The Change Up Project : using social norming theory with young people to address domestic abuse and promote healthy relationships

This paper presents the findings of a secondary analysis of data collected during a pilot project, Change Up, which used a social norming approach (SNA) to address domestic violence and abuse (DVA) with young people aged 13–14. A SNA is based upon a well-articulated theory of behavior and evidence-based methodology for addressing social justice issues. This reflects a paradigm shift focusing upon strengths and positives, rather than pathologizing behaviours. Adopting a SNA, the Change Up project comprised a baseline survey followed by the intervention (workshop and peer-to-peer campaign), ending with a post-intervention survey. It was delivered in two high schools in a UK city between 2015 and 16. A secondary analysis of the survey data collected during the surveys and qualitative data collected at the end of each workshop was undertaken and this is reported here. Change Up data illustrates that most young people in the sample thought that DVA is unacceptable. There was, however, a gender difference in the norms held about the social acceptability of girls using physical violence against boys (and vice versa). The analysis of Change Up data indicates that a social norming approach to DVA programs aimed at young people can be successful in promoting attitude and behaviour change. It also highlights a continuing need for young people’s education about relationships and gender equality

Partnering to proceed: scaling up adolescent sexual reproductive health programmes in Tanzania. Operational research into the factors that influenced local government uptake and implementation

BACKGROUND: Little is known about how to implement promising small-scale projects to reduce reproductive ill health and HIV vulnerability in young people on a large scale. This evaluation documents and explains how a partnership between a non-governmental organization (NGO) and local government authorities (LGAs) influenced the LGA-led scale-up of an innovative NGO programme in the wider context of a new national multisectoral AIDS strategy. METHODS: Four rounds of semi-structured interviews with 82 key informants, 8 group discussions with 49 district trainers and supervisors (DTS), 8 participatory workshops involving 52 DTS, and participant observations of 80% of LGA-led and 100% of NGO-led meetings were conducted, to ascertain views on project components, flow of communication and decision-making and amount of time DTS utilized undertaking project activities. RESULTS: Despite a successful ten-fold scale-up of intervention activities in three years, full integration into LGA systems did not materialize. LGAs contributed significant human resources but limited finances; the NGO retained control over finances and decision-making and LGAs largely continued to view activities as NGO driven. Embedding of technical assistants (TAs) in the LGAs contributed to capacity building among district implementers, but may paradoxically have hindered project integration, because TAs were unable to effectively transition from an implementing to a facilitating role. Operation of NGO administration and financial mechanisms also hindered integration into district systems. CONCLUSIONS: Sustainable intervention scale-up requires operational, financial and psychological integration into local government mechanisms. This must include substantial time for district systems to try out implementation with only minimal NGO support and modest output targets. It must therefore go beyond the typical three- to four-year project cycles. Scale-up of NGO pilot projects of this nature also need NGOs to be flexible enough to adapt to local government planning cycles and ongoing evaluation is needed to ensure strategies employed to do so really do achieve full intervention integration

Clinical implementation of rapid CYP2C19 genotyping to guide antiplatelet therapy after percutaneous coronary intervention

© 2018 The Author(s). Background: The CYP2C19 nonfunctional genotype reduces clopidogrel effectiveness after percutaneous coronary intervention (PCI). Following clinical implementation of CYP2C19 genotyping at University Florida (UF) Health Shands Hospital in 2012, where genotype results are available approximately 3 days after PCI, testing was expanded to UF Health Jacksonville in 2016 utilizing a rapid genotyping approach. We describe metrics with this latter implementation. Methods: Patients at UF Health Jacksonville undergoing left heart catheterization with intent to undergo PCI were targeted for genotyping using the Spartan RX™ system. Testing metrics and provider acceptance of testing and response to genotype results were examined, as was antiplatelet therapy over the 6 months following genotyping. Results: In the first year, 931 patients, including 392/505 (78%) total patients undergoing PCI, were genotyped. The median genotype test turnaround time was 96 min. Genotype results were available for 388 (99%) PCI patients prior to discharge. Of 336 genotyped PCI patients alive at discharge and not enrolled in an antiplatelet therapy trial, 1/6 (17%) poor metabolizers (PMs, with two nonfunctional alleles), 38/93 (41%) intermediate metabolizers (IMs, with one nonfunctional allele), and 119/237 (50%) patients without a nonfunctional allele were prescribed clopidogrel (p = 0.110). Clopidogrel use was higher among non-ACS versus ACS patients (78.6% vs. 42.2%, p < 0.001). Six months later, among patients with follow-up data, clopidogrel was prescribed in 0/4 (0%) PMs, 33/65 (51%) IMs, and 115/182 (63%) patients without a nonfunctional allele (p = 0.008 across groups; p = 0.020 for PMs versus those without a nonfunctional allele). Conclusion: These data demonstrate that rapid genotyping is clinically feasible at a high volume cardiac catheterization facility and allows informed chronic antiplatelet prescribing, with lower clopidogrel use in PMs at 6 months

Beam Energy Dependence of Jet-Quenching Effects in Au plus Au Collisions at root s(NN)=7.7, 11.5, 14.5, 19.6, 27, 39, and 62.4 GeV

We report measurements of the nuclear modification factor, $R_{ \mathrm{CP}}$, for charged hadrons as well as identified $\pi^{+(-)}$, $K^{+(-)}$, and $p(\overline{p})$ for Au+Au collision energies of $\sqrt{s_{_{ \mathrm{NN}}}}$ = 7.7, 11.5, 14.5, 19.6, 27, 39, and 62.4 GeV. We observe a clear high-$p_{\mathrm{T}}$ net suppression in central collisions at 62.4 GeV for charged hadrons which evolves smoothly to a large net enhancement at lower energies. This trend is driven by the evolution of the pion spectra, but is also very similar for the kaon spectra. While the magnitude of the proton $R_{ \mathrm{CP}}$ at high $p_{\mathrm{T}}$ does depend on collision energy, neither the proton nor the anti-proton $R_{ \mathrm{CP}}$ at high $p_{\mathrm{T}}$ exhibit net suppression at any energy. A study of how the binary collision scaled high-$p_{\mathrm{T}}$ yield evolves with centrality reveals a non-monotonic shape that is consistent with the idea that jet-quenching is increasing faster than the combined phenomena that lead to enhancement.We report measurements of the nuclear modification factor RCP for charged hadrons as well as identified π+(-), K+(-), and p(p¯) for Au+Au collision energies of sNN=7.7, 11.5, 14.5, 19.6, 27, 39, and 62.4 GeV. We observe a clear high-pT net suppression in central collisions at 62.4 GeV for charged hadrons which evolves smoothly to a large net enhancement at lower energies. This trend is driven by the evolution of the pion spectra but is also very similar for the kaon spectra. While the magnitude of the proton RCP at high pT does depend on the collision energy, neither the proton nor the antiproton RCP at high pT exhibit net suppression at any energy. A study of how the binary collision-scaled high-pT yield evolves with centrality reveals a nonmonotonic shape that is consistent with the idea that jet quenching is increasing faster than the combined phenomena that lead to enhancement

The Pharmacogenomics Research Network Translational Pharmacogenetics Program: Outcomes and Metrics of Pharmacogenetic Implementations Across Diverse Healthcare Systems

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/138257/1/cpt630-sup-0001-suppinfo1.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/138257/2/cpt630_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/138257/3/cpt630.pd