Setting a Local Research Agenda for Women's Health: The National Centers of Excellence in Women's Health

Although women's health research expanded greatly in the past 10 years, significant gaps in knowledge remain. Prioritization and promotion of research will help assure continuing progress in closing such gaps and improving the health of women. Although a comprehensive agenda for the new millennium has been developed at the national level, the process for establishing a local research agenda is not well defined. The purpose of this study was to describe criteria for and barriers to establishing a local research agenda in women's health. A secondary aim was to describe mechanisms for identifying women's health researchers and for facilitating multidisciplinary research. Directors of Research at National Centers of Excellence in Women's Health (CoEs) (n = 18) were surveyed by mail for this information. The results indicate that the local research agenda should emphasize health issues that are prevalent in women, research that is likely to establish treatment, psychosocial/cultural factors, and quality of life issues. The process of setting a research agenda should include input from the communities served as well as from scientists. Critical evaluation of scientific strengths and weaknesses is an essential preliminary step in prioritizing research opportunities in order to implement and evaluate a research agenda in women's health.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/63225/1/152460901317193512.pd

Aperture effects on Star Formation Rate, Metallicity and Reddening

(Abridged) We use 101 galaxies selected from the Nearby Field Galaxy Survey (NFGS) to investigate the effect of aperture size on the star formation rate, metallicity and reddening determinations for galaxies. We compare the star formation rate, metallicity and reddening derived from nuclear spectra to those derived from integrated spectra. For apertures capturing <20% of the B(26) light, the differences between nuclear and global metallicity, extinction and star formation rate are substantial. We calculate an `expected' star formation rate using our nuclear spectra and apply the commonly-used aperture correction method. The expected star formation rate overestimates the global value for early type spirals, with large scatter for all Hubble types, particularly late types. The differences between the expected and global star formation rates probably result from the assumption that the distributions of the emission-line gas and the continuum are identical. We discuss the implications of these results for metallicity-luminosity relations and star formation history studies based on fiber spectra. To reduce systematic and random errors from aperture effects, we recommend selecting samples with fibers that capture >20% of the galaxy light. For the Sloan Digital Sky Survey and the 2dFGRS, redshifts z>0.04 and z>0.06 are required, respectively, to ensure a covering fraction >20% for galaxies similar to the average size, type, and luminosity observed in our sample. Higher luminosity samples and samples containing many late-type galaxies require a larger minimum redshift to ensure that >20% of the galaxy light is enclosed by the fiber.Comment: 19 pages, 11 figures, 5 tables. Accepted for publication in the PAS

[OII] as a Star Formation Rate Indicator

We investigate the [OII] emission-line as a star formation rate (SFR) indicator using integrated spectra of 97 galaxies from the Nearby Field Galaxies Survey (NFGS). The sample includes all Hubble types and contains SFRs ranging from 0.01 to 100 Msun/yr. We compare the Kennicutt [OII] and H-alpha SFR calibrations and show that there are two significant effects which produce disagreement between SFR[OII] and SFR(H-alpha): reddening and metallicity. Differences in the ionization state of the ISM do not contribute significantly to the observed difference between SFR([OII]) and SFR(H-alpha) for the NFGS galaxies with metallicities log(O/H)12>8.5. The Kennicutt [OII]-SFR relation assumes a typical reddening for nearby galaxies; in practice, the reddening differs significantly from sample to sample. We derive a new SFR([OII]) calibration which does not contain a reddening assumption. Our new SFR([OII]) calibration also provides an optional correction for metallicity. Our SFRs derived from [OII] agree with those derived from H-alpha to within 0.03-0.05 dex. We apply our SFR([OII]) calibration with metallicity correction to two samples: high-redshift 0.8<z<1.6 galaxies from the NICMOS H-alpha survey, and 0.5<z<1.1 galaxies from the Canada-France Redshift Survey. The SFR([OII]) and SFR(H-alpha) for these samples agree to within the scatter observed for the NFGS sample, indicating that our SFR([OII]) relation can be applied to both local and high-z galaxies. Finally, we apply our SFR([OII]) to estimates of the cosmic star formation history. After reddening and metallicity corrections, the star formation rate densities derived from [OII] and H-alpha agree to within 30%.Comment: 34 pages, 19 figures. To be published in the April 2004 issue of the Astronomical Jourma

Exploring factors affecting undergraduate medical students’ study strategies in the clinical years: a qualitative study

The aim of this study is to explore the effects of clinical supervision, and assessment characteristics on the study strategies used by undergraduate medical students during their clinical rotations. We conducted a qualitative phenomenological study at King Saud Bin Abdulaziz University for Health Sciences, College of Medicine, Riyadh, Saudi Arabia during the period from November 2007 to December 2008. We conducted semi-structured focus groups interviews with students and conducted individual interviews with teachers and students to explore students’ and clinical teachers’ perceptions and interpretations of factors influencing students’ study strategies. Data collection was continued until saturation was reached. We used Atlas-ti Computer Software (Version 5.2) to analyse the data, apply the obtained themes to the whole dataset and rearrange the data according to the themes and sub-themes. Analysis of data from interviews with twenty-eight students and thirteen clinical supervisors yielded three major themes relating to factors affecting students’ study strategies: “clinical supervisors and supervision”, “stress and anxiety” and “assessment”. The three themes we identified played a role in students’ adoption of different study strategies in the “community of clinical practice”. It appeared that teachers played a key role, particularly as assessors, clinical supervisors and as a source of stress to students

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570