School Readiness: Implications for Policy

Includes bibliographical references.To prepare children for success in school, policies must provide support for all the contexts that influence child development starting from birth, and must seek to optimize children's functioning across all domains of development. This paper outlines a variety of factors affecting school readiness

Decolonising Aboriginal and Torres Strait Islander Research

There is an important but unwieldy research policy infrastructure designed to engage with Aboriginal and Torres Strait Islander research and researchers. This framework links the key performance indicators and policies of funders and institutions to researchers and communities. In this article, we explain the relevant policies and targets, with a view to showing how sector regulation interconnects in practice and identifying ways to strengthen institutional commitments to meaningful engagement with, and implementation of, Aboriginal and Torres Strait Islander research policy. We suggest next steps that are needed to help researchers comply with funder and institution-mandated obligations and to empower Indigenous Peoples to make informed decisions about the benefits of research collaboration with universities

The Effects of Mountain Pine Beetle Attack on Lodgepole Pine Wood Morphology and Chemistry: Implications for Wood and Fiber Quality

The mountain pine beetle, Dendroctonus ponderosae Hopkins, is currently devastating the lodgepole pine resource in western Canada, and in an attempt to circumvent the problem significant volumes of infested or dead wood are being harvested. In order to fully utilize the killed resource, it is crucial to understand how the pine beetle impacts wood quality. A thorough analysis of beetle-killed and sound lodgepole pine trees indicated that the infested sapwood and heartwood had substantial moisture loss, and that the moisture content decreased with increasing tree height when compared to sound wood. The infested wood was also shown to have a lower specific gravity than sound wood, and tended to decrease with increasing tree height. Chemical analysis indicated that the infested sapwood contained significantly lower concentrations of extractives when compared to sound sapwood, and that extractives content increased towards the crown. Additionally, the infested sapwood also had lower lignin and hemicellulose contents when compared to the sound sapwood. Wood permeability showed that infested sapwood was more permeable than sound sapwood, while the opposite was true for the heartwood, with the sound heartwood being more permeable than the infested heartwood. Permeability in both sapwood and heartwood varied with tree height and correlated with extractives content. These chemical and morphological changes significantly influence the quality of wood and fiber obtained from this substantial resource

Structure and Service Delivery Approach of the Children’s Bureau’s Resource Centers and Implementation Centers

The Children’s Bureau (CB) provides a system of training and technical assistance (T/TA) to build the capacity of state and tribal child welfare systems, with the goal of improving outcomes for children and families. During the time period of 2008-2014, this infrastructure included ten National Child Welfare Resource Centers (NRCs), five Child Welfare Implementation Centers (ICs), and a Training and Technical Assistance Coordination Center (TTACC). Individual ICs and NRCs differed in structure and content expertise, yet they served the same jurisdictions and at times provided services concurrently. To increase cohesion and consistency, the NRCs, ICs, TTACC, and CB worked together to develop a service delivery approach for delivering T/TA services. This approach encompassed an overall vision of T/TA that promoted individualized, coordinated, and evidence-informed services. Operationalization of the model incorporated a standardized business process for responding to T/TA requests. This included a Standard Assessment Tool that supported identifying the desired outcomes of services and assessing the jurisdiction’s ability to make use of the T/TA by considering elements of readiness for organizational change. CB also encouraged the NRCs and ICs to apply concepts from research on leadership and implementation to their services; these frameworks supported involvement of stakeholders in the assessment process and throughout T/TA delivery. Three examples illustrate how T/TA consistent with this service delivery approach were provided to one tribal nation and two states

Pregnancy and contraceptive use among women participating in an HIV prevention trial in Tanzania.

OBJECTIVES: Information on pregnancy rates and factors associated with pregnancy and contraceptive use is important for clinical trials in women in sub-Saharan Africa where withdrawal of investigational products may be required in the event of pregnancy with a consequent effect on sample size and trial power. METHODS: A prospective cohort analysis of pregnancy and contraceptive use was conducted in Tanzanian women enrolled in a randomised placebo-controlled trial of herpes simplex virus-suppressive therapy with acyclovir to measure the effect on HIV incidence in HIV-negative women and on genital and plasma HIV viral load in HIV-positive women. The cohort was followed every 3 months for 12-30 months. Women at each visit were categorised into users or non-users of contraception. Pregnancy rates and factors associated with pregnancy incidence and contraceptive use were measured. RESULTS: Overall 254 of 1305 enrolled women became pregnant at least once during follow-up (pregnancy rate: 12.0/100 person-years). Younger age, being unmarried, higher baseline parity and changes in contraceptive method during follow-up were independently associated with pregnancy. Having paid sex and being HIV positive were associated with lower risk of pregnancy. Uptake of contraception was associated with young age, being unmarried, occupation, parity and the number and type of sexual partners. CONCLUSIONS: Data on use of contraceptive methods and risk factors for pregnancy can help to guide decisions on trial eligibility and the need for additional counselling. Mandatory reliable contraceptive use in study participants may be required to reduce pregnancy rates in studies where pregnancy is contraindicated

Changing relative and absolute socioeconomic health inequalities in Ontario, Canada:A population-based cohort study of adult premature mortality, 1992 to 2017

BackgroundThis study aimed to characterize trends in absolute and relative socioeconomic inequalities in adult premature mortality between 1992 and 2017, in the context of declining population-wide mortality rates. We conducted a population-based cohort study of all adult premature deaths in Ontario, Canada using provincial vital statistics data linked to census-based, area-level deprivation indices for socioeconomic status.MethodsThe cohort included all individuals eligible for Ontario's single-payer health insurance system at any time between January 1, 1992 and December 31, 2017 with a recorded Ontario place of residence and valid socioeconomic status information (N = 820,370). Deaths between ages 18 and 74 were used to calculate adult premature mortality rates per 1000, stratified by provincial quintile of material deprivation. Relative inequalities were measured using Relative Index of Inequality (RII) measures. Absolute inequalities were estimated using Slope Index of Inequality (SII) measures. All outcome measures were calculated as sex-specific, annual measures for each year from 1992 to 2017.ResultsPremature mortality rates declined in all socioeconomic groups between 1992 and 2017. Relative inequalities in premature mortality increased over the same period. Absolute inequalities were mostly stable between 1992 and 2007, but increased dramatically between 2008 and 2017, with larger increases to absolute inequalities seen in females than in males.ConclusionsAs in other developed countries, long-term downward trends in all-cause premature mortality in Ontario, Canada have shifted to a plateau pattern in recent years, especially in lower- socioeconomic status subpopulations. Determinants of this may differ by setting. Regular monitoring of mortality by socioeconomic status is the only way that this phenomenon can be detected sensitively and early, for public health attention and possible corrective action

The impact of a human papillomavirus (HPV) vaccination campaign on routine primary health service provision and health workers in Tanzania: a controlled before and after study.

BACKGROUND: The burden of cervical cancer and shortage of screening services in Tanzania confers an urgent need for human papillomavirus (HPV) vaccination. However, the sustainability and impact of another new vaccine campaign in an under-resourced health system requires consideration. We aimed to determine the impact of the government's school-based HPV vaccine campaign in Kilimanjaro region on the provision of routine primary health services and staff workload. METHODS: Data on daily numbers of consultations were collected from health facility register books in 63 dispensaries and health centres in North-West Tanzania for 20 weeks in 2014. Changes in outpatient, antenatal care (ANC), family planning (FP) and immunisation service activity levels before, during and after the two HPV vaccination campaigns in 2014 in 30 facilities within Kilimanjaro region ('intervention facilities') were compared with changes in activity levels in 33 facilities in Arusha region ('controls'). Qualitative interviews were conducted with health workers in Kilimanjaro region who delivered HPV vaccination and those who remained at the facility during in-school HPV vaccine delivery to explore perceptions of workload and capacity. RESULTS: Health facility activity levels were low and very variable in both regions. Controlling for district, facility type, catchment population, clinical staff per 1000 catchment population and the timing of other campaigns, no evidence of a decrease in consultations at the health facility during HPV vaccination week was found across outpatient, ANC, routine immunisation and FP services. However, compared to the average week before and after the campaign, health workers reported longer working hours and patient waiting times, feeling over-stretched and performing duties outside their normal roles whilst colleagues were absent from the facility conducting the HPV vaccine campaign. CONCLUSION: Qualitative interviews with health workers revealed that staff absence from the health facility is common for a number of reasons, including vaccination campaigns. Health workers perceived that the absence of their colleagues increased the workload at the health facility. The numbers of consultations for each service on 'normal days' were low and highly variable and there was no clear detrimental effect of the HPV vaccination campaign on routine health service activity

HIV Infection among Young People in Northwest Tanzania: The Role of Biological, Behavioural and Socio-Demographic Risk Factors.

BACKGROUND: Young people are at high risk of HIV and developing appropriate prevention programmes requires an understanding of the risk factors for HIV in this age group. We investigated factors associated with HIV among participants aged 15-30 years in a 2007-8 cross-sectional survey nested within a community-randomised trial of the MEMA kwa Vijana intervention in 20 rural communities in northwest Tanzania. METHODS: We analysed data for 7259(53%) males and 6476(47%) females. Using a proximate-determinant conceptual framework and conditional logistic regression, we obtained sex-specific Odds Ratios (ORs) for the association of HIV infection with socio-demographic, knowledge, behavioural and biological factors. RESULTS: HSV-2 infection was strongly associated with HIV infection (females: adjOR 4.4, 95%CI 3.2-6.1; males: adjOR 4.2, 95%CI 2.8-6.2). Several socio-demographic factors (such as age, marital status and mobility), behavioural factors (condom use, number and type of sexual partnerships) and biological factors (blood transfusion, lifetime pregnancies, genital ulcers, Neisseria gonorrhoeae) were also associated with HIV infection. Among females, lifetime sexual partners (linear trend, p<0.001), ≥2 partners in the past year (adjOR 2.0, 95%CI 1.4-2.8), ≥2 new partners in the past year (adjOR 1.9 95%CI 1.2, 3.3) and concurrent partners in the past year (adjOR 1.6 95%CI 1.1, 2.4) were all associated with HIV infection. CONCLUSIONS: Efforts must be intensified to find effective interventions to reduce HSV-2. Effective behavioural interventions focusing on reducing the number of sexual partnerships and risk behaviour within partnerships are also needed. An increase in risky sexual behaviour may occur following marriage dissolution or when a young woman travels outside of her community and interventions addressing the needs of these subgroups of vulnerable women may be important. TRIAL REGISTRATION: ClinicalTrial.gov NCT00248469

Achieving fruit, juice, and vegetable recipe preparation goals influences consumption by 4th grade students

<p>Abstract</p> <p>Background</p> <p>Including children in food preparation activities has long been recommended as a method to encourage children's consumption, but has not been evaluated. Goal setting is also a common component of behavior change programs. This study assessed the impact of attaining goals to prepare fruit-juice or vegetable recipes on student fruit and vegetable consumption as part of a 10-week fruit and vegetable intervention for fourth grade students.</p> <p>Methods</p> <p>At six of the 10 sessions, students (n = 671) selected a fruit-juice or vegetable recipe to prepare at home before the next session. Students returned parent-signed notes reporting their child's goal attainment. Baseline and post consumption were assessed with up to four days of dietary recalls. Analyses included regression models predicting post consumption from the number of fruit-juice or vegetable recipe preparation goals attained, controlling for baseline consumption.</p> <p>Results</p> <p>In general, girls and Hispanic students achieved the most recipe preparation goals. For students with highest baseline fruit-juice consumption, post fruit-juice consumption was higher by about 1.0 serving for those achieving 2 or 3 fruit-juice recipe preparation goals. Post vegetable consumption was highest for students reporting the highest baseline vegetable consumption and who achieved two or three vegetable recipe preparation goals. In general, recipe goal setting was a useful procedure primarily for those with high baseline consumption.</p> <p>Conclusion</p> <p>This is one of the first reports demonstrating that home recipe preparation was correlated with dietary change among children.</p

Active commuting to school and association with physical activity and adiposity among US youth

Background: Walking or bicycling to school (ie, active commuting) has shown promise for improving physical activity and preventing obesity in youth. Our objectives were to examine, among US youth, whether active commuting was inversely associated with adiposity and positively associated with moderate-to-vigorous physical activity (MVPA). We also examined whether MVPA mediated the relationships between active commuting and adiposity. Methods: Using data of participants aged 12 to 19 years from the US National Health and Nutrition Examination Survey 2003 to 2004 (n = 789 unweighted), we constructed multiple linear regression models that controlled for dietary energy intake and sociodemographics. The main exposure variable was active commuting. The outcomes were BMI z-score, waist circumference, skinfolds and objectively measured MVPA. The product-of-coefficients method was used to test for mediation. Results: Active commuting was inversely associated with BMI z-score (&beta; = &ndash;0.07, P = .046) and skinfolds (&beta; = &ndash;0.06, P = .029), and positively associated with overall daily (&beta; = 0.12, P = .024) and before- and after-school (&beta; = 0.20, P &lt; .001) MVPA. Greater before- and after-school MVPA explained part of the relationship between active commuting and waist circumference (Sobel z = &ndash;1.98, P = .048). Conclusions: Active commuting was associated with greater MVPA and lower measures of adiposity among US youth. Before- and after-school MVPA mediated the relationships between active commuting and waist circumference