What do beginning students, in a rurally focused medical course, think about rural practice?

Background: Medical schools may select students for their attitudes towards rural medical practice, yet the rural–urban disparity in availability of medical practitioners and services has not diminished in recent times despite government initiatives and increasing numbers being trained for a career in medicine. One medical school, with a focus on rural and remote medicine, aims to select students with positive perceptions for rural medical practice. A research project collected data on the perceptions of these medical students in the first week of their medical studies. Methods: Students completed a low stakes essay on the life and work of a rural doctor. Initially, this formed part of a literacy assessment to determine any students requiring remediation. All students were asked if they would consent to their essay being reviewed for a research project. Data was obtained from those students who consented and handed their essays in for review. The 103 student essays underwent thematic analysis and sentences were coded into three main themes of rural lifestyle, doctor role and rural practice. Second level themes were further elicited and results were quantified according to whether they were positive or negative. Positive themes included rural lifestyle, doctor role, views of doctor, impact on community, broader work and skills knowledge, and better relationships with community and patients. Negative themes included doctor's health, pressure on doctor, family problems, greater workload, privacy and confidentiality issues, cultural issues, isolation, limited resources and financial impacts. Quantitisation of this data was used to transform essay sentences into a numerical form which allowed statistical analysis and comparison of perceptions using Z tests. Results: No significant differences on the number of positive and negative responses for rural lifestyle and rural practice were found. The rural doctor role had a significantly more positive than negative views. Significant differences were found for positive views of the rural doctor role and negative views of rural practice. Participants from a capital city background reported a significantly higher percentage of responses related to negative views of rural practice than their regional and rural counterparts. Students from capital city areas had significantly more negative views about the rural doctor role, especially related to workload, limited resources and isolation than students from rural and regional areas. Conclusion: Students entering medical school already have both positive and negative views about the life and work of a rural doctor. Those students from capital city areas have significantly more negative views despite being selected to enter a medical course with a rural focus based on their expressed rural perceptions. Further work is required to refine selection criteria and the year level experiences and learning opportunities which may positively influence student perceptions about rural medical practice to overcome early negative perceptions at the beginning of medical school

Wellness and Professional Quality of Life in Counselor-in-Training Interns: Assessment of Wellness and Non-Wellness-Infused Supervision

Introduction: Counselors-in-training (CITs) commonly encounter issues of burnout, compassion fatigue, and/or vicarious traumatization due to the nature of their jobs in the helping profession. Wellness infused supervision may help CITs foster personal wellness and mitigate deleterious effects of helping. This investigation examined connections related to counselor-in-training wellness and professional quality of life during an internship-level supervision course across a wellness and control section. Methods: A quasi-experimental design was piloted, comparing a wellness-focused supervision internship section with a non-wellness control group supervision internship section during one academic semester. Participants included 15 clinical mental health CITs (9 experimental; 6 control), who were randomly assigned into the wellness or control internship section. Internship classes consisted of two-hour meetings across a 16 week semester, with participants working towards 300 clock hours of experience. All participants who were offered inclusion into internship accepted, and were randomly assigned into the wellness-infused or control internship sections, which took place within a large, Council for Accreditation in Counseling and Related Educational Program (CACREP) accredited program. Results: Results indicated decreased wellness scores in both internship sections from pre-to-post assessment, no differences between wellness-based internship and the control group in wellness or professional quality of life, and an increase in compassion satisfaction in the wellness-based internship group. Conclusion: Although counselors are vulnerable to compromised wellness due to the nature of their work, training CITs to work from a wellness paradigm in their personal and professional lives may facilitate well-being, and mitigate the effects of burnout and fatigue. Results from this study shed light on how CITs are viewing their personal wellness and how supervisors can utilize assessments to facilitate reflective conversations with supervisees about their wellness and quality of life

Quantifying Activity Levels After Sport-Related Concussion Using Actigraph and Mobile (mHealth) Technologies

Context Interest in identifying the effects of physical and mental activity on recovery after sport-related concussion is growing. Clinical studies of concussed athletes\u27 activities require well-validated methods for tracking their intensity and timing. Objective To develop and validate a novel multimodal approach to monitoring activity postconcussion using mobile (mHealth) technologies. Design Cohort study. Setting Translational research unit. Patients or Other Participants A total of 40 high school and collegiate football players were evaluated at preseason and followed longitudinally after either concussion (n = 25; age = 17.88 ± 1.74 years, height = 182.07 ± 8.08 cm, mass = 98.36 ± 21.70 kg) or selection as a nonconcussed control (n = 15; age = 18.27 ± 1.83 years, height = 180.01 ± 7.19 cm, mass = 93.83 ± 24.56 kg). Main Outcome Measure(s) Participants wore a commercial actigraph and completed a daily mobile survey for 2 weeks. Analyses focused on comparisons between groups for actigraph-based physical activity and self-reported physical and mental activity during the follow-up period. Results For the first 2 days postinjury, objective measures showed fewer daily steps in concussed (6663 ± 2667 steps) than in control (11 148 ± 3381 steps) athletes (P \u3c .001), and both objective and self-reported measures indicated less moderate to vigorous physical activity in concussed (27.6 ± 32.6 min/d and 25.0 ± 43.6 min/d, respectively) than in control (57.3 ± 38.6 min/d and 67.5 ± 40.1 min/d, respectively) athletes (both P values \u3c .05). Correlations between objective and self-reported measures of moderate to vigorous physical activity were moderate across select 1-week and 2-week averages. We observed no group differences in self-reported mental activities. Conclusions Physical activity after sport-related concussion varied widely across athletes but on average was reduced during the acute and early subacute postinjury periods for both objective and self-reported measures. The lack of differences in mental activities between groups may reflect limited change in mental exertion postconcussion or difficulty accurately measuring mental activities. Assessing concussed athletes\u27 activities using actigraphy and self-reported scales may help monitor their compliance with activity recommendations and be useful in studies aimed at better understanding the effects of physical activity on concussion recovery

Is there an association between spatial access to parks/green space and childhood overweight/obesity in Calgary, Canada?

<p>Abstract</p> <p>Background</p> <p>The recent increase in childhood obesity is expected to add significantly to the prevalence of chronic diseases. We used multivariate multilevel analysis to examine associations between parks/green space and childhood overweight/obesity across communities in Calgary, Canada, a city characterized by intensified urban sprawl and high car use.</p> <p>Methods</p> <p>Body Mass Index was calculated from measured height and weight data obtained from 6,772 children (mean age = 4.95 years) attending public health clinics for pre-school vaccinations. Each child's home postal code was geocoded using ESRI ArcGIS 9.2. We examined four measures of spatial access to parks/green space (based on Geographic Information Systems): 1) the number of parks/green spaces per 10,000 residents, 2) the area of parks/green space as a proportion of the total area within a community, 3) average distance to a park/green space, and 4) the proportion of parks/green space service area as a proportion of the total area within a community. Analyses were adjusted for dissemination area median family income (as a proxy for an individual child's family income) community-level education, and community-level proportion of visible minorities.</p> <p>Results</p> <p>In general, parks/green space at the community level was not associated with overweight/obesity in Calgary, with the exception of a marginally significant effect whereby a moderate number of parks/green spaces per 10,000 residents was associated with lower odds of overweight/obesity. This effect was non-significant in adjusted analyses.</p> <p>Conclusion</p> <p>Our null findings may reflect the popularity of car travel in Calgary, Canada and suggest that the role built environment characteristics play in explaining health outcomes may differ depending on the type of urban environment being studied.</p

A method for exposing rodents to resuspended particles using whole-body plethysmography

BACKGROUND: Epidemiological studies have reported increased risks of cardiopulmonary-related hospitalization and death in association with exposure to elevated levels of particulate matter (PM) across a wide range of urban areas. In response to these findings, researchers have conducted animal inhalation exposures aimed at reproducing the observed toxicologic effects. However, it is technically difficult to quantitate the actual amount of PM delivered to the lung in such studies, and dose is frequently estimated using default respiration parameters. Consequently, the interpretation of PM-induced effects in rodents exposed via whole-body inhalation is often compromised by the inability to determine deposited dose. To address this problem, we have developed an exposure system that merges the generation of dry, aerosolized particles with whole-body plethysmography (WBP), thus permitting inhalation exposures in the unrestrained rat while simultaneously obtaining data on pulmonary function. RESULTS: This system was validated using an oil combustion-derived particle (HP12) at three nominal concentrations (3, 12, and 13 mg/m(3)) for four consecutive exposure days (6 hr/day); a single 6-hour exposure to 13 mg/m(3 )of HP12 was also conducted. These results demonstrated that the system was both reliable and consistent over these exposure protocols, achieving average concentrations that were within 10% of the targeted concentration. In-line filters located on the exhaust outlets of individual WBP chambers showed relative agreement in HP12 mass for each day and were not statistically different when compared to one another (p = 0.16). Temperatures and relative humidities were also similar between chambers during PM and air exposures. Finally, detailed composition analyses of both HP12 filter and bulk samples showed that grinding and aerosolization did not change particle chemistry. CONCLUSION: The results of this study demonstrate that it is possible to expose rodents to resuspended, dry PM via whole-body inhalation while these animals are maintained in WBP chambers. This new methodology should significantly improve the ability to assess dosimetry under minimally stressful exposure conditions

A Pharmacogenomic and Protein Analysis of Human Lacrimal Fluid in Varying Age Groups

Proteins are large biological molecules located within all cells. They are considered the basic functional components of cells that allow them to operate appropriately. Genes consist of both DNA and RNA, and are the cellular components that code for the proteins. A biomarker is any cellular component that is an indication of a biological state. Therefore, genetic and protein biomarkers are specific genes and proteins, respectively, present in cells that indicate a specific biological state of a cell. Identification of proteins and genetic biomarkers in relative quantities has been found to reflect various disease states and age groups in humans. Comparisons of possible techniques for collecting lacrimal fluids from human subjects which could potentially be utilized in the design of the study

Probabilistic Volcanic Hazard Assessment of the 22.5–28°S Segment of the Central Volcanic Zone of the Andes

Evaluation of volcanic hazards typically focusses on single eruptive centres or spatially restricted areas, such as volcanic fields. Expanding hazard assessments across wide regions (e.g., large sections of a continental margin) has rarely been attempted, due to the complexity of integrating temporal and spatial variability in tectonic and magmatic processes. In this study, we investigate new approaches to quantify the hazards of such long-term active and complex settings, using the example of the 22.5–28°S segment of the Central Volcanic Zone of the Andes. This research is based on the estimation of: 1) spatial probability of future volcanic activity (based on kernel density estimation using a new volcanic geospatial database), 2) temporal probability of future volcanic events, and 3) areas susceptible to volcanic flow and fall processes (based on computer modeling). Integrating these results, we produce a set of volcanic hazard maps. We then calculate the relative probabilities of population centres in the area being affected by any volcanic phenomenon. Touristic towns such as La Poma (Argentina), Toconao (Chile), Antofagasta de la Sierra (Argentina), Socaire (Chile), and Talabre (Chile) are exposed to the highest relative volcanic hazard. In addition, through this work we delineate five regions of high spatial probability (i.e., volcanic clusters), three of which correlate well with geophysical evidence of mid-crustal partial melt bodies. Many of the eruptive centres within these volcanic clusters have poorly known eruption histories and are recommended to be targeted for future work. We hope this contribution will be a useful approach to encourage probabilistic volcanic hazard assessments for other arc segments.Fil: Bertin, Daniel. University of Auckland; Nueva ZelandaFil: Lindsay, Jan M.. University of Auckland; Nueva ZelandaFil: Cronin, Shane J.. University of Auckland; Nueva ZelandaFil: de Silva, Shanaka L.. State University of Oregon; Estados UnidosFil: Connor, Charles B.. University of Florida; Estados UnidosFil: Caffe, Pablo Jorge. Universidad Nacional de Jujuy. Instituto de Ecorregiones Andinas. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Salta. Instituto de Ecorregiones Andinas; ArgentinaFil: Grosse, Pablo. Fundación Miguel Lillo; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Tucumán; ArgentinaFil: Báez, Walter. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Salta. Instituto de Bio y Geociencias del NOA. Universidad Nacional de Salta. Facultad de Ciencias Naturales. Museo de Ciencias Naturales. Instituto de Bio y Geociencias del NOA; ArgentinaFil: Bustos, Emilce. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Salta. Instituto de Bio y Geociencias del NOA. Universidad Nacional de Salta. Facultad de Ciencias Naturales. Museo de Ciencias Naturales. Instituto de Bio y Geociencias del NOA; ArgentinaFil: Constantinescu, Robert. University of Florida; Estados Unido

Vegetation response to invasive Tamarix control in southwestern U.S. rivers: a collaborative study including 416 sites

Most studies assessing vegetation response following control of invasive Tamarix trees along southwestern U.S. rivers have been small in scale (e.g., river reach), or at a regional scale but with poor spatial-temporal replication, and most have not included testing the effects of a now widely used biological control. We monitored plant composition following Tamarix control along hydrologic, soil, and climatic gradients in 244 treated and 172 reference sites across six U.S. states. This represents the largest comprehensive assessment to date on the vegetation response to the four most common Tamarix control treatments. Biocontrol by a defoliating beetle (treatment 1) reduced the abundance of Tamarix less than active removal by mechanically using hand and chain-saws (2), heavy machinery (3) or burning (4). Tamarix abundance also decreased with lower temperatures, higher precipitation, and follow-up treatments for Tamarix resprouting. Native cover generally increased over time in active Tamarix removal sites, however, the increases observed were small and was not consistently increased by active revegetation. Overall, native cover was correlated to permanent stream flow, lower grazing pressure, lower soil salinity and temperatures, and higher precipitation. Species diversity also increased where Tamarix was removed. However, Tamarix treatments, especially those generating the highest disturbance (burning and heavy machinery), also often promoted secondary invasions of exotic forbs. The abundance of hydrophytic species was much lower in treated than in reference sites, suggesting that management of southwestern U.S. rivers has focused too much on weed control, overlooking restoration of fluvial processes that provide habitat for hydrophytic and floodplain vegetation. These results can help inform future management of Tamarix-infested rivers to restore hydrogeomorphic processes, increase native biodiversity and reduce abundance of noxious species