Culture-specific programs for children and adults from minority groups who have asthma (Review)

Background People with asthma who come from minority groups have poorer asthma outcomes and more asthma related visits to Emergency Departments (ED). Various programmes are used to educate and empower people with asthma and these have previously been shown to improve certain asthma outcomes. Models of care for chronic diseases in minority groups usually include a focus of the cultural context of the individual and not just the symptoms of the disease. Therefore, questions about whether culturally specific asthma education programmes for people from minority groups are effective at improving asthma outcomes, are feasible and are cost-effective need to be answered. Objectives To determine whether culture-specific asthma programmes, in comparison to generic asthma education programmes or usual care, improve asthma related outcomes in children and adults with asthma who belong to minority groups. Search strategy We searched the Cochrane Register of Controlled Trials (CENTRAL), the Cochrane Airways Group Specialised Register, MEDLINE, EMBASE, review articles and reference lists of relevant articles. The latest search was performed in May 2008. Selection criteria All randomised controlled trials (RCTs) comparing the use of culture-specific asthma education programmes with generic asthma education programmes, or usual care, in adults or children from minority groups who suffer from asthma. Data collection and analysis Two review authors independently selected, extracted and assessed the data for inclusion. We contacted authors for further information if required. Main results Four studies were eligible for inclusion in the review. A total of 617 patients, aged from 5 to 59 years were included in the meta-analysis of data. Use of a culture-specific programme was superior to generic programmes or usual care, in improving asthma quality of life scores in adults, pooled WMD 0.25 (95% CI 0.09 to 0.41), asthma knowledge scores in children, WMD 3.30 (95% CI 1.07 to 5.53), and in a single study, reducing asthma exacerbation in children (risk ratio for hospitalisations 0.32, 95% CI 0.15, 0.70). Authors' conclusions Current limited data show that culture-specific programmes for adults and children from minority groups with asthma, are more effective than generic programmes in improving most (quality of life, asthma knowledge, asthma exacerbations, asthma control) but not all asthma outcomes. This evidence is limited by the small number of included studies and the lack of reported outcomes. Further trials are required to answer this question conclusively

Can we use the approaches of ecological inference to learn about the potential for dependence bias in dualsystem estimation? An application to cancer registration data

The dual-system estimator, or estimators with a similar underlying set of assumptions and structure, is a widely used approach to estimate the unknown size of a population. Within official statistics its use is linked with population census, while in health applications it is often used to estimate true levels of incidence from imperfect reporting systems; the classic example being work by Sekar and Deming exploring the estimation of births in India in the 1940s. Critical to the implementation of dual-system estimation are the assumptions that the probability of being counted in a source is homogeneous and that the event of being counted in each source is independent. When either of these assumptions fails, the two by two table will have an odds ratio different to one and the dual-system estimator will be biased. Inferential frameworks such as the aggregate association index (AAI) have been developed to allow the researcher to assess the plausibility of independence between two variables in a two by two table, when only the margins are observed. Given any appropriate measure of relationship, this strategy relies on determining the AAI, which provides an indication of the likely association structure between the variables given only the marginal information. Further advances of the AAI have also been established including its link with the odds ratio and its relationship with the size of the study being undertaken. Determining the population size from a two by two table given limited information is an alternative variation of the framework on which the AAI is built. Therefore the underlying theoretical properties of the two by two table are identical in both scenarios – it is only the nature of the unknown information that differs. In this paper we make the first steps to exploring the use of an AAI type framework (and its relatives) to assess the plausibility of an independence assumption in applications of population size estimation. We use alternative data set-ups based on real data relating to historical cancer registration (with three sources of registration) to demonstrate that the chi-square statistic behaves differently over a range of values for the missing data for differing true relationships between the two variables. We then apply the approach to the cancer registration from two of the registration systems to show that we can see evidence of potential dependence from the observed but incomplete data. The first results in this paper demonstrate the possibility of exploring the independence assumption when estimating the unknown population size from two lists. As with the AAI framework, the aim is not to directly estimate the level of the association but rather alert the analyst to the potential for an association and its direction allowing them to assess the likelihood of a biased estimate for the population size. This has important implications within a health setting where it is potentially useful to understand if the true population size, of say cancer patients, is likely to be higher or lower than the estimate constructed assuming independence. Within the official statistics setting, it can alert us to situations where it is advantageous to explore whether external data exist that would allow an adjustment for dependence in our two lists

Environmental Attitudes and Behaviors among Secondary Students in Hong Kong

Although researchers have identified correlations between specific attitudes and particular behaviors in the pro-environmental domain, the general relationship between young people’s development of environmental knowledge, attitudes, and behaviors is not well understood. Past research indicates that geographic context can play a role, while social factors such as age and gender can have a more significant impact on predicting attitudes and behaviors than formal education. Few studies have systematically examined the relationships between education and environmental attitudes and behaviors among youth in Hong Kong. The purpose of this paper is to report the findings of a study comparing secondary school students’ environmental attitudes and behaviors with age and related factors in two international schools and two government schools in Hong Kong. Students’ attitudes and behaviors were compared based on school type (curriculum), while the authors additionally compared the significance of social factors and attitudes on students’ behaviors. Design/methodology/approach – Attitudes were measured using the New Ecological Paradigm (NEP) and the NEP for Children (NEPC), the most commonly used, internationally standardized tools for investigating environmental attitudes and values of adults and young people for comparative purposes. The authors compared NEP/NEPC scores and student self-reported environmental behaviors using a short questionnaire. Findings – No significant differences were found in attitudes or behaviors based on school type. However the authors did observe a significant effect of gender and age on students’ attitudes, and a significant correlation of student attitudes in the NEP with students’ self-reports regarding air conditioning consumption. Originality/value – This study builds a foundation for cross-national studies and for evaluating the impact of curricula over time.postprin

Generic 3D Representation via Pose Estimation and Matching

Though a large body of computer vision research has investigated developing generic semantic representations, efforts towards developing a similar representation for 3D has been limited. In this paper, we learn a generic 3D representation through solving a set of foundational proxy 3D tasks: object-centric camera pose estimation and wide baseline feature matching. Our method is based upon the premise that by providing supervision over a set of carefully selected foundational tasks, generalization to novel tasks and abstraction capabilities can be achieved. We empirically show that the internal representation of a multi-task ConvNet trained to solve the above core problems generalizes to novel 3D tasks (e.g., scene layout estimation, object pose estimation, surface normal estimation) without the need for fine-tuning and shows traits of abstraction abilities (e.g., cross-modality pose estimation). In the context of the core supervised tasks, we demonstrate our representation achieves state-of-the-art wide baseline feature matching results without requiring apriori rectification (unlike SIFT and the majority of learned features). We also show 6DOF camera pose estimation given a pair local image patches. The accuracy of both supervised tasks come comparable to humans. Finally, we contribute a large-scale dataset composed of object-centric street view scenes along with point correspondences and camera pose information, and conclude with a discussion on the learned representation and open research questions.Comment: Published in ECCV16. See the project website http://3drepresentation.stanford.edu/ and dataset website https://github.com/amir32002/3D_Street_Vie

Plaque Rupture in Coronary Atherosclerosis Is Associated With Increased Plaque Structural Stress.

OBJECTIVES: The aim of this study was to identify the determinants of plaque structural stress (PSS) and the relationship between PSS and plaques with rupture. BACKGROUND: Plaque rupture is the most common cause of myocardial infarction, occurring particularly in higher risk lesions such as fibroatheromas. However, prospective intravascular ultrasound-virtual histology studies indicate that 135 kPa was a good predictor of rupture in higher risk regions. CONCLUSIONS: PSS is determined by plaque composition, plaque architecture, and lumen geometry. PSS and PSS variability are increased in plaques with rupture, particularly at proximal segments. Incorporating PSS into plaque assessment may improve identification of rupture-prone plaques.This work was supported by British Heart Foundation grants CH/20000003/12800, FS/13/33/30168, and FS/15/26/31441; Heart Research UK grant RG2638/14/16 and MRC Confidence in Concepts award; and the NIHR Cambridge Biomedical Research Centre

TGF-b2 induction regulates invasiveness of theileria-transformed leukocytes and disease susceptibility

Theileria parasites invade and transform bovine leukocytes causing either East Coast fever (T. parva), or tropical theileriosis (T. annulata). Susceptible animals usually die within weeks of infection, but indigenous infected cattle show markedly reduced pathology, suggesting that host genetic factors may cause disease susceptibility. Attenuated live vaccines are widely used to control tropical theileriosis and attenuation is associated with reduced invasiveness of infected macrophages in vitro. Disease pathogenesis is therefore linked to aggressive invasiveness, rather than uncontrolled proliferation of Theileria-infected leukocytes. We show that the invasive potential of Theileria-transformed leukocytes involves TGF-b signalling. Attenuated live vaccine lines express reduced TGF-b2 and their invasiveness can be rescued with exogenous TGF-b. Importantly, infected macrophages from disease susceptible Holstein-Friesian (HF) cows express more TGF-b2 and traverse Matrigel with great efficiency compared to those from disease-resistant Sahiwal cattle. Thus, TGF-b2 levels correlate with disease susceptibility. Using fluorescence and time-lapse video microscopy we show that Theileria-infected, disease-susceptible HF macrophages exhibit increased actin dynamics in their lamellipodia and podosomal adhesion structures and develop more membrane blebs. TGF-b2-associated invasiveness in HF macrophages has a transcription-independent element that relies on cytoskeleton remodelling via activation of Rho kinase (ROCK). We propose that a TGF-b autocrine loop confers an amoeboid-like motility on Theileria-infected leukocytes, which combines with MMP-dependent motility to drive invasiveness and virulence

A randomized, placebo-controlled trial of late Na current inhibition (ranolazine) in coronary microvascular dysfunction (CMD): impact on angina and myocardial perfusion reserve.

AimsThe mechanistic basis of the symptoms and signs of myocardial ischaemia in patients without obstructive coronary artery disease (CAD) and evidence of coronary microvascular dysfunction (CMD) is unclear. The aim of this study was to mechanistically test short-term late sodium current inhibition (ranolazine) in such subjects on angina, myocardial perfusion reserve index, and diastolic filling.Materials and resultsRandomized, double-blind, placebo-controlled, crossover, mechanistic trial in subjects with evidence of CMD [invasive coronary reactivity testing or non-invasive cardiac magnetic resonance imaging myocardial perfusion reserve index (MPRI)]. Short-term oral ranolazine 500-1000 mg twice daily for 2 weeks vs. placebo. Angina measured by Seattle Angina Questionnaire (SAQ) and SAQ-7 (co-primaries), diary angina (secondary), stress MPRI, diastolic filling, quality of life (QoL). Of 128 (96% women) subjects, no treatment differences in the outcomes were observed. Peak heart rate was lower during pharmacological stress during ranolazine (-3.55 b.p.m., P < 0.001). The change in SAQ-7 directly correlated with the change in MPRI (correlation 0.25, P = 0.005). The change in MPRI predicted the change in SAQ QoL, adjusted for body mass index (BMI), prior myocardial infarction, and site (P = 0.0032). Low coronary flow reserve (CFR <2.5) subjects improved MPRI (P < 0.0137), SAQ angina frequency (P = 0.027), and SAQ-7 (P = 0.041).ConclusionsIn this mechanistic trial among symptomatic subjects, no obstructive CAD, short-term late sodium current inhibition was not generally effective for SAQ angina. Angina and myocardial perfusion reserve changes were related, supporting the notion that strategies to improve ischaemia should be tested in these subjects.Trial registrationclinicaltrials.gov Identifier: NCT01342029

An essential function for the ATR-Activation-Domain (AAD) of TopBP1 in mouse development and cellular senescence

ATR activation is dependent on temporal and spatial interactions with partner proteins. In the budding yeast model, three proteins – Dpb11TopBP1, Ddc1Rad9 and Dna2 - all interact with and activate Mec1ATR. Each contains an ATR activation domain (ADD) that interacts directly with the Mec1ATR:Ddc2ATRIP complex. Any of the Dpb11TopBP1, Ddc1Rad9 or Dna2 ADDs is sufficient to activate Mec1ATR in vitro. All three can also independently activate Mec1ATR in vivo: the checkpoint is lost only when all three AADs are absent. In metazoans, only TopBP1 has been identified as a direct ATR activator. Depletion-replacement approaches suggest the TopBP1-AAD is both sufficient and necessary for ATR activation. The physiological function of the TopBP1 AAD is, however, unknown. We created a knock-in point mutation (W1147R) that ablates mouse TopBP1-AAD function. TopBP1-W1147R is early embryonic lethal. To analyse TopBP1-W1147R cellular function in vivo, we silenced the wild type TopBP1 allele in heterozygous MEFs. AAD inactivation impaired cell proliferation, promoted premature senescence and compromised Chk1 signalling following UV irradiation. We also show enforced TopBP1 dimerization promotes ATR-dependent Chk1 phosphorylation. Our data suggest that, unlike the yeast models, the TopBP1-AAD is the major activator of ATR, sustaining cell proliferation and embryonic development