704 research outputs found
Employing community data to investigate social and structural dimensions of urban neighborhoods: An early childhood education example
The present study sought to define neighborhood context by examining relationships among data from city-level administrative databases at the level of the census block group. The present neighborhood investigation included 1,801 block groups comprising a large, northeastern metropolitan area. Common factor analyses and multistage, hierarchical cluster analyses yielded two dimensions (i.e., Social Stress, Structural Danger) and two typologies (i.e., Racial Composition, Property Structure Composition) of neighborhood context. Simultaneous multiple regression analyses revealed small but statistically significant associations between neighborhood variables and academic outcomes for public school kindergarten children
To what extent do Australian child and youth health policies address the social determinants of health and health equity?: a document analysis study
Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.Background
There is a significant body of evidence that highlights the importance of addressing the social determinants of child and youth health. In order to tackle health inequities Australian governments are being called upon to take action in this area at a policy level. Recent research suggests that the health and well-being of children and youth in Australia is ‘middle of the road’ when compared to other OECD countries. To date, there have been no systematic analyses of Australian child/youth health policies with a social determinants and health equity focus and this study aimed to contribute to addressing this gap.
Methods
Document analysis of seventeen strategic level child/youth health policies across Australia used an a priori coding framework specifically developed to assess the extent to which health departments address the social determinants of child/youth health and health equity. Policies were selected from a review of all federal and state/territory strategic health department policies dated between 2008 and 2013. They were included if the title of the policy addressed children, youth, paediatric health or families directly. We also included whole of government policies that addressed child/youth health issues and linked to the health department, and health promotion policies with a chapter or extensive section dedicated to children.
Results
Australian child/youth health policies address health inequities to some extent, with the best examples in Aboriginal or child protection policies, and whole of government policies. However, action on the social determinants of child/youth health was limited. Whilst all policies acknowledge the SDH, strategies were predominantly about improving health services delivery or access to health services. With some exceptions, the policies that appeared to address important SDH, such as early childhood development and healthy settings, often took a narrow view of the evidence and drifted back to focus on the individual.
Conclusions
This research highlights that policy action on the social determinants of child/youth health in Australia is limited and that a more balanced approach to reducing health inequities is needed, moving away from a dominant medical or behavioural approach, to address the structural determinants of child/youth health
A Proposed Classification of the Immunological Diseases
The formal recognition and genetic understanding of the autoinflammatory diseases has defined mechanisms of self-directed inflammation that are independent of adaptive immunity
PP2A inhibition overcomes acquired resistance to HER2 targeted therapy
Background: HER2 targeted therapies including trastuzumab and more recently lapatinib have significantly
improved the prognosis for HER2 positive breast cancer patients. However, resistance to these agents is a
significant clinical problem. Although several mechanisms have been proposed for resistance to trastuzumab, the
mechanisms of lapatinib resistance remain largely unknown. In this study we generated new models of acquired
resistance to HER2 targeted therapy and investigated mechanisms of resistance using phospho-proteomic profiling.
Results: Long-term continuous exposure of SKBR3 cells to low dose lapatinib established a cell line, SKBR3-L,
which is resistant to both lapatinib and trastuzumab. Phospho-proteomic profiling and immunoblotting revealed
significant alterations in phospho-proteins involved in key signaling pathways and molecular events. In particular,
phosphorylation of eukaryotic elongation factor 2 (eEF2), which inactivates eEF2, was significantly decreased in
SKBR3-L cells compared to the parental SKBR3 cells. SKBR3-L cells exhibited significantly increased activity of protein
phosphatase 2A (PP2A), a phosphatase that dephosphorylates eEF2. SKBR3-L cells showed increased sensitivity to
PP2A inhibition, with okadaic acid, compared to SKBR3 cells. PP2A inhibition significantly enhanced response to
lapatinib in both the SKBR3 and SKBR3-L cells. Furthermore, treatment of SKBR3 parental cells with the PP2A
activator, FTY720, decreased sensitivity to lapatinib. The alteration in eEF2 phosphorylation, PP2A activity and
sensitivity to okadaic acid were also observed in a second HER2 positive cell line model of acquired lapatinib
resistance, HCC1954-L.
Conclusions: Our data suggests that decreased eEF2 phosphorylation, mediated by increased PP2A activity,
contributes to resistance to HER2 inhibition and may provide novel targets for therapeutic intervention in HER2
positive breast cancer which is resistant to HER2 targeted therapies
Indigenous family violence : an attempt to understand the problems and inform appropriate and effective responses to criminal justice system intervention
Whilst high levels of concern about the prevalence of family violence within Indigenous communities have long been expressed, progress in the development of evidence-based intervention programs for known perpetrators has been slow. This review of the literature aims to provide a resource for practitioners who work in this area, and a framework from within which culturally specific violence prevention programs can be developed and delivered. It is suggested that effective responses to Indigenous family violence need to be informed by culturally informed models of violence, and that significant work is needed to develop interventions that successfully manage the risk of perpetrators of family violence committing further offences.<br /
Power, Process and Context in Theory Based Evaluation of Policy Implementation: A Response to Recent Commentaries
Developing a Framework for a Program Theory-Based Approach to Evaluating Policy Processes and Outcomes: Health in All Policies in South Australia
Abstract
Background: The importance of evaluating policy processes to achieve health equity is well recognised but such
evaluation encounters methodological, theoretical and political challenges. This paper describes how a program theorybased evaluation framework can be developed and tested, using the example of an evaluation of the South Australian
Health in All Policies (HiAP) initiative.
Methods: A framework of the theorised components and relationships of the HiAP initiative was produced to guide
evaluation. The framework was the product of a collaborative, iterative process underpinned by a policy-research
partnership and drew on social and political science theory and relevant policy literature.
Results: The process engaged key stakeholders to capture both HiAP specific and broader bureaucratic knowledge and
was informed by a number of social and political science theories. The framework provides a basis for exploring the
interactions between framework components and how they shape policy-making and public policy. It also enables an
assessment of HiAP’s success in integrating health and equity considerations in policies, thereby laying a foundation for
predicting the impacts of resulting policies.
Conclusion: The use of a program theory-based evaluation framework developed through a consultative process
and informed by social and political science theory has accommodated the complexity of public policy-making. The
framework allows for examination of HiAP processes and impacts, and for the tracking of contribution towards distal
outcomes through the explicit articulation of the underpinning program theory
Modification and preservation of environmental signals in speleothems
Speleothems are primarily studied in order to generate archives of climatic change and results have led to significant advances in identifying and dating major shifts in the climate system. However, the climatological meaning of many speleothem records cannot be interpreted unequivocally; this is particularly so for more subtle shifts and shorter time periods, but the use of multiple proxies and improving understanding of formation mechanisms offers a clear way forward. An explicit description of speleothem records as time series draws attention to the nature and importance of the signal filtering processes by which the weather, the seasons and longer-term climatic and other environmental fluctuations become encoded in speleothems. We distinguish five sources of variation that influence speleothem geochemistry: atmospheric, vegetation/soil, karstic aquifer, primary speleothem crystal growth and secondary alteration and give specific examples of their influence. The direct role of climate diminishes progressively through these five factors. \ud
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We identify and review a number of processes identified in recent and current work that bear significantly on the conventional interpretation of speleothem records, for example: \ud
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1) speleothem geochemistry can vary seasonally and hence a research need is to establish the proportion of growth attributable to different seasons and whether this varies over time. \ud
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2) whereas there has traditionally been a focus on monthly mean �´18O data of atmospheric moisture, current work emphasizes the importance of understanding the synoptic processes that lead to characteristic isotope signals, since changing relative abundance of different weather types might 1Corresponding author, fax +44(0)1214145528, E-mail: [email protected] control their variation on the longer-term. \ud
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3) the ecosystem and soil zone overlying the cave fundamentally imprint the carbon and trace element signals and can show characteristic variations with time. \ud
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4) new modelling on aquifer plumbing allows quantification of the effects of aquifer mixing. \ud
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5) recent work has emphasized the importance and seasonal variability of CO2-degassing leading to calcite precipitation upflow of a depositional site on carbon isotope and trace element composition of speleothems. \ud
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6) Although much is known about the chemical partitioning between water and stalagmites, variability in relation to crystal growth mechanisms and kinetics is a research frontier. \ud
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7) Aragonite is susceptible to conversion to calcite with major loss of chemical information, but the controls on the rate of this process are obscure. \ud
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Analytical factors are critical to generate high-resolution speleothem records. A variety of methods of trace element analysis are available, but standardization is a common problem with the most rapid methods. New stable isotope data on Irish stalagmite CC3 compares rapid laser-ablation techniques with the conventional analysis of micromilled powders and ion microprobe methods. A high degree of comparability between techniques for �´18O is found on the mm-cm scale, but a previously described high-amplitude oxygen isotope excursion around 8.3 ka is identified as an analytical artefact related to fractionation of the laser-analysis associated with sample cracking. High-frequency variability of not less than 0.5o/oo may be an inherent feature of speleothem �´18O records
Prior Mental Fatigue Impairs Marksmanship Decision Performance
Purpose: Mental fatigue has been shown to impair subsequent physical performance in
continuous and discontinuous exercise. However, its influence on subsequent fine-motor
performance in an applied setting (e.g., marksmanship for trained soldiers) is relatively unknown. The purpose of this study was to investigate whether prior mental fatigue
influences subsequent marksmanship performance as measured by shooting accuracy
and judgment of soldiers in a live-fire scenario.
Methods: Twenty trained infantry soldiers engaged targets after completing either a
mental fatigue or control intervention in a repeated measure design. Heart rate variability
and the NASA-TLX were used to gauge physiological and subjective effects of the
interventions. Target hit proportion, projectile group accuracy, and precision were used to measure marksmanship accuracy. Marksmanship accuracy was assessed by measuring
bullet group accuracy (i.e., how close a group of shots are relative to center of mass) and
bullet group precision (i.e., how close are each individual shot to each other). Additionally, marksmanship decision accuracy (correctly shooting vs. correctly withholding shot) when engaging targets was used to examine marksmanship performance.
Results: Soldiers rated the mentally fatiguing task (59.88 ± 23.7) as having greater mental workload relative to the control intervention [31.29 ± 12.3, t(19) = 1.72, p < 0.001]. Additionally, soldiers completing the mental fatigue intervention (96.04 ± = 37.1) also had lower time-domain (standard deviation of normal to normal R-R intervals) heart rate variability relative to the control [134.39 ± 47.4, t(18) = 3.59, p < 0.001]. Projectile group accuracy and group precision failed to show differences
between interventions [t(19) = 0.98, p = 0.34, t(19) = 0.18, p = 0.87, respectively].
Marksmanship decision errors significantly increased after soldiers completed the mental
fatigue intervention (48% ± 22.4) relative to the control intervention [M = 32% ± 79.9,
t(19) = 4.39, p < 0.001]. There was a significant negative correlation between shooting response time and errors of commission (r = −0.61; p = 0.004) when preceded by the
mental fatigue intervention, but not the control (r = −0.31; p = 0.17).
Conclusion: The mental fatigue intervention was successful in eliciting fatigue which
was supported subjectively and objectively. Marksmanship judgment performance is
significantly reduced when soldiers are mentally fatigued, although shot accuracy is not
An evaluation of the quality of evidence underpinning diabetes management models: a review of the literature
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