Isolated Voices: Perspectives of Teachers, School Nurses, and Administrators Regarding Implementation of Sexual Health Education Policy.

BackgroundComprehensive sexual health education (SHE) reduces risky sexual behavior and increases protective behavior in adolescents. It is important to understand how professionals responsible for implementing SHE policy interpret state and local policy and what influences their commitment to formal SHE policy implementation.MethodsThis descriptive study explored content and delivery of SHE policy in a rural, southwestern state with high levels of poverty, unintended adolescent pregnancy, and sexually transmitted infections. The social ecological model (SEM) was used to better understand levels of influence on the implementation of SHE policy.ResultsWe conducted telephone surveys with 38 teachers, 63 nurses, and 21 administrators in public secondary schools. There was substantial local variability in the scope and content of SHE curricula. Respondents identified significant barriers to the delivery of SHE content and minimal evaluation of whether educational objectives were met. Based on participant responses, community and organizational SEM levels had the greatest influence on SHE policy implementation, although examples of all SEM levels were identified.ConclusionsGiven perceived challenges regarding subject matter, successful SHE implementation at the local level requires committed stakeholders working in concert at the school and community levels, backed by strong policy commitment at the state level

A Geographical Location Model for Targeted Implementation of Lure-and-Kill Strategies Against Disease-Transmitting Mosquitoes in Rural Areas

Outdoor devices for luring and killing disease-transmitting mosquitoes have been proposed as potential com- plementary interventions alongside existing intra-domiciliary methods namely insecticide treated nets and house spraying with residual insecticides. To enhance effectiveness of such outdoor interventions, it is essential to optimally locate them in such a way that they target most of the outdoor mosquitoes. Using odour-baited lure and kill stations (OBS) as an example, we describe a map model derived from: 1) com-munity participatory mapping conducted to identify mosquito breeding habitats, 2) entomological field studies conducted to estimate outdoor mosquito densities and to determine safe distances of the OBS from human dwellings, and 3) field surveys conducted to map households, roads, outdoor human aggregations and landmarks. The resulting data were combined in a Ge- ographical Information Systems (GIS) environment and analysed to determine optimal locations for the OBS. Separately, a GIS-interpolated map produced by asking community members to rank different zones of the study area and show where they expected to find most mosquitoes, was visually compared to another map interpolated from the entomological survey of outdoor mosquito densities. An easy-to-interpret suitability map showing optimal sites for placing OBS was produced, which clearly depicted areas least suitable and areas most suitable for locating the devices. Comparative visual interpretation of maps derived from interpolating the community knowledge and entomological data revealed major similarities between the two maps. Using distribution patterns of human and mosquito populations as well as characteristics of candidate outdoor interventions, it is possible to readily determine suitable areas for targeted positioning of the interventions, thus improve effectiveness. This study also highlights possibilities of relying on community knowledge to approximate areas where mosquitoes are most abundant and where to locate outdoor complementary interventions such as odour-baited lure and kill stations for controlling disease-transmitting mosquitoes.\u

The Double Bind of School Nurses and Policy Implementation: Intersecting the Street-Level Bureaucracy Framework and Teaching Sexual Health Education.

As described in the Framework for 21st Century School Nursing Practice, school nurses bridge the realities of health and education policy within the school community every day. This role is inclusive of helping teach sexual health education (SHE) to students. We were interested in characterizing how school nurses navigate requirements of health education policy to provide their students with the SHE content that they need. Using data from a larger study, we organized a subset of school nurse data within the street-level bureaucracy framework to better understand the many challenges school nurses face in implementing SHE policy. School nurses' involvement in SHE policy implementation was congruent with characteristics of the framework. This included using their professional discretion to manage dilemmas, working with inadequate resources, unclear policy expectations, lack of support, and ambiguous policy goals. Trusted relationships with teachers and students helped school nurses with their SHE policy implementation responsibilities

Biologically Inspired Feedback Design for Drosophila Flight

We use a biologically motivated model of the Drosophila's flight mechanics and sensor processing to design a feedback control scheme to regulate forward flight. The model used for insect flight is the grand unified fly (GUF) [3] simulation consisting of rigid body kinematics, aerodynamic forces and moments, sensory systems, and a 3D environment model. We seek to design a control algorithm that will convert the sensory signals into proper wing beat commands to regulate forward flight. Modulating the wing beat frequency and mean stroke angle produces changes in the flight envelope. The sensory signals consist of estimates of rotational velocity from the haltere organs and translational velocity estimates from visual elementary motion detectors (EMD's) and matched retinal velocity filters. The controller is designed based on a longitudinal model of the flight dynamics. Feedforward commands are generated based on a desired forward velocity. The dynamics are linearized around this operating point and a feedback controller designed to correct deviations from the operating point. The control algorithm is implemented in the GUF simulator and achieves the desired tracking of the forward reference velocities and exhibits biologically realistic responses

Algorithmic approach to adiabatic quantum optimization

It is believed that the presence of anticrossings with exponentially small gaps between the lowest two energy levels of the system Hamiltonian, can render adiabatic quantum optimization inefficient. Here, we present a simple adiabatic quantum algorithm designed to eliminate exponentially small gaps caused by anticrossings between eigenstates that correspond with the local and global minima of the problem Hamiltonian. In each iteration of the algorithm, information is gathered about the local minima that are reached after passing the anticrossing non-adiabatically. This information is then used to penalize pathways to the corresponding local minima, by adjusting the initial Hamiltonian. This is repeated for multiple clusters of local minima as needed. We generate 64-qubit random instances of the maximum independent set problem, skewed to be extremely hard, with between 10^5 and 10^6 highly-degenerate local minima. Using quantum Monte Carlo simulations, it is found that the algorithm can trivially solve all the instances in ~10 iterations.Comment: 7 pages, 3 figure

Experiences of diagnosis, stigma, culpability, and disclosure in male patients with hepatitis C virus: an interpretative phenomenological analysis

The current study aimed to explore the lived experience of patients with hepatitis C virus infection. Semi-structured interviews were conducted with seven male participants living with hepatitis C virus and were analysed using interpretative phenomenological analysis. Two master themes were identified: (1) diagnosis and the search for meaning and (2) impact of stigma on disclosure. Participants reported fears of contaminating others, feelings of stigma and concerns of disclosing the condition to others. Response to diagnosis, stigma and disclosure among the participants appeared to be interrelated and directly related to locus of blame for virus contraction. More specifically, hepatitis C virus transmission via medical routes led to an externalisation of culpability and an openness to disclosure. Transmission of hepatitis C virus as a direct result of intravenous drug use led to internalised blame and a fear of disclosure. The inter- and intra-personal consequences of hepatitis C virus explored in the current study have potential implications for tailoring future psychological therapy and psychoeducation to the specific needs of the hepatitis C virus population