738 research outputs found
Putting the public (back) into public health: leadership, evidence and action.
There is a strong evidence-based rationale for community capacity building and community empowerment as part of a strategic response to reduce health inequalities. Within the current UK policy context, there are calls for increased public engagement in prevention and local decision-making in order to give people greater control over the conditions that determine health. With reference to the challenges and opportunities within the English public health system, this essay seeks to open debate about what is required to mainstream community-centred approaches and ensure that the public is central to public health. The essay sets out the case for a reorientation of public health practice in order to build impactful action with communities at scale leading to a reduction in the health gap. National frameworks that support local practice are described. Four areas of challenge that could potentially drive an implementation gap are discussed: (i) achieving integration and scale, (ii) effective community mobilization, (iii) evidencing impact and (iv) achieving a shift in power. The essay concludes with a call to action for developing a contemporary public health practice that is rooted in communities and offers local leadership to strengthen local assets, increase community control and reduce health inequalities
Other-Sex Friendships in Late Adolescence: Risky Associations for Substance Use and Sexual Debut?
Adolescentsâ friendships with other-sex peers serve important developmental functions, but they may also facilitate engagement in problem behavior. This study examines the unique contributions of other-sex friendships and friendsâ behavior to alcohol use, smoking, and initiation of sexual intercourse among late adolescent girls and boys. A total of 320 adolescents (53% girls; 33% racial/ethnic minorities) provided sociometric nominations of friendships annually in grades 10â12. Friendship networks were derived using social network analysis in each grade. Adolescents and their friends also reported on their alcohol use, smoking, and sexual debut at each assessment. After controlling for demographics, previous problem behavior, and friendsâ behavior, other-sex friendships in 10th grade were associated with initiation of smoking among girls over the following year, and other-sex friendships in 11th grade were linked with lower levels of subsequent alcohol use among boys. Additionally, friendsâ smoking and sexual experience in 10th grade predicted the same behaviors for all adolescents over the following year. Other-sex friendships thus appear to serve as a risk context for adolescent girlsâ smoking and a protective context for adolescent boysâ drinking. Promoting mixed-gender activities and friendships among older high school students may be helpful in reducing malesâ alcohol use, but may need to incorporate additional components to prevent increases in femalesâ smoking
Upper- and mid-mantle interaction between the Samoan plume and the Tonga-Kermadec slabs
Mantle plumes are thought to play a key role in transferring heat from the core\u2013mantle
boundary to the lithosphere, where it can significantly influence plate tectonics. On impinging
on the lithosphere at spreading ridges or in intra-plate settings, mantle plumes may generate
hotspots, large igneous provinces and hence considerable dynamic topography. However, the
active role of mantle plumes on subducting slabs remains poorly understood. Here we show
that the stagnation at 660 km and fastest trench retreat of the Tonga slab in Southwestern
Pacific are consistent with an interaction with the Samoan plume and the Hikurangi plateau.
Our findings are based on comparisons between 3D anisotropic tomography images and 3D
petrological-thermo-mechanical models, which self-consistently explain several unique
features of the Fiji\u2013Tonga region. We identify four possible slip systems of bridgmanite in the
lower mantle that reconcile the observed seismic anisotropy beneath the Tonga slab
(VSH4VSV) with thermo-mechanical calculations
Evidence-based practice profiles of physiotherapists transitioning into the workforce: a study of two cohorts
<p>Abstract</p> <p>Background</p> <p>Training in the five steps of evidence-based practice (EBP) has been recommended for inclusion in entry-level health professional training. The effectiveness of EBP education has been explored predominantly in the medical and nursing professions and more commonly in post-graduate than entry-level students. Few studies have investigated longitudinal changes in EBP attitudes and behaviours. This study aimed to assess the changes in EBP knowledge, attitudes and behaviours in entry-level physiotherapy students transitioning into the workforce.</p> <p>Methods</p> <p>A prospective, observational, longitudinal design was used, with two cohorts. From 2008, 29 participants were tested in their final year in a physiotherapy program, and after the first and second workforce years. From 2009, 76 participants were tested in their final entry-level and first workforce years. Participants completed an Evidence-Based Practice Profile questionnaire (EBP<sup>2</sup>), which includes self-report EBP domains [Relevance, Terminology (knowledge of EBP concepts), Confidence, Practice (EBP implementation), Sympathy (disposition towards EBP)]. Mixed model analysis with sequential Bonferroni adjustment was used to analyse the matched data. Effect sizes (ES) (95% CI) were calculated for all changes.</p> <p>Results</p> <p>Effect sizes of the changes in EBP domains were small (ES range 0.02 to 0.42). While most changes were not significant there was a consistent pattern of decline in scores for Relevance in the first workforce year (ES -0.42 to -0.29) followed by an improvement in the second year (ES +0.27). Scores in Terminology improved (ES +0.19 to +0.26) in each of the first two workforce years, while Practice scores declined (ES -0.23 to -0.19) in the first year and improved minimally in the second year (ES +0.04). Confidence scores improved during the second workforce year (ES +0.27). Scores for Sympathy showed little change.</p> <p>Conclusions</p> <p>During the first two years in the workforce, there was a transitory decline in the self-reported practice and sense of relevance of EBP, despite increases in confidence and knowledge. The pattern of progression of EBP skills beyond these early professional working years is unknown.</p
Standardising outcome reporting for clinical trials of interventions for heavy menstrual bleeding: Development of a core outcome set
OBJECTIVE: To develop a core outcome set for heavy menstrual bleeding (HMB). DESIGN: Core outcome set (COS) development methodology described by the COMET initiative. SETTING: University hospital gynaecology department, online international survey and web-based international consensus meetings. POPULATION OR SAMPLE: Phase 1: Systematic review of previously reported outcomes to identify potential core outcomes. Phase 2: Qualitative studies with patients to identify outcomes most important to them. Phase 3: Online two-round Delphi survey to achieve consensus about which outcomes are most important. Phase 4: A consensus meeting to finalise the COS. METHODS: Phase 1: Systematic review of previously reported outcomes to identify potential core outcomes. Phase 2: Qualitative studies with patients to identify outcomes most important to them. Phase 3: Online two-round Delphi survey to achieve consensus about which outcomes are most important. Phase 4: A consensus meeting to finalise the COS. MAIN OUTCOME MEASURES: Outcome importance was assessed in the Delphi survey on a 9-point scale. RESULTS: From the âlong listâ of 114, 10 outcomes were included in the final COS: subjective blood loss; flooding; menstrual cycle metrics; severity of dysmenorrhoea; number of days with dysmenorrhoea; quality of life; adverse events; patient satisfaction; number of patients going on to have further treatment for HMB and haemoglobin level. CONCLUSIONS: The final COS includes variables that are feasible for use in clinical trials in all resource settings and apply to all known underlying causes of the symptom of HMB. These outcomes should be reported in all future trials of interventions, their systematic reviews, and clinical guidelines to underpin policy
Multidisciplinary approaches to the study of eating disorders and obesity: recent progress in research and development and future prospects
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Models and simulations for the photometric lsst astronomical time series classification challenge (Plasticc)
We describe the simulated data sample for the "Photometric LSST Astronomical Time Series Classification Challenge" (PLAsTiCC), a publicly available challenge to classify transient and variable events that will be observed by the Large Synoptic Survey Telescope (LSST), a new facility expected to start in the early 2020s. The challenge was hosted by Kaggle, ran from 2018 September 28 to 2018 December 17, and included 1,094 teams competing for prizes. Here we provide details of the 18 transient and variable source models, which were not revealed until after the challenge, and release the model libraries at this https URL. We describe the LSST Operations Simulator used to predict realistic observing conditions, and we describe the publicly available SNANA simulation code used to transform the models into observed fluxes and uncertainties in the LSST passbands (ugrizy). Although PLAsTiCC has finished, the publicly available models and simulation tools are being used within the astronomy community to further improve classification, and to study contamination in photometrically identified samples of type Ia supernova used to measure properties of dark energy. Our simulation framework will continue serving as a platform to improve the PLAsTiCC models, and to develop new models
Immune-Mobilizing Monoclonal T Cell Receptors Mediate Specific and Rapid Elimination of Hepatitis B-Infected Cells
Background and Aims:
Therapies for chronic hepatitis B virus (HBV) infection are urgently needed because of viral integration, persistence of viral antigen expression, inadequate HBVâspecific immune responses, and treatment regimens that require lifelong adherence to suppress the virus. Immune mobilizing monoclonal T Cell receptors against virus (ImmTAV) molecules represent a therapeutic strategy combining an affinityâenhanced T Cell receptor with an antiâCD3 T Cellâactivating moiety. This bispecific fusion protein redirects T cells to specifically lyse infected cells expressing the target virusâderived peptides presented by human leukocyte antigen (HLA).
Approach and Results:
ImmTAV molecules specific for HLAâA*02:01ârestricted epitopes from HBV envelope, polymerase, and core antigens were engineered. The ability of ImmTAVâEnv to activate and redirect polyclonal T cells toward cells containing integrated HBV and cells infected with HBV was assessed using cytokine secretion assays and imagingâbased killing assays. Elimination of infected cells was further quantified using a modified fluorescent hybridization of viral RNA assay. Here, we demonstrate that picomolar concentrations of ImmTAVâEnv can redirect T cells from healthy and HBVâinfected donors toward hepatocellular carcinoma (HCC) cells containing integrated HBV DNA resulting in cytokine release, which could be suppressed by the addition of a corticosteroid in vitro. Importantly, ImmTAVâEnv redirection of T cells induced cytolysis of antigenâpositive HCC cells and cells infected with HBV in vitro, causing a reduction of hepatitis B e antigen and specific loss of cells expressing viral RNA.
Conclusions:
The ImmTAV platform has the potential to enable the elimination of infected cells by redirecting endogenous nonâHBVâspecific T cells, bypassing exhausted HBVâspecific T cells. This represents a promising therapeutic option in the treatment of chronic hepatitis B, with our lead candidate now entering trials
Morphology of the megalopa of the mud crab, Rhithropanopeus harrisii (Gould, 1841) (Decapoda, Brachyura, Panopeidae), identified by DNA barcode.
The morphology of the megalopa stage of the
panopeid Rhithropanopeus harrisii is redescribed and
illustrated in detail from plankton specimens identified by
DNA barcode (16S mtDNA) as previous descriptions do
not meet the current standard of brachyuran larval
description. Several morphological characters vary widely
from those of other panopeid species which could cast
some doubt on the speciesâ placement in the same family.
Besides, some anomalous megalopae of R. harrisii were
found among specimens reared at the laboratory from
zoeae collected in the plankton. These anomalous morphological
features are discussed in terms of problems
associated with laboratory rearing conditions
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