New Concepts in Median Nail Dystrophy, Onychomycosis, and Hand, Foot, and Mouth Disease Nail Pathology

Nails are underutilized as diagnostic tools, despite being involved in many dermatologic conditions. This paper explores new concepts in the treatment of median nail dystrophy (MND), onychomycosis, and the nail pathology of hand, foot, and mouth disease (HFMD). A Pubmed database literature search was conducted for MND treatment, onychomycosis treatment, and HFMD nail pathology. Only papers published after January 2008 were reviewed. The results showed that 0.1% tacrolimus ointment can be an effective treatment for MND. Early studies on laser therapy indicate that it is a safe and efficacious treatment option for onychomycosis, compared to conventional oral antifungal agents. Vicks VapoRub (The Proctor & Gamble Company, Cincinnati, OH) is effective against onychomycosis and is a reasonable option in patients who choose to forgo conventional treatments. Lastly, there is evidence to support a correlation between HFMD and onychomadesis

Troubled Worlds: A Course Syllabus about Information Work and the Anthropocene

The goal of this syllabus is to interrogate the material, and socioeconomic processes which underpin our everyday information work. In particular, we examine the relationships developing between contemporary information practices and what problematically gets configured as “nature”—that messy world of non-human entanglements that often exists beyond the purview of innovation work, whether digital software development or industrial engineering. Much recent work on the environmental conditions of computing has sought to break down technology-nature dualisms in order to expose the implication of information technology in broader social and material ecologies. Library and information professionals and researchers are well poised to deepen this inquiry by presenting alternative nature-technology epistemologies grounded in longstanding analyses of information resources and their consumption. The “Troubled Worlds” syllabus starts with a discussion of concerns most obviously germane to the work of most library and information science professionals: practices at the intersection of structuring information and computing. Building on this attention, we turn to humanistic approaches to thinking through the era of dominant human activities widely known as the “Anthropocene” by introducing poetic, artistic, and activist lenses. We explore how artistic objects representing an increasingly troubled natural world raise awareness of the challenges facing it, as well as how they may incorporate and reshape information for aesthetic ends. We then look to questions of disability justice and how it works in blended built and natural spaces as well as the many different ways in which bodies respond to the toxic environments produced by information technologies. We next consider the newer design approaches to library and information research, specifically asking how design perspectives on digital information objects get inscribed in the Anthropocene. Lastly, we consider paradigms of repair and making and analyze the different valences through which information researchers and professionals categorize and contextualize what is possible with them. This compilation does not provide a comprehensive review of the literature on the environment within the information fields. Instead, it extends this literature to promote experimental research and practice. The modules construct an interdisciplinary and provisional path through the related literature in a form that we hope may be continually adjusted, rearranged, and augmented. Pre-print first published online 03/15/202

The effects of frequent nocturnal home hemodialysis: the Frequent Hemodialysis Network Nocturnal Trial

Prior small studies have shown multiple benefits of frequent nocturnal hemodialysis compared to conventional three times per week treatments. To study this further, we randomized 87 patients to three times per week conventional hemodialysis or to nocturnal hemodialysis six times per week, all with single-use high-flux dialyzers. The 45 patients in the frequent nocturnal arm had a 1.82-fold higher mean weekly stdKt/Vurea, a 1.74-fold higher average number of treatments per week, and a 2.45-fold higher average weekly treatment time than the 42 patients in the conventional arm. We did not find a significant effect of nocturnal hemodialysis for either of the two coprimary outcomes (death or left ventricular mass (measured by MRI) with a hazard ratio of 0.68, or of death or RAND Physical Health Composite with a hazard ratio of 0.91). Possible explanations for the left ventricular mass result include limited sample size and patient characteristics. Secondary outcomes included cognitive performance, self-reported depression, laboratory markers of nutrition, mineral metabolism and anemia, blood pressure and rates of hospitalization, and vascular access interventions. Patients in the nocturnal arm had improved control of hyperphosphatemia and hypertension, but no significant benefit among the other main secondary outcomes. There was a trend for increased vascular access events in the nocturnal arm. Thus, we were unable to demonstrate a definitive benefit of more frequent nocturnal hemodialysis for either coprimary outcome

Synergies, Strengths and Challenges: Findings on Community Capability from a Systematic Health Systems Research Literature Review

Background: Community capability is the combined influence of a community’s social systems and collective resources that can address community problems and broaden community opportunities. We frame it as consisting of three domains that together support community empowerment: what communities have; how communities act; and for whom communities act. We sought to further understand these domains through a secondary analysis of a previous systematic review on community participation in health systems interventions in low and middle income countries (LMICs). Methods: We searched for journal articles published between 2000 and 2012 related to the concepts of “community”, “capability/participation”, “health systems research” and “LMIC.” We identified 64 with rich accounts of community participation involving service delivery and governance in health systems research for thematic analysis following the three domains framing community capability. Results: When considering what communities have, articles reported external linkages as the most frequently gained resource, especially when partnerships resulted in more community power over the intervention. In contrast, financial assets were the least mentioned, despite their importance for sustainability. With how communities act, articles discussed challenges of ensuring inclusive participation and detailed strategies to improve inclusiveness. Very little was reported about strengthening community cohesiveness and collective efficacy despite their importance in community initiatives. When reviewing for whom communities act, the importance of strong local leadership was mentioned frequently, while conflict resolution strategies and skills were rarely discussed. Synergies were found across these elements of community capability, with tangible success in one area leading to positive changes in another. Access to information and opportunities to develop skills were crucial to community participation, critical thinking, problem solving and ownership. Although there are many quantitative scales measuring community capability, health systems research engaged with community participation has rarely made use of these tools or the concepts informing them. Overall, the amount of information related to elements of community capability reported by these articles was low and often of poor quality. Conclusions: Strengthening community capability is critical to ensuring that community participation leads to genuine empowerment. Our simpler framework to define community capability may help researchers better recognize, support and assess it

The architecture and effect of participation: a systematic review of community participation for communicable disease control and elimination. Implications for malaria elimination

Community engagement and participation has played a critical role in successful disease control and elimination campaigns in many countries. Despite this, its benefits for malaria control and elimination are yet to be fully realized. This may be due to a limited understanding of the influences on participation in developing countries as well as inadequate investment in infrastructure and resources to support sustainable community participation. This paper reports the findings of an atypical systematic review of 60 years of literature in order to arrive at a more comprehensive awareness of the constructs of participation for communicable disease control and elimination and provide guidance for the current malaria elimination campaign.Evidence derived from quantitative research was considered both independently and collectively with qualitative research papers and case reports. All papers included in the review were systematically coded using a pre-determined qualitative coding matrix that identified influences on community participation at the individual, household, community and government/civil society levels. Colour coding was also carried out to reflect the key primary health care period in which community participation programmes originated. These processes allowed exhaustive content analysis and synthesis of data in an attempt to realize conceptual development beyond that able to be achieved by individual empirical studies or case reports.Of the 60 papers meeting the selection criteria, only four studies attempted to determine the effect of community participation on disease transmission. Due to inherent differences in their design, interventions and outcome measures, results could not be compared. However, these studies showed statistically significant reductions in disease incidence or prevalence using various forms of community participation. The use of locally selected volunteers provided with adequate training, supervision and resources are common and important elements of the success of the interventions in these studies. In addition, qualitative synthesis of all 60 papers elucidates the complex architecture of community participation for communicable disease control and elimination which is presented herein.The current global malaria elimination campaign calls for a health systems strengthening approach to provide an enabling environment for programmes in developing countries. In order to realize the benefits of this approach it is vital to provide adequate investment in the 'people' component of health systems and understand the multi-level factors that influence their participation. The challenges of strengthening this component of health systems are discussed, as is the importance of ensuring that current global malaria elimination efforts do not derail renewed momentum towards the comprehensive primary health care approach. It is recommended that the application of the results of this systematic review be considered for other diseases of poverty in order to harmonize efforts at building 'competent communities' for communicable disease control and optimising health system effectiveness

New Concepts in Median Nail Dystrophy, Onychomycosis, and Hand, Foot, and Mouth Disease Nail Pathology

Nails are underutilized as diagnostic tools, despite being involved in many dermatologic conditions. This paper explores new concepts in the treatment of median nail dystrophy (MND), onychomycosis, and the nail pathology of hand, foot, and mouth disease (HFMD). A Pubmed database literature search was conducted for MND treatment, onychomycosis treatment, and HFMD nail pathology. Only papers published after January 2008 were reviewed. The results showed that 0.1% tacrolimus ointment can be an effective treatment for MND. Early studies on laser therapy indicate that it is a safe and efficacious treatment option for onychomycosis, compared to conventional oral antifungal agents. Vicks VapoRub (The Proctor & Gamble Company, Cincinnati, OH) is effective against onychomycosis and is a reasonable option in patients who choose to forgo conventional treatments. Lastly, there is evidence to support a correlation between HFMD and onychomadesis.Peer Reviewe

Mapping the Cost of a Balanced Diet, as a Function of Travel Time and Food Price

We present a new method for analyzing spatial variation in the cost of a balanced diet, as an alternative to food desert classification. Our specific hypothesis is that the cost of a balanced diet varies according to where one lives, as a function of travel and food item costs. We collected price data for the USDA Thrifty Food Plan from approximately 30 percent of food retail outlets of various kinds in the three Gulf Coast counties of Mississippi, and these prices were extrapolated to the remaining stores. Transportation costs were calculated for both driving by automobile and the combination of walking and public transportation by bus, accounting for both the shoppers' time and the cost of automobile mileage. We developed a "traveling purchaser problem" algorithm to estimate the lowest-cost combination of travel and food costs for purchasing all items in the Thrifty Food Plan for each residential parcel in the study area, and mapped the resulting costs and examined their variation. Estimated costs varied more because of transportation costs than food prices, and ranged from US$109 to US$215 for automobile travel and from US$111 to US$439 for a combination of walking and public transportation. In general, costs were lowest in the more populated areas near the coast and higher in more rural areas further inland. Results of this analysis demonstrate that the cost of acquiring a balanced diet varies considerably and more or less continuously. Food is not equally cheap for all; it depends on where one lives. For any given location, an estimate of the cost of a balanced diet, including both food price and transportation, is more useful than a classification as food desert or not in understanding access issues and needs. Furthermore, policy alternatives that are intended to influence access should be evaluated based on how much they influence costs, and for whom, depending on where people live