Researching education outcomes in Burundi, Malawi, Senegal and Uganda: using participatory tools and collaborative approaches : The Improving Learning Outcomes in Primary Schools (ILOPS) Project | Project methodology

In January 2008, ActionAid, Dr Karen Edge (IOE) and partners in Burundi, Malawi, Uganda and Senegal studied the role of parents and teachers in enhancing learning outcomes. The Improving Learning Outcomes in Primary Schools (ILOPS) Project was supported by the Quality Education in Developing Countries Initiative of the William and Flora Hewlett Foundation in partnership with the Bill & Melinda Gates Foundation. Findings from the ILOPS Project are presented in three separate briefs exploring teacher quality, parental participation and, this paper, exploring our tools and approaches. This paper, primarily designed for practitioner audiences, outlines the participatory research methodology designed by Dr Karen Edge and the strategies employ the methods with a team of 53 senior educational leaders from participating countries. The strategies were designed to bring teams of non-researchers together, to build national-level team capacity and collaboration and support their work in the field by collaborating with all participants to design the overall conceptual framework and methods of the study. In this paper, we provide details on the development and implementation of our approach as well as the lessons learned throughout the process for others interested in following similar approaches. This approach has been employed within several other IOE project, led by Dr Edge. In addition, the approach has influenced the work of ActionAid and other participating stakeholders

Development and application of a steady state code for supercritical carbon dioxide cycles

Thesis (S.B.)--Massachusetts Institute of Technology, Dept. of Nuclear Science and Engineering, 2006.Leaf 63 blank.Includes bibliographical references (leaf 62).The supercritical CO2 power conversion system is of interest for advanced nuclear reactor applications because the same efficiencies are obtained as for the most developed of the closed gas-turbine cycles (helium-Brayton), but at lower temperatures and higher pressures. The original in-house code, named CYCLES, could potentially be used by others who are researching the S-CO2 cycle, but it has its shortcomings. In particular, CYCLES does not factor in the pressure drops due to pipes and plena. Also, for new users, it takes a significant amount of time to fully understand how to use the code. The objectives of this thesis were to modify CYCLES to ensure that pipe and plena effects were included, and to improve the readability and functionality of the code. Changes to CYCLES are included in the rewritten code, named CYCLES II, and are also documented in this thesis. Furthermore, documentation of the program input and output is given, along with a flow chart of the algorithm logic. Two applications of the code are provided to show the effect of the pipes and plena on cycle performance. In comparing the cycle efficiency with and without the effects of the pipes and plena, for a 300 MWe S-CO2 Brayton power conversion system, the results indicate that the net cycle efficiency drops from 49% to 45% when pipes and plena of reasonable dimensions are included in the calculations. The losses are dominated by the low pressure pipe and plena segments. However, the effects of the pipes and plena on cycle efficiency are not characteristic of the S-CO2 cycle only. All Brayton cycles have this same issue, and the effects are worse for the helium-Brayton cycle because it operates at lower pressures.by David M. Legault.S.B

Analyse phénoménologique des expériences de soutien à l’exercice des droits en soins psychiatriques

Introduction : Le personnel infirmier doit souvent composer avec les procédures médico-légales autorisant l’hospitalisation ou le traitement involontaire des personnes vivant avec une problématique de santé mentale. Ces mesures coercitives, dont les effets thérapeutiques sont contestés, portent atteinte aux libertés et droits fondamentaux de ces personnes. Bien que leur importance soit reconnue, les pratiques de soutien à l’exercice des droits restent informelles et peu documentées. Un projet de recherche a été réalisé au Québec (Canada) pour comprendre la signification du soutien à l’exercice des droits à partir de l’expérience de personnes ayant vécu une hospitalisation ou un traitement involontaire en psychiatrie. Les résultats de cette étude permettent de décrire la signification expérientielle du soutien à l’exercice des droits lors d’hospitalisation ou de traitement involontaire en psychiatrie. Méthodes : Un devis qualitatif de type phénoménologique interprétatif a été employé. Des entrevues semi-dirigées accompagnées d’un formulaire sociodémographique ont été réalisées auprès de 10 participants. Résultats : Les résultats suggèrent que les expériences d’abandon et d’incompréhension sont fréquentes chez les participants, qui expriment un manque de soutien à l’exercice de leurs droits. Ceux-ci vivent un sentiment d’injustice, perçoivent leurs droits comme malléables et difficiles à faire reconnaitre. Discussion et conclusion : Première étude canadienne sur le sujet, cette recherche s’inscrit dans la lignée des efforts menés à l’international pour mettre fin à la violation des droits humains en psychiatrie. Sa diffusion favorisera le développement d’interventions infirmières orientées vers les dimensions éthiques du soin, plus précisément vers la reconnaissance et le soutien à l’exercice des droits humains en psychiatrie.Introduction : Le personnel infirmier doit souvent composer avec les procédures médico-légales autorisant l’hospitalisation ou le traitement involontaire des personnes vivant avec une problématique de santé mentale. Ces mesures coercitives, dont les effets thérapeutiques sont contestés, portent atteinte aux libertés et droits fondamentaux de ces personnes. Bien que leur importance soit reconnue, les pratiques de soutien à l’exercice des droits restent informelles et peu documentées. Un projet de recherche a été réalisé au Québec (Canada) pour comprendre la signification du soutien à l’exercice des droits à partir de l’expérience de personnes ayant vécu une hospitalisation ou un traitement involontaire en psychiatrie. Les résultats de cette étude permettent de décrire la signification expérientielle du soutien à l’exercice des droits lors d’hospitalisation ou de traitement involontaire en psychiatrie. Méthodes : Un devis qualitatif de type phénoménologique interprétatif a été employé. Des entrevues semi-dirigées accompagnées d’un formulaire sociodémographique ont été réalisées auprès de 10 participants. Résultats : Les résultats suggèrent que les expériences d’abandon et d’incompréhension sont fréquentes chez les participants, qui expriment un manque de soutien à l’exercice de leurs droits. Ceux-ci vivent un sentiment d’injustice, perçoivent leurs droits comme malléables et difficiles à faire reconnaitre. Discussion et conclusion : Première étude canadienne sur le sujet, cette recherche s’inscrit dans la lignée des efforts menés à l’international pour mettre fin à la violation des droits humains en psychiatrie. Sa diffusion favorisera le développement d’interventions infirmières orientées vers les dimensions éthiques du soin, plus précisément vers la reconnaissance et le soutien à l’exercice des droits humains en psychiatrie

Le développement de pratiques de soutien à l’exercice des droits en soins psychiatriques à partir de l’expérience qu’en font les personnes vivant avec une problématique de santé mentale en contexte d’hospitalisation ou de traitement involontaire: protocole de recherche d’une analyse phénoménologique interprétative

Introduction: Worldwide, there is an increased use of coercion in psychiatry, particularly through involuntary hospitalization or treatment. Like many other Canadian provinces, Quebec is no exception. However, the therapeutic outcomes of these measures are questioned when compared to voluntary care. Given the infringement of human rights and freedoms, coercion in psychiatry has been contested by many organizations, including the World Health Organization (2021). Human rights-based practices have been recognized as an important nursing role in Quebec. However, these practices are often informal and poorly documented in scientific literature. Objective: This article presents the research protocol of an interpretative phenomenological study that aims to understand the lived experiences of coercion and human rights-based practices in psychiatry from the perspectives of people living with mental health problems. Methods: This qualitative study uses an interpretative phenomenological analysis design developed by Smith et al. (2009). In depth, one-on-one interviews along with socio-demographic questionnaire will be conducted with approximately 10 participants. Data analysis will follow an iterative and hermeneutic emergence coding process. Discussion and conclusion: By centering human rights-based practices to the lived experiences of people living with mental health problems who encountered coercion, this study will highlight contributing and limiting factors to the recognition of human rights in nursing practices. This study will also promote the development of nursing knowledge and practices that can significantly contribute to individuals’ recovery process.Introduction : À travers le monde, le recours à la coercition en soins psychiatriques, notamment par l’hospitalisation et le traitement involontaire, est croissant. Le Québec, comme plusieurs autres provinces canadiennes, n’échappe pas à cette tendance. Pourtant, l’efficacité de ces mesures est contestée lorsqu’elles sont comparées aux soins offerts sur une base volontaire. Devant l’atteinte aux libertés et droits fondamentaux, la coercition en soins psychiatriques est dénoncée par de nombreuses instances dont l’Organisation mondiale de la Santé (2021). Les pratiques de soutien à l’exercice des droits sont désormais reconnues comme un rôle important du personnel infirmier au Québec (Canada). Pourtant, ces pratiques sont souvent informelles et peu documentées dans la littérature scientifique. Objectifs : Cet article présente le protocole de recherche d’une étude phénoménologique interprétative visant à comprendre l’expérience de la coercition et des pratiques de soutien à l’exercice des droits en soins psychiatriques, selon la perspective des personnes vivant avec une problématique de santé mentale. Méthodes : L’analyse phénoménologique interprétative développée par Smith et al. (2009) est le devis retenu pour cette étude qualitative. Des entrevues individuelles accompagnées d’un questionnaire sociodémographique seront menées auprès d’approximativement 10 participants. L’analyse des données se réalisera suivant un processus itératif et herméneutique de codification par émergence. Discussion et conclusion : En plaçant le soutien à l’exercice des droits au centre de l’expérience vécue des personnes ciblées par la coercition en soins psychiatriques, cette étude mettra de l’avant les facteurs favorables et les obstacles à la reconnaissance des droits dans l’actualisation des pratiques infirmières. Elle contribuera également au développement de savoirs infirmiers et de pratiques de soins susceptibles d’apporter une contribution significative au processus de rétablissement des personnes

From Military to Healthcare: Adopting and Expanding Ethical Principles for Generative Artificial Intelligence

In 2020, the U.S. Department of Defense officially disclosed a set of ethical principles to guide the use of Artificial Intelligence (AI) technologies on future battlefields. Despite stark differences, there are core similarities between the military and medical service. Warriors on battlefields often face life-altering circumstances that require quick decision-making. Medical providers experience similar challenges in a rapidly changing healthcare environment, such as in the emergency department or during surgery treating a life-threatening condition. Generative AI, an emerging technology designed to efficiently generate valuable information, holds great promise. As computing power becomes more accessible and the abundance of health data, such as electronic health records, electrocardiograms, and medical images, increases, it is inevitable that healthcare will be revolutionized by this technology. Recently, generative AI has captivated the research community, leading to debates about its application in healthcare, mainly due to concerns about transparency and related issues. Meanwhile, concerns about the potential exacerbation of health disparities due to modeling biases have raised notable ethical concerns regarding the use of this technology in healthcare. However, the ethical principles for generative AI in healthcare have been understudied, and decision-makers often fail to consider the significance of generative AI. In this paper, we propose GREAT PLEA ethical principles, encompassing governance, reliability, equity, accountability, traceability, privacy, lawfulness, empathy, and autonomy, for generative AI in healthcare. We aim to proactively address the ethical dilemmas and challenges posed by the integration of generative AI in healthcare

EFFECTS OF INTENSIVE DIET AND EXERCISE ON KNEE JOINT LOADS, INFLAMMATION, AND CLINICAL OUTCOMES AMONG OVERWEIGHT AND OBESE ADULTS WITH KNEE OSTEOARTHRITIS

Importance Knee osteoarthritis (OA), a common cause of chronic pain and disability, has biomechanical and inflammatory origins and is exacerbated by obesity. Objective To determine whether a ≥10% reduction in body weight induced by diet, with or without exercise, would improve mechanistic and clinical outcomes more than exercise alone. Design, Setting, and Participants Single-blind, 18-month, randomized clinical trial at Wake Forest University between July 2006 and April 2011. The diet and exercise interventions were center-based with options for the exercise groups to transition to a home-based program. Participants were 454 overweight and obese older community-dwelling adults (age ≥55 years with body mass index of 27-41) with pain and radiographic knee OA. Interventions Intensive diet-induced weight loss plus exercise, intensive diet-induced weight loss, or exercise. Main Outcomes and Measures Mechanistic primary outcomes: knee joint compressive force and plasma IL-6 levels; secondary clinical outcomes: self-reported pain (range, 0-20), function (range, 0-68), mobility, and health-related quality of life (range, 0-100). Results Three hundred ninety-nine participants (88%) completed the study. Mean weight loss for diet + exercise participants was 10.6 kg (11.4%); for the diet group, 8.9 kg (9.5%); and for the exercise group, 1.8 kg (2.0%). After 18 months, knee compressive forces were lower in diet participants (mean, 2487 N; 95% CI, 2393 to 2581) compared with exercise participants (2687 N; 95% CI, 2590 to 2784, pairwise difference [Δ]exercise vs diet = 200 N; 95% CI, 55 to 345; P = .007). Concentrations of IL-6 were lower in diet + exercise (2.7 pg/mL; 95% CI, 2.5 to 3.0) and diet participants (2.7 pg/mL; 95% CI, 2.4 to 3.0) compared with exercise participants (3.1 pg/mL; 95% CI, 2.9 to 3.4; Δexercise vs diet + exercise = 0.39 pg/mL; 95% CI, −0.03 to 0.81; P = .007; Δexercise vs diet = 0.43 pg/mL; 95% CI, 0.01 to 0.85, P = .006). The diet + exercise group had less pain (3.6; 95% CI, 3.2 to 4.1) and better function (14.1; 95% CI, 12.6 to 15.6) than both the diet group (4.8; 95% CI, 4.3 to 5.2) and exercise group (4.7; 95% CI, 4.2 to 5.1, Δexercise vs diet + exercise = 1.02; 95% CI, 0.33 to 1.71; Ppain = .004; 18.4; 95% CI, 16.9 to 19.9; Δexercise vs diet + exercise, 4.29; 95% CI, 2.07 to 6.50; Pfunction < .001). The diet + exercise group (44.7; 95% CI, 43.4 to 46.0) also had better physical health-related quality of life scores than the exercise group (41.9; 95% CI, 40.5 to 43.2; Δexercise vs diet + exercise = −2.81; 95% CI, −4.76 to −0.86; P = .005). Conclusions and Relevance Among overweight and obese adults with knee OA, after 18 months, participants in the diet + exercise and diet groups had more weight loss and greater reductions in IL-6 levels than those in the exercise group; those in the diet group had greater reductions in knee compressive force than those in the exercise group

Pharmacogenomics of the efficacy and safety of Colchicine in COLCOT

© 2021 The Authors. Circulation: Genomic and Precision Medicine is published on behalf of the American Heart Association, Inc., by Wolters Kluwer Health, Inc. This is an open access article under the terms of the Creative Commons Attribution Non-Commercial License, which permits use, distribution, and reproduction in any medium, provided that the original work is properly cited and is not used for commercial purposes.Background: The randomized, placebo-controlled COLCOT (Colchicine Cardiovascular Outcomes Trial) has shown the benefits of colchicine 0.5 mg daily to lower the rate of ischemic cardiovascular events in patients with a recent myocardial infarction. Here, we conducted a post hoc pharmacogenomic study of COLCOT with the aim to identify genetic predictors of the efficacy and safety of treatment with colchicine. Methods: There were 1522 participants of European ancestry from the COLCOT trial available for the pharmacogenomic study of COLCOT trial. The pharmacogenomic study's primary cardiovascular end point was defined as for the main trial, as time to first occurrence of cardiovascular death, resuscitated cardiac arrest, myocardial infarction, stroke, or urgent hospitalization for angina requiring coronary revascularization. The safety end point was time to the first report of gastrointestinal events. Patients' DNA was genotyped using the Illumina Global Screening array followed by imputation. We performed a genome-wide association study in colchicine-treated patients. Results: None of the genetic variants passed the genome-wide association study significance threshold for the primary cardiovascular end point conducted in 702 patients in the colchicine arm who were compliant to medication. The genome-wide association study for gastrointestinal events was conducted in all 767 patients in the colchicine arm and found 2 significant association signals, one with lead variant rs6916345 (hazard ratio, 1.89 [95% CI, 1.52-2.35], P=7.41×10-9) in a locus which colocalizes with Crohn disease, and one with lead variant rs74795203 (hazard ratio, 2.51 [95% CI, 1.82-3.47]; P=2.70×10-8), an intronic variant in gene SEPHS1. The interaction terms between the genetic variants and treatment with colchicine versus placebo were significant. Conclusions: We found 2 genomic regions associated with gastrointestinal events in patients treated with colchicine. Those findings will benefit from replication to confirm that some patients may have genetic predispositions to lower tolerability of treatment with colchicine.info:eu-repo/semantics/publishedVersio

Diversity of Haloquadratum and other haloarchaea in three, geographically distant, Australian saltern crystallizer ponds

Haloquadratum walsbyi is frequently a dominant member of the microbial communities in hypersaline waters. 16S rRNA gene sequences indicate that divergence within this species is very low but relatively few sites have been examined, particularly in the southern hemisphere. The diversity of Haloquadratum was examined in three coastal, but geographically distant saltern crystallizer ponds in Australia, using both culture-independent and culture-dependent methods. Two 97%-OTU, comprising Haloquadratum- and Halorubrum-related sequences, were shared by all three sites, with the former OTU representing about 40% of the sequences recovered at each site. Sequences 99.5% identical to that of Hqr. walsbyi C23T were present at all three sites and, overall, 98% of the Haloquadratum-related sequences displayed ≤2% divergence from that of the type strain. While haloarchaeal diversity at each site was relatively low (9–16 OTUs), seven phylogroups (clones and/or isolates) and 4 different clones showed ≤90% sequence identity to classified taxa, and appear to represent novel genera. Six of these branched together in phylogenetic tree reconstructions, forming a clade (MSP8-clade) whose members were only distantly related to classified taxa. Such sequences have only rarely been previously detected but were found at all three Australian crystallizers

Polyclonality of Concurrent Natural Populations of Alteromonas macleodii

We have analyzed a natural population of the marine bacterium, Alteromonas macleodii, from a single sample of seawater to evaluate the genomic diversity present. We performed full genome sequencing of four isolates and 161 metagenomic fosmid clones, all of which were assigned to A. macleodii by sequence similarity. Out of the four strain genomes, A. macleodii deep ecotype (AltDE1) represented a different genome, whereas AltDE2 and AltDE3 were identical to the previously described AltDE. Although the core genome (∼80%) had an average nucleotide identity of 98.51%, both AltDE and AltDE1 contained flexible genomic islands (fGIs), that is, genomic islands present in both genomes in the same genomic context but having different gene content. Some of the fGIs encode cell surface receptors known to be phage recognition targets, such as the O-chain of the lipopolysaccharide, whereas others have genes involved in physiological traits (e.g., nutrient transport, degradation, and metal resistance) denoting microniche specialization. The presence in metagenomic fosmids of genomic fragments differing from the sequenced strain genomes, together with the presence of new fGIs, indicates that there are at least two more A. macleodii clones present. The availability of three or more sequences overlapping the same genomic region also allowed us to estimate the frequency and distribution of recombination events among these different clones, indicating that these clustered near the genomic islands. The results indicate that this natural A. macleodii population has multiple clones with a potential for different phage susceptibility and exploitation of resources, within a seemingly unstructured habitat