Strategic Planning for Recruitment and Retention of Older African Americans in Health Promotion Research Programs

The purpose of this study was to 1) describe a strategic plan for recruitment and retention used in conducting eye health education research with African-Americans living in urban and rural areas of Alabama and 2) characterize recruitment and retention patterns for this project. We evaluated an eye health education program tailored specifically to older African Americans. InCHARGE was designed to promote eye disease prevention by conveying the personal benefits of annual dilated comprehensive eye care and teaching strategies to minimize barriers to eye care. The InCHARGEÓ program or a social contact control program was delivered at 20 senior centers in predominately African American urban and rural communities. From pooled data across three studies, 380 African Americans completed a questionnaire about knowledge and attitudes/beliefs about eye disease and eye care before the program and by telephone at either 3 or 6 months after the presentation. The project consisted of 4 phases and 9 strategic objectives for both recruitment and retention of older African Americans that were implemented in a systematic fashion. Overall, retention rates for follow-up at either 3 or 6 months were 75% and 66% respectively. African Americans from rural areas were more likely to be lost to follow-up compared to those from urban areas. We discuss the benefits of utilizing a strategic plan that serves to address problems with underrepresentation of minorities in clinical research

Principles for Designing Teaching and Learning Spaces

"The Principles for Designing Teaching and Learning Spaces consider the classroom environment within the context of what is known about students’ learning. These Principles are then translated into specific design features to guide design decisions, such that learning spaces become a physical manifestation of the university’s teaching and learning vision.

Research-Informed Principles for (Re)designing Teaching and Learning Spaces

Designing physical learning environments that connect to indicators of effective educational practice reflects a university’s pedagogical commitment to student success. This article describes an approach to teaching and learning space design based on research-informed pedagogical principles implemented successfully at our university. It then articulates how those principles can be translated into classroom design features, with examples. These principles have had an operational and conceptual impact on campus, providing a framework for diverse audiences to think about spaces in a way that reflects shared goals, language and values

Preliminary Evaluation of the InCHARGE Program Among Older African Americans in Rural Alabama

Objective: Blindness rates among older African Americans are two times higher than for older whites. Our purpose was to understand attitudes about eye care and perceived barriers to care among older African Americans living in rural Alabama and to determine whether an educational program reduced perceived barriers to care. InCHARGE, an eye health education program for older African Americans, promotes eye disease prevention by conveying the personal benefits of annual dilated comprehensive eye care and by teaching strategies to minimize barriers to eye care. Design and Participants: InCHARGE was presented in five senior centers to 111 individuals. Using a questionnaire before and three months after InCHARGE, we evaluated what impact InCHARGE had on attitudes and knowledge about prevention and strategies for reducing barriers. Results: Before InCHARGE, 52.3% reported receiving an eye examination in the past year. Almost all indicated that they felt finding, getting to, and communicating with a doctor were not problems yet about one-quarter indicated that the cost of an examination and/or eyeglasses were problems. After InCHARGE the percentage saying that cost was a problem increased to almost half. Conclusions: Older African Americans in rural Alabama have positive attitudes about comprehensive eye care, yet only about half reported receiving an exam by an eye care provider in the past year. The cost of care is a barrier for many, a problem that was not mitigated by InCHARGE. In order to improve eye health in this population, eye health education initiatives are not enough; economic strategies must be implemented to address the cost barrier

Pneumonia and exposure to household air pollution in children under the age of 5 years in rural Malawi findings from the Cooking And Pneumonia Study

Background Exposure to household air pollution is associated with an increased risk of pneumonia in children in low- and middle-income countries, however exposure-response data are limited and there are uncertainties around the extent to which biomass-fueled cookstoves can reduce these exposures. Research question What is the association between exposure to household air pollution and pneumonia in children under the age of 5 years in rural Malawi and what are the effects of a biomass-fueled cookstove intervention on personal exposure to household air pollution? Study design and methods We measured personal exposure to carbon monoxide (CO) [48 hours of continuous measurement and transcutaneous carboxyhemoglobin (COHb)] 6-monthly in children participating in a cluster-randomised controlled trial of a cleaner-burning biomass-fueled cookstove intervention to prevent pneumonia in children under the age of 5 years in rural Malawi – the Cooking And Pneumonia Study (CAPS). Exposure-response and multi-variable analyses were done. Results We recruited 1805 (928 intervention; 877 control) children (mean age 25.6 months, 50.6% female). We found no evidence of an association between exposure to CO (IRR=1.0 95% CI:0.967-1.014; p=0.53) or COHb (IRR=1.00 95% CI:0.993-1.003; p=0.41)) in children who experienced pneumonia versus those who did not. Median exposure to CO in the intervention and control groups was was 0.34 ppm (IQR 0.15-0.81) and 0.37 ppm (IQR 0.15-0.97), respectively. The group difference in means was 0.46 (95% CI:-0.95-0.012; p=0.06). Interpretation Exposure to CO in our population was low with no association seen between exposure to CO and pneumonia incidence and no effect of the CAPS intervention on these exposures. These findings suggest that CO may not be an appropriate measure of household air pollution exposure in settings like rural Malawi and that there is a need to develop ways to directly measure particulate matter exposures in young children instead

A cleaner burning biomass-fuelled cookstove intervention to prevent pneumonia in children under 5 years old in rural Malawi (the Cooking and Pneumonia Study): a cluster randomised controlled trial

Medical Research Council, UK Department for International Development, and Wellcome Trust

Coronary atherosclerosis in diabetes mellitus A population-based autopsy study

AbstractObjectivesThe study was conducted to test the hypothesis that the prevalence of coronary atherosclerosis is greater among diabetic than among nondiabetic individuals and is similar for diabetic individuals without clinical coronary artery disease (CAD) and nondiabetics with clinical CAD.BackgroundPersons with diabetes but without clinical CAD encounter cardiovascular mortality similar to nondiabetic individuals with clinical CAD. This excess mortality is not fully explained. We examined the association between diabetes and coronary atherosclerosis in a geographically defined autopsied population, while capitalizing on the autopsy rate and medical record linkage system available via the Rochester Epidemiology Project, which allows rigorous ascertainment of coronary atherosclerosis, clinical CAD, and diabetes.MethodsUsing two measures, namely a global coronary score and high-grade stenoses, the prevalence of atherosclerosis was analyzed in a cohort of autopsied residents of Rochester, Minnesota, age 30 years or older at death, while stratifying on diabetes, clinical CAD diagnosis, age, and gender.ResultsIn this cohort, diabetes was associated with a higher prevalence of atherosclerosis. Among diabetic decedents without clinical CAD, almost three-fourths had high-grade coronary atherosclerosis and more than half had multivessel disease. Without diabetes, women had less atherosclerosis than men, but this female advantage was lost with diabetes. Among those without clinical CAD, diabetes was associated with a global coronary disease burden and a prevalence of high-grade atherosclerosis similar to that observed among nondiabetic subjects with clinical CAD.ConclusionsThese findings provide mechanistic insights into the excess risk of clinical CAD among diabetic individuals, thereby supporting the need for aggressive prevention of atherosclerosis in all diabetic individuals, irrespective of clinical CAD symptoms

Efficacy of Aerial Spraying of Mosquito Adulticide in Reducing Incidence of West Nile Virus, California, 2005

One-sentence summary for table of contents: Aerial spraying reduced incidence of human infection

A new primary dental care service compared with standard care for child and family to reduce the re-occurrence of childhood dental caries (Dental RECUR): study protocol for a randomised controlled trial

Background: In England and Scotland, dental extraction is the single highest cause of planned admission to the hospital for children under 11 years. Traditional dental services have had limited success in reducing this disease burden. Interventions based on motivational interviewing have been shown to impact positively dental health behaviours and could facilitate the prevention of re-occurrence of dental caries in this high-risk population. The objective of the study is to evaluate whether a new, dental nurse-led service, delivered using a brief negotiated interview based on motivational interviewing, is a more cost-effective service than treatment as usual, in reducing the re-occurrence of dental decay in young children with previous dental extractions. Methods/Design: This 2-year, two-arm, multicentre, randomised controlled trial will include 224 child participants, initially aged 5 to 7 years, who are scheduled to have one or more primary teeth extracted for dental caries under general anaesthesia (GA), relative analgesia (RA: inhalation sedation) or local anaesthesia (LA). The trial will be conducted in University Dental Hospitals, Secondary Care Centres or other providers of dental extraction services across the United Kingdom. The intervention will include a brief negotiated interview (based on the principles of motivational interviewing) delivered between enrolment and 6 weeks post-extraction, followed by directed prevention in primary dental care. Participants will be followed up for 2 years. The main outcome measure will be the dental caries experienced by 2 years post-enrolment at the level of dentine involvement on any tooth in either dentition, which had been caries-free at the baseline assessment. Discussion: The participants are a hard-to-reach group in which secondary prevention is a challenge. Lack of engagement with dental care makes the children and their families scheduled for extraction particularly difficult to recruit to an RCT. Variations in service delivery between sites have also added to the challenges in implementing the Dental RECUR protocol during the recruitment phase. Trial registration: ISRCTN24958829 (date of registration: 27 September 2013), Current protocol version: 5.0

Expanding the diversity of mycobacteriophages: insights into genome architecture and evolution.

Mycobacteriophages are viruses that infect mycobacterial hosts such as Mycobacterium smegmatis and Mycobacterium tuberculosis. All mycobacteriophages characterized to date are dsDNA tailed phages, and have either siphoviral or myoviral morphotypes. However, their genetic diversity is considerable, and although sixty-two genomes have been sequenced and comparatively analyzed, these likely represent only a small portion of the diversity of the mycobacteriophage population at large. Here we report the isolation, sequencing and comparative genomic analysis of 18 new mycobacteriophages isolated from geographically distinct locations within the United States. Although no clear correlation between location and genome type can be discerned, these genomes expand our knowledge of mycobacteriophage diversity and enhance our understanding of the roles of mobile elements in viral evolution. Expansion of the number of mycobacteriophages grouped within Cluster A provides insights into the basis of immune specificity in these temperate phages, and we also describe a novel example of apparent immunity theft. The isolation and genomic analysis of bacteriophages by freshman college students provides an example of an authentic research experience for novice scientists