Telehealth in the Context of COVID-19: Changing Perspectives in Australia, the United Kingdom, and the United States

Background: On the 12th March 2020, the World Health Organization (WHO) announced the COVID-19 virus outbreak as a pandemic. On that date there were 134,576 reported cases and 4,981 deaths worldwide. By 26th March, just two weeks later, reported cases had increased fourfold to 531,865 and deaths fivefold to 24,073. Older people are both major users of telehealth services and are more likely to die as a result of COVID-19. Objectives: This paper examines the extent to which Australia, the United Kingdom (UK) and the United States (US) during the two weeks following the pandemic announcement, sought to promote telehealth as a tool that could help identify COVID-19 among older people who may live alone, be frail and/or be self-isolating; and give support or facilitate the treatment of people who are or maybe infected. Methods: The paper reports, for the two-week period or immediately prior, on activities and initiatives in the three countries taken by governments or their agencies (at national or state levels); together with publications of or guidance issued by professional, trade and charitable bodies. Different sources of information are drawn upon that point to the perceived likely benefits of telehealth in fighting the pandemic. It is not the purpose of this paper to draw together or analyse information that reflects growing knowledge about COVID-19, except where telehealth is seen as a component. Results: The picture that emerges for the three countries, based on the sources identified, shows a number of differences. These differences centre on the nature of their health services; the extent of attention given to older people (and the circumstances that can relate to them); the different geographies (notably concerned with rurality) and the changes to funding frameworks that impact on these. Common to all three countries is the value attributed to maintaining quality safeguards in the wider context of their health services but where such services are noted as sometimes having precluded significant telehealth use. Conclusion: The COVID-19 pandemic is forcing changes and may help to establish telehealth more firmly in its aftermath. Some of the changes may not be long-lasting. However, the momentum is such that telehealth will almost certainly find a stronger place within health service frameworks for each of the three countries and is likely to have increased acceptance among both patients and healthcare providers

The Relationship Between N-myc Copy Number or Expression and Resistance to Therapy in Human Neuroblastoma Cell Lines

The copy number of the N-myc oncogene provides a prognostic index for neuroblastoma. The mechanism for this is not known, but may be related to cellular resistance to radiation or cytotoxic drugs. Seven human neuroblastoma cell lines were used to investigate the relationship between N-myc copy number or expression and sensitivity to ionising radiation and cisplatin. N-myc copy number was assessed by Southern blotting and hybridisation using the p-Nbl probe. The signal produced from DNA of the cell lines was compared with that of human placental DNA which has single copy N-myc (the normal copy number for diploid cells), A range of N-myc copy numbers from 1 - 800 was found. Expression levels of N-myc messenger RNA were compared by "dot-blotting" and subsequent hybridising to the p-Nbl probe. Radiosensitivity was investigated by irradiating multicellular tumour spheroids or cell monolayers using a 60Co source, (dose range 0.5 - 5 Gy). Survival curves were produced using both colony formation and spheroid regrowth delay as end points. The response to radiation was assessed by surviving fraction at 2 Gy (SF2); values ranged from 0.13 - 0.52. Sensitivity to cisplatin was indicated by comparison of isoeffective concentrations (concentration required to produce 1 log cell kill) from survival curves produced as above. These concentrations ranged from 7.5 - 13 muM. Cisplatin studies showed a border-line correlation between N-myc copy number (though not expression) and resistance to this drug. If this relationship is causal it may explain why treatment fails in those patients with elevated N-myc copy number. However, no correlation was found between N-myc copy number or expression and sensitivity to radiation. It is possible that N-myc amplification confers resistance to some, but not all, treatments used in the therapy of neuroblastoma. Further investigations along these lines may lead to the identification of agents which are most appropriate for the treatment of neuroblastoma with amplified N-myc gene

Youth participatory action research and school improvement: The missing voices of black youth in Montreal

The article discusses the implementation and results of a youth participatory action research (YPAR) project carried out with black high school students in 2009 and 2010 in Montreal, QC. The aim of the project was to involve black youth in studying the factors that either enhance or impede their success in school and thereby have them identify solutions that would be effective in reducing the high dropout rate of black students in Montreal. The participating students were 15 to 18 years of age, attended four high schools located across the city, and thus represented the cultural and linguistic diversity of Montreal’s black community. The results demonstrate that YPAR can lead to a deeper and fuller understanding of the factors that shape students’ experiences and performance in school than research that ignores the voices of young people. The study shows that black youth believe academic achievement is influenced by multiple and inter-related factors, including family, peers, school, and neighbourhood. The youth contend that high schools must do more to support black students by setting high expectations for success, maintaining positive teacher–student relations, integrating multicultural curricula such as courses on black history, promoting more innovative pedagogies in the classroom, expanding the range of extra-curricular activities, and working more closely with black community organizations.RésuméCet article présente les résultats d’un projet de recherche participative qui s’est tenu en 2009–2010 avec un groupe de jeunes élèves noirs fréquentant des écoles secondaires de Montréal (Québec). L’objectif du projet était d’impliquer des jeunes noirs dans un processus d’étude des facteurs pouvant encourager ou inhiber leur succès scolaire, et ainsi d’identifier avec eux des mesures pouvant réduire les taux de décrochage scolaire des étudiants noirs à Montréal. Les élèves recrutés pour ce projet étaient âgés de 15 à 18 ans et fréquentaient quatre écoles secondaires situées dans différents quartiers de l’île de Montréal, et ainsi représentaient bien la diversité culturelle et linguistique des communautés noires de Montréal. Les résultats démontrent que les recherches participatives impliquant des élèves peuvent mener à une compréhension plus riche et plus profonde des facteurs qui influencent les expériences et les performances scolaires des élèves que les études qui ne prennent pas en considération leurs considérations. Les résultats de notre étude démontrent que les jeunes noirs y ayant participé expliquent que la réussite scolaire est influencée par des facteurs multiples et interreliés, incluant la famille, les pairs, l’école, et la communauté environnante. Ces jeunes croient que les écoles devraient offrir plus de soutien aux étudiants noirs afin qu’ils et elles réussissent, avec des mesures telles un meilleur climat à l’école, des interrelations positives entre les étudiants et les enseignants, l’implantation d’un curriculum interculturel incluant des cours sur l’histoire des noirs, des approches pédagogiques variées et novatrices, un plus grand choix d’activités parascolaires, et des partenariats avec des organismes de la communauté noire

Red Noise in Anomalous X-ray Pulsar Timing Residuals

Anomalous X-ray Pulsars (AXPs), thought to be magnetars, exhibit poorly understood deviations from a simple spin-down called "timing noise". AXP timing noise has strong low-frequency components which pose significant challenges for quantification. We describe a procedure for extracting two quantities of interest, the intensity and power spectral index of timing noise. We apply this procedure to timing data from three sources: a monitoring campaign of five AXPs, observations of five young pulsars, and the stable rotator PSR B1937+21.Comment: submitted to the proceedings of the "40 Years of Pulsars" conferenc

Racial Politics and Social Policy in Urban Canada

The dissertation presents findings from a comparative study of urban policies the provincial governments of Quebec and Ontario introduced simultaneously, yet independently, in the year of 2006. Its central purpose is to resolve an unexpected paradox between the two cases. In 2006, the two provinces launched new policies in direct response to crises of urban violence that were steeped in racial stereotypes of deviant young black males. In defiance of its reputation for progressive social policy, Quebec embarked on a disciplinary strategy of law enforcement and detention. In Ontario, the government broke from the history of neo-liberal cuts and injected new funds into social provision for low-income youth. To answer the puzzle, the study combines data from interviews with respondents who participated in the policy process in each province and archival material. Findings show that the causes of the policy change were roughly the same across the two provinces, and reflected a convergence between exogenous pressures and the interests of political institutions. In each case, well-publicized incidents of gun violence became “focusing events” that created a window of opportunity for advocates to push through their preferred policy. In Quebec, those advocates were police chiefs, who lobbied successfully for a crime-fighting strategy against “street gangs.” In Ontario, black Liberal politicians and black community organizations in Toronto were instrumental in framing the policy agenda around the need to tackle poverty, inequality, and racial discrimination. To explain the source of these discrepancies, the dissertation develops an explanatory frame that centers on the interaction between political institutions and black political incorporation. It argues that the history of multiculturalism, decentralization, black political mobilization, and multi-racial coalitions in Toronto created the context for black political actors to be represented in the policy process in 2005. In Quebec, black political mobilization remains low due to sub-state nationalism, centralization, and a politics of culture and ethnic identity that overrides race. The dissertation further concludes that Ontario’s policy of youth development has been more conducive to solving problems of urban distress and racial inequality; in contrast, Quebec’s policy of “street gangs” has reinforced negative racial stereotypes of black youth and racial inequality

The role of technology in addressing health and social care needs and opportunities in a rural environment

People who live in rural areas do not have access to the health and personal care services that are available to the rest of the population. Some of their needs can be addressed using technology enabled services. The purpose of this paper is to describe the infrastructure requirements for successful implementation of technology enabled health and support services, and to consider the opportunities for using technology to satisfy the needs of people at each level of the Maslow Hierarchy. This involves the development of a more technology-related pyramid and a consideration of the requirements for a range of application examples for each level. It was found that applications relevant to physical and safety domains are mature, available and easy to implement. However, higher levels of need require people to have broadband or fast mobile access, as well as their own mobile computing devices such as a tablet or smartphone. These allow the use of apps that provide powerful ways of addressing needs. It is suggested that few existing technology services providers can offer a spectrum of applications that would be required by most end-users but that innovators will develop service delivery partnerships and utilize more generic support workers. Some pump priming may be necessary to ensure that service providers offer the required level of investment in training and equipment

No detectable radio emission from the magnetar-like pulsar in Kes 75

The rotation-powered pulsar PSR J1846-0258 in the supernova remnant Kes 75 was recently shown to have exhibited magnetar-like X-ray bursts in mid-2006. Radio emission has not yet been observed from this source, but other magnetar-like sources have exhibited transient radio emission following X-ray bursts. We report on a deep 1.9 GHz radio observation of PSR J1846-0258 with the 100-m Green Bank Telescope in late 2007 designed to search for radio pulsations or bursts from this target. We have also analyzed three shorter serendipitous 1.4 GHz radio observations of the source taken with the 64-m Parkes telescope during the 2006 bursting period. We detected no radio emission from PSR J1846-0258 in either the Green Bank or Parkes datasets. We place an upper limit of 4.9 \mu Jy on coherent pulsed emission from PSR J1846-0258 based on the 2007 November 2 observation, and an upper limit of 27 \mu Jy around the time of the X-ray bursts. Serendipitously, we observed radio pulses from the nearby RRAT J1846-02, and place a 3\sigma confidence level upper limit on its period derivative of 1.7 * 10^{-13}, implying its surface dipole magnetic field is less than 2.6 * 10^{13} G.Comment: 15 pages, 2 figures, submitted to Ap

Commercial weight loss diets meet nutrient requirements in free living adults over 8 weeks: A randomised controlled weight loss trial

Objective: To investigate the effect of commercial weight loss programmes on macronutrient composition and micronutrient adequacy over a 2 month period

GRADE-ADOLOPMENT process to develop 24-hour movement behavior recommendations and physical activity guidelines for the under 5s in the United Kingdom, 2019

Background: This article summarizes the approach taken to develop UK Chief Medical Officers' physical activity guidelines for the Under 5s, 2019. Methods: The Grading of Recommendations Assessment, Development and Evaluation (GRADE)- Adaptation, Adoption, De Novo Development (ADOLOPMENT) approach was used, based on the guidelines from Canada and Australia, with evidence updated to February 2018. Recommendations were based on the associations between (1) time spent in sleep, sedentary time, physical activity, and 10 health outcomes and (2) time spent in physical activity and sedentary behavior on sleep outcomes (duration and latency). Results: For many outcomes, more time spent in physical activity and sleep (up to a point) was beneficial, as was less time spent in sedentary behavior. The authors present, for the first time, evidence in GRADE format on behavior type-outcome associations for infants, toddlers, and preschoolers. Stakeholders supported all recommendations, but recommendations on sleep and screen time were not accepted by the Chief Medical Officers; UK guidelines will refer only to physical activity. Conclusions: This is the first European use of GRADE-ADOLOPMENT to develop physical activity guidelines. The process is robust, rapid, and inexpensive, but the UK experience illustrates a number of challenges that should help development of physical activity guidelines in future