidence-based public health training course developed in 1997 by the Prevention Research Center in St. Louis has been taught by a transdisciplinary team multiple times with positive results. In order to scale up evidence-based practices, a train-the-trainer initiative was launched in 2010. METHODS: This study examines the outcomes achieved among participants of courses led by trained state-level faculty. Participants from trainee-led courses in four states (Indiana, Colorado, Nebraska, and Kansas) over three years were asked to complete an online survey. Attempts were made to contact 317 past participants. One-hundred forty-four (50.9 %) reachable participants were included in analysis. Outcomes measured include frequency of use of materials, resources, and other skills or tools from the course; reasons for not using the materials and resources; and benefits from attending the course. Survey responses were tabulated and compared using Chi-square tests. RESULTS: Among the most commonly reported benefits, 88 % of respondents agreed that they acquired knowledge about a new subject, 85 % saw applications for the knowledge to their work, and 78 % agreed the course also improved abilities to make scientifically informed decisions at work. The most commonly reported reasons for not using course content as much as intended included not having enough time to implement evidence-based approaches (42 %); other staff/peers lack training (34 %); and not enough funding for continued training (34 %). The study findings suggest that utilization of course materials and teachings remains relatively high across practitioner groups, whether they were taught by the original trainers or by state-based trainers. CONCLUSIONS: The findings of this study suggest that train-the-trainer is an effective method for broadly disseminating evidence-based public health principles. Train-the-trainer is less costly than the traditional method and allows for courses to be tailored to local issues, thus making it a viable approach to dissemination and scale up of new public health practices. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12913-015-1224-2) contains supplementary material, which is available to authorized users

Mass-Producible 2D-MoS2‑Impregnated Screen-Printed Electrodes

This document is the Accepted Manuscript version of a Published Work that appeared in final form in ACS Applied Materials and Interfaces, copyright © American Chemical Society after peer review and technical editing by the publisher. To access the final edited and published work see https://pubs.acs.org/doi/10.1021/acsami.7b05104Two-dimensional molybdenum disulfide (2D-MoS2) screen-printed electrodes (2D-MoS2-SPEs) have been designed, fabricated, and evaluated toward the electrochemical oxygen reduction reaction (ORR) within acidic aqueous media. A screen-printable ink has been developed that allows for the tailoring of the 2D-MoS2 content/mass used in the fabrication of the 2D-MoS2-SPEs, which critically affects the observed ORR performance. In comparison to the graphite SPEs (G-SPEs), the 2D-MoS2-SPEs are shown to exhibit an electrocatalytic behavior toward the ORR which is found, critically, to be reliant upon the percentage mass incorporation of 2D-MoS2 in the 2D-MoS2-SPEs; a greater percentage mass of 2D-MoS2 incorporated into the 2D-MoS2-SPEs results in a significantly less electronegative ORR onset potential and a greater signal output (current density). Using optimally fabricated 2D-MoS2-SPEs, an ORR onset and a peak current of approximately +0.16 V [vs saturated calomel electrode (SCE)] and −1.62 mA cm–2, respectively, are observed, which exceeds the −0.53 V (vs SCE) and −635 μA cm–2 performance of unmodified G-SPEs, indicating an electrocatalytic response toward the ORR utilizing the 2D-MoS2-SPEs. An investigation of the underlying electrochemical reaction mechanism of the ORR within acidic aqueous solutions reveals that the reaction proceeds via a direct four-electron process for all of the 2D-MoS2-SPE variants studied herein, where oxygen is electrochemically favorably reduced to water. The fabricated 2D-MoS2-SPEs are found to exhibit no degradation in the observed achievable current over the course of 1000 repeat scans. The production of such inks and the resultant mass-producible 2D-MoS2-SPEs mitigates the need to modify post hoc an electrode via the drop-casting technique that has been previously shown to result in a loss of achievable current over the course of 1000 repeat scans. The 2D-MoS2-SPEs designed, fabricated, and tested herein could have commercial viability as electrocatalytic fuel cell electrodes because of being economical as a result of their scales of economy and inherent tailorability. The technique utilized herein to produce the 2D-MoS2-SPEs could be adapted for the incorporation of different 2D nanomaterials, resulting in SPEs with the inherent advantages identified above

Exploring the reactivity of distinct electron transfer sites at CVD grown monolayer graphene through the selective electrodeposition of MoO2 nanowires

The origin of electron transfer at Chemical Vapour Deposition (CVD) grown monolayer graphene using a polymer-free transfer methodology is explored through the selective electrodeposition of Molybdenum (di)oxide (MoO2). The electrochemical decoration of CVD monolayer graphene with MoO2 is shown to originate from the edge plane like- sites/defects. Edge plane decoration of MoO2 nanowires upon monolayer graphene is observed via electrochemical deposition over short time periods only (ca. −0.6 V for 1 second (vs. Ag/AgCl)). At more electrochemically negative potentials (ca. −1.0 V) or longer deposition times, a large MoO2 film is created/deposited on the graphene sheet, originating and expanding from the original nucleation points at edge plane like- sites/defects/wrinkles. Nanowire fabrication along the edge plane like- sites/defects of graphene is confirmed with Cyclic Voltammetry, Scanning Electron Microscopy (SEM), Atomic Force Microscopy (AFM) and Raman Spectroscopy. Monitoring the electrochemical response towards [Ru(NH3)6]3+/2+ and comparing the heterogeneous electron transfer (HET) kinetics at CVD grown monolayer graphene prior and post nanowire fabrication reveals key understandings into the fundamental electrochemical properties of carbon materials. The HET kinetics (k0obs) at MoO2 nanowire decorated monolayer graphene sheets, when edge plane like- sites/defects have been coated/blocked with MoO2, are significantly reduced in comparison to the unmodified graphene alternative. Interestingly, MoO2 nucleation originates on the edge plane like- sites/defects of the graphene sheets, where the basal plane sites remain unaltered until the available edge plane like- sites/defects have been fully utilised; after which MoO2 deposition propagates towards and onto the basal planes, eventually covering the entire surface of the monolayer graphene surface. In such instances, there is no longer an observable electrochemical response. This work demonstrates the distinct electron transfer properties of edge and basal plane sites on CVD grown monolayer graphene, inferring favourable electrochemical reactivity at edge plane like- sites/defects and clarifying the origin of graphene electro-activity

Toward optimal implementation of cancer prevention and control programs in public health: A study protocol on mis-implementation

Abstract Background Much of the cancer burden in the USA is preventable, through application of existing knowledge. State-level funders and public health practitioners are in ideal positions to affect programs and policies related to cancer control. Mis-implementation refers to ending effective programs and policies prematurely or continuing ineffective ones. Greater attention to mis-implementation should lead to use of effective interventions and more efficient expenditure of resources, which in the long term, will lead to more positive cancer outcomes. Methods This is a three-phase study that takes a comprehensive approach, leading to the elucidation of tactics for addressing mis-implementation. Phase 1: We assess the extent to which mis-implementation is occurring among state cancer control programs in public health. This initial phase will involve a survey of 800 practitioners representing all states. The programs represented will span the full continuum of cancer control, from primary prevention to survivorship. Phase 2: Using data from phase 1 to identify organizations in which mis-implementation is particularly high or low, the team will conduct eight comparative case studies to get a richer understanding of mis-implementation and to understand contextual differences. These case studies will highlight lessons learned about mis-implementation and identify hypothesized drivers. Phase 3: Agent-based modeling will be used to identify dynamic interactions between individual capacity, organizational capacity, use of evidence, funding, and external factors driving mis-implementation. The team will then translate and disseminate findings from phases 1 to 3 to practitioners and practice-related stakeholders to support the reduction of mis-implementation. Discussion This study is innovative and significant because it will (1) be the first to refine and further develop reliable and valid measures of mis-implementation of public health programs; (2) bring together a strong, transdisciplinary team with significant expertise in practice-based research; (3) use agent-based modeling to address cancer control implementation; and (4) use a participatory, evidence-based, stakeholder-driven approach that will identify key leverage points for addressing mis-implementation among state public health programs. This research is expected to provide replicable computational simulation models that can identify leverage points and public health system dynamics to reduce mis-implementation in cancer control and may be of interest to other health areas

Advancing the application, quality and harmonization of implementation science measures

BACKGROUND: The field of implementation science (IS) encompasses a broad range of constructs and uses measures from a variety of disciplines. However, there has been little standardization of measures or agreement on definitions of constructs across different studies, fields, authors, or research groups. METHODS: We describe a collaborative, web-based activity using the United States National Cancer Institute’s (NCI) Grid-Enabled Measures (GEM) portal that uses a wiki platform to focus discussion and engage the research community to enhance the quality and harmonization of measures for IS health-related research and practice. We present the history, process, and preliminary data from the GEM Dissemination & Implementation (D&I) Campaign on IS measurement. RESULTS: The GEM D&I Campaign has been ongoing for eight weeks as of this writing, and has used a combination of expert opinion and crowd-sourcing approaches. To date it has listed definitions for 45 constructs and summarized information on 120 measures. Usage of the website peaked at a rate of 124 views from 89 visitors on week seven. Users from seven countries have contributed measures and/or constructs, shared experience in using different measures, contributed comments, and identified research gaps and needs. CONCLUSION: Thus far, this campaign has provided information about different IS measures, their associated characteristics, and comments. The next step is to rate these measures for quality and practicality. This resource and ongoing activity have potential to advance the quality and harmonization of IS measures and constructs, and we invite readers to contribute to the process