48 research outputs found
Understanding of factors that enable health promoters in implementing health-promoting schools: A systematic review and narrative synthesis of qualitative evidence
© 2014 Hung et al. Health-promoting schools have been regarded as an important initiative in promoting child and adolescent health in school settings using the whole-school approach. Quantitative research has proved its effectiveness in various school-based programmes. However, few qualitative studies have been conducted to investigate the strategies used by health promoters to implement such initiatives. In this study, the researchers conducted a systematic review and narrative synthesis of the qualitative literature to identify important enablers assisting the implementation of health-promoting schools from the perspectives of health promoters. Five enablers have been identified from the review: (a) Following a framework/guideline to implement health-promoting schools; (b) Obtaining committed support and contributions from the school staff, school board management, government authorities, health agencies and other stakeholders; (c) Adopting a multidisciplinary, collaborative approach to implementing HPS; (d) Establishing professional networks and relationships; and (e) Continuing training and education in school health promotion. This highlights the importance of developing school health policies that meet local health needs, and socio-cultural characteristics that can foster mutual understanding between the health and education sectors so as to foster health promotion in children and adolescents
A service learning subject cultivates university freshmen’s social responsibility through a health ambassador scheme : mentoring health ambassadors in school communities
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High magnetic field scales and critical currents in SmFeAs(O,F) crystals: promising for applications
Superconducting technology provides most sensitive field detectors, promising
implementations of qubits and high field magnets for medical imaging and for
most powerful particle accelerators. Thus, with the discovery of new
superconducting materials, such as the iron pnictides, exploring their
potential for applications is one of the foremost tasks. Even if the critical
temperature Tc is high, intrinsic electronic properties might render
applications rather difficult, particularly if extreme electronic anisotropy
prevents effective pinning of vortices and thus severely limits the critical
current density, a problem well known for cuprates. While many questions
concerning microscopic electronic properties of the iron pnictides have been
successfully addressed and estimates point to a very high upper critical field,
their application potential is less clarified. Thus we focus here on the
critical currents, their anisotropy and the onset of electrical dissipation in
high magnetic fields up to 65 T. Our detailed study of the transport properties
of optimally doped SmFeAs(O,F) single crystals reveals a promising combination
of high (>2 x 10^6 A/cm^2) and nearly isotropic critical current densities
along all crystal directions. This favorable intragrain current transport in
SmFeAs(O,F), which shows the highest Tc of 54 K at ambient pressure, is a
crucial requirement for possible applications. Essential in these experiments
are 4-probe measurements on Focused Ion Beam (FIB) cut single crystals with
sub-\mu\m^2 cross-section, with current along and perpendicular to the
crystallographic c-axis and very good signal-to-noise ratio (SNR) in pulsed
magnetic fields. The pinning forces have been characterized by scaling the
magnetically measured "peak effect"
Coexistence of metallic and nonmetallic properties in the pyrochlore Lu2Rh2O7
Transition metal oxides of the and block have recently become the
targets of materials discovery, largely due to their strong spin-orbit coupling
that can generate exotic magnetic and electronic states. Here we report the
high pressure synthesis of LuRhO, a new cubic pyrochlore oxide
based on Rh and characterizations via thermodynamic, electrical
transport, and muon spin relaxation measurements. Magnetic susceptibility
measurements reveal a large temperature-independent Pauli paramagnetic
contribution, while heat capacity shows an enhanced Sommerfeld coefficient,
= 21.8(1) mJ/mol-Rh K. Muon spin relaxation measurements confirm
that LuRhO remains paramagnetic down to 2 K. Taken in combination,
these three measurements suggest that LuRhO is a correlated
paramagnetic metal with a Wilson ratio of . However, electric
transport measurements present a striking contradiction as the resistivity of
LuRhO is observed to monotonically increase with decreasing
temperature, indicative of a nonmetallic state. Furthermore, although the
magnitude of the resistivity is that of a semiconductor, the temperature
dependence does not obey any conventional form. Thus, we propose that
LuRhO may belong to the same novel class of non-Fermi liquids as
the nonmetallic metal FeCrAs.Comment: 11 pages, 5 figure
Imaging the Fano Lattice to 'Hidden Order' Transition in URu2Si2
Within a Kondo lattice, the strong hybridization between electrons localized
in real space (r-space) and those delocalized in momentum-space (k-space)
generates exotic electronic states called 'heavy fermions'. In URu2Si2 these
effects begin at temperatures around 55K but they are suddenly altered by an
unidentified electronic phase transition at To = 17.5 K. Whether this is
conventional ordering of the k-space states, or a change in the hybridization
of the r-space states at each U atom, is unknown. Here we use spectroscopic
imaging scanning tunnelling microscopy (SI-STM) to image the evolution of
URuSi2 electronic structure simultaneously in r-space and k-space. Above To,
the 'Fano lattice' electronic structure predicted for Kondo screening of a
magnetic lattice is revealed. Below To, a partial energy gap without any
associated density-wave signatures emerges from this Fano lattice.
Heavy-quasiparticle interference imaging within this gap reveals its cause as
the rapid splitting below To of a light k-space band into two new heavy fermion
bands. Thus, the URu2Si2 'hidden order' state emerges directly from the Fano
lattice electronic structure and exhibits characteristics, not of a
conventional density wave, but of sudden alterations in both the hybridization
at each U atom and the associated heavy fermion states.Comment: Main Article + Supplementary Informatio
AiDAPT: automated insulin delivery amongst pregnant women with type 1 diabetes: a multicentre randomized controlled trial – study protocol
Background
Pregnant women with type 1 diabetes strive for tight glucose targets (3.5-7.8 mmol/L) to minimise the risks of obstetric and neonatal complications. Despite using diabetes technologies including continuous glucose monitoring (CGM), insulin pumps and contemporary insulin analogues, most women struggle to achieve and maintain the recommended pregnancy glucose targets. This study aims to evaluate whether the use of automated closed-loop insulin delivery improves antenatal glucose levels in pregnant women with type 1 diabetes.
Methods/design
A multicentre, open label, randomized, controlled trial of pregnant women with type 1 diabetes and a HbA1c of ≥48 mmol/mol (6.5%) at pregnancy confirmation and ≤ 86 mmol/mol (10%) at randomization. Participants who provide written informed consent before 13 weeks 6 days gestation will be entered into a run-in phase to collect 96 h (24 h overnight) of CGM glucose values. Eligible participants will be randomized on a 1:1 basis to CGM (Dexcom G6) with usual insulin delivery (control) or closed-loop (intervention). The closed-loop system includes a model predictive control algorithm (CamAPS FX application), hosted on an android smartphone that communicates wirelessly with the insulin pump (Dana Diabecare RS) and CGM transmitter. Research visits and device training will be provided virtually or face-to-face in conjunction with 4-weekly antenatal clinic visits where possible. Randomization will stratify for clinic site. One hundred twenty-four participants will be recruited. This takes into account 10% attrition and 10% who experience miscarriage or pregnancy loss. Analyses will be performed according to intention to treat. The primary analysis will evaluate the change in the time spent in the target glucose range (3.5-7.8 mmol/l) between the intervention and control group from 16 weeks gestation until delivery. Secondary outcomes include overnight time in target, time above target (> 7.8 mmol/l), standard CGM metrics, HbA1c and psychosocial functioning and health economic measures. Safety outcomes include the number and severity of ketoacidosis, severe hypoglycaemia and adverse device events.
Discussion
This will be the largest randomized controlled trial to evaluate the impact of closed-loop insulin delivery during type 1 diabetes pregnancy.
Trial registration
ISRCTN 56898625 Registration Date: 10 April, 2018
The overlapping burden of the three leading causes of disability and death in sub-Saharan African children
Despite substantial declines since 2000, lower respiratory infections (LRIs), diarrhoeal diseases, and malaria remain among the leading causes of nonfatal and fatal disease burden for children under 5 years of age (under 5), primarily in sub-Saharan Africa (SSA). The spatial burden of each of these diseases has been estimated subnationally across SSA, yet no prior analyses have examined the pattern of their combined burden. Here we synthesise subnational estimates of the burden of LRIs, diarrhoea, and malaria in children under-5 from 2000 to 2017 for 43 sub-Saharan countries. Some units faced a relatively equal burden from each of the three diseases, while others had one or two dominant sources of unit-level burden, with no consistent pattern geographically across the entire subcontinent. Using a subnational counterfactual analysis, we show that nearly 300 million DALYs could have been averted since 2000 by raising all units to their national average. Our findings are directly relevant for decision-makers in determining which and targeting where the most appropriate interventions are for increasing child survival. © 2022, The Author(s).Funding text 1: This work was primarily supported by grant OPP1132415 from the Bill & Melinda Gates Foundation. ; Funding text 2: This study was funded by the Bill & Melinda Gates Foundation. The corresponding author had full access to all the data in the study and had final responsibility for the decision to submit for publication. The non-consortium authors have no competing interests . Competing interests for consortium authors is as follows: Robert Ancuceanu reports receiving consultancy or speaker feeds from UCB, Sandoz, Abbvie, Zentiva, Teva, Laropharm, CEGEDIM, Angelini, Biessen Pharma, Hofigal, AstraZeneca, and Stada. Jacek Jerzy Jozwiak reports personal fees from Amgen, ALAB Laboratories, Teva, Synexus, Boehringer Ingelheim, and Zentiva, all outside the submitted work. Kewal Krishan reports non-financial support from UGC Centre of Advanced Study, CAS II, Department of Anthropology, Panjab University, Chandigarh, India, outside the submitted work. Walter Mendoza is a Program Analyst in Population and Development at the United Nations Population Fund-UNFPA Country Office in Peru, which does not necessarily endorse or support these findings. Maarten J Postma reports grants and personal fees from MSD, GSK, Pfizer, Boehringer Ingelheim, Novavax, BMS, Seqirus, Astra Zeneca, Sanofi, IQVIA, grants from Bayer, BioMerieux, WHO, EU, FIND, Antilope, DIKTI, LPDP, Budi, personal fees from Novartis, Quintiles, Pharmerit, owning stock options in Health-Ecore and PAG Ltd, and being advisor to Asc Academics, all outside the submitted work. Jasviner A Singh reports personal fees from Crealta/Horizon, Medisys, Fidia, UBM LLC, Trio health, Medscape, WebMD, Clinical Care options, Clearview healthcare partners, Putnam associates, Focus forward, Navigant consulting, Spherix, Practice Point communications, the National Institutes of Health, the American College of Rheumatology, and Simply Speaking, owning stock options in Amarin, Viking, Moderna, Vaxart pharmaceuticals and Charlotte’s Web Holdings, being a member of FDA Arthritis Advisory Committee, the steering committee of OMERACT, an international organization that develops measures for clinical trials and receives arm’s length funding from 12 pharmaceutical companies, and the Veterans Affairs Rheumatology Field Advisory Committee, and acting as Editor and Director of the UAB Cochrane Musculoskeletal Group Satellite Center on Network Meta-analysis, all outside the submitted work. Era Upadhyay has a patent A system and method of reusable filters for anti-pollution mask pending, and a patent A system and method for electricity generation through crop stubble by using microbial fuel cells pending
Global, regional, and national mortality among young people aged 10–24 years, 1950–2019: a systematic analysis for the Global Burden of Disease Study 2019
Summary: Background Documentation of patterns and long-term trends in mortality in young people, which reflect huge changes in demographic and social determinants of adolescent health, enables identification of global investment priorities for this age group. We aimed to analyse data on the number of deaths, years of life lost, and mortality rates by sex and age group in people aged 10–24 years in 204 countries and territories from 1950 to 2019 by use of estimates from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019. Methods We report trends in estimated total numbers of deaths and mortality rate per 100 000 population in young people aged 10–24 years by age group (10–14 years, 15–19 years, and 20–24 years) and sex in 204 countries and territories between 1950 and 2019 for all causes, and between 1980 and 2019 by cause of death. We analyse variation in outcomes by region, age group, and sex, and compare annual rate of change in mortality in young people aged 10–24 years with that in children aged 0–9 years from 1990 to 2019. We then analyse the association between mortality in people aged 10–24 years and socioeconomic development using the GBD Socio-demographic Index (SDI), a composite measure based on average national educational attainment in people older than 15 years, total fertility rate in people younger than 25 years, and income per capita. We assess the association between SDI and all-cause mortality in 2019, and analyse the ratio of observed to expected mortality by SDI using the most recent available data release (2017). Findings In 2019 there were 1·49 million deaths (95% uncertainty interval 1·39–1·59) worldwide in people aged 10–24 years, of which 61% occurred in males. 32·7% of all adolescent deaths were due to transport injuries, unintentional injuries, or interpersonal violence and conflict; 32·1% were due to communicable, nutritional, or maternal causes; 27·0% were due to non-communicable diseases; and 8·2% were due to self-harm. Since 1950, deaths in this age group decreased by 30·0% in females and 15·3% in males, and sex-based differences in mortality rate have widened in most regions of the world. Geographical variation has also increased, particularly in people aged 10–14 years. Since 1980, communicable and maternal causes of death have decreased sharply as a proportion of total deaths in most GBD super-regions, but remain some of the most common causes in sub-Saharan Africa and south Asia, where more than half of all adolescent deaths occur. Annual percentage decrease in all-cause mortality rate since 1990 in adolescents aged 15–19 years was 1·3% in males and 1·6% in females, almost half that of males aged 1–4 years (2·4%), and around a third less than in females aged 1–4 years (2·5%). The proportion of global deaths in people aged 0–24 years that occurred in people aged 10–24 years more than doubled between 1950 and 2019, from 9·5% to 21·6%. Interpretation Variation in adolescent mortality between countries and by sex is widening, driven by poor progress in reducing deaths in males and older adolescents. Improving global adolescent mortality will require action to address the specific vulnerabilities of this age group, which are being overlooked. Furthermore, indirect effects of the COVID-19 pandemic are likely to jeopardise efforts to improve health outcomes including mortality in young people aged 10–24 years. There is an urgent need to respond to the changing global burden of adolescent mortality, address inequities where they occur, and improve the availability and quality of primary mortality data in this age group