Why HITnet kiosks didn\u27t hit the mark for sexual health education of Western Australian Aboriginal youth

Objective: To assess the use, appropriateness of, and staff feedback on specific sexual health modules, which were installed on Heuristic Interactive Technology (HITnet) kiosks at Aboriginal Community Controlled Health Services (ACCHS). The HITnet kiosks were aimed at Aboriginal youth visiting these sites. Methods: Modules on the HITnet kiosks were assessed for (1) cultural appropriateness using Yunkaporta’s Aboriginal pedagogy framework and (2) compliance with the World Health Organization’s (WHO) advice on key elements for comprehensive sexual health education for young people. Data measuring kiosk use were obtained through HITnet kiosk activity reports. An online survey of ACCHS staff was used to qualitatively assess use of, and staff perceptions of, HITnet kiosks. Results: Kiosk modules were consistent with seven of the eight elements of Yunkaporta’s framework and all of the WHO recommendations. The most popular module generated 3,066 purposeful sessions and the least popular module generated 724 purposeful sessions across nine sites in 2012. While teenagers were the most frequent of the kiosk user groups (39.5% in 2012), the majority of users (56%) were not in the target group (i.e. elders 4%, adults 25%, children 27%). Key issues reported by ACCHS staff (n=11) included: lack of clarity regarding staff responsibility for overseeing kiosk functionality; kiosks attracting “inappropriate ages”; and “lack of privacy” based on kiosk location, screen visibility, and absence of headphones preventing discreet access. Conclusions: The modules were tailored to a young Aboriginal audience through technology thought to be appealing to this group. However, barriers to use of the kiosk included kiosk design features, location, and lack of clarity around responsibility for kiosk operation. Implications: Aboriginal youth need easy access to sexual health messages in a ‘safe’, non-judgmental space. Information and communication that is accessible via personal and mobile devices may be a better vehicle than public kiosks

Patterns of Lakeshore Usage Around Lake Bemidji

ABSTRACT - The eutrophication of lakes has been the subject of much discussion in scientific journals and the popular press .. Usually the e.utrophication process is accelerated by human activities. This study evaluates the extent of lakeshore development and recreational use of Lake Bemidji in north central Minnesota and examines the willingness of lakeshore residents to be assessed for corrective measures to halt deterioration of this valuable recreational lake. The shoreline of Lake Bemidji is highly developed, and the high density human habitation represents a potential source of nutrients from percolation through the sand and gravel soils which surround the lake. Residents around Lake Bemidji believe that growth of algae and aquatic vascular plants is not now severe and that it does not affect their use of the lake for recreational purposes. Although seventy-five percent of the residents favor regulation of lakeshore use and development, only 37 percent indicate willingness to be assessed for construction of a sewer line surrounding the lake

Fracture healing following high energy tibial trauma: Ilizarov versus Taylor Spatial Frame

Introduction: The optimal treatment of high energy tibial fractures remains controversial and a challenging orthopaedic problem. The role of external fi xators for all these tibial fractures has been shown to be crucial. Methods: A fi ve-year consecutive series was reviewed retrospectively, identifying two treatment groups: Ilizarov and Taylor Spatial Frame (TSF; Smith & Nephew, Memphis, TN, US). Fracture healing time was the primary outcome measure. Results: A total of 112 patients (85 Ilizarov, 37 TSF) were identifi ed for the review with a mean age of 45 years. This was higher in women (57 years) than in men (41 years). There was no signifi cant difference between frame types (p=0.83). The median healing time was 163 days in both groups. There was no signifi cant difference in healing time between smokers and non-smokers (180 vs 165 days respectively, p=0.07), open or closed fractures (p=0.13) or age and healing time (Spearman's r=0.12, p=0.18). There was no incidence of non-union or re-fracture following frame removal in either group. Conclusions: Despite the assumption of the rigid construct of the TSF, the median time to union was similar to that of the Ilizarov frame and the TSF therefore can play a signifi cant role in complex tibial fractures

Access to substance use treatment among young adults who use prescription opioids non-medically

BACKGROUND: Non-medical prescription opioid (NMPO) use is a substantial public health problem in the United States, with 1.5 million new initiates annually. Only 746,000 people received treatment for NMPO use in 2013, demonstrating substantial disparities in access to treatment. This study aimed to assess correlates of accessing substance use treatment among young adult NMPO users in Rhode Island, a state heavily impacted by NMPO use and opioid overdose. METHODS: This analysis uses data from a study of 200 Rhode Island residents aged 18 to 29 who reported NMPO use in the past 30 days. We compared individuals who had ever successfully enrolled in a substance use treatment program without ever facing barriers, individuals who had ever attempted to enroll but were unable, and individuals who never attempted to enroll. We used multinomial logistic regression to determine the independent correlates of never attempting and unsuccessfully attempting to access substance use treatment. RESULTS: Among 200 participants, the mean age was 24.5, 65.5% were male, and 61.5% were white. Nearly half (45.5%) had never attempted to enroll in substance use treatment, while 35.0% had successfully enrolled without ever facing barriers and 19.5% were unsuccessful in at least one attempt to enroll. In multivariable models, non-white participants were more likely to never have attempted to enroll compared to white participants. Previous incarceration, experiencing drug-related discrimination by the medical community, and a monthly income of $501 -$1500 were associated with a decreased likelihood of never attempting to enroll. A history of overdose and a monthly income of $501 -$1500 were associated with an increased likelihood of unsuccessfully accessing treatment. The most commonly reported barriers to accessing treatment were waiting lists (n = 23), health insurance not approving enrollment (n = 20), and inability to pay (n = 16). CONCLUSIONS: This study demonstrates significant disparities in access to treatment among young adults who report NMPO use. A history of overdose was shown to correlate with experiencing barriers to substance use treatment utilization. Interventions are needed to reduce drug-related discrimination in clinical settings and to provide mechanisms that link young adults (particularly with a history of overdose) to evidence-based treatment

Neural computations underlying action-based decision making in the human brain

Action-based decision making involves choices between different physical actions to obtain rewards. To make such decisions the brain needs to assign a value to each action and then compare them to make a choice. Using fMRI in human subjects, we found evidence for action-value signals in supplementary motor cortex. Separate brain regions, most prominently ventromedial prefrontal cortex, were involved in encoding the expected value of the action that was ultimately taken. These findings differentiate two main forms of value signals in the human brain: those relating to the value of each available action, likely reflecting signals that are a precursor of choice, and those corresponding to the expected value of the action that is subsequently chosen, and therefore reflecting the consequence of the decision process. Furthermore, we also found signals in the dorsomedial frontal cortex that resemble the output of a decision comparator, which implicates this region in the computation of the decision itself

Implementation of a flexible and modular multiphase framework for the analysis of surface-tension-driven flows based on a LS-VOF approach

The mathematical modelling and numerical simulation of multi-phase flows are both a demanding and highly complex exercise. In typical problems with industrial relevance, the fluids are often in non-isothermal conditions and interfacial phenomena are a relevant part of the problem. A number of effects due to the presence of temperature differences must be adequately taken into account to make the results of numerical simulations consistent and realistic. Moreover, in general, gradients of surface tension at the interface separating two liquids are a source of numerical issues that can delay (and even prevent completely in some circumstances) the convergence of the solution algorithm. Here, we propose a fundamental and concerted approach for the simulation of the typical dynamics resulting from the presence of a dispersed phase in an external matrix in nonisothermal conditions based on the modular computer-aided design, modelling, and simulations capabilities of the OpenFOAM environment. The resulting framework is tested against the migration of a droplet induced by thermocapillary effects in the absence of gravity. The simulations are fully three-dimensional and based on an adaptive mesh refinement (AMR) strategy. We describe in detail the countermeasures taken to circumvent the problematic issues associated with the simulation of this kind of flows

Notch and Presenilin Regulate Cellular Expansion and Cytokine Secretion but Cannot Instruct Th1/Th2 Fate Acquisition

Recent reports suggested that Delta1, 4 and Jagged1, 2 possessed the ability to instruct CD4+ T cell into selection of Th1 or Th2 fates, respectively, although the underlying mechanism endowing the cleaved Notch receptor with memory of ligand involved in its activation remains elusive. To examine this, we prepared artificial antigen-presenting cells expressing either DLL1 or Jag1. Although both ligands were efficient in inducing Notch2 cleavage and activation in CD4+ T or reporter cells, the presence of Lunatic Fringe in CD4+ T cells inhibited Jag1 activation of Notch1 receptor. Neither ligand could induce Th1 or Th2 fate choice independently of cytokines or redirect cytokine-driven Th1 or Th2 development. Instead, we find that Notch ligands only augment cytokine production during T cell differentiation in the presence of polarizing IL-12 and IL-4. Moreover, the differentiation choices of naïve CD4+ T cells lacking γ-secretase, RBP-J, or both in response to polarizing cytokines revealed that neither presenilin proteins nor RBP-J were required for cytokine-induced Th1/Th2 fate selection. However, presenilins facilitate cellular proliferation and cytokine secretion in an RBP-J (and thus, Notch) independent manner. The controversies surrounding the role of Notch and presenilins in Th1/Th2 polarization may reflect their role as genetic modifiers of T-helper cells differentiation

Notch and Presenilin Regulate Cellular Expansion and Cytokine Secretion but Cannot Instruct Th1/Th2 Fate Acquisition

Recent reports suggested that Delta1, 4 and Jagged1, 2 possessed the ability to instruct CD4+ T cell into selection of Th1 or Th2 fates, respectively, although the underlying mechanism endowing the cleaved Notch receptor with memory of ligand involved in its activation remains elusive. To examine this, we prepared artificial antigen-presenting cells expressing either DLL1 or Jag1. Although both ligands were efficient in inducing Notch2 cleavage and activation in CD4+ T or reporter cells, the presence of Lunatic Fringe in CD4+ T cells inhibited Jag1 activation of Notch1 receptor. Neither ligand could induce Th1 or Th2 fate choice independently of cytokines or redirect cytokine-driven Th1 or Th2 development. Instead, we find that Notch ligands only augment cytokine production during T cell differentiation in the presence of polarizing IL-12 and IL-4. Moreover, the differentiation choices of naïve CD4+ T cells lacking γ-secretase, RBP-J, or both in response to polarizing cytokines revealed that neither presenilin proteins nor RBP-J were required for cytokine-induced Th1/Th2 fate selection. However, presenilins facilitate cellular proliferation and cytokine secretion in an RBP-J (and thus, Notch) independent manner. The controversies surrounding the role of Notch and presenilins in Th1/Th2 polarization may reflect their role as genetic modifiers of T-helper cells differentiation

NOTCH signaling specifies arterial-type definitive hemogenic endothelium from human pluripotent stem cells

NOTCH signaling is required for the arterial specification and formation of hematopoietic stem cells (HSCs) and lympho-myeloid progenitors in the embryonic aorta-gonad-mesonephros region and extraembryonic vasculature from a distinct lineage of vascular endothelial cells with hemogenic potential. However, the role of NOTCH signaling in hemogenic endothelium (HE) specification from human pluripotent stem cell (hPSC) has not been studied. Here, using a chemically defined hPSC differentiation system combined with the use of DLL1-Fc and DAPT to manipulate NOTCH, we discover that NOTCH activation in hPSC-derived immature HE progenitors leads to formation of CD144+CD43−CD73−DLL4+Runx1 + 23-GFP+ arterial-type HE, which requires NOTCH signaling to undergo endothelial-to-hematopoietic transition and produce definitive lympho-myeloid and erythroid cells. These findings demonstrate that NOTCH-mediated arterialization of HE is an essential prerequisite for establishing definitive lympho-myeloid program and suggest that exploring molecular pathways that lead to arterial specification may aid in vitro approaches to enhance definitive hematopoiesis from hPSCs