Measuring Poverty at the State Level

Outlines a model for using the National Academy of Sciences poverty measure, which accounts for all income, non-discretionary work and out-of-pocket health expenses, and geographic cost variations, to estimate the effects of poverty reduction policies

Modeling Au nanostar geometry in bulk solutions.

The findings within make it possible to reference gold nanostars based on their geometric properties, similar to how a radius describes a nanosphere, rather than just the LSPR of the structure-the current practice. The average tip approximation presented reduces the complexity of nanostars in discrete dipole approximation simulations. By matching the projected area and LSPR of the modeled nanostars to synthesized nanostars, the volume, surface area, and number of tips can be approximated without a lengthy characterization process. Knowing the nanoparticle geometry can determine drug carrier capacity, an approximate number of hot spots for EM imaging, and how the particle will interact with cells. The geometric data obtained will drive the biological application and increase the usability of this particle class

Basic suture technique: Instructional videos explaining suturing for medical students in a qualitative study

Background: Understanding basic surgical skills is important for medical students prior to entering residency regardless of future specialty. In these videos we provide instruction for suturing as it relates to skin closure. Material and methods: Instructional videos were created by the senior faculty (R.A. and M.K.) to teach medical students at the University of Louisville suturing techniques. Results: Entering and exiting the needle at an angle of 90° or greater allows for tissue eversion. Inadequate eversion of tissue or inadequate angling of the needle will lead to tissue inversion. When suturing uneven edges, a deep bite on the low side and a shallow bite on the high side will allow for appropriate tissue leveling. For buried sutures, skin eversion with substantial dermal bites and proper knot location is essential. Conclusion: Understanding the basics of skin apposition will provide students with knowledge about primary wound healing and prepare them for residency

Gender essentialism and occupational segregation in insolvency practice

Advances towards egalitarianism in professional recruitment may be offset by processes of occupational re-segregation. Drawing on gender theory this paper investigates horizontal segregation in the UK insolvency profession, as revealed through the lived experiences of female and male practitioners. It is shown that horizontal segregation pervades at different levels of practice and is undergirded by various elements of gender essentialism. Physical essentialism explains why insolvency practice has been traditionally gendered male. Interactional essentialism combines with the management of work-life balance to define the subfields of corporate and personal insolvency as masculine and feminine respectively. Gender essentialist assumptions also pervade the distribution of roles and the allocation of work tasks. Networks are identified as arenas for the reproduction and perpetuation of occupational segregation. The findings indicate the continuing potency of gender in everyday professional life, the limitations of diversity-orientated policies and the complexities of formulating transformative agendas

Dual bronchodilators in Bronchiectasis study (DIBS): protocol for a pragmatic, multicentre, placebo-controlled, three-arm, double-blinded, randomised controlled trial studying bronchodilators in preventing exacerbations of bronchiectasis

INTRODUCTION: Bronchiectasis is a long-term lung condition, with dilated bronchi, chronic inflammation, chronic infection and acute exacerbations. Recurrent exacerbations are associated with poorer clinical outcomes such as increased severity of lung disease, further exacerbations, hospitalisations, reduced quality of life and increased risk of death. Despite an increasing prevalence of bronchiectasis, there is a critical lack of high-quality studies into the disease and no treatments specifically approved for its treatment. This trial aims to establish whether inhaled dual bronchodilators (long acting beta agonist (LABA) and long acting muscarinic antagonist (LAMA)) taken as either a stand-alone therapy or in combination with inhaled corticosteroid (ICS) reduce the number of exacerbations of bronchiectasis requiring treatment with antibiotics during a 12 month treatment period. METHODS: This is a multicentre, pragmatic, double-blind, randomised controlled trial, incorporating an internal pilot and embedded economic evaluation. 600 adult patients (≥18 years) with CT confirmed bronchiectasis will be recruited and randomised to either inhaled dual therapy (LABA+LAMA), triple therapy (LABA+LAMA+ICS) or matched placebo, in a 2:2:1 ratio (respectively). The primary outcome is the number of protocol defined exacerbations requiring treatment with antibiotics during the 12 month treatment period. ETHICS AND DISSEMINATION: Favourable ethical opinion was received from the North East-Newcastle and North Tyneside 2 Research Ethics Committee (reference: 21/NE/0020). Results will be disseminated in peer-reviewed publications, at national and international conferences, in the NIHR Health Technology Assessments journal and to participants and the public (using lay language). TRIAL REGISTRATION NUMBER: ISRCTN15988757

Determinants of self-reported hypertension among women in South Africa: evidence from the population-based survey

Background: Hypertension (HTN), characterized by an elevation of blood pressure, is a serious public health chronic condition that significantly raises the risks of heart, brain, kidney, and other diseases. In South Africa, the prevalence of HTN (measured objectively) was reported at 46.0% in females, nonetheless little is known regarding the prevalence and risks factors of self-reported HTN among the same population. Therefore, the aim of this study was to examine determinants of self-reported HTN among women in South Africa. Methods: The study used data obtained from the 2016 South African Demographic and Health Survey. In total, 6,027 women aged ≥ 20 years were analyzed in this study. Self-reported HTN was defined as a case in which an individual has not been clinically diagnosed with this chronic condition by a medical doctor, nurse, or health worker. Multiple logistic regression models were employed to examine the independent factors of self-reported HTN while considering the complex survey design. Results: Overall, self-reported HTN was reported in 23.6% (95% confidence interval [CI], 23.1–24.1) of South African women. Being younger (adjusted odds ratio [aOR], 0.04; 95% CI, 0.03–0.06), never married (aOR, 0.69; 95% CI, 0.56–0.85), and not covered by health insurance (aOR, 0.74; 95% CI, 0.58–0.95) reduced the odds of self-reported HTN. On the other hand, being black/African (aOR, 1.73; 95% CI, 1.17–2.54), perception of being overweight (aOR, 1.72; 95% CI, 1.40–2.11), and perception of having poor health status (aOR, 3.53; 95% CI, 2.53–5.21) and the presence of other comorbidities (aOR, 7.92; 95% CI, 3.63–17.29) increased the odds of self-reported HTN. Conclusions: Self-reported HTN was largely associated with multiple sociodemographic, health, and lifestyle factors and the presence of other chronic conditions. Health promotion and services aiming at reducing the burden of HTN in South Africa should consider the associated factors reported in this study to ensure healthy aging and quality of life among women

Acceptance and Commitment Therapy group for treatment-resistant participants: A randomized controlled trial.

Acceptance and Commitment Therapy (ACT) is a theoretically coherent approach addressing common processes across a range of disorders. The aim of this study was to investigate the effectiveness of a group-based ACT intervention for "treatment-resistant" participants with various diagnoses, who had already completed at least one psychosocial intervention. Of 61 individuals randomized into a service-based trial comparing ACT and Treatment as Usual based on Cognitive Behavior Therapy (TAU-CBT), 45 provided data (ACT n=26; TAU-CBT n=19). Primary outcomes were measures of psychological symptoms. All participants showed reduced symptoms immediately after intervention but improvements were more completely sustained in the ACT group at 6-month follow-up. More elaborate and more fully controlled evaluations are required to confirm the findings, improve understanding of ACT processes and assess health economic benefits