Sustaining remote-area programs: retinal camera use by Aboriginal health workers and nurses in a Kimberley partnership

Objective: to describe how a novel program of diabetic retinopathy screening was conceived, refined and sustained in a remote region over 10 years, and to evaluate its activities and outcomes. Design: program description; analysis of regional screening database; audit of electronic client registers of Aboriginal community controlled health services (ACCHSs). Setting and participants: 1318 Aboriginal and 271 non-Aboriginal individuals who underwent retinal screening in the 5 years to September 2004 in the Kimberley region of north-west Australia; 11 758 regular local Aboriginal clients of Kimberley ACCHSs as at January 2005. Main outcome measures: characteristics of clients and camera operators, prevalence of retinopathy, photograph quality, screening intervals and coverage. Results: among Aboriginal clients, 21% had diabetic retinopathy: 19% with nonproliferative retinopathy, 1.2% with proliferative retinopathy, and 2.8% with maculopathy. Corresponding figures for non-Aboriginal clients were 11%, 11%, 0 and 0.4%, respectively. Photograph quality was generally high, and better for non-Aboriginal clients, younger Aboriginal clients and from 2002 (when mydriatic use became universal). Quality was not related to operator qualifications, certification or experience. Of 718 regular Aboriginal clients with diabetes on local ACCHS databases, 48% had a record of retinal screening within the previous 18 months, and 65% within the previous 30 months. Conclusions: Screening for diabetic retinopathy performed locally by Aboriginal health workers and nurses with fundus cameras can be successfully sustained with regional support. Formal certification appears unnecessary. Data sharing across services, client recall and point-of-care prompts generated by electronic information systems, together with policies making primary care providers responsible for care coordination, support appropriate timely screening

Evaluating the role of a galanin enhancer genotype on a range of metabolic, depressive and addictive phenotypes

Funded by •ERC. Grant Number: 284167 •NIH. Grant Number: 1RO1DK0921127-01 •NWO. Grant Numbers: 463-06-001, 451-04-034Peer reviewedPublisher PD

Learning and animal movement

Authors acknowledge the following grants for supporting this research: NSERC Discovery (ML and MA-M), NSF DMS-1853465 (WF and EG), and Canada Research Chairs Program (ML and MA-M).Integrating diverse concepts from animal behavior, movement ecology, and machine learning, we develop an overview of the ecology of learning and animal movement. Learning-based movement is clearly relevant to ecological problems, but the subject is rooted firmly in psychology, including a distinct terminology. We contrast this psychological origin of learning with the task-oriented perspective on learning that has emerged from the field of machine learning. We review conceptual frameworks that characterize the role of learning in movement, discuss emerging trends, and summarize recent developments in the analysis of movement data. We also discuss the relative advantages of different modeling approaches for exploring the learning-movement interface. We explore in depth how individual and social modalities of learning can matter to the ecology of animal movement, and highlight how diverse kinds of field studies, ranging from translocation efforts to manipulative experiments, can provide critical insight into the learning process in animal movement.Publisher PDFPeer reviewe

Gravitational Nanolensing from Subsolar Mass Dark Matter Halos

We investigate the feasibility of extracting the gravitational nanolensing signal due to the presence of subsolar mass halos within galaxy-sized dark matter halos. We show that subsolar mass halos in a lensing galaxy can cause strong nanolensing events with shorter durations and smaller amplitudes than microlensing events caused by stars. We develop techniques that can be used in future surveys such as Pan-STARRS, LSST and OMEGA to search for the nanolensing signal from subsolar mass halos.Comment: 12 pages, 10 figures. Replaced with version accepted for publication in ApJ. Very minor changes from version

Development and Assessment of the Multiple Mini-Interview in a School of Pharmacy Admissions Model

Objective. To describe the development, implementation, and evaluation of the multiple mini-interview (MMI) within a doctor of pharmacy (PharmD) admissions model

Lightly Fluorinated Graphene as a Protective Layer for n-Type Si(111) Photoanodes in Aqueous Electrolytes

The behavior of n-Si(111) photoanodes covered by monolayer sheets of fluorinated graphene (F–Gr) was investigated under a range of chemical and electrochemical conditions. The electrochemical behavior of n-Si/F–Gr and np^+-Si/F–Gr photoanodes was compared to hydride-terminated n-Si (n-Si−H) and np+-Si−H electrodes in contact with aqueous Fe(CN)_6^(3-/4-) and Br_2/HBr electrolytes as well as in contact with a series of outer-sphere, one-electron redox couples in nonaqueous electrolytes. Illuminated n-Si/F–Gr and np^+-Si/F–Gr electrodes in contact with an aqueous K_3(Fe(CN)_6/K4(Fe(CN)_6 solutions exhibited stable short-circuit photocurrent densities of ∼10 mA cm^(–2) for 100,000 s (>24 h), in comparison to bare Si electrodes, which yielded nearly a complete photocurrent decay over ∼100 s. X-ray photoelectron spectra collected before and after exposure to aqueous anodic conditions showed that oxide formation at the Si surface was significantly inhibited for Si electrodes coated with F–Gr relative to bare Si electrodes exposed to the same conditions. The variation of the open-circuit potential for n-Si/F–Gr in contact with a series of nonaqueous electrolytes of varying reduction potential indicated that the n-Si/F–Gr did not form a buried junction with respect to the solution contact. Further, illuminated n-Si/F−Gr electrodes in contact with Br_2/HBr(aq) were significantly more electrochemically stable than n-Si−H electrodes, and n-Si/F−Gr electrodes coupled to a Pt catalyst exhibited ideal regenerative cell efficiencies of up to 5% for the oxidation of Br^– to Br_2

Exposure to nitrosamines in thirdhand tobacco smoke increases cancer risk in non-smokers

In addition to passive inhalation, non-smokers, and especially children, are exposed to residual tobacco smoke gases and particles that are deposited to surfaces and dust, known as thirdhand smoke (THS). However, until now the potential cancer risks of this pathway of exposure have been highly uncertain and not considered in public health policy. In this study, we estimate for the first time the potential cancer risk by age group through non-dietary ingestion and dermal exposure to carcinogen N-nitrosamines and tobacco-specific nitrosamines (TSNAs) measured in house dust samples. Using a highly sensitive and selective analytical approach we have determined the presence of nicotine, eight N-nitrosamines and five tobacco-specific nitrosamines in forty-six settled dust samples from homes occupied by both smokers and non-smokers. Using observations of house dust composition, we have estimated the cancer risk by applying the most recent official toxicological information. Calculated cancer risks through exposure to the observed levels of TSNAs at an early life stage (1 to 6. years old) exceeded the upper-bound risk recommended by the USEPA in 77% of smokers' and 64% of non-smokers' homes. The maximum risk from exposure to all nitrosamines measured in a smoker occupied home was one excess cancer case per one thousand population exposed.The results presented here highlight the potentially severe long-term consequences of THS exposure, particularly to children, and give strong evidence of its potential health risk and, therefore, they should be considered when developing future environmental and health policies