Genetic epidemiology of lymphatic filariasis in American Samoa after mass drug administration

Over 892 million people in 48 countries are at risk of infection by nematodes that cause lymphatic filariasis. As part of the Global Programme to Eliminate Lymphatic Filariasis, mass drug administration is distributed to communities until surveillance indicates infection rates are below target prevalence thresholds. In some countries, including American Samoa, lymphatic filariasis transmission persists despite years of mass drug administration and/or has resurged after cessation. Nothing is known about the population genetics of Wuchereria bancrofti worms in Polynesia, or whether local transmission is persisting and/or increasing due to inadequate mass drug administration coverage, expansion from residual hotspots, reintroduction from elsewhere, or a combination. We extracted DNA from microfilariae on blood slides collected during prevalence surveys in 2014 and 2016, comprising 31 pools of five microfilariae from 22 persons living in eight villages. We sequenced 1104 bp across three mitochondrial markers (ND4, COI, CYTB). We quantified parasite genetic differentiation using variant calls and estimated haplotypes using principal components analysis, F-statistics, and haplotype networks. Of the variants called, all but eight were shared across the main island of Tutuila, and three of those were from a previously described hotspot village, Fagali’i. Genotypic data did not support population genetic structure among regions or villages in 2016, although differences were observed between worms collected in Fagali’i in 2014 and those from 2016. Because estimated haplotype frequency varied between villages, these statistics suggested genetic differentiation, but were not consistent among villages. Finally, haplotype networks demonstrated American Samoan sequence clusters were related to previously published sequences from Papua New Guinea. These are, to our knowledge, the first reports of W. bancrofti genetic variation in Polynesia. The resurgent parasites circulating on the main island of American Samoa represent a single population. This study is the first step towards investigating how parasite population structure might inform strategies to manage resurgence and elimination of lymphatic filariasis

International home economics

The conference was planned to serve the interests of those who wish to work in home economics programs abroad and those who are concerned with the education of international students in the universities and colleges of the United States. Approximately 165 home economists from other states and from foreign countries I including the African and Latin American countries I participated in the conference.https://lib.dr.iastate.edu/card_reports/1026/thumbnail.jp

Impact of specialist prostate cancer nurses on patient reported and health service outcomes: a comparative effectiveness study

The scope of advanced practice nursing roles has expanded, however few adequately powered trials have reported on how such roles impact on patient and health service outcomes. A new prostate cancer specialist nursing (PCSN) service was established in 12 hospitals in Australia providing a unique opportunity to evaluate the impact of advanced nursing roles on patient and health service outcomes. Separate cohorts of men treated for primary or recurrent prostate cancer were assessed at two time points: - (1) six months before implementation; - (2) a six month period following 12 months of service implementation. Patient reported outcomes (PROMs) assessed were care experiences, supportive care needs, severity of prostate cancer specific symptoms, quality of life and decisional regret. Bivariate analyses were conducted to identify covariates to be adjusted for when comparing outcomes. Multiple regression analyses were used. Adjusted covariates were entered in models at the first step, and the group variable (PCSN or no PCSN) entered at the last step. Data were analysed for 302 pre- and 260 post-implementation patients. After adjusting for demographic differences between groups, compared to patients who did not have access to a PCSN(pre-implementation group), patients who did have access to a PCSN (post-implementation group) reported a significantly higher level of symptom severity in relation to urinary incontinence (b = -0.10, p = 0.03) and sexual function (b = -0.10, p = 0.02), but showed significantly lower need in the area of sexuality (b = 0.12, p = 0.03) and had better experiences of in-hospital care (b = -0.15, p = 0.001). Patients’ health related quality of life and level of decisional regret did not differ according to whether they did or did not access a PCSN. While men who had access to a PCSN reported higher symptom severity in areas of urinary and sexual function and no differences were noted between groups in overall quality of life, men who accessed a PCSN had lower level of need in key areas of concern for this population and better care experiences compared to men who did not access the service. These findings add important knowledge about key PROMs that can be improved by advanced cancer nurses

International home economics

The conference was planned to serve the interests of those who wish to work in home economics programs abroad and those who are concerned with the education of international students in the universities and colleges of the United States. Approximately 165 home economists from other states and from foreign countries I including the African and Latin American countries I participated in the conference.</p

Differences in the symptom experience of older versus younger oncology outpatients: a cross-sectional study

<p>Abstract</p> <p>Background</p> <p>Mortality rates for cancer are decreasing in patients under 60 and increasing in those over 60 years of age. The reasons for these differences in mortality rates remain poorly understood. One explanation may be that older patients received substandard treatment because of concerns about adverse effects. Given the paucity of research on the multiple dimensions of the symptom experience in older oncology patients, the purpose of this study was to evaluate for differences in ratings of symptom occurrence, severity, frequency, and distress between younger (< 60 years) and older ( ≥ 60 years) adults undergoing cancer treatment. We hypothesized that older patients would have significantly lower ratings on four symptom dimensions.</p> <p>Methods</p> <p>Data from two studies in the United States and one study in Australia were combined to conduct this analysis. All three studies used the MSAS to evaluate the occurrence, severity, frequency, and distress of 32 symptoms.</p> <p>Results</p> <p>Data from 593 oncology outpatients receiving active treatment for their cancer (i.e., 44.4% were < 60 years and 55.6% were ≥ 60 years of age) were evaluated. Of the 32 MSAS symptoms, after controlling for significant covariates, older patients reported significantly lower occurrence rates for 15 (46.9%) symptoms, lower severity ratings for 6 (18.9%) symptoms, lower frequency ratings for 4 (12.5%) symptoms, and lower distress ratings for 14 (43.8%) symptoms.</p> <p>Conclusions</p> <p>This study is the first to evaluate for differences in multiple dimensions of symptom experience in older oncology patients. For almost 50% of the MSAS symptoms, older patients reported significantly lower occurrence rates. While fewer age-related differences were found in ratings of symptom severity, frequency, and distress, a similar pattern was found across all three dimensions. Future research needs to focus on a detailed evaluation of patient and clinical characteristics (i.e., type and dose of treatment) that explain the differences in symptom experience identified in this study.</p

Public COAPI Toolkit of Open Access Policy Resources

The Coalition of Open Access Policy Institutions (COAPI, https://sparcopen.org/coapi ) is committed to sharing information and resources to assist in the development and implementation of institutional Open Access (OA) policies. The COAPI Toolkit includes a diverse collection of resources that COAPI members have developed in the course of their OA policy initiatives. These resources are openly accessible and published here under Creative Commons Attribution 4.0 licenses, unless otherwise noted on the resources themselves