Which primary care practitioners have poor human papillomavirus (HPV) knowledge? A step towards informing the development of professional education initiatives

Background: Primary care practitioners (PCP) play key roles in cervical cancer prevention. Human papillomavirus (HPV) knowledge is an important influence on PCPs’ cervical cancer prevention-related behaviours. We investigated HPV knowledge, and associated factors, among general practitioners (GPs) and practice nurses. Methods: A survey, including factual questions about HPV infection and vaccination, was mailed to GPs and practice nurses in Ireland. Multivariable logistic regression was used to determine which PCPs had low knowledge (questions correctly answered: infection ≤5/11; vaccination: ≤4/10). Questions least often answered correctly were identified. Results: 697 PCPs participated. For HPV infection, GPs and practice nurses answered a median of nine and seven questions correctly, respectively (p⅓ of PCPs. Conclusions: There are important limitations in HPV infection and vaccination knowledge among PCPs. By identifying factors associated with poor knowledge, and areas of particular uncertainty, these results can inform development of professional education initiatives thereby ensuring women have access to uniformly high-quality HPV-related information and advice

Paths to Active Citizenship: The Development Of and Connection Between Civic Engagement Involvement and Attitudes in College Students

Thesis advisor: Larry H. LudlowHigher education has renewed its focus on civic engagement due to a growing recognition of the distinctive opportunities for students to internalize civic values during college. This unique role has become increasingly important in context of the shifting trend in American youth away from traditional political participation towards increasing involvement in civic life. Past research in higher education and youth civic engagement has suggested connections between participation in and attitudes supportive of civic engagement across both civic and political realms. To further investigate this relationship, this dissertation looked at how students' civic engagement involvement and attitudes develop over time, tracking how participation levels in civic, political, and expressive activities impact the acquisition of a comprehensive set of civic attitudes during students' undergraduate tenure. The specific attitudes of interest in this study were students' self-efficacy through community service, politics, and civic involvement, commitment to civic accountability, and tolerance of diversity. This dissertation utilized data from two cohorts (N=137) of a multi-year study at a single institution as its main data source, with data from a nationally-representative sample of college students used for scale development and anchoring. A mixed-method three-factor within subjects design was used to explore the development within and between students' civic engagement involvement and attitudes across their four years at college by gender and minority status. Through the Rasch rating scale model, repeated measures analyses of variance, and repeated measures analyses of covariance, students' longitudinal commitment to civic engagement was shown to be much more complex than expected. Canonical correlation analysis was then used to address the connection between students' involvement and attitudes within their freshman, sophomore, junior, and senior years. While the results of this study were typically non-significant with regard to students' development of civic engagement involvement and attitudes, these findings provided valuable insights into the relationship between participation in specific types of activities at certain stages of students' college experiences and the acquisition of particular civic engagement attitudes.Thesis (PhD) — Boston College, 2010.Submitted to: Boston College. Lynch School of Education.Discipline: Educational Research, Measurement, and Evaluation

Healthy lifestyle behaviours for people with intellectual disabilities: An exploration of organizational barriers and enablers

BackgroundThe health-related behaviours of people with intellectual disabilities may be determined by organisational influences. This innovative study aimed to explore managers’ and staffs’ perspectives on organisational influences on the promotion of healthy behaviours for this population.MethodA qualitative methodology was employed. Four focus groups with staff and eleven telephone interviews with managers were undertaken across three residential services in one region (Northern Ireland) of the UK. Transcripts were analysed thematically.FindingsThe organisations involved in this study did not have the cultural ethos or capacity to sustain consistent support for staff involvement in health promotion. Organisational support and outcome-focused strategies are recommended for encouraging staff involvement in health promotion activities.ConclusionThese findings have implications for some organisations that support people with intellectual disabilities in improving the way they facilitate health promotion. They highlight the need for organisational cultures to facilitate knowledge translation and embrace evidence-based health promotion interventions

Neonatal vaccination of low birthweight infants in Ghana.

OBJECTIVES: Global vaccination policy advocates for identifying and targeting groups who are underserved by vaccination to increase equity and uptake. We investigated whether birth weight and other factors are determinants of neonatal BCG vaccination in order to identify infants underserved by vaccination. METHODS: We used logistic regression to calculate adjusted ORs (AORs) for the association between birth weight (categorised as non-low birth weight (NLBW) (≥2.50 kg) and low birth weight (LBW) (2-2.49 kg, 1.50-1.99 kg and 0.19). Facility-born infants were vaccinated at a mean of 6 days, suggesting that they were not vaccinated in the facility at birth but were referred for vaccination. CONCLUSIONS: LBW is a risk factor for neonatal under-vaccination, even for facility-born infants. Ensuring vaccination at facility births would substantively improve timing and equitable BCG vaccination

Exploring nurses’ online perspectives and social networks during a global pandemic COVID‐19

ObjectivesExamine the online interactions, social networks, and perspectives of nursing actors on COVID-19 from conversations on Twitter to understand how the profession responded to this global pandemic.DesignMixed methods.SampleTen-thousand five-hundred and seventy-four tweets by 2790 individuals and organizations.MeasurementsNodeXL software was used for social network analysis to produce a network visualization. The betweenness centrality algorithm identified key users who were influential in COVID-19 related conversations on Twitter. Inductive content analysis enabled exploration of tweet content. A communicative figurations framework guided the study.ResultsNursing actors formed different social groupings, and communicated with one another across groups. Tweets covered four themes; (1) outbreak and clinical management of the infectious disease, (2) education and information sharing, (3) social, economic, and political context, and (4) working together and supporting each other.ConclusionIn addition to spreading knowledge, nurses tried to reach out through social media to political and healthcare leaders to advocate for improvements needed to address COVID-19. However, they primarily conversed within their own professional community. Action is needed to better understand how social media is and can be used by nurses for health communication, and to improve their preparedness to be influential on social media beyond the nursing community

Exploring nurses' online perspectives and social networks during a global pandemic COVID-19

Objectives Examine the online interactions, social networks, and perspectives of nursing actors on COVID-19 from conversations on Twitter to understand how the profession responded to this global pandemic. Design Mixed methods. Sample Ten-thousand five-hundred and seventy-four tweets by 2790 individuals and organizations. Measurements NodeXL software was used for social network analysis to produce a network visualization. The betweenness centrality algorithm identified key users who were influential in COVID-19 related conversations on Twitter. Inductive content analysis enabled exploration of tweet content. A communicative figurations framework guided the study. Results Nursing actors formed different social groupings, and communicated with one another across groups. Tweets covered four themes; (1) outbreak and clinical management of the infectious disease, (2) education and information sharing, (3) social, economic, and political context, and (4) working together and supporting each other. Conclusion In addition to spreading knowledge, nurses tried to reach out through social media to political and healthcare leaders to advocate for improvements needed to address COVID-19. However, they primarily conversed within their own professional community. Action is needed to better understand how social media is and can be used by nurses for health communication, and to improve their preparedness to be influential on social media beyond the nursing community

Detecting Compaction Disequilibrium with Anisotropy of Magnetic Susceptibility

In clay-rich sediment, microstructures and macrostructures influence how sediments deform when under stress. When lithology is fairly constant, anisotropy of magnetic susceptibility (AMS) can be a simple technique for measuring the relative consolidation state of sediment, which reflects the sediment burial history. AMS can reveal areas of high water content and apparent overconsolidation associated with unconformities where sediment overburden has been removed. Many other methods for testing consolidation and water content are destructive and invasive, whereas AMS provides a nondestructive means to focus on areas for additional geotechnical study. In zones where the magnetic minerals are undergoing diagenesis, AMS should not be used for detecting compaction state. By utilizing AMS in the Santa Barbara Basin, we were able to identify one clear unconformity and eight zones of high water content in three cores. With the addition of susceptibility, anhysteretic remanent magnetization, and isothermal remanent magnetization rock magnetic techniques, we excluded 3 out of 11 zones from being compaction disequilibria. The AMS signals for these three zones are the result of diagenesis, coring deformation, and burrows. In addition, using AMS eigenvectors, we are able to accurately show the direction of maximum compression for the accumulation zone of the Gaviota Slide

Birth incidence, deaths and hospitalisations of children and young people with Down syndrome, 1990–2015: birth cohort study

Objective: To investigate current Down syndrome live birth and death rates, and childhood hospitalisations, compared with peers.Setting: General community.Participants: All live births with Down syndrome, 1990–2015, identified via Scottish regional cytogenetic laboratories, each age–sex–neighbourhood deprivation matched with five non-Down syndrome controls. Record linkage to Scotland’s hospital admissions and death data.Primary outcome: HRs comparing risk of first hospitalisation (any and emergency), readmission for children with Down syndrome and matched controls were calculated using stratified Cox proportional hazards (PH) model, and length of hospital stay was calculated using a conditional log-linear regression model.Results: 689/1479 (46.6%) female and 769/1479 (51.9%) male children/young people with Down syndrome were identified (1.0/1000 births, with no reduction over time); 1235 were matched. 92/1235 (7.4%) died during the period, 18.5 times more than controls. More of the Down syndrome group had at least one admission (incidence rate ratio(IRR) 72.89 (68.72–77.32) vs 40.51 (39.15–41.92); adjusted HR=1.84 (1.68, 2.01)) and readmissions (IRR 54.85 (51.46–58.46) vs 15.06 (14.36–15.80); adjusted HR=2.56 (2.08, 3.14)). More of their admissions were emergencies (IRR 56.78 (53.13–60.72) vs 28.88 (27.73–30.07); first emergency admission adjusted HR=2.87 (2.61, 3.15)). Children with Down syndrome had 28% longer first admission after birth. Admission rate increased from 1990–2003 to 2004–2014 for the Down syndrome group (from 90.7% to 92.2%) and decreased for controls (from 63.3% to 44.8%).Conclusions: We provide contemporaneous statistics on the live birth rate of babies with Down syndrome, and their childhood death rate. They require more hospital admissions, readmissions emergency admissions and longer lengths of stays than their peers, which has received scant research attention in the past. This demonstrates the importance of statutory planning as well as informal support to families to avoid added problems in child development and family bonding over and above that brought by the intellectual disabilities associated with Down syndrome

Critical Habitats and Biodiversity: Inventory, Thresholds and Governance

The High Level Panel for Sustainable Ocean Economy (https://oceanpanel.org/) has commissioned a series of “Blue Papers” to explore pressing challenges at the nexus of the ocean and the economy. This paper is part of a series of 16 papers to be published between November 2019 and October 2020. It addresses how multiple human impacts will impact biodiversity underpinning ecosystem services such as marine fisheries, aquaculture, coastal protection and tourism. The paper examines the distribution of marine species and critical marine habitats around the world; analyses trends in drivers, pressures, impacts and response; and establishes thresholds for protecting biodiversity hot spots, and indicators to monitor change. From this scientific base, it assesses the current legal framework and available tools for biodiversity protection, current gaps in ocean governance and management and the implications for achieving a sustainable ocean economy tailored to individual coastal states grouped by social indicators