On the Team: Equal Opportunity for Transgender Student Athletes

This think tank report includes best practice and policy recommendations for high school and collegiate athletic programs about providing transgender student athletes with equal opportunities to participation in school-based sports programs. In addition to specific policy recommendations for both high school and college athletics, the report provides guidance for implementing these policies to ensure the safety, privacy, and dignity of transgender student athletes as well as their teammates. Specific best practice recommendations are provided for athletic administrators, coaches, student athletes, parents, and the media

The OECD in Irish higher education : a study of two policy reviews, 1962-64 and 2003-04.

The thesis is an interpretive account and analysis ofthe influence of the Organisation for Economic Cooperation and Development (OECD) on higher education policy in Ireland. Documentary sources associated with two OECD reviews are used to explore the roots of policy changes in Ireland's higher education system The first, a report on technician training in 1964, became the catalyst for the creation of a binary higher education system The second, a 2004 report on the financing and governance of higher education, has become the source document of contemporary policy changes in the system The OECD's higher education agenda has itself evolved over the decades. The study examines different phases of that evolution and how they impacted on both the content and the transmission of its influence on national policies. Moreover, a convergence between OECD policies and its peer review system with those of the European Union has greatly strengthened the agenda setting capacity of the OECD in Ireland. Hence the thesis is a study of the politics of policy formation in one sector during two separate episodes of change. The study looks at the often -tortuous routes taken to design reform programmes in tune with OECD recommendations and the long-term results of the measures adopted. What emerges is a case study of an important trend in contemporary policy development. While issues are locally defined, the space for an exclusively national competence in education matters has eroded so that policy initiatives have taken on a supranational dimension in which the OECD is the pre-eminent player

Systematic reviews of and integrated report on the quantitative, qualitative and economic evidence base for the management of obesity in men

<b>Background</b><p></p> Obesity increases the risk of many serious illnesses such as coronary heart disease, type 2 diabetes and osteoarthritis. More men than women are overweight or obese in the UK but men are less likely to perceive their weight as a problem and less likely to engage with weight-loss services.<p></p> <b>Objective</b><p></p> The aim of this study was to systematically review evidence-based management strategies for treating obesity in men and investigate how to engage men in obesity services by integrating the quantitative, qualitative and health economic evidence base.<p></p> <b>Data sources</b><p></p> Electronic databases including MEDLINE, EMBASE, PsycINFO, the Cochrane Central Register of Controlled Trials, the Database of Abstracts of Reviews of Effects and the NHS Economic Evaluation Database were searched from inception to January 2012, with a limited update search in July 2012. Subject-specific websites, reference lists and professional health-care and commercial organisations were also consulted.<p></p> <b>Review methods</b><p></p> Six systematic reviews were conducted to consider the clinical effectiveness, cost-effectiveness and qualitative evidence on interventions for treating obesity in men, and men in contrast to women, and the effectiveness of interventions to engage men in their weight reduction. Randomised controlled trials (RCTs) with follow-up data of at least 1 year, or any study design and length of follow-up for UK studies, were included. Qualitative and mixed-method studies linked to RCTs and non-randomised intervention studies, and UK-based, men-only qualitative studies not linked to interventions were included. One reviewer extracted data from the included studies and a second reviewer checked data for omissions or inaccuracies. Two reviewers carried out quality assessment. We undertook meta-analysis of quantitative data and a realist approach to integrating the qualitative and quantitative evidence synthesis.<p></p> <b>Results</b><p></p> From a total of 12,764 titles reviewed, 33 RCTs with 12 linked reports, 24 non-randomised reports, five economic evaluations with two linked reports, and 22 qualitative studies were included. Men were more likely than women to benefit if physical activity was part of a weight-loss programme. Reducing diets tended to produce more favourable weight loss than physical activity alone (mean weight change after 1 year from a reducing diet compared with an exercise programme -3.2 kg, 95% CI -4.8 kg to -1.6 kg). The type of reducing diet did not affect long-term weight loss. A reducing diet plus physical activity and behaviour change gave the most effective results. Low-fat reducing diets, some with meal replacements, combined with physical activity and behaviour change training gave the most effective long-term weight change in men [-5.2 kg (standard error 0.2 kg) after 4 years]. Such trials may prevent type 2 diabetes in men and improve erectile dysfunction. Although fewer men joined weight-loss programmes, once recruited they were less likely to drop out than women (difference 11%, 95% CI 8% to 14%). The perception of having a health problem (e.g. being defined as obese by a health professional), the impact of weight loss on health problems and desire to improve personal appearance without looking too thin were motivators for weight loss amongst men. The key components differ from those found for women, with men preferring more factual information on how to lose weight and more emphasis on physical activity programmes. Interventions delivered in social settings were preferred to those delivered in health-care settings. Group-based programmes showed benefits by facilitating support for men with similar health problems, and some individual tailoring of advice assisted weight loss in some studies. Generally, men preferred interventions that were individualised, fact-based and flexible, which used business-like language and which included simple to understand information. Preferences for men-only versus mixed-sex weight-loss group programmes were divided. In terms of context, programmes which were cited in a sporting context where participants have a strong sense of affiliation showed low drop out rates and high satisfaction. Although some men preferred weight-loss programmes delivered in an NHS context, the evidence comparing NHS and commercial programmes for men was unclear. The effect of family and friends on participants in weight-loss programmes was inconsistent in the evidence reviewed - benefits were shown in some cases, but the social role of food in maintaining relationships may also act as a barrier to weight loss. Evidence on the economics of managing obesity in men was limited and heterogeneous.<p></p> <b>Limitations</b><p></p> The main limitations were the limited quantity and quality of the evidence base and narrow outcome reporting, particularly for men from disadvantaged and minority groups. Few of the studies were undertaken in the UK.<p></p> <b>Conclusions</b><p></p> Weight reduction for men is best achieved and maintained with the combination of a reducing diet, physical activity advice or a physical activity programme, and behaviour change techniques. Tailoring interventions and settings for men may enhance effectiveness, though further research is needed to better understand the influence of context and content. Future studies should include cost-effectiveness analyses in the UK setting

Game of Stones:feasibility randomised controlled trial of how to engage men with obesity in text message and incentive interventions for weight loss

Objectives To examine the acceptability and feasibility of narrative text messages with or without financial incentives to support weight loss for men. Design Individually randomised three-arm feasibility trial with 12 months’ follow-up. Setting Two sites in Scotland with high levels of disadvantage according to Scottish Index for Multiple Deprivation (SIMD). Participants Men with obesity (n=105) recruited through community outreach and general practitioner registers. Interventions Participants randomised to: (A) narrative text messages plus financial incentive for 12 months (short message service (SMS)+I), (B) narrative text messages for 12 months (SMS only), or (C) waiting list control. Outcomes Acceptability and feasibility of recruitment, retention, intervention components and trial procedures assessed by analysing quantitative and qualitative data at 3, 6 and 12 months. Results 105 men were recruited, 60% from more disadvantaged areas (SIMD quintiles 1 or 2). Retention at 12 months was 74%. Fewer SMS+I participants (64%) completed 12-month assessments compared with SMS only (79%) and control (83%). Narrative texts were acceptable to many men, but some reported negative reactions. No evidence emerged that level of disadvantage was related to acceptability of narrative texts. Eleven SMS+I participants (31%) successfully met or partially met weight loss targets. The cost of the incentive per participant was £81.94 (95% CI £34.59 to £129.30). Incentives were acceptable, but improving health was reported as the key motivator for weight loss. All groups lost weight (SMS+I: −2.51 kg (SD=4.94); SMS only: −1.29 kg (SD=5.03); control: −0.86 kg (SD=5.64) at 12 months). Conclusions This three-arm weight management feasibility trial recruited and retained men from across the socioeconomic spectrum, with the majority from areas of disadvantage, was broadly acceptable to most participants and feasible to deliver

Investigation of Heavy Metals in a Large Mortality Event in Caribou of Northern Alaska

We measured element concentrations (As, Cd, Cu, Pb, Zn, Fe) and body condition (gross and histologic endpoints) of animals from a caribou (Rangifer tarandus) mortality event that occurred in Alaska, in the area of Point Hope and Cape Thompson (including the Chariot site), in 1995. These were compared to results from hunter-killed caribou from reference sites (Barrow and Teshekpuk Lake, Alaska) and from the area of a mine (Red Dog Mine) to determine whether heavy metals had played a role in the mortality event or whether any elements were at concentrations of concern for human consumers. Starvation and malnutrition were major factors leading to death or severe weakness, as very little or no fat (very low body condition scores) and serous atrophy of fat (observed as watery contents of the marrow cavity, with no apparent fat, and histologically) were more prevalent in caribou associated with the mortality event than in hunter-killed animals from reference sites. Accumulation of hepatic (liver) hemosiderin in Kupffer cells (macrophages) was noted as an indicator of cachexia. Concentrations of lead in feces and liver, copper in the rumen contents, and arsenic in muscle were higher in caribou harvested near Red Dog Mine, as might be expected in that mineral-rich area, but were not at levels of concern for toxicoses. Kidney concentrations of cadmium, which increased significantly with increasing age, present a potential concern for human consumers, and this is an expected finding. We concluded that caribou had starved and that heavy metals had played no role in the mortality event. Further investigation of regional mineral differences is required to understand the sources and transport mechanisms that explain these findings and to properly address mining activity. Mortality events on the north slope of Alaska are common and likely involve starvation as described here, but in most cases they are not investigated, even though recent industrial activities have heightened concern among some local residents and wildlife managers.On a mesuré la concentration en éléments (As, Cd, Cu, Pb, Zn, Fe) et l'état corporel (points limites bruts et histologiques) de caribous (Rangifer tarandus) prélevés lors d'un épisode de mortalité qui s'est produit en 1995 en Alaska, dans la région de Point Hope et de Cape Thompson (y compris le site Chariot). On a comparé ces résultats à ceux de caribous tués par des chasseurs à des emplacements témoins (Barrow et Teshekpuk Lake, en Alaska) et à proximité d'une mine (Red Dog Mine) pour trouver si les métaux lourds avaient joué un rôle dans l'épisode de mortalité ou si la concentration d'un ou plusieurs éléments pouvait constituer un risque pour la consommation humaine. La famine et la malnutrition étaient des facteurs majeurs ayant causé la mort ou une extrême faiblesse, vu que la présence minime ou l'absence de graisse (très basses notes d'état corporel) et une atrophie séreuse de la graisse (observée sous forme de contenu aqueux de la cavité médullaire, sans graisse visible, et à la suite de l'examen histologique) étaient plus courantes chez le caribou associé à l'épisode de mortalité que chez les animaux des emplacements témoins tués par les chasseurs. On a noté dans le foie une accumulation d'hémosidérine hépatique des cellules de Kupffer (cellules macrophages) témoignant d'une cachexie. La concentration de plomb dans les matières fécales et le foie, de cuivre dans le rumen et d'arsenic dans le tissu musculaire était plus élevée chez le caribou provenant de Red Dog Mine, comme on pouvait s'y attendre dans cette zone riche en minéraux, mais cette concentration n'atteignait pas un niveau pouvant provoquer des toxicoses. La concentration de cadmium dans le rein, qui augmentait de façon significative avec l'âge, pourrait constituer un risque pour la consommation humaine, ce qui n'est pas surprenant. On a conclu que les caribous étaient morts de faim et que les métaux lourds n'avaient joué aucun rôle dans l'épisode de mortalité. Il faudrait effectuer des recherches plus poussées sur les différences régionales en minéraux afin de comprendre les mécanismes d'origine et de transport qui expliquent ces résultats et d'aborder comme il le faut les activités minières. Les épisodes de mortalité sont courants sur le versant Nord de l'Alaska et sont probablement liés à la famine, comme le décrit cet article, mais dans la plupart des cas ils ne font pas l'objet d'une enquête, même si l'activité industrielle récente est un sujet qui préoccupe de plus en plus certains résidents et gestionnaires locaux de la faune

Text messaging and financial incentives to encourage weight loss in men with obesity: the Game of Stones feasibility RCT

Funding: This project was funded by the National Institute for Health Research (NIHR) Public Health Research programme and will be published in full in Public Health Research; Vol. 8, No. 11. See the NIHR Journals Library website for further project information.Peer reviewedPublisher PD

Ibuprofen inhibits colitis-induced overexpression of tumor-related Rac1b

The serrated pathway to colorectal tumor formation involves oncogenic mutations in the BRAF gene which are sufficient for initiation of hyperplastic growth but not for tumor progression. The analysis of colorectal tumors revealed that overexpression of splice variant Rac1b occurs in around 80% of tumors with mutant B-Raf and both events were shown to cooperate in tumor cell survival. Here we provide evidence for increased expression of Rac1b in samples from inflammatory bowel disease patients as well as following experimentally induced colitis in mice. The increase of Rac1b in the mouse model was specifically prevented by the non-steroidal anti-inflammatory drug ibuprofen, which also inhibited Rac1b expression in cultured HT29 colorectal tumour cells through a cyclooxygenase inhibition-independent mechanism. Accordingly, the presence of ibuprofen led to a reduction of HT29 cell survival in vitro and inhibited Rac1b-dependent tumor growth of HT29 xenografts. Together, our results suggest that stromal cues, namely inflammation can trigger changes in Rac1b expression in the colon and identify ibuprofen as a highly specific and efficient inhibitor of Rac1b overexpression in colorectal tumors. Our data suggest that the use of ibuprofen may be beneficial in the treatment of patients with serrated colorectal tumors and in cancer prophylaxis following colon inflammation disorders

Recruiting men from across the socioeconomic spectrum via GP registers and community outreach to a weight management feasibility randomised controlled trial

Background Men, particularly those living in disadvantaged areas, are less likely to participate in weight management programmes than women despite similar levels of excess weight. Little is known about how best to recruit men to weight management interventions. This paper describes patient and public involvement in pre-trial decisions relevant to recruitment and aims to report on recruitment to the subsequent men-only weight management feasibility trial, including the: i) acceptability and feasibility of recruitment; and ii) baseline sample characteristics by recruitment strategy. Methods Men with BMI ≥30 kg/m2 and/or waist circumference ≥ 40 in. were recruited to the feasibility trial via two strategies; community outreach (venue information stands and word of mouth) and GP letters, targeting disadvantaged areas. Recruitment activities (e.g. letters sent, researcher venue hours) were recorded systematically, and baseline characteristics questionnaire data collated. Qualitative interviews (n = 50) were conducted three months post-recruitment. Analyses and reporting followed a complementary mixed methods approach. Results 105 men were recruited within four months (community n = 60, GP letter n = 45). Community outreach took 2.3 recruiter hours per participant and GP letters had an opt-in rate of 10.2% (n = 90/879). More men were interested than could be accommodated. Most participants (60%) lived in more disadvantaged areas. Compared to community outreach, men recruited via GP letters were older (mean = 57 vs 48 years); more likely to report an obesity-related co-morbidity (87% vs 44%); and less educated (no formal qualifications, 32% vs 10%, degree educated 11% vs 41%). Recruitment strategies were acceptable, a sensitive approach and trusting relationships with recruiters valued, and the ‘catchy’ study name drew attention. Conclusions Targeted community outreach and GP letters were acceptable strategies that successfully recruited participants to a men-only weight management feasibility trial. Both strategies engaged men from disadvantaged areas, a typically underserved population. Using two recruitment strategies produced samples with different health risk profiles, which could add value to research where either primary or secondary prevention is of interest. Further work is required to examine how these strategies could be implemented and sustained in practice