Researcher development program of the primary health care research, evaluation and development strategy

Author accepted manuscript (Post-Print) made available according to publisher copyright policy.The Research Development Program (RDP) was initiated in 2004 under the Primary Health Care Research, Evaluation and Development (PHCRED) Strategy to increase the number and range of people with knowledge and skills in primary health care research and evaluation. RDP Fellows were invited to participate in an online survey about the effect the program had on their research knowledge, attitudes and practice. The response rate was 42% (105/248). Most were female (88%) with 66% aged between 31 and 50 years. Over two-thirds (72%) were health practitioners. Activities undertaken during the RDP ranged from literature reviews, developing a research question, preparing ethics submissions, attending and presenting at conferences and seminars, preparing papers and reports, and submitting grant applications. Despite the fact that only 52% agreed that the RDP time was adequate, 94% agreed that the RDP was a valuable experience, with 89% expressing interest in undertaking further research. These results indicate that this program has had a positive effect on the RDP Fellows in terms of their knowledge about research, their attitude to research, and the way they use research in their work

Energy Conservation and Gravity Waves in Sound-proof Treatments of Stellar Interiors: Part I Anelastic Approximations

Typical flows in stellar interiors are much slower than the speed of sound. To follow the slow evolution of subsonic motions, various sound-proof equations are in wide use, particularly in stellar astrophysical fluid dynamics. These low-Mach number equations include the anelastic equations. Generally, these equations are valid in nearly adiabatically stratified regions like stellar convection zones, but may not be valid in the sub-adiabatic, stably stratified stellar radiative interiors. Understanding the coupling between the convection zone and the radiative interior is a problem of crucial interest and may have strong implications for solar and stellar dynamo theories as the interface between the two, called the tachocline in the Sun, plays a crucial role in many solar dynamo theories. Here we study the properties of gravity waves in stably-stratified atmospheres. In particular, we explore how gravity waves are handled in various sound-proof equations. We find that some anelastic treatments fail to conserve energy in stably-stratified atmospheres, instead conserving pseudo-energies that depend on the stratification, and we demonstrate this numerically. One anelastic equation set does conserve energy in all atmospheres and we provide recommendations for converting low-Mach number anelastic codes to this set of equations.Comment: Accepted for publication in ApJ. 20 pages emulateapj format, 7 figure

Evaluation of the Researcher Development Program (RDP) of the Primary Health Care Research, Evaluation and Development (PHCRED) Strategy: The Fellows’ perspective

This study examines the extent to which the Researcher Development Program (RDP) has impacted on knowledge, attitudes and practice in relation to research and to develop a profile of RDP participants. RDP fellows (appointed between 2005 and 2009) were invited to complete an on-line survey which looked at issues such as previous research experience, research training and activities during the RDP and time allocated to RDP

Renal function, sex and age influence purines and pyrimidines in urine and could lead to diagnostic misinterpretation

Glomerular filtration rate (GFR) is commonly used in clinical practice for the diagnosis and follow-up of chronic kidney disease. Screening for inborn errors of metabolism (IEM) is based on analysis of biomarkers in urine, reported by their ratio to urinary creatinine (crn). Impaired renal function may complicate the interpretation of several biomarkers used for screening of IEM. Our goal was to investigate the influence of kidney function, in terms of measured GFR (mGFR) on purines and pyrimidines in urine, in addition to the relationship to sex, age, pH and ketosis. Children (n = 96) with chronic kidney disease (CKD), in different CKD stages, were included. Urine samples were obtained prior to the injection of iohexol. Serum samples at 7 time-points were used to calculate mGFR based on iohexol plasma clearance. The association with sex, age, ketosis and pH was examined in samples of the laboratory production from 2015 to 2021 (n = 8192). Age was a highly significant covariate for all markers. GFR correlated positively to several purines and pyrimidines; the ratios hypoxanthine/crn, xanthine/crn and urate/crn (p = 2.0 × 10−14, < 3 × 10−15 and 7.2 × 10−4, respectively), and the ratios orotic acid/crn, uracil/crn, and carbamyl-β-alanine/crn (p = 0.03, 1.4 × 10−6 and 0.003, respectively). The values of urate/crn, xanthine/crn, uracil/crn, and carbamyl-β-alanine/crn were higher in females above 16 years of age. Ketosis and pH influenced some markers. In conclusion, decreased renal function interferes with the excretion of urinary purines and pyrimidines, and this could change decision limits substantially, e.g. result in false negative results in Lesch-Nyhan syndrome.publishedVersio

Percorsi adriatici. Mobilit&#224; studentesca e dinamiche sociali tra le universitates della Puglia, Padova e Venezia (XV-XVI secolo)

Questa ricerca si concentra sulla mobilit\ue0 di studenti che, muovendo dai territori della Puglia storica tra il XV e il XVI secolo, scelsero lo Studio di Padova come sede privilegiata per la propria formazione accademica, facendo tappa anche presso quelli di Ferrara e Bologna. Tale fenomeno si inscrive nel quadro di secolari e costanti rapporti politici, commerciali e culturali lungo l\u2019area adriatica. L\u2019incrocio della variegata documentazione rintracciata - documentazione di carattere universitario, registri di notai, raccolte documentarie come i Codici Diplomatici e i Libri Rossi, Cronache locali - unita alla bibliografia sul tema, ha fatto emergere una vasta gamma di notizie, che sono state analizzate e sviluppate nel corso dei capitoli. La prima parte della ricerca costituisce una presentazione del caso di studio, delle questioni storiografiche che sono alla base, delle metodologie adottate. La seconda parte prende in esame i contesti sociali e culturali di provenienza degli studenti, i luoghi e le modalit\ue0 della formazione in patria e quelli della successiva formazione universitaria. La terza parte si concentra esclusivamente sugli attori di questa particolare forma di mobilit\ue0: si ricostruiscono le estrazioni sociali, i casi di tradizioni familiari di studi, le reti di relazioni costruite, le carriere intraprese con il titolo di dottore. La quarta ed ultima parte si concretizza in un catalogo di studenti e dottori pugliesi, dove sono raccolte tutte le notizie di carattere biografico rintracciate. La ricerca si conclude con una appendice documentaria e con l\u2019elenco delle fonti e la bibliografia.This research concentrate on student mobility from Apulian cities during the XV and the XVI century, in particular towards Padua\u2019s Studium, but also towards Ferrara and Bologna. This phenomenon belongs in the secular and political, economic, cultural relationships in the Adriatic area. Sources utilized \u2013 universitary documentation, notarial acts, Codici Diplomatici and Libri Rossi, local chronicles \u2013 and bibliography, are important for informations analised during the research. The first part is a presentation of the case-study, historiographical questions and methodologies. The second part analise social and cultural context of students and their local and universitary studies. The third part is concentrated on students: their social origin, family traditions of studies, social relationships, careers. The fourth part is a catalogue of Apulian students and doctors, with biographical informations. The last part contained documentation and the list of sources and the bibliography

Systolic myocardial function measured by echocardiographic speckle-tracking and peak oxygen consumption in pediatric childhood cancer survivors—a PACCS study

BackgroundCancer therapy-related cardiotoxicity is a major cause of cardiovascular morbidity in childhood cancer survivors. The aims of this study were to investigate systolic myocardial function and its association to cardiorespiratory fitness in pediatric childhood cancer survivors.MethodsIn this sub-study of the international study “Physical Activity and fitness in Childhood Cancer Survivors” (PACCS), echocardiographic measures of left ventricular global longitudinal strain (LV-GLS) and right ventricular longitudinal strain (RV-LS) were measured in 128 childhood cancer survivors aged 9–18 years and in 23 age- and sex-matched controls. Cardiorespiratory fitness was measured as peak oxygen consumption achieved on treadmill and correlated to myocardial function.ResultsMean LV-GLS was reduced in the childhood cancer survivors compared to the controls, −19.7% [95% confidence interval (CI) −20.1% to −19.3%] vs. −21.3% (95% CI: −22.2% to −20.3%) (p = 0.004), however, mainly within normal range. Only 13% of the childhood cancer survivors had reduced LV longitudinal strain z-score. Mean RV-LS was similar in the childhood cancer survivors and the controls, −23.2% (95% CI: −23.7% to −22.6%) vs. −23.3% (95% CI: −24.6% to −22.0%) (p = 0.8). In the childhood cancer survivors, lower myocardial function was associated with lower peak oxygen consumption [correlation coefficient (r) = −0.3 for LV-GLS]. Higher doses of anthracyclines (r = 0.5 for LV-GLS and 0.2 for RV-LS) and increasing time after treatment (r = 0.3 for LV-GLS and 0.2 for RV-LS) were associated with lower myocardial function.ConclusionsLeft ventricular function, but not right ventricular function, was reduced in pediatric childhood cancer survivors compared to controls, and a lower left ventricular myocardial function was associated with lower peak oxygen consumption. Furthermore, higher anthracycline doses and increasing time after treatment were associated with lower myocardial function, implying that long-term follow-up is important in this population at risk

The Physical Activity and Fitness in Childhood Cancer Survivors (PACCS) Study: Protocol for an International Mixed Methods Study

BACKGROUND Survivors of childhood cancer represent a growing population with a long life expectancy but high risks of treatment-induced morbidity and premature mortality. Regular physical activity (PA) may improve their long-term health; however, high-quality empirical knowledge is sparse. OBJECTIVE The Physical Activity and Fitness in Childhood Cancer Survivors (PACCS) study comprises 4 work packages (WPs) aiming for the objective determination of PA and self-reported health behavior, fatigue, and quality of life (WP 1); physical fitness determination (WP 2); the evaluation of barriers to and facilitators of PA (WP 1 and 3); and the feasibility testing of an intervention to increase PA and physical fitness (WP 4). METHODS The PACCS study will use a mixed methods design, combining patient-reported outcome measures and objective clinical and physiological assessments with qualitative data gathering methods. A total of 500 survivors of childhood cancer aged 9 to 18 years with ≥1 year after treatment completion will be recruited in follow-up care clinics in Norway, Denmark, Finland, Germany, and Switzerland. All participants will participate in WP 1, of which approximately 150, 40, and 30 will be recruited to WP 2, WP3, and WP 4, respectively. The reference material for WP 1 is available from existing studies, whereas WP 2 will recruit healthy controls. PA levels will be measured using ActiGraph accelerometers and self-reports. Validated questionnaires will be used to assess health behaviors, fatigue, and quality of life. Physical fitness will be measured by a cardiopulmonary exercise test, isometric muscle strength tests, and muscle power and endurance tests. Limiting factors will be identified via neurological, pulmonary, and cardiac evaluations and the assessment of body composition and muscle size. Semistructured, qualitative interviews, analyzed using systematic text condensation, will identify the perceived barriers to and facilitators of PA for survivors of childhood cancer. In WP 4, we will evaluate the feasibility of a 6-month personalized PA intervention with the involvement of local structures. RESULTS Ethical approvals have been secured at all participating sites (Norwegian Regional Committee for Medical Research Ethics [2016/953 and 2018/739]; the Oslo University Hospital Data Protection Officer; equivalent institutions in Finland, Denmark [file H-19032270], Germany, and Switzerland [Ethics Committee of Northwestern and Central Switzerland, project ID: 2019-00410]). Data collection for WP 1 to 3 is complete. This will be completed by July 2022 for WP 4. Several publications are already in preparation, and 2 have been published. CONCLUSIONS The PACCS study will generate high-quality knowledge that will contribute to the development of an evidence-based PA intervention for young survivors of childhood cancer to improve their long-term care and health. We will identify physiological, psychological, and social barriers to PA that can be targeted in interventions with immediate benefits for young survivors of childhood cancer in need of rehabilitation. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/35838