430 research outputs found

    A Region-Wide Field Placement Program Built on the Foundation of Mentorship and Professionalism

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    Background: The Region IV Public Health Training Center (R-IV PHTC) provides public health students from the eight states of HHS Region IV with essential practice experiences that demonstrate the value of working with underserved populations. The Pathways to Practice Scholars field placement program is built on a foundation of mentorship, professionalism, and community. Methods: Sixteen student scholars (13 graduate; 3 undergraduate) were selected to work during May-August 2015 in practiceoriented agencies serving underserved populations. Each scholar received a $1500 living allowance. Seven of 16 accepted an internship outside the state of their university. In conjunction with mentors, Scholars developed work plans based on Council on Linkages Core Competency domains. Requirements included a pre-, mid- and post-assessment, an executive summary/reflection, and a virtual webinar presentation. Results: Student Scholars worked at sites across eight states in state or local health departments, Area Health Education Centers (AHECs), and healthcare settings. Students identified Core Competency domains they developed most during the field placement: Communication, Analytical/Assessment, Leadership/Systems Thinking, and Community Engagement. The R-IV PHTC asked mentors to treat interns as valued employees and include them in activities beyond their specific project. Indicators of successful mentorship included expressed appreciation for student assistance and the desire to enrich the student experience while benefiting the agency mission. Mentors provided clearly defined projects for a short timeframe (10-12 weeks), adjusted to the students’ capacity and readiness, and offered opportunities to apply classroom skills to practice. They helped students develop immediately useful products in collaboration with community stakeholders. Conclusions: Mentors play a crucial role in the development and success of field placement students, but students and mentors share equal responsibility in fostering the relationship. Past case studies from this program demonstrate that some students find employment in these same agencies after graduation, and become mentors for future students, thus, creating a self-perpetuating learning community

    Meeting the Public Health Workforce’s Training Priorities in Georgia and the Southeast

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    Background: The mission of the Region IV Public Health Training Center (R-IV PHTC) is to build knowledge and skills in the public health workforce in the eight states of HHS Region IV by providing competency-based training. Workforce training needs are changing quickly and dramatically in light of new developments in public health practice and science, emerging diseases, changes in the health care environment, and the growing emphasis on inter-professional practice. Additionally, a 2014 survey conducted by the Association of State and Territorial Health Officials (ASTHO) found that at least 38% of the current public health workforce plans to retire by 2020. Therefore, it is increasingly crucial to prepare upcoming managers for leadership positions and to train entry-level workers to assume more advanced roles. Methods: To address current and emerging training needs in Georgia and the southeast, the R-IV PHTC continually identifies emerging priorities and effective training approaches. It explores training needs through a review of formal needs assessments, key stakeholder interviews, surveys of targeted audiences, informal partner communications, and training evaluation data. An interactive component of the GPHA session allowed participants to identify and discuss their own professional training needs. Results: Workforce development needs assessments data across several southeastern states identified recurring training needs for professionals in Tiers 1, 2 and 3 of the Council on Linkages Core Competency domains for Analytical/Assessment Skills and Financial Planning/Management. In Georgia, top competency training needs gathered from a variety of assessment methods included Cultural Competency, Communication, Financial Planning/Management, Public Health Science, and Leadership/Systems Thinking. Participants in the workshop’s interactive component expressed highest personal need for training in Financial Planning/Management, Analytical/Assessment Skills, and Policy Development/Program Planning. However, for others in their organizations, they identified a priority need for leadership training. Conclusions: The R-IV PHTC assesses training needs and provides training resources to respond to current and emerging public health workforce development needs in Georgia and the southeast

    Enhancing the Future Public Health Workforce Through Competency-Based Student Field Placements

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    Background: The Public Health Workforce Interest and Needs (PHWINS) 2014 survey from ASTHO (Association of State and Territorial Health Officials) demonstrated a dramatic need for succession planning and retention of the future public health workforce. To address this need, the Region IV Public Health Training Center’s (R-IV PHTC) Pathways to Practice Scholars Program places students from accredited schools and programs of public health into practical field placement positions across eight states. Skill- and competency-based student field placements reinforce the value of working with medically underserved areas/populations (MUA/Ps) through public health agencies. Field placements use adult learning theory through experiential learning to build essential skills from the Council on Linkage (COL) core competencies. Methods: Host agencies include state and local health departments, Area Health Education Centers, primary care settings, and community organizations in one of eight southeastern states serving MUA/Ps. Agencies propose practical projects using COL domains. Proposals are converted to job postings. Once an agency selects a student, the team collaboratively develops a detailed work plan using specific COL competencies. Results: A brief overview of evaluation findings will be shared but are not the focus of this workshop. Evaluation instruments included a pre-survey, work plan, mid-term survey, final evaluation, and alumni survey. Students submit a final report, reflection summary, webinar presentation and/or abstract worthy of submission to a professional conference. Findings demonstrated increases in students’ perceived ability to perform core competencies and future plans to work in MUA/Ps. Conclusions: This program builds leadership and real-world experience in the future workforce while serving immediate needs of public health agencies. The workshop focuses on interactive discussion about processes and tools to create COL competencybased field placement position descriptions and detailed work plans. Participants can engage in dialogue about developing student positions which enhance their work while training the future workforce

    Promoting Policy and Environmental Change in Faith-Based Organizations: Organizational Level Findings From a Mini Grants Program

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    Background: High rates of heart disease, cancer, and stroke exist in rural South Georgia, where Emory’s Cancer Prevention and Control Research Network provided mini-grants and technical assistance to six faith-based organizations to implement policy and environmental changes to promote healthy eating (HE), physical activity (PA), and tobacco use prevention (TUP). Drawing from a Social Ecological Framework, we hypothesized that church members would perceive an increase in messages, programs, and the availability of facilities to support HE, PA, and TUP over a 1-year period. Methods: Members (N=258) completed self-administered questionnaires that assessed perceptions of the existing church health promotion environment relative to HE, PA, and TUP policies, as well as their eating behavior and intention to use PA facilities at church at baseline and 1-year follow-up. Results:Members at three of the six churches perceived increases in delivery of HE messages via sermons, church bulletins, and food labels, and increased availability of programs that support HE (p Conclusions: Community mini-grants may be a viable mechanism for promoting environmental change supporting HE, PA, and TUP policies in church environments

    Forest fire history in Amazonia inferred from intensive soil charcoal sampling and radiocarbon dating

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    This study was supported by funding from the UK Natural Environment Research Council (NERC, NE/N011570/1 and NE/R017980/1) and a radiocarbon dating allocation (allocation 2122.0818) from the NERC-funded NEIF Radiocarbon Laboratory.Fire has a historical role in tropical forests related to past climate and ancient land use spanning the Holocene; however, it is unclear from charcoal records how fire varied at different spatiotemporal scales and what sampling strategies are required to determine fire history and their effects. We evaluated fire variation in structurally intact, terra-firme Amazon forests, by intensive soil charcoal sampling from three replicate soil pits in sites in Guyana and northern and southern Peru. We used radiocarbon (14C) measurement to assess (1) locally, how the timing of fires represented in our sample varied across the surface of forest plots and with soil depth, (2) basin-wide, how the age of fires varies across climate and environmental gradients, and (3) how many samples are appropriate when applying the 14C approach to assess the date of last fire. Considering all 14C dates (n = 33), the most recent fires occurred at a similar time at each of the three sites (median ages: 728–851 cal years BP), indicating that in terms of fire disturbance at least, these forests could be considered old-growth. The number of unique fire events ranged from 1 to 4 per pit and from 4 to 6 per site. Based upon our sampling strategy, the N-Peru site—with the highest annual precipitation—had the most fire events. Median fire return intervals varied from 455 to 2,950 cal years BP among sites. Based on available dates, at least three samples (1 from the top of each of 3 pits) are required for the sampling to have a reasonable likelihood of capturing the most recent fire for forests with no history of a recent fire. The maximum fire return interval for two sites was shorter than the time since the last fire, suggesting that over the past ∼800 years these forests have undergone a longer fire-free period than the past 2,000–3,500 years. Our analysis from terra-firme forest soils helps to improve understanding of changes in fire regime, information necessary to evaluate post-fire legacies on modern vegetation and soil and to calibrate models to predict forest response to fire under climate change.Publisher PDFPeer reviewe

    Normative spatiotemporal fetal brain maturation with satisfactory development at 2 years

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    Maturation of the human fetal brain should follow precisely scheduled structural growth and folding of the cerebral cortex for optimal postnatal function1 . We present a normative digital atlas of fetal brain maturation based on a prospective international cohort of healthy pregnant women2 , selected using World Health Organization recommendations for growth standards3 . Their fetuses were accurately dated in the first trimester, with satisfactory growth and neurodevelopment from early pregnancy to 2 years of age4,5 . The atlas was produced using 1,059 optimal quality, three dimensional ultrasound brain volumes from 899 of the fetuses and an automated analysis pipeline6–8 . The atlas corresponds structurally to published magnetic resonance images9 , but with finer anatomical details in deep grey matter. The between study site variability represented less than 8.0% of the total variance of all brain measures, supporting pooling data from the eight study sites to produce patterns of normative maturation. We have thereby generated an average representation of each cerebral hemisphere between 14 and 31 weeks’ gestation with quantification of intracranial volume variability and growth patterns. Emergent asymmetries were detectable from as early as 14 weeks, with peak asymmetries in regions associated with language development and functional lateralization between 20 and 26 weeks’ gestation. These patterns were validated in 1,487 three-dimensional brain volumes from 1,295 different fetuses in the same cohort. We provide a unique spatiotemporal benchmark of fetal brain maturation from a large cohort with normative postnatal growth and neurodevelopment

    EACVI survey on investigations and imaging modalities in chronic coronary syndromes

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    AIMS The European Association of Cardiovascular Imaging (EACVI) Scientific Initiatives Committee performed a global survey to evaluate current practice for the assessment and management of patients with suspected and confirmed chronic coronary syndromes. METHODS AND RESULTS One-hundred and ten imaging centres from 37 countries across the world responded to the survey. Most non-invasive investigations for coronary artery disease were widely available, except cardiovascular magnetic resonance (available 40% centres). Coronary computed tomography angiography (CCTA) and nuclear scans were reported by a multi-disciplinary team in only a quarter of centres. In the initial assessment of patients presenting with chest pain, only 32% of respondents indicated that they rely on pre-test probability for selecting the optimal imaging test while 31% proceed directly to CCTA. In patients with established coronary artery disease and recurrent chest pain, respondents opted for stress echocardiography (27%) and nuclear stress perfusion scans (26%). In asymptomatic patients with coronary artery disease and an obstructive (>70%) right coronary artery stenosis, 58% of respondents were happy to pursue medical therapy without further testing or intervention. This proportion fell to 29% with left anterior descending artery stenosis and 1% with left main stem obstruction. In asymptomatic patients with evidence of moderate-to-severe myocardial ischaemia (15%), only 18% of respondents would continue medical therapy without further investigation. CONCLUSION Despite guidelines recommendations pre-test probability is used to assess patients with suspected coronary artery in a minority of centres, one-third of centres moving directly to CCTA. Clinicians remain reticent to pursue a strategy of optimal medical therapy without further investigation or intervention in patients with controlled symptoms but obstructive coronary artery stenoses or myocardial ischaemia

    Women Are More Susceptible to Caries but Individuals Born with Clefts Are Not

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    The identification of individuals at a higher risk of developing caries is of great interest. Isolated forms of cleft lip and palate are among the most common craniofacial congenital anomalies in humans. Historically, several reports suggest that individuals born with clefts have a higher risk for caries. Caries continues to be the most common infectious noncontagious disease worldwide and a great burden to any health system. The identification of individuals of higher susceptibility to caries is of great interest. In this paper, we assessed caries experience of 1,593 individuals from three distinct populations. The study included individuals born with clefts, their unaffected relatives, and unrelated unaffected controls that were recruited from areas with similar cultural pressures and limited access to dental care. DMFT/dmft scores were obtained, and caries experience rates were compared among the three groups in each geographic area. Individuals born with clefts did not present higher caries experience in comparison to their unaffected relatives or unrelated unaffected controls. Women tend to present higher caries rates in comparison to men. Our work provides strong evidence that individuals born with clefts are not at higher risk to caries; however, women tend to have more severe caries experience

    Women are more susceptible to caries but individuals born with clefts are not

    Get PDF
    The identification of individuals at a higher risk of developing caries is of great interest. Isolated forms of cleft lip and palate are among the most common craniofacial congenital anomalies in humans. Historically, several reports suggest that individuals born with clefts have a higher risk for caries. Caries continues to be the most common infectious noncontagious disease worldwide and a great burden to any health system. The identification of individuals of higher susceptibility to caries is of great interest. In this paper, we assessed caries experience of 1,593 individuals from three distinct populations. The study included individuals born with clefts, their unaffected relatives, and unrelated unaffected controls that were recruited from areas with similar cultural pressures and limited access to dental care. DMFT/dmft scores were obtained, and caries experience rates were compared among the three groups in each geographic area. Individuals born with clefts did not present higher caries experience in comparison to their unaffected relatives or unrelated unaffected controls. Women tend to present higher caries rates in comparison to men. Our work provides strong evidence that individuals born with clefts are not at higher risk to caries; however, women tend to have more severe caries experience.Instituto Multidisciplinario de Biología Celula
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