Impact of user fees on maternal health service utilization and related health outcomes: a systematic review.

OBJECTIVE: To assess the evidence of the impact of user fees on maternal health service utilization and related health outcomes in low- and middle-income countries, as well as their impact on inequalities in these outcomes. METHODS: Studies were identified by modifying a search strategy from a related systematic review. Primary studies of any design were included if they reported the effect of fee changes on maternal health service utilization, related health outcomes and inequalities in these outcomes. For each study, data were systematically extracted and a quality assessment conducted. Due to the heterogeneity of study methods, results were examined narratively. FINDINGS: Twenty studies were included. Designs and analytic approaches comprised: two interrupted time series, eight repeated cross-sectional, nine before-and-after without comparison groups and one before-and-after in three groups. Overall, the quality of studies was poor. Few studies addressed potential sources of bias, such as secular trends over time, and even basic tests of statistical significance were often not reported. Consistency in the direction of effects provided some evidence of an increase in facility delivery in particular after fees were removed, as well as possible increases in the number of managed delivery complications. There was little evidence of the effect on health outcomes or inequality in accessing care and, where available, the direction of effect varied. CONCLUSION: Despite the global momentum to abolish user fees for maternal and child health services, robust evidence quantifying impact remains scant. Improved methods for evaluating and reporting on these interventions are recommended, including better descriptions of the interventions and context, looking at a range of outcome measures, and adopting robust analytical methods that allow for adjustment of underlying and seasonal trends, reporting immediate as well as longer-term (e.g. at 6 months and 1 year) effects and using comparison groups where possible

Listening to students\u27 voices in mathematics education

In many tertiary institutions, mathematics education staff teach courses from early childhood education through to professional development courses at Masters level. Similarly, research into teacher education processes spans these contexts. Common principles that underpin this work include staff willingness to be responsive to students&rsquo; needs. This symposium focuses on the importance of listening to students&rsquo; voices in mathematics teaching and research &ndash; no matter how old students are.<br /

'My teeth don't chew on shrapnel': an anthology of poetry by military veterans

This anthology, created by Oxford Brookes Poetry Centre, features poetry written by participants and associates of the Oxford Brookes Veterans' Poetry Workshop, 2019-20. Nine poets are represted here: Jo Young, Tom Laaser, Claire Hughes, Noel Harrower, John Thampi, Jamie Broady, Andrew Fassett, Stewart Hill, and Maggs Vibo. The anthology also includes an introduction by Niall Munro, an explanation of the workshop process by Susie Campbell, an essay about women veteran writers by Jane Potter, and reflections on her research into the perceptions of veterans in the UK and the US by Rita Phillips. Susie Campbell has also provided helpful writing prompts linked to the poems for those readers who are - or would like to be - writers. In addition to the four versions of the anthology, this package of files also includes transcripts of each of the interviews conducted by Dr Niall Munro with ten workshop participants, not all of whom appear in the anthology: Eugene Ratz, John Thampi, J. Robin Whitely, Jo Young (two interviews), Andrew Fassett, Tom Laaser, Stewart Hill, Claire Hughes, Maggs Vibo, and Jamie Broady. The transcriptions were completed by Dr Hester Bradley

Clinical impairment in premanifest and early Huntington's disease is associated with regionally specific atrophy.

TRACK-HD is a multicentre longitudinal observational study investigating the use of clinical assessments and 3-Tesla magnetic resonance imaging as potential biomarkers for future therapeutic trials in Huntington's disease (HD). The cross-sectional data from this large well-characterized dataset provide the opportunity to improve our knowledge of how the underlying neuropathology of HD may contribute to the clinical manifestations of the disease across the spectrum of premanifest (PreHD) and early HD. Two hundred and thirty nine gene-positive subjects (120 PreHD and 119 early HD) from the TRACK-HD study were included. Using voxel-based morphometry (VBM), grey and white matter volumes were correlated with performance in four domains: quantitative motor (tongue force, metronome tapping, and gait); oculomotor [anti-saccade error rate (ASE)]; cognition (negative emotion recognition, spot the change and the University of Pennsylvania smell identification test) and neuropsychiatric measures (apathy, affect and irritability). After adjusting for estimated disease severity, regionally specific associations between structural loss and task performance were found (familywise error corrected, P < 0.05); impairment in tongue force, metronome tapping and ASE were all associated with striatal loss. Additionally, tongue force deficits and ASE were associated with volume reduction in the occipital lobe. Impaired recognition of negative emotions was associated with volumetric reductions in the precuneus and cuneus. Our study reveals specific associations between atrophy and decline in a range of clinical modalities, demonstrating the utility of VBM correlation analysis for investigating these relationships in HD

2020-05-11 DAILY UNM GLOBAL HEALTH COVID-19 BRIEFING

Executive Summary: NM case counts. Navajo Nation documentary. Medicaid reimbursement increase. Excess NYC mortality. German R0\u3e1. Chile COVID-19 certificates. High female incidence in Quebec. Swab 3D printing. Evidence lacking school reopening. Cloth mask review. WHO 2nd wave warning. Higher mortality in minorities. Environmental transmission controls. Behavior change. Correctional environment guidelines. Wuhan hospital transformation. Maximizing GI training. Threat and conformity. Recommendations on managing COVID-19 (first Italian SARS patients), and obesity and metabolic syndrome. Guidelines for neurologists. Ethics of off-label drugs use. Abbott antibody test approval. CRISPR test FDA approval. Viral sample inactivation. HCQ+azithromycin no benefit. Public-Private partnership for clinical trials. Drug repurposing. Cancer patient considerations. 35 new COVID-19 trials. Hyperinflammatory shock in children. Symptom app

Opening up the subsurface for the cities of tomorrow Considering access to subsurface knowledge – Evaluation of practices and techniques

This report is the result of COST Action TU1206 Working Group 2, Work package 2.3, and focusses on 3D urban subsurface modelling and visualisation. The major aims of this report are: 1) evaluating current techniques and identify good practices / best efforts in 3D geological modelling and visualisation of the urban subsurface, based on case studies, and 2) co-developing (subsurface specialists & model users) requirements for optimal use of 3D geological modelling information in specific planning and policy contexts. Three major topics have been considered: • Constructing and maintaining 3D urban geological models • Modelling man-made ground • Visualising 3D urban subsurface model results To improve the use of subsurface modelling in urban planning in the future, the following challenges have been identified: • The complexity of the urban subsurface, including man-made ground, combined with the level of detail of information asked for in many urban planning issues demand that geologists look beyond their traditional data sources. • Combined 3D property modelling of the small-scale heterogeneity of man-made deposits and natural deposits requires new modelling approaches. • Management of the shallow urban subsurface requires model tools that can be frequently updated to reflect the frequently changing properties and functions of the urban subsurface. • There is a need for dynamic (4D) urban subsurface models that can be used for real-time monitoring and incorporation of time-series data on subsurface properties. • It would be cost-effective to have an actively maintained, scalable geological framework model of a city available that forms a common basis for the various kinds of dedicated models of parts of the city. • To give subsurface information a firm position in urban planning and management, geological information will have to be presented in the right format, and at the right time. It is absolutely necessary to include the subsurface infrastructure and to combine the model with above-ground information

2020-05-14 DAILY UNM GLOBAL HEALTH COVID-19 BRIEFING

Executive Summary: NM restrictions loosen. NM case count. Navajo Nation case count. 9 state parks open. Sunport revenue loss. Trump projects vaccine delivery. Wisconsin court case. Smokers quit. Ireland reopening. Danish schools open. Philippine typhoon evacuation. PPE-induced pressure injuries and facial dermatoses. U.S. mask stockpile. PPE for surgeons. Intubation time with aerosol box. Consumer spending with social restrictions. Suicide increase expected. Undetected virus homeless. Chinese infection control. 5% Spain infected. Sanitizing booth. Healthcare worker infection routes. Kawasaki disease France. CDC Kawaski guidance. Italian deaths characterized. CDC reopening school guidance. COVID-19 and epistemology. Monitoring misleading claims. UN mental health policy brief. CDC vaccination schedules. Guidelines on managing endoscopy units. COVID-19 lab testing (for lab professionals). Cancer surgery triage. Operating room practices. Orthodontic treatment. 3D printed NP swabs effective. Salt-water irrigation reduces duration. Corticosteroids ineffectual. Vaccines require biomanufacturing infrastructure. French pharm giant promises fair vaccine distribution. 26 new trials registered. LDH, lymphocytes and hs-CRP predict mortality. Fibrinogen higher in SARS. Insulin resistance. Glycemic monitoring. Hemostasis abnormalities. New phobia scale. OR global consensus. Inpatient cognitive assessments are challenging. Loud speech increases transmission. Monkeys present similarly. Human-to-dog transmission. Cat transmission

Natational Dress: Functionality, Fashion and the Fracturing of Separate Spheres in Victorian Britain

In 1873, The Englishwoman's Domestic Magazine extolled the values of swimming for women and gave advice on the best form of bathing dress, one which preserved modesty and met the demands of contemporary fashion. This essentially impractical type of bathing outfit has been the subject of much of the historiography surrounding female swimming costumes but it was not the only swimming dress on show during the “long” Victorian period. The women of all classes who participated in more serious swimming required something functional rather than fashionable while working-class professional natationists, who appeared regularly in water shows throughout the country, wore attire that combined functionality, tight to the body while allowing freedom of movement, with public appeal, a critical consideration for female exhibitors. Their activities and costumes challenged prevailing notions of “separate spheres” and this paper explores Victorian aquatic dress in the context of class, gender and social space

Individual nutrition therapy and exercise regime: A controlled trial of injured, vulnerable elderly (INTERACTIVE trial)

© 2008 Thomas et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.Background Proximal femoral fractures are amongst the most devastating consequences of osteoporosis and injurious accidental falls with 25–35% of patients dying in the first year post-fracture. Effective rehabilitation strategies are evolving however, despite established associations between nutrition, mobility, strength and strength-related functional outcomes; there has been only one small study with older adults immediately following fragility fracture where a combination of both exercise and nutrition have been provided. The aim of the INTERACTIVE trial is to establish whether a six month, individualised exercise and nutrition program commencing within fourteen days of surgery for proximal femur fracture, results in clinically and statistically significant improvements in physical function, body composition and quality of life at an acceptable level of cost and resource use and without increasing the burden of caregivers. Methods and Design This randomised controlled trial will be performed across two sites, a 500 bed acute hospital in Adelaide, South Australia and a 250 bed acute hospital in Sydney, New South Wales. Four hundred and sixty community-dwelling older adults aged > 70 will be recruited after suffering a proximal femoral fracture and followed into the community over a 12-month period. Participants allocated to the intervention group will receive a six month individualised care plan combining resistance training and nutrition therapy commencing within 14 days post-surgery. Outcomes will be assessed by an individual masked to treatment allocation at six and 12 months. To determine differences between the groups at the primary end-point (six months), ANCOVA or logistic regression will be used with models adjusted according to potential confounders. Discussion The INTERACTIVE trial is among the first to combine nutrition and exercise therapy as an early intervention to address the serious consequence of rapid deconditioning and weight loss and subsequent ability to regain pre-morbid function in older patients post proximal femoral fracture. The results of this trial will guide the development of more effective rehabilitation programs, which may ultimately lead to reduced health care costs, and improvements in mobility, independence and quality of life for proximal femoral fracture sufferers. Trial registration Australian Clinical Trials Registry: ACTRN12607000017426

Patient-derived xenograft (PDX) models in basic and translational breast cancer research

Patient-derived xenograft (PDX) models of a growing spectrum of cancers are rapidly supplanting long-established traditional cell lines as preferred models for conducting basic and translational preclinical research. In breast cancer, to complement the now curated collection of approximately 45 long-established human breast cancer cell lines, a newly formed consortium of academic laboratories, currently from Europe, Australia, and North America, herein summarizes data on over 500 stably transplantable PDX models representing all three clinical subtypes of breast cancer (ER+, HER2+, and "Triple-negative" (TNBC)). Many of these models are well-characterized with respect to genomic, transcriptomic, and proteomic features, metastatic behavior, and treatment response to a variety of standard-of-care and experimental therapeutics. These stably transplantable PDX lines are generally available for dissemination to laboratories conducting translational research, and contact information for each collection is provided. This review summarizes current experiences related to PDX generation across participating groups, efforts to develop data standards for annotation and dissemination of patient clinical information that does not compromise patient privacy, efforts to develop complementary data standards for annotation of PDX characteristics and biology, and progress toward "credentialing" of PDX models as surrogates to represent individual patients for use in preclinical and co-clinical translational research. In addition, this review highlights important unresolved questions, as well as current limitations, that have hampered more efficient generation of PDX lines and more rapid adoption of PDX use in translational breast cancer research