Simulations on a Mathematical Model of Dengue Fever with a Focus on Mobility

Dengue fever is a major public health threat, especially for countries in tropical climates. In order to investigate the spread of dengue fever in neighboring communities, an ordinary differential equation model is formulated based on two previous models of vector-borne diseases, one that specifically describes dengue fever transmission and another that incorporates movement of populations when describing malaria transmission. The resulting SIR/SI model is used to simulate transmission of dengue fever in neighboring communities of differing population size with particular focus on cities in Sri Lanka. Models representing connections between two communities and among three communities are investigated. Initial infection details and relative population size may affect the dynamics of disease spread. An outbreak in a highly populated area may spread somewhat more rapidly through that area as well as neighboring communities than an outbreak beginning in a nearby rural area

Postmenopausal Women With Greater Paracardial Fat Have More Coronary Artery Calcification Than Premenopausal Women: The Study of Women's Health Across the Nation (SWAN) Cardiovascular Fat Ancillary Study.

BackgroundVolumes of paracardial adipose tissue (PAT) and epicardial adipose tissue (EAT) are greater after menopause. Interestingly, PAT but not EAT is associated with estradiol decline, suggesting a potential role of menopause in PAT accumulation. We assessed whether volumes of heart fat depot (EAT and PAT) were associated with coronary artery calcification (CAC) in women at midlife and whether these associations were modified by menopausal status and estradiol levels.Methods and resultsEAT and PAT volumes and CAC were measured using electron beam computed tomography scans. CAC was evaluated as (1) the presence of CAC (CAC Agatston score ≥10) and (2) the extent of any CAC (log CAC Agatston score >0). The study included 478 women aged 50.9 years (58% pre- or early perimenopausal, 10% late perimenopausal, and 32% postmenopausal). EAT was significantly associated with CAC measures, and these associations were not modified by menopausal status or estradiol. In contrast, associations between PAT and CAC measures were modified by menopausal status (interaction-P≤0.01). Independent of study covariates including other adiposity measures, each 1-SD unit increase in log PAT was associated with 102% higher risk of CAC presence (P=0.04) and an 80% increase in CAC extent (P=0.008) in postmenopausal women compared with pre- or early perimenopausal women. Additional adjustment for estradiol and hormone therapy attenuated these differences. Moreover, the association between PAT and CAC extent was stronger in women with lower estradiol levels (interaction P=0.004).ConclusionsThe findings suggest that PAT is a potential menopause-specific coronary artery disease risk marker, supporting the need to monitor and target this fat depot for intervention in women at midlife

Helping children understand divorce (2004)

"This guide is a revision and update of two previous guides: Helping Children Understand Divorce, originally written by Sara Gable, state specialist in human development and family studies at the University of Missouri-Columbia, and Kelly Cole, former extension associate at the University of Missouri-Columbia, and The Effects of Divorce on Children, originally written by Karen DeBord, former state specialist in human development and family studies at the University of Missouri-Columbia.""Information from Human Environmental Sciences Extension.""Family relations."Revised 3/04/10M

Potential for natural and enhanced attenuation of sulphanilamide in a contaminated chalk aquifer

Understanding antibiotic biodegradation is important to the appreciation of their fate and removal from the environment. In this research an Isotope Ratio Mass Spectrometry (IRMS) method was developed to evaluate the extent of biodegradation of the antibiotic, sulphanilamide, in contaminated groundwater. Results indicted an enrichment in δ13C of 8.44‰ from − 26.56 (at the contaminant source) to − 18.12‰ (300 m downfield of the source). These results confirm reductions in sulphanilamide concentrations (from 650 to 10 mg/L) across the contaminant plume to be attributable to biodegradation (56%) vs. other natural attenuation processes, such as dilution or dispersion (42%). To understand the controls on sulphanilamide degradation ex-situ microcosms assessed the influence of sulphanilamide concentration, redox conditions and an alternative carbon source. Results indicated, high levels of anaerobic capacity (~ 50% mineralisation) to degrade sulphanilamide under high (263 mg/L), moderate (10 mg/L) and low (0.02 mg/L) substrate concentrations. The addition of electron acceptors; nitrate and sulphate, did not significantly enhance the capacity of the groundwater to anaerobically biodegrade sulphanilamide. Interestingly, where alternative carbon sources were present, the addition of nitrate and sulphate inhibited sulphanilamide biodegradation. These results suggest, under in-situ conditions, when a preferential carbon source was available for biodegradation, sulphanilamide could be acting as a nitrogen and/or sulphur source. These findings are important as they highlight sulphanilamide being used as a carbon and a putative nitrogen and sulphur source, under prevailing iron reducing conditions

IMPACT: The Journal of the Center for Interdisciplinary Teaching and Learning. Volume 9, Issue 1, Winter 2020

Explicitly established to foreground interdisciplinary teaching and learning, Impact also welcomes evidence and discussion of experiential learning. Often the two – interdisciplinary teaching and experiential learning – co-exist. Yet even when they do not, both practices model how to think in myriad ways and to notice how knowledge is constructed. As our winter 2019 issue makes clear, interdisciplinary teaching and learning and experiential learning often begin with questions. Why does it matter that students grapple directly with archival material? What happens when undergraduates practice psychology by training dogs? Do students understand financial literacy? This issue also asks questions about students’ reading habits and faculty expectations of them as readers

Local Implementation of Cancer Control Activities in Rural Appalachia, 2006

Underserved communities with high cancer rates often are not involved in implementing state cancer control activities locally. An East Tennessee State University research team formed 2 Appalachian Community Cancer Research Review Work Groups, 1 in northeast Tennessee and 1 in southwest Virginia. During 4 sessions, the research team presented regional cancer data to the work groups. Work group participants explored research from a lay perspective and identified possible reasons for cancer disparities in central Appalachia. The fifth session was a community dissemination activity in which work group participants engaged in cancer education and action by presenting the research to their local communities in unique ways. During a sixth session, both work groups discussed these interventions and further attempted to answer the question, "What makes the experience of cancer unique in Appalachia?" This article describes the key steps of this community-based participatory research process

Injuries Following Implementation of a Progressive Load Carriage Program in United States Marine Corps Training

PURPOSE: The overall physical demands placed on recruits completing United States Marine Corps (USMC) training is high and comes concomitantly with high rates of injuries. Load carriage with heavy loads is of particular concern. However, load carriage conditioning, if optimised, can reduce injury risk. METHODS: Retrospective injury data of recruits completing training informed this study. Data were drawn from recruits completing an original load carriage (OLC) program (n=2,363) and those completing a modified load carriage (LCMOD) program (n=681). Musculoskeletal injury data were drawn from the USMC San Diego sports medicine injury database. A population estimate of the OLC:LCMOD relative risk ratio (RR) was calculated. RESULTS: The proportion of injuries sustained by the LCMOD cohort (n=268; 39%) was notably lower than that sustained by the OLC cohort (n=1,372; 58%). The reoccurrence rate *f injury for LCMOD soldiers compared to the OLC was 0.68 (95% CI 0.61 to 0.75). The leading nature of injury (i.e., sprains and strains) was consistent between both cohorts (OLC: n=396; 29% vs. LCMOD: n=66; 25%). Inflammation (n=172; 13%) and fractures (n=144; 11%) were next most common for OLC recruits; while pain (n=58; 22%) and medial tibial stress syndrome (n=18; 8%) were next most common for LCMOD recruits. While stress reactions were proportionally higher in LCMOD (n=17; 6%) when compared to OLC (n=4; 0.3%), stress fractures were proportionality lower (LCMOD: n=9; 3% vs. OLC: n=114; 8%). Pre-existing / chronic injuries were higher in LCMOD (+5%) while new overuse injuries were lower (-7%). Totalling 65% (OLC) and 70% (LCMOD) of reported injuries the knee, lower leg, ankle, and foot were the top 4 bodily sites of injuries, although there were variations in the orders of presentations (See Table 1 for top 10 bodily sites). RELEVANCE: Careful periodisation and planning of a load carriage program can reduce injuries without reducing training outcomes

"If he could speak, he would be able to point out who does those things to him": Experiences of violence and access to child protection among children with disabilities in Uganda and Malawi.

INTRODUCTION: There is growing evidence that children with disabilities face an increased risk of violence globally. While child protection mechanisms to prevent and respond to violence-including formal government systems and more informal programmes and activities run by local communities or NGOs-are slowly becoming operationalised in low- and- middle-income countries, little is known about whether existing mechanisms are disability-inclusive. The aim of this study is to provide a better understanding of children with disabilities' experiences of violence and their access to available child protection mechanisms in low resource settings. METHODS: This study was conducted in Kasungu and Mulanje districts in Malawi and Kamuli district in Uganda between October-December 2015. In-depth, semi-structured interviews were conducted with approximately 20 purposively selected child/caregiver pairs in each country (43 pairs total). Interviews with key informants involved in the provision of child protection and disability support were also conducted. All interviews were recorded, transcribed and coded in NVivo. Thematic Analysis, complemented by constant comparison as described in Grounded Theory, was used to analyse the data. RESULTS: Almost all children with disabilities reported experiencing violence, with verbal abuse and bullying the most common forms. Very few of these children sought recourse through available child protection mechanisms. Some of the key factors impeding access to child protection for children with disabilities included: lack of local government disability-inclusive planning and budgeting; centralization of limited disability and social protection services; financial barriers to seeking and receiving care; and stigma and negative attitudes toward disabilities. CONCLUSION: Children with disabilities face both high levels of violence and high barriers to accessing available child protection mechanisms. There is an urgent need to ensure that all efforts to prevent and respond to violence against children are more disability-inclusive. In addition, it may be appropriate to target child protection mechanisms specifically toward children with disabilities because of the different and intersecting vulnerabilities that they face

Trauma Care in Older People: charting a path from outlier to excellence

Trauma in older people leads to substantial morbidity and mortality. The National Hip Fracture Database (NHFD) has driven improved practice with units compared to identify outliers. In 2013, our unit was an outlier for mortality post hip fracture (30-day mortality 12.2% vs. 8.3% nationally). This triggered external review. In 2019 the unit was highlighted as an exemplar in the UK. We describe the process that moved us from outlier to outstanding. After the initial review process, we made changes to our healthcare system, with regular reassessment of progress and care quality. Examples include a dedicated hip fracture unit, strong leadership (Nursing, Orthopaedic, Geriatrician, Anaesthetic), consultant-led in-depth monthly mortality reviews, changes to admission pathways and delirium prevention. Improvements were seen in all aspects of hip fracture care in 2019 compared with 2012. Thirty-day case-mixed adjusted mortality halved (12.2–6.1%), with substantial reductions in reoperations and pressure sores. Length of stay reduced by 5.9 days. In 2019 our unit’s performance was significantly above the national average for all six indicators assessed by NHFD: prompt orthogeriatric review (97% vs. 91% national average), prompt surgery (85% vs. 68%); NICE compliant surgery (85% vs. 74%); prompt mobilisation (93% vs. 81%); not delirious postoperatively (77% vs. 69%); return to original residence (78% vs. 71%). The NHFD highlighted our Unit as one of nine (from 175 total) highly performing UK trusts. We summarise our service development and improvement work undertaken to achieve ‘outstanding’ status, which provides a valuable template to units managing trauma in older people