Impact Evaluation of Integrated Extension Programs: Lessons Learned from the Community Gardening Program

Integrated programming is a coordinated Extension approach to address multi-faceted community issues. An integrated Extension approach is needed to address complex community issues in a meaningful way. Planning, implementation, and evaluation of an integrated program should be considered as a joint effort by the partnering Extension agents. This article describes how to document the impacts of integrated Extension program to reflect the coordinated effort of the Extension team. Documentation as well as sharing impacts with the partners is necessary to strengthen the collaboration and sustain the integrated Extension programming effort

Introduction to the Special Section: Suicide Risk Assessment and Intervention in School Counselor Training

This special section on school counselor preparation in assessing for crisis and suicide risk considers the impact of the perception of school counselor training and expertise related to suicide assessment and intervention. The collection of six articles focuses on considerations and best practices in assessing and intervening with PK-12 students experiencing suicidality, the unique considerations within a school setting, and corresponding implications for school counselor training

Bio-Hacking Better Health—Leveraging Metabolic Biochemistry to Maximise Healthspan

In the pursuit of longevity and healthspan, we are challenged with first overcoming chronic diseases of ageing: cardiovascular disease, hypertension, cancer, dementias, type 2 diabetes mellitus. These are hyperinsulinaemia diseases presented in different tissue types. Hyperinsulinaemia reduces endogenous antioxidants, via increased consumption and reduced synthesis. Hyperinsulinaemia enforces glucose fuelling, consuming 4 NAD+ to produce 2 acetyl moieties; beta-oxidation, ketolysis and acetoacetate consume 2, 1 and 0, respectively. This decreases sirtuin, PARPs and oxidative management capacity, leaving reactive oxygen species to diffuse to the cytosol, upregulating aerobic glycolysis, NF-kB and cell division signalling. Also, oxidising cardiolipin, reducing oxidative phosphorylation (OXPHOS) and apoptosis ability; driving a tumourigenic phenotype. Over time, increasing senescent/pathological cell populations occurs, increasing morbidity and mortality. Beta-hydroxybutyrate, an antioxidant, metabolite and signalling molecule, increases synthesis of antioxidants via preserving NAD+ availability and enhancing OXPHOS capacity. Fasting and ketogenic diets increase ketogenesis concurrently decreasing insulin secretion and demand; hyperinsulinaemia inhibits ketogenesis. Lifestyles that maintain lower insulin levels decrease antioxidant catabolism, additionally increasing their synthesis, improving oxidative stress management and mitochondrial function and, subsequently, producing healthier cells. This supports tissue and organ health, leading to a better healthspan, the first challenge that must be overcome in the pursuit of youthful longevity

Use of Demonstration Gardens in Extension: Challenges and Benefits

Extension agents\u27 use of demonstration gardens was studied to determine how gardens are employed in horticultural programming, perceived benefits and challenges of using gardens for Extension programming, and desired competencies. Gardens are primarily used to enhance educational efforts by providing hands-on learning experiences. Greatest perceived benefits of gardens were their effectiveness as an educational delivery method, as well as their ability to provide opportunities for meaningful volunteer service and facilitate the development of partnerships. Greatest perceived challenges were availability of time, money, and volunteer support. Findings support the use of gardens as an appropriate educational strategy for Extension programming

Design Matters in Community Gardens

With increased focus on local foods, food safety, nutrition, and physical health, community gardens are being created by a variety of entities, many of which are seeking assistance from Extension agents and specialists in the fields of horticulture, family consumer science, and 4-H. Extension professionals have expertise in nutrition, health, food safety, and food production, yet have little training in community garden design, which can provide the framework for successful gardens. Based on analysis of landscape elements of 10 professionally designed community gardens, recommendations were developed to help Extension professionals work with garden designers and volunteers

Socioeconomic inequalities in survival and provision of neonatal care: population based study of very preterm infants

Objectives To assess socioeconomic inequalities in survival and provision of neonatal care among very preterm infants

County Commissioner Perceptions of Cooperative Extension: Implications for Strengthening the Partnership with County Government

We undertook a study to determine county commissioner perceptions of Cooperative Extension. The majority of county commissioners had had prior involvement with Extension. Nearly 59% represented rural counties, and 94% indicated that agriculture is important to their county economies. Overall, the commissioners had a positive perception of Cooperative Extension, and their overall perception positively correlated with the significance of agriculture to the local economy. Our findings have implications for county-based Cooperative Extension professionals seeking to build all-important strong partnerships with county commissioners

Nature of socioeconomic inequalities in neonatal mortality: population based study

Objective To investigate time trends in socioeconomic inequalities in cause specific neonatal mortality in order to assess changing patterns in mortality due to different causes, particularly prematurity, and identify key areas of focus for future intervention strategies

Antibiotic resistance among clinical Ureaplasma Isolates Recovered from Neonates in England and Wales between 2007 and 2013

Ureaplasma spp. are associated with numerous clinical sequelae with treatment options being limited due to patient and pathogen factors. This report examines the prevalence and mechanisms of antibiotic resistance among clinical strains isolated from 95 neonates, 32 women attending a sexual health clinic, and 3 patients under investigation for immunological disorders, between 2007 and 2013 in England and Wales. MICs were determined by using broth microdilution assays, and a subset of isolates were compared using the broth microdilution method and the Mycoplasma IST2 assay. The underlying molecular mechanisms for resistance were determined for all resistant isolates. Three isolates carried the tet(M) tetracycline resistance gene (2.3%; confidence interval [CI], 0.49 to 6.86%); two isolates were ciprofloxacin resistant (1.5%; CI, 0.07 to 5.79%) but sensitive to levofloxacin and moxifloxacin, while no resistance was seen to any macrolides tested. The MIC values for chloramphenicol were universally low (2 μg/ml), while inherently high-level MIC values for gentamicin were seen (44 to 66 μg/ml). The Mycoplasma IST2 assay identified a number of false positives for ciprofloxacin resistance, as the method does not conform to international testing guidelines. While antibiotic resistance among Ureaplasma isolates remains low, continued surveillance is essential to monitor trends and threats from importation of resistant clones

Susceptible and Protective HLA Class 1 Alleles against Dengue Fever and Dengue Hemorrhagic Fever Patients in a Malaysian Population

BACKGROUND: The human leukocyte antigen alleles have been implicated as probable genetic markers in predicting the susceptibility and/or protection to severe manifestations of dengue virus (DENV) infection. In this present study, we aimed to investigate for the first time, the genotype variants of HLA Class 1(-A and -B) of DENV infected patients against healthy individuals in Malaysia. METHODOLOGY/PRINCIPAL FINDINGS: This study was carried out with 92 dengue disease patients and 95 healthy controls from three different ethnic groups (Malay, Chinese and Indian) in Malaysia. All patients with clinical and laboratory confirmation of DENV infection were typed for the HLA-A and B loci, using polymerase chain reaction-sequence specific primer techniques. In our total population, a significant increase for HLA-B*53 (P = 0.042, Pc = 1.008) allele and a significant decrease for A*03 (P = 0.015, Pc = 0.18, OR = 5.23, 95% CI = 1.19-23.02) and B*18 (P = 0.017, Pc = 0.408) alleles were noted in DHF patients as compared to healthy donors. We also observed that in the Malay DHF patients, allele B*13 (P = 0.049, Pc = 1.176, OR = 0.18, 95% CI = 0.03-0.90) was present at a significantly higher frequency in this population while allele HLA-B*18 (P = 0.024, Pc = 0.576) was seen to be negatively associated with DHF. CONCLUSIONS/SIGNIFICANCE: These are the first findings on genetic polymorphisms in our population and we conclude that: (1) In our total population, HLA-B*53 probably involve in disease susceptibility, while the HLA-A*03 and HLA-B*18 may confer protection from progression to severe disease; (2) In the Malay population, HLA-B*13 and B*18 are probably associated in disease susceptibility and protection, respectively. These results could furnish as a valuable predictive tool to identify ethnically different individuals at risk and/or protection from severe forms of DENV infection and would provide valuable informations for the design of future dengue vaccine