Improving Young Adult - Provider Communication About Sexual Health During Medical Visits

Introduction: Of all age groups in the United States, young adults have some of the poorest sexual and reproductive health outcomes. There are numerous factors that account for this phenomenon – one of which is lack of high-quality communication between young adult patients and providers of sexual and reproductive health care. The objective of this study was to gain feedback from focus groups: (a) about barriers and facilitators to communication surrounding sexual health and (b) the feasibility and acceptability of the question prompt list and informational video as tools of patient empowerment via education and question-asking during medical visits. Methods: A total of three focus groups were conducted: two with patients (n =14) and one with providers (n = 5) of sexual and reproductive health care services for young adults. Young adult participants were aged 18-22 years old. Provider participants were recruited from healthcare clinics. Results: Participants identified several barriers to communication including feelings of embarrassment and assumptions about patients’ knowledge. One facilitator of communication identified was patient-friendly language. Focus group participants offered various suggestions on how to improve the question prompt list and the video, as well as themes that should be covered in the educational video. The question prompt list and educational video were also viewed as useful for encouraging conversation between patient and provider. Conclusions: There are many barriers that prevent optimal communication between young adult patient and their providers when discussing sexual health. Several improvements to the question prompt list and educational video were identified in this study. It was determined that both the question prompt list and educational video can be used to enhance patient-provider communication.Doctor of Pharmac

Logan Medallist 7. Appinite Complexes, Granitoid Batholiths and Crustal Growth: A Conceptual Model

Appinite bodies are a suite of plutonic rocks, ranging from ultramafic to felsic in composition, that are characterized by idiomorphic hornblende as the dominant mafic mineral in all lithologies and by spectacularly diverse textures, including planar and linear magmatic fabrics, mafic pegmatites and widespread evidence of mingling between coeval mafic and felsic compositions. These features suggest crystallization from anomalously water-rich magma which, according to limited isotopic studies, has both mantle and meteoric components. Appinite bodies typically occur as small (~2 km diameter) complexes emplaced along the periphery of granitoid plutons and commonly adjacent to major deep crustal faults, which they preferentially exploit during their ascent. Several studies emphasize the relationship between intrusion of appinite, granitoid plutonism and termination of subduction. However, recent geochronological data suggest a more long-lived genetic relationship between appinite and granitoid magma generation and subduction.Appinite may represent aliquots of hydrous basaltic magma derived from variably fractionated mafic underplates that were originally emplaced during protracted subduction adjacent to the Moho, triggering generation of voluminous granitoid magma by partial melting in the overlying MASH zone. Hydrous mafic magma from this underplate may have ascended, accumulated, and differentiated at mid-to-upper crustal levels (ca. 3–6 kbar, 15 km depth) and crystallized under water-saturated conditions. The granitoid magma was emplaced in pulses when transient stresses activated favourably oriented structures which became conduits for magma transport. The ascent of late mafic magma, however, is impeded by the rheological barriers created by the structurally overlying granitoid magma bodies. Magma that forms appinite complexes evaded those rheological barriers because it preferentially exploited the deep crustal faults that bounded the plutonic system. In this scenario, appinite complexes may be a direct connection to the mafic underplate and so its most mafic components may provide insights into processes that generate granitoid batholiths and, more generally, into crustal growth in arc systems.Les corps d’appinite sont une suite de roches plutoniques, de composition ultramafique à felsique, qui se caractérisent par de la hornblende idiomorphe comme minéral mafique dominant dans toutes les lithologies et par des textures spectaculairement diverses, y compris des fabriques magmatiques planaires et linéaires, des pegmatites mafiques et de nombreuses preuves de « mingling », mélange hétérogène, des compositions mafiques et felsiques de même âge. Ces caractéristiques suggèrent une cristallisation à partir d'un magma anormalement riche en eau qui, selon un nombre limité d’études isotopiques, possède à la fois des composants mantelliques et météoriques.Les corps d’appinite se présentent généralement sous la forme de petits complexes (~ 2 km de diamètre) mis en place à la périphérie des plutons granitoïdes et généralement adjacents aux principales failles crustales profondes qu'ils exploitent préférentiellement lors de leur ascension. Plusieurs études soulignent la relation entre l'intrusion d'appinite, le plutonisme granitoïde et l’arrêt de la subduction. Cependant, des données géochronologiques récentes suggèrent une relation génétique de plus longue durée entre la génération d'appinite et de de magma granitoïde et la subduction.L'appinite peut représenter des aliquotes de magma basaltique hydraté dérivées de sous-plaques mafiques à fractionnement variable qui ont été initialement mises en place lors d'une subduction prolongée adjacente au Moho, déclenchant la génération de magma granitoïde volumineux par fusion partielle dans la zone MASH sus-jacente. Le magma mafique hydraté de cette sous-plaque peut avoir remonté et s’être accumulé et différencié à des niveaux crustaux moyens à supérieurs (environ 3 à 6 kbar, 15 km de profondeur) et avoir cristallisé dans des conditions de saturation en eau. Le magma granitoïde s'est mis en place par impulsions lorsque des contraintes transitoires ont activé des structures favorablement orientées qui sont devenues des conduits pour le transport du magma. L'ascension du magma mafique tardif, cependant, est entravée par les barrières rhéologiques créées par les corps magmatiques granitoïdes structurellement sus-jacents. Le magma qui forme des complexes d'appinite a échappé à ces barrières rhéologiques car il a exploité préférentiellement les failles crustales profondes qui délimitaient le système plutonique. Dans ce scénario, les complexes d'appinite peuvent être une connexion directe à la sous-plaque mafique et ainsi ses composants les plus mafiques peuvent fournir des informations sur les processus qui génèrent des batholites granitoïdes et, plus généralement, sur la croissance crustale dans les systèmes d'arc

The Between-Competition Running Demands of Elite Hurling Match-Play

The current study aimed to investigate the differences in running demands between the National Hurling League (NHL) and the Championship, and within playing positions. GPS (10 Hz, STATSports Apex GNSS) were used to analyse the running demands during 34 games (2017–2020 seasons) of the Championship and the NHL. The running demands (total-, relative-, high-speed- [\u3e17 km·h−1] and sprint [≥22 km·h−1] distance, number and length of sprints, and peak speed) were compared between competitions. Greater total- [ES = 0.32], relative- [ES = 0.26], and sprint-distance [ES = 0.41], and number of sprints [ES = 1.29] were completed in the Championship. The high-speed distance was similar between competitions. Half-backs and half-forwards covered greater total- (ES = 0.91 and 0.21, respectively), relative- (ES = 1.14 and 0.68, respectively), high-speed- (ES = 0.69 and 0.44, respectively), and sprint-distance (ES = 0.50 and 1.26, respectively), number of sprints (ES = 2.66 and 1.73, respectively), and peak speed (ES = 1.09 and 1.32, respectively) in the Championship. There was no difference (p \u3c 0.05) in the sprint distance covered between positions in the Championship. The results showed that the Championship is more physically demanding. The findings present key implications for the transition between competitions

Return on investment of public health interventions : a systematic review

BACKGROUND: Public sector austerity measures in many high-income countries mean that public health budgets are reducing year on year. To help inform the potential impact of these proposed disinvestments in public health, we set out to determine the return on investment (ROI) from a range of existing public health interventions. METHODS: We conducted systematic searches on all relevant databases (including MEDLINE; EMBASE; CINAHL; AMED; PubMed, Cochrane and Scopus) to identify studies that calculated a ROI or cost-benefit ratio (CBR) for public health interventions in high-income countries. RESULTS: We identified 2957 titles, and included 52 studies. The median ROI for public health interventions was 14.3 to 1, and median CBR was 8.3. The median ROI for all 29 local public health interventions was 4.1 to 1, and median CBR was 10.3. Even larger benefits were reported in 28 studies analysing nationwide public health interventions; the median ROI was 27.2, and median CBR was 17.5. CONCLUSIONS: This systematic review suggests that local and national public health interventions are highly cost-saving. Cuts to public health budgets in high income countries therefore represent a false economy, and are likely to generate billions of pounds of additional costs to health services and the wider economy