Race and “Hotspots” of Preventable Hospitalizations

Abstract Preventable hospitalizations (PHs) are those for ambulatory care-sensitive conditions that indicate insufficiencies in local primary healthcare. PH rates tend to be higher among African Americans, in urban centers, rural areas and areas with more African American residents. The objective of this study is to determine geographic clusters of high PH rates (“spatial clusters”) by race. Data from Maryland hospitals were utilized to determine the rates of PHs in zip code tabulation areas (ZCTAs) by race in 2010. Geographic clusters of ZCTAs with higher than expected PH rates were identified using Scan Statistic and Anselin’s Local Moran’s I. 10 PH spatial clusters were observed among the total population with an average PH rate of 3,046.6 per 100,000 population. Among whites, the average PH rate was 3,339.9 per 100,000 in 11 PH spatial clusters. Only five PH spatial clusters were observed among African Americans with a higher average PH rate (3,710.8 per 100,000). The locations and other characteristics of PH spatial clusters differed by race. These results can be used to target resources to areas with high PH rates. Because PH spatial clusters are observed in differing locations for African Americans, approaches that include cultural tailoring may need to be specifically targeted

Analytical Intercomparison Between Flow Injection-Chemiluminescence and Flow Injection-Spectrophotometry for the Determination of Picomolar Concentrations of Iron in Seawater

A lab- and ship-based analytical intercomparison of two flow injection methods for the determination of iron in seawater was conducted, using three different sets of seawater samples collected from the Southern Ocean and South Atlantic. In one exercise, iron was determined in three different size-fractions (\u3c 0.03 &μm, \u3c 0.4 μm, and unfiltered) in an effort to better characterize the operational nature of each analytical technique with respect to filter size. Measured Fe concentrations were in the range 0.19 to 1.19 nM using flow injection with luminol chemiluminescence detection (FI-CL), and 0.07 to 1.54 nM using flow injection with catalytic spectrophotometric detection with N, N-dimethyl-p-phenylenediamine dihydrochloride (FI-DPD). The arithmetic mean for the FI-CL method was higher (by 0.09 nM) than the FI-DPD method for dissolved (\u3c 0.4 μm) Fe, a difference that is comparable to the analytical blanks, which were as high as 0.13 nM ( CL) and 0.09 nM (DPD). There was generally good agreement between the FI-CL determinations for the \u3c 0.03 μm size fraction and the FI-DPD determinations for the \u3c 0.4 μm size fraction in freshly collected samples. Differences in total-dissolvable ( unfiltered) Fe concentrations determined by the two FI methods were more variable, reflecting the added complexity associated with the analysis of partially digested particulate material in these samples. Overall, however, the FI-CL determinations were significantly (P = 0.05) lower than the FI-DPD determinations for the unfiltered samples. Our results suggest that the observed, systematic inter-method differences reflect measurement of different physicochemical fractions of Fe present in seawater, such that colloidal and/or organic iron species are better determined by the FI-CL method than the FI-DPD method. This idea is supported by our observation that inter-method differences were largest for freshly collected acidified seawater, which suggests extended storage (\u3e6 months) of acidified samples as a possible protocol for the determination of dissolved iron in seawater

Bringing languages to life: a longitudinal study of the development of creative practice in student teachers of modern languages

Hulse, B. (2017). Bringing languages to life: a longitudinal study of the development of creative practice in student teachers of modern languages. Power and Education, 10(1), 25-29. https://doi.org/10.1177/1757743817748664 Copyright © 2018 SAGE. Reprinted by permission of SAGE Publications.This article reports the findings of a longitudinal study exploring the process of learning to teach modern languages in the changing landscape of teacher education. It employs a postmodern critical ethnographic methodology to examine the experiences of a group of student teachers over the course of a one-year postgraduate teacher education programme in England. The focus is on how experiences in university and in school encourage or discourage the development of creativity. The schools inspectorate, Ofsted, is critical of lifeless teaching which fails to inspire young people to learn languages. However, the pressures of ‘performative’ requirements act as a discouragement to creativity. The data indicates that whilst student teachers express a desire to be more creative, they find it difficult to implement their ideas in school. A post-structuralist analysis of Marx’s theory of alienation is employed to argue that the early formation of professional identity is a process of acquiescence to oppressive external structures over which individuals have no control. The study concludes that it is possible to create spaces where the temporary suspension of alienation can allow individuals to put life back into language learning

Nexus researching church toddler groups

The Headlines This unique research project revealed fascinating insights into the spiritual flourishing of very young children and how this is nourished within church toddler groups in England. The findings have uncovered evidence of very young children exploring self-understanding and the nurturing of relationships with others. We found that church toddler groups contribute to children’s spiritual flourishing through: • Providing an environment that fosters a non-threatening connection with spirituality and faith. • Nurturing and sustaining relationships with families. • Offering a safe place for young families to come together, play together, and feel supported in their spiritual well-being. • Enabling a sense of belonging to the church community through engagement in the church toddler group. However, we also found that: • There is a need for adults to have a deeper awareness of the significant role they play in enabling the spiritual flourishing of very young children. • A common misunderstanding of spiritual nurture in terms of faith development hampers focused attention on the spiritual nurture of very young children

Characterization of the SAM domain of the PKD-related protein ANKS6 and its interaction with ANKS3

Background: Autosomal dominant polycystic kidney disease (ADPKD) is the most common genetic disorder leading to end-stage renal failure in humans. In the PKD/Mhm(cy/+) rat model of ADPKD, the point mutation R823W in the sterile alpha motif (SAM) domain of the protein ANKS6 is responsible for disease. SAM domains are known protein-protein interaction domains, capable of binding each other to form polymers and heterodimers. Despite its physiological importance, little is known about the function of ANKS6 and how the R823W point mutation leads to PKD. Recent work has revealed that ANKS6 interacts with a related protein called ANKS3. Both ANKS6 and ANKS3 have a similar domain structure, with ankyrin repeats at the N-terminus and a SAM domain at the C-terminus. Results: The SAM domain of ANKS3 is identified as a direct binding partner of the ANKS6 SAM domain. We find that ANKS3-SAM polymerizes and ANKS6-SAM can bind to one end of the polymer. We present crystal structures of both the ANKS3-SAM polymer and the ANKS3-SAM/ANKS6-SAM complex, revealing the molecular details of their association. We also learn how the R823W mutation disrupts ANKS6 function by dramatically destabilizing the SAM domain such that the interaction with ANKS3-SAM is lost. Conclusions: ANKS3 is a direct interacting partner of ANKS6. By structurally and biochemically characterizing the interaction between the ANKS3 and ANKS6 SAM domains, our work provides a basis for future investigation of how the interaction between these proteins mediates kidney function

Elasticity Theory Connection Rules for Epitaxial Interfaces

Elasticity theory provides an accurate description of the long-wavelength vibrational dynamics of homogeneous crystalline solids, and with supplemental boundary conditions on the displacement field can also be applied to abrupt heterojunctions and interfaces. The conventional interface boundary conditions, or connection rules, require that the displacement field and its associated stress field be continuous through the interface. We argue, however, that these boundary conditions are generally incorrect for epitaxial interfaces, and we give the general procedure for deriving the correct conditions, which depend essentially on the detailed microscopic structure of the interface. As a simple application of our theory we analyze in detail a one-dimensional model of an inhomogeneous crystal, a chain of harmonic oscillators with an abrupt change in mass and spring stiffness parameters. Our results have implications for phonon dynamics in nanostructures such as superlattices and nanoparticles, as well as for the thermal boundary resistance at epitaxial interfaces.Comment: 7 pages, Revte

Concentrations of dissolved iron and dissolved iron(II) from R/V Knorr cruises KN199-04 and KN204-01 in the Subtropical northern Atlantic Ocean from 2010-2011 (U.S. GEOTRACES NAT project)

Dataset: GT10-11 - dFe and dFe-IIThis dataset includes concentrations of dissolved iron and dissolved iron(II) from R/V Knorr cruises KN199-04 and KN204-01 in the Subtropical northern Atlantic Ocean from 2010-2011 (U.S. GEOTRACES NAT project). For a complete list of measurements, refer to the full dataset description in the supplemental file 'Dataset_description.pdf'. The most current version of this dataset is available at: https://www.bco-dmo.org/dataset/3826NSF Division of Ocean Sciences (NSF OCE) OCE-092728

Designability of lattice model heteropolymers

Protein folds are highly designable, in the sense that many sequences fold to the same conformation. In the present work we derive an expression for the designability in a 20 letter lattice model of proteins which, relying only on the Central Limit Theorem, has a generality which goes beyond the simple model used in its derivation. This expression displays an exponential dependence on the energy of the optimal sequence folding on the given conformation measured with respect to the lowest energy of the conformational dissimilar structures, energy difference which constitutes the only parameter controlling designability. Accordingly, the designability of a native conformation is intimately connected to the stability of the sequences folding to them.Comment: in press on Phys. Rev.

Religious Coping and Types and Sources of Information Used in Making Prostate Cancer Treatment Decisions.

Treatment experiences for prostate cancer survivors can be challenging and dependent on many clinical and psychosocial factors. One area that is less understood is the information needs and sources men utilize. Among these is the influence of religion as a valid typology and the value it may have on treatment decisions. The objective of this study was to assess the relationship between race, religion, and cancer treatment decisions in African American men compared with White men. Data were from the Diagnosis and Decisions in Prostate Cancer Treatment Outcomes Study that consisted of 877 African American and White men. The main dependent variables sought respondents’ use of resources or advisors when making treatment decisions. Questions also assessed men perceptions of prostate cancer from the perspective of religious coping. After adjusting for age, marital status, education, and insurance status, race differences in the number of sources utilized were partially mediated by cancer was a punishment from God (β = −0.46, SE = 0.012, p \u3c .001), cancer was a test of faith (β = −0.49, SE = 0.013, p \u3c .001), and cancer can be cured with enough prayer (β = −0.47, SE = 0.013, p \u3c .001). Similarly, race differences in the number of advisors utilized in making the treatment decision were partially mediated by cancer was a punishment from God (β = −0.39, SE = 0.014, p = .006), and cancer was a test of faith (β = −0.39, SE = 0.014, p = .006). Religious views on prostate cancer may play an important role in explaining race differences in information used and the number of advisors utilized for treatment decision making for prostate cancer

Barriers and attitudes influencing non-engagement in a peer feedback model to inform evidence for GP appraisal

<p>Abstract</p> <p>Background</p> <p>The UK general practitioner (GP) appraisal system is deemed to be an inadequate source of performance evidence to inform a future medical revalidation process. A long-running voluntary model of external peer review in the west of Scotland provides feedback by trained peers on the standard of GP colleagues' core appraisal activities and may 'add value' in strengthening the robustness of the current system in support of revalidation. A significant minority of GPs has participated in the peer feedback model, but a clear majority has yet to engage with it. We aimed to explore the views of non-participants to identify barriers to engagement and attitudes to external peer review as a means to inform the current appraisal system.</p> <p>Methods</p> <p>We conducted semi-structured interviews with a sample of west of Scotland GPs who had yet to participate in the peer review model. A thematic analysis of the interview transcriptions was conducted using a constant comparative approach.</p> <p>Results</p> <p>13 GPs were interviewed of whom nine were males. Four core themes were identified in relation to the perceived and experienced 'value' placed on the topics discussed and their relevance to routine clinical practice and professional appraisal: 1. Value of the appraisal improvement activity. 2. Value of external peer review. 3. Value of the external peer review model and host organisation and 4. Attitudes to external peer review.</p> <p>Conclusions</p> <p>GPs in this study questioned the 'value' of participation in the external peer review model and the national appraisal system over the standard of internal feedback received from immediate work colleagues. There was a limited understanding of the concept, context and purpose of external peer review and some distrust of the host educational provider. Future engagement with the model by these GPs is likely to be influenced by policy to improve the standard of appraisal and contractual related activities, rather than a self-directed recognition of learning needs.</p