Competing risk models of stillbirth inform populations but not individuals.

This is the final version of the article. It first appeared from Wiley via http://dx.doi.org/10.1111/1471-0528.1394

Emerging land markets in rural and urban China: Policies and practices

This article examines the evolution of China's land system in the past two decades. Since the early 1980s, China has altered its land use arrangements and introduced new regulations to manage land use changes. In the process the administrative allocation of land to users has been transformed into a complex hierarchical system of primary and secondary markets for land use rights. The changes in China's land system were adopted primarily for two reasons: to develop land markets to allocate land more efficiently and to protect agricultural land. An analysis of available data suggests that the development of land markets is still at an early stage, that the conversion of land to non-agricultural use continues but at a slower pace, and that illegal land use is pervasive. The article concludes with an assessment of the new land system and a discussion of some likely future changes.published_or_final_versio

Transformation of a rural economy in the Zhujiang delta

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A CARTOMANTE E A VIOLÊNCIA OCULTA

O texto tem como principal objetivo relacionar o conto "A cartomante", escrito por Machado de Assis, com o Direito, trazendo uma breve vinculação do meio jurídico entre os fatos ocorrido na época, com os fatos da atualidade, dentre eles, os crimes que, por diversas vezes, ocorrem na sociedade

The relationship between human placental morphometry and ultrasonic measurements of utero-placental blood flow and fetal growth.

INTRODUCTION: Ultrasonic fetal biometry and arterial Doppler flow velocimetry are widely used to assess the risk of pregnancy complications. There is an extensive literature on the relationship between pregnancy outcomes and the size and shape of the placenta. However, ultrasonic fetal biometry and arterial Doppler flow velocimetry have not previously been studied in relation to postnatal placental morphometry in detail. METHODS: We conducted a prospective cohort study of nulliparous women in The Rosie Hospital, Cambridge (UK). We studied a group of 2120 women who had complete data on uterine and umbilical Doppler velocimetry and fetal biometry at 20, 28 and 36 weeks' gestational age, digital images of the placenta available, and delivered a liveborn infant at term. Associations were expressed as the difference in the standard deviation (SD) score of the gestational age adjusted ultrasound measurement (z-score) comparing the lowest and highest decile of the given placental morphometric measurement. RESULTS: The lowest decile of placental surface area was associated with 0.87 SD higher uterine artery Doppler mean pulsatility index (PI) at 20 weeks (95% CI: 0.68 to 1.07, P < 0.001). The lowest decile of placental weight was associated with 0.73 SD higher umbilical artery Doppler PI at 36 weeks (95% CI: 0.54 to 0.93, P < 0.001). The lowest decile of both placental weight and placental area were associated with reduced growth velocity of the fetal abdominal circumference between 20 and 36 weeks (both P < 0.001). CONCLUSION: Placental area and weight are associated with uterine and umbilical blood flow, respectively, and both are associated with fetal growth rate.This study was funded by the NIHR Cambridge Comprehensive Biomedical Research Centre (grant number A019057) and Stillbirth and Neonatal Death Society (SANDS). GE donated two ultrasound machines for use in the project.This is the author accepted manuscript. The final version is available from Elsevier via http://dx.doi.org/10.1016/j.placenta.2015.12.00

Tempo-spatial patterns of land use changes and urban development in globalizing China: A study of Beijing

This study examines the temporal and spatial changes in land use as a consequence of rapid urban development in the city of Beijing. Using a combination of techniques of remote sensing and GIS, the study identifies a substantial loss of plain dryland and a phenomenal expansion of urban construction land over the recent decade. Geographically, there is a clear shifting of urban construction land from the inner city to the outskirts as a consequence of suburbanization. The outward expansion of the ring-road system is found to be one of the most important driving forces explaining the temporal and spatial pattern of land use change. The uneven distribution of population stands as another factor with significant correlation with land use change. The application of the techniques of remote sensing and GIS can enhance the precision and comparability of research on land use change and urban transformation in China. © 2007 by MDPI.published_or_final_versio

Global Health Perspectives in Physical Therapy Education: A Qualitative Report on a Service Learning Experience in Guatemala

Authors: Winter F Wildt-Bailey, SPT; Adriana Sandoval, SPT; Holly J Roberts, PT, DPT, GCS, NCS Global Health Perspectives in Physical Therapy Education: A Qualitative Report on a Service Learning Experience in Guatemala Purpose: Doctor of physical therapy (DPT) students at the University of Puget Sound traveled to Zacapa, Guatemala to deliver physical therapy services for 5 days as part of an elective course introducing students to physical therapy and health care delivery from a global health perspective. Participants journaled about their experiences, responding to prompts provided by the course professor/clinical instructor. The purpose of this research was to explore the impact of the experience by identifying common themes among the journal entries. Methods: Ten student physical therapists (SPT), 9 females, 1 male, mean age 29yrs (range 25-40) at the end of their second year of a three-year DPT program consented to allow their journals to be included in this report. Two SPTs noted recurring themes that emerged in the de-identified journal entries. Results: Five common themes emerged among the journal entries: 1) Cultural Bias: recognizing cultural biases, the impact they have on patient care, and identifying strategies for addressing them; 2) Healthcare Disparities: recognizing disparities in access to healthcare, patient education, and resources between the U.S. and Guatemala; 3) Confidence and Competency: overcoming feelings of inadequacy as novice clinicians and appreciating the extent of knowledge and skill gained through didactic coursework; 4) Identity: reaffirming one\u27s decision to pursue a physical therapy career and that it aligns with one\u27s values and identity; and 5) Skills Development: adapting to working with limited resources, and developing effective communication skills with a language barrier. Conclusions: Reflection is a central tenet of service learning. The personal reflections of DPT students participating in a short-term service learning trip to Guatemala as part of an elective course in global health perspectives revealed the experience allowed students to recognize and address cultural biases, recognize healthcare disparities, build professional confidence and competence, reaffirm professional goals, and develop important skills in communication and healthcare delivery. Clinical Relevance: The results of this qualitative report are consistent with literature examining the benefits of experiential learning in healthcare education. They demonstrate the potential for an international service learning experience to facilitate development of cultural competence, clinical reasoning skills, communication skills, and confidence in one\u27s knowledge and abilities. Keywords: global health, service learning, experiential learning References: Benson JD, Provident I, Szucs KA. An experiential learning lab embedded in a didactic course: outcomes from a pediatric intervention course. Occ Ther Health Care. 2013; 27:46-57. Knecht-Sabres LJ. Experiential learning in occupational therapy: can it enhance readiness for clinical practice? J Exp Educ. 2013; 36:22-36. Paterson C, Chapman J. Enhancing skills of critical reflection to evidence learning in professional practice. Phys Ther Sport. 2013; 14:133-138. Seif G, Coker-Bolt P, Kraft S, Gonsalves W, Simpson K, Johnson E. The development of clinical reasoning and interprofessional behaviors: service-learning at a student-run free clinic. J Interprof Care. 2014; 28(6):559-564. Smith S, Crocker A. Experiential learning in physical therapy education. Adv Med Educ Pract. 2017; 8:427-433. Village D, Clouten N, Millar AL, Geigle A, et al. Comparison of the use of service learning, volunteer, and pro bono activities in physical therapy curricula. J Phys Ther Educ St Louis. 2004;18(1):22-28

International Service Learning: An Overview

International Service Learning: An Overview Kaitlynn McKirgan, SPT; Daniel Murty, SPT; Dr. Holly Roberts, PT, DPT, GCS, NCS Affiliation: 1. The School of Physical Therapy, University of Puget Sound Abstract Purpose A wide range of healthcare disciplines including nursing, public health, occupational therapy, and physical therapy (PT) now recognize global health participation and education as a necessary component of healthcare education. Increasingly, students applying to and choosing which PT program to attend must now consider the design, purpose, benefits, and potential drawbacks of such a program in their education. The purpose of this report is to provide an overview of International Service Learning (ISL) structure, its proposed benefits and concerns, and to briefly compare how the University of Puget Sound’s (UPS) pilot ISL program compared to recommendations found within the literature in order to define possible areas of improvement. Methods Literature search was performed using PubMed, Google Scholar, ProQuest, Academic Search Premiere, and Cochrane. Search terms used were: Global health, international service learning, physical therapy, experiential learning. Programs described in the literature were compared to the course structure outlined in the UPS Global Health Perspectives Course PT677 Syllabus. The course instructor was interviewed to gain any knowledge not available within the syllabus regarding program structure. Results Pechak and Thompson recommend 7 components to create a program with positive outcomes: 1. A partner that understands the role of PT; 2. Community identified needs; 3. Explicit service and learning objectives; 4. Reflection; 5. Preparations; 6. Risk Management; 7. Service learning outcome measure. Benefits to students participating in ISL programs include: increased confidence, improved communication skills, self- empowerment, independence, increased student self-assessment scores, increased experiential learning opportunities and increased understanding and confidence in professional roles when ISL project includes cooperation with other professions.  Ethical concerns are inherent and individual programs must pay close attention to the impact they have on the communities they seek to serve. Common ethical dilemmas that should be considered include the power dynamic between the community and those rendering services, the quality of care being provided, sustainability at the community and individual levels, and community need. Conclusion The UPS pilot ISL program met 6/7 components for optimal ISL outlined by Pechak and Thompson: Use of an outcome measure to evaluate the service learning experience should be applied in future programs. Other recommended improvements to the program include incorporating instruction to local care providers to increase service community self-efficacy. Finally, increased medical Spanish education in the months leading up to the ISL program is advised. Works cited Pechak CM, Thompson M. A Conceptual Model of Optimal International Service-Learning and Its Application to Global Health Initiatives in Rehabilitation. Physical Therapy. 2009;89(11):1192-1204. Smith SN, Crocker AF. Experiential learning in physical therapy education. Adv Med Educ Pract. 2017;8:427-433. doi:10.2147/AMEP.S140373. Reisch RA. International Service Learning Programs: Ethical Issues and Recommendations. Developing World Bioethics. 2011;11(2):93-98. doi:10.1111/j.1471-8847.2011.00299.x. Pechak C, Gonzalez E, Summers C, Capshaw S. Interprofessional Education: A Pilot Study of Rehabilitation Sciences Students Participating in Interdisciplinary International Service-Learning. Journal of Allied Health; Washington. 2013;42(3):e61-6. Fries KS, Bowers DM, Gross M, Frost L. Service learning in Guatemala: using qualitative content analysis to explore an interdisciplinary learning experience among students in health care professional programs. J Multidiscip Healthc. 2013;6:45-52. doi:10.2147/JMDH.S35867