Girls’ Motivation, Participation And Preference For Visual Arts Subjects In Four Senior High Schools In Central Region, Ghana

The study sought to examine girls’ motivation for and subject preferences on the Senior High School Visual Arts programme in Ghana. Using findings based on the multi-site case study research method with direct observation and interviews, the study found that 54% of 300 girls in four schools in the Central Region made personal decisions to study Visual Arts while 34% were coerced into the programme by school Heads; only 12% were inspired or persuaded. Textiles emerged the most preferred elective subject because it involves “girl-friendly” skills and offers “female-appropriate” occupations. The Textiles-with-Graphic Design elective combination facilitates access into the fashion industry but many girls shun Picture-Making because girls generally lack the level of drawing skills required; Ceramics is “girl-friendly” except that clay easily dirties their clothes. Sculpture is the least preferred elective because it demands much energy and effort, involves using sharp tools and working of heavy materials; it is therefore an “inappropriate” subject for girls. This apparent discriminatory attitude towards some Visual Arts subjects impacts negatively on girls’ academic achievement on the programme and undermines gender equality in learning, educational and career development. Effective delivery of the Visual Arts curriculum and counselling could encourage more girls to participate fully in the programme

Interstate Variation in the Burden of Fragility Fractures

Demographic differences may produce interstate variation in the burden of osteoporosis. We estimated the burden of fragility fractures by race/ethnicity, age, sex, and service site across five diverse and populous states. State inpatient databases for 2000 were used to describe hospital fracture admissions, and a Markov decision model was used to estimate annual fracture incidence and cost for populations ≥50 yr of age for 2005–2025 in Arizona (AZ), California (CA), Florida (FL), Massachusetts (MA), and New York (NY). In 2000, mean hospital charges for incident fractures varied 1.7-fold across states. For hip fracture, mean charges ranged from $16,700 (MA) to$29,500 (CA), length of stay from 5.3 (AZ) to 8.9 days (NY), and discharge rate to long-term care from 43% (NY) to 71% (CA). In 2005, projected fracture incidence rates ranged from 199 (CA) to 266 (MA) per 10,000. Total cost ranged from $270 million (AZ) to$1,434 million (CA). Men accounted for 26–30% of costs. Across states, hip fractures constituted on average 77% of costs; “other” fractures (e.g., leg, arm), 10%; pelvic, 6%; vertebral, 5%; and wrist, 2%. By 2025, Hispanics are projected to represent 20% of fractures in AZ and CA and Asian/Other populations to represent 27% of fractures in NY. In conclusion, state initiatives to prevent fractures should include nonwhite populations and men, as well as white women, and should address fractures at all skeletal sites. Interstate variation in service utilization merits further evaluation to determine efficient and effective disease management strategies

An Optimization Approach to the Ordering Phase of an Attended Home Delivery Service

Attended Home Delivery (AHD) systems are used whenever a supplying company offers online shopping services that require that customers must be present when their deliveries arrive. Therefore, the supplying company and the customer must both agree on a time window, which ideally is rather short, during which delivery is guaranteed. Typically, a capacitated Vehicle Routing Problem with Time Windows forms the underlying optimization problem of the AHD system. In this work, we consider an AHD system that runs the online grocery shopping service of an international grocery retailer. The ordering phase, during which customers place their orders through the web service, is the computationally most challenging part of the AHD system. The delivery schedule must be built dynamically as new orders are placed. We propose a solution approach that allows to (non-stochastically) determine which delivery time windows can be offered to potential customers. We split the computations of the ordering phase into four key steps. For performing these basic steps we suggest both a heuristic approach and a hybrid approach employing mixed-integer linear programs. In an experimental evaluation we demonstrate the efficiency of our approaches

Elevated Ratio of Urinary Metabolites of Thromboxane and Prostacyclin Is Associated with Adverse Cardiovascular Events in ADAPT

Results from prevention trials, including the Alzheimer's Disease Anti-inflammatory Prevention Trial (ADAPT), have fueled discussion about the cardiovascular (CV) risks associated with non-steroidal anti-inflammatory drugs (NSAIDs). We tested the hypotheses that (i) adverse CV events reported among ADAPT participants (aged 70 years and older) are associated with increased ratio of urine 11-dehydrothromboxane B2 (Tx-M) to 2′3-donor–6-keto-PGF1 (PGI-M) attributable to NSAID treatments; (ii) coincident use of aspirin (ASA) would attenuate NSAID-induced changes in Tx-M/PGI-M ratio; and (iii) use of NSAIDs and/or ASA would not alter urine or plasma concentrations of F2-isoprostanes (IsoPs), in vivo biomarkers of free radical damage. We quantified urine Tx-M and PGI-M, and urine and plasma F2-IsoPs from 315 ADAPT participants using stable isotope dilution assays with gas chromatography/mass spectrometry, and analyzed these data by randomized drug assignment and self-report compliance as well as ASA use. Adverse CV events were significantly associated with higher urine Tx-M/PGI-M ratio, which seemed to derive mainly from lowered PGI-M. Participants taking ASA alone had reduced urine Tx-M/PGI-M compared to no ASA or NSAID; however, participants taking NSAIDs plus ASA did not have reduced urine Tx-M/PGI-M ratio compared to NSAIDs alone. Neither NSAID nor ASA use altered plasma or urine F2-IsoPs. These data suggest a possible mechanism for the increased risk of CV events reported in ADAPT participants assigned to NSAIDs, and suggest that the changes in the Tx-M/PGI-M ratio was not substantively mitigated by coincident use of ASA in individuals 70 years or older

Recent global-warming hiatus tied to equatorial Pacific surface cooling

Despite the continued increase of atmospheric greenhouse gases, the annual-mean global temperature has not risen in this century, challenging the prevailing view that anthropogenic forcing causes climate warming. Various mechanisms have been proposed for this hiatus of global warming, but their relative importance has not been quantified, hampering observational estimates of climate sensitivity. Here we show that accounting for recent cooling in the eastern equatorial Pacific reconciles climate simulations and observations. We present a novel method to unravel mechanisms for global temperature change by prescribing the observed history of sea surface temperature over the deep tropical Pacific in a climate model, in addition to radiative forcing. Although the surface temperature prescription is limited to only 8.2% of the global surface, our model reproduces the annual-mean global temperature remarkably well with r = 0.97 for 1970-2012 (a period including the current hiatus and an accelerated global warming). Moreover, our simulation captures major seasonal and regional characteristics of the hiatus, including the intensified Walker circulation, the winter cooling in northwestern and prolonged drought in southern North America. Our results show that the current hiatus is part of natural climate variability, tied specifically to a La Niña-like decadal cooling. While similar decadal hiatus events may occur in the future, multi-decadal warming trend is very likely to continue with greenhouse gas increase

Governance, Decentralization and Co-Management: Lessons From Africa

Today, decentralization and democratic participation are presented as necessary conditions to achieve poverty alleviation and ensure the sustainable use of our diminishing natural resources. In small-scale fisheries, similar ideas predominate and decentralization has become the new management paradigm through the concepts of community-based and co-management. In this paper, we present the conclusions of a series of governance analyses recently completed in five African countries (Cameroon, Niger, Nigeria, Malawi, and Zambia). Relying on a new analytical framework which emphasizes the different nature of governance reforms and reflects in particular the distinction between deconcentration, devolution and decentralization, these governance analyses propose to assess the various co-management programmes implemented in these countries. From these reviews, it appears that the (mainly-donor funded and often top-down) fisheries governance reforms implemented in Africa have been successful in challenging the previous (centralized) governance system. However, the reviews also suggest that, contrary to their intent of empowering primary resource users, the inabilities of local governments, deconcentrated agencies and fisherfolk to take up their newfound mandates has frequently resulted in the division of influence among local power brokers and in the instrumentalization of the co-management process. From a conceptual point of view, the analysis highlights the limits of the conventional approach to co-management and questions in particular the view that participation is the key-element to ensure successful decentralization. Instead, the document highlights the crucial importance of downward accountability as the main ‘driving belt’ ensuring an efficient representativity of the local communities, and underscores the importance of recognising the political economy dimension of co-management

Synergistic tumor suppression by combined inhibition of telomerase and CDKN1A

Tumor suppressor p53 plays an important role in mediating growth inhibition upon telomere dysfunction. Here, we show that loss of the p53 target gene cyclin-dependent kinase inhibitor 1A (CDKN1A, also known as p21WAF1/CIP1) increases apoptosis induction following telomerase inhibition in a variety of cancer cell lines and mouse xenografts. This effect is highly specific to p21, as loss of other checkpoint proteins and CDK inhibitors did not affect apoptosis. In telomerase, inhibited cell loss of p21 leads to E2F1- and p53-mediated transcriptional activation of p53-upregulated modulator of apoptosis, resulting in increased apoptosis. Combined genetic or pharmacological inhibition of telomerase and p21 synergistically suppresses tumor growth. Furthermore, we demonstrate that simultaneous inhibition of telomerase and p21 also suppresses growth of tumors containing mutant p53 following pharmacological restoration of p53 activity. Collectively, our results establish that inactivation of p21 leads to increased apoptosis upon telomerase inhibition and thus identify a genetic vulnerability that can be exploited to treat many human cancers containing either wild-type or mutant p53

Improving community ambulation after stroke: the AMBULATE trial

<p>Abstract</p> <p>Background</p> <p>It has been reported that following rehabilitation, only 7% of stroke survivors are able to walk at a level commensurate with community participation. Previous research indicates that treadmill and overground walking training can improve walking capacity in people living in the community after stroke. The main objectives of the AMBULATE trial are to determine (i) whether a 4-month treadmill walking program is more effective than a 2-month program, compared to control, in improving walking capacity, health and community participation and (ii) the "threshold" walking speed that results in sufficient walking capacity that makes walking self-sustaining.</p> <p>Methods/Design</p> <p>A prospective randomised controlled trial of unsupported treadmill training with a 12 month follow-up with concealed allocation and blinded assessment will be conducted. 210 community-dwelling people after stroke who are able to walk independently but slowly will be recruited and randomly allocated to either a 4 month training group, 2 month training group or the control (no intervention) group. Intervention for the two training groups will occur 3 days per week for 30 minutes each session. Measurements of walking, health and community participation will be taken at baseline, 2 months, 4 months, 6 months and 12 months. This study has obtained ethical approval from the relevant Human Research Ethics Committees.</p> <p>Discussion</p> <p>By improving stroke survivors' walking ability, it is likely also to improve their general wellbeing by promoting better health and greater community participation. Furthermore, if stroke survivors can reach a point where their walking and community participation is self-sustaining, this will reduce the burden of care on family and friends as well as the economic burden on the health system. Given the major demographic shift in developed nations involving significant growth in the aged population, this research will make an important evidence-based contribution to the promotion of healthy ageing.</p> <p>Trial registration</p> <p>This trial is registered with the Australian New Zealand Clinical Trials Registry, (ACTRN012607000227493)</p

Experience with an online prospective database on adolescent idiopathic scoliosis: development and implementation

Considerable variability exists in the surgical treatment and outcomes of adolescent idiopathic scoliosis (AIS). This is due to the lack of evidence-based treatment guidelines and outcome measures. Although clinical trials have been extolled as the highest form of evidence for evaluating treatment efficacy, the disadvantage of cost, time, lack of feasibility, and ethical considerations indicate a need for a new paradigm for evidence based research in this spinal deformity. High quality clinical databases offer an alternative approach for evidence-based research in medicine. So, we developed and established Scolisoft, an international, multidimensional and relational database designed to be a repository of surgical cases for AIS, and an active vehicle for standardized surgical information in a format that would permit qualitative and quantitative research and analysis. Here, we describe and discuss the utility of Scolisoft as a new paradigm for evidence-based research on AIS. Scolisoft was developed using dot.net platform and SQL server from Microsoft. All data is deidentified to protect patient privacy. Scolisoft can be accessed at www.scolisoft.org. Collection of high quality data on surgical cases of AIS is a priority and processes continue to improve the database quality. The database currently has 67 registered users from 21 countries. To date, Scolisoft has 200 detailed surgical cases with pre, post, and follow up data. Scolisoft provides a structured process and practical information for surgeons to benchmark their treatment methods against other like treatments. Scolisoft is multifaceted and its use extends to education of health care providers in training, patients, ability to mine important data to stimulate research and quality improvement initiatives of healthcare organizations