Comparing the Characteristics of Homeless Adults in Poland and the United States

This study compared the characteristics of probability samples of homeless adults in Poland (N = 200 from two cities) and the United States (N = 219 from one city), using measures with established reliability and validity in homeless populations. The same measures were used across nations and a systemic translation procedure assured comparability of measurement. The two samples were similar on some measures: In both nations, most homeless adults were male, many reported having dependent children and experiencing out-of-home placements when they themselves were children, and high levels of physical health problems were observed. Significant national differences were also found: Those in Poland were older, had been homeless for longer, showed lower rates on all psychiatric diagnoses assessed (including severe mental and substance abuse disorders), reported less contact with family and supportive network members, were less satisfied when they sought support from their networks, and reported fewer recent stressful life events and fewer risky sexual behaviors. Culturally-informed interpretations of these findings and their implications are presented

Shear localisation, strain partitioning and frictional melting in a debris avalanche generated by volcanic flank collapse

The Arequipa volcanic landslide deposit to the east of Arequipa (Peru) originated from the Pichu Pichu volcanic complex, covering an area ~200 km2. The debris avalanche deposit exhibits internal flow structures and basal pseudotachylytes. We present field, microstructural and chemical observations from slip surfaces below and within the deposit which show varying degrees of strain localisation. At one locality the basal shear zone is localised to a 1–2 cm thick, extremely sheared layer of mixed ultracataclasite and pseudotachylyte containing fragments of earlier frictional melts. Rheological modelling indicates brittle fragmentation of the melt may have occurred due to high strain rates, at velocities of >31 m s−1 and that frictional melting is unlikely to provide a mechanism for basal lubrication. Elsewhere, we observe a ~40 cm thick basal shear zone, overprinted by sub-parallel faults that truncate topological asperities to localise strain. We also observe shear zones within the avalanche deposit, suggesting that strain was partitioned. In conclusion, we find that deformation mechanisms fluctuated between cataclasis and frictional melting during emplacement of the volcanic debris avalanche; exhibiting strain partitioning and variable shear localisation, which, along with underlying topography, changed the resistance to flow and impacted runout distance

Identification of pathologic features associated with “ulcerative colitis-like” Crohn’s disease

AIM: To identify pathologic features associated with this “ulcerative colitis (UC)-like” subgroup of Crohn’s disease (CD). METHODS: Seventeen subjects diagnosed as having UC who underwent proctocolectomy (RPC) from 2003-2007 and subsequently developed CD of the ileal pouch were identified. UC was diagnosed based on pre-operative clinical, endoscopic, and pathologic studies. Eighteen patients who underwent RPC for UC within the same time period without subsequently developing CD were randomly selected and used as controls. Pathology reports and histological slides were reviewed for a wide range of gross and microscopic pathological features, as well as extent of disease. The demographics, gross description and histopathology of the resection specimens were reviewed and compared between the two groups. RESULTS: Patients with “UC-like” CD were on average 13 years younger than those with “true” UC (P < 0.01). More severe disease in the proximal involved region and active ileitis with/without architectural distortion were observed in 6 of 17 (35%) and 7 of 17 (41%) “UC-like” CD cases, respectively, but in none of the “true” UC cases (P < 0.05). Active appendicitis occurred in 8 of 16 (50%) “UC-like” CD cases but in only two (11%) “true” UC cases (P < 0.05). Conspicuous lamina propria neutrophils were more specific for “UC-like” CD (76% vs 22%, P < 0.05). In addition, prominent lymphoid aggregates tended to be more common in “UC-like” CD (P = 0.07). The “true” UC group contained a greater number of cases with severe activity (78% vs 47%). Therefore, the features more commonly seen in “UC-like” CD were not due to a more severe disease process. Crohn’s granulomas and transmural inflammation in non-ulcerated areas were absent in both groups. CONCLUSION: More severe disease in the proximal involved region, terminal ileum involvement, active appendicitis, and prominent lamina propria neutrophils may be morphological factors associated with “UC-like” CD

Frictional Behaviour, Wear and Comminution of Synthetic Porous Geomaterials

During shearing in geological environments, frictional processes, including the wear of sliding rock surfaces, control the nature of the slip events. Multiple studies focusing on natural samples have investigated the frictional behaviour of a large suite of geological materials. However, due to the varied and heterogeneous nature of geomaterials, the individual controls of material properties on friction and wear remain unconstrained. Here, we use variably porous synthetic glass samples (8, 19 and 30% porosity) to explore the frictional behaviour and development of wear in geomaterials at low normal stresses ( 641\ua0MPa). We propose that porosity provides an inherent roughness to material which wear and abrasion cannot smooth, allowing material at the pore margins to interact with the slip surface. This results in an increase in measured friction coefficient from <0.4 for 8% porosity, to <0.55 for 19% porosity and 0.6\u20130.8 for 30% porosity for the slip rates evaluated. For a given porosity, wear rate reduces with slip rate due to less asperity interaction time. At higher slip rates, samples also exhibit slip weakening behaviour, either due to evolution of the slipping zone or by the activation of temperature-dependent microphysical processes. However, heating rate and peak temperature may be reduced by rapid wear rates as frictional heating and wear compete. The higher wear rates and reduced heating rates of porous rocks during slip may delay the onset of thermally triggered dynamic weakening mechanisms such as flash heating, frictional melting and thermal pressurisation. Hence porosity, and the resultant friction coefficient, work, heating rate and wear rate, of materials can influence the dynamics of slip during such events as shallow crustal faulting or mass movements

Declining liver graft quality threatens the future of liver transplantation in the United States

National liver transplantation (LT) volume has declined since 2006, in part because of worsening donor organ quality. Trends that degrade organ quality are expected to continue over the next 2 decades. We used the United Network for Organ Sharing (UNOS) database to inform a 20-year discrete event simulation estimating LT volume from 2010 to 2030. Data to inform the model were obtained from deceased organ donors between 2000 and 2009. If donor liver utilization practices remain constant, utilization will fall from 78% to 44% by 2030, resulting in 2230 fewer LTs. If transplant centers increase their risk tolerance for marginal grafts, utilization would decrease to 48%. The institution of "opt-out" organ donation policies to increase the donor pool would still result in 1380 to 1866 fewer transplants. Ex vivo perfusion techniques that increase the use of marginal donor livers may stabilize LT volume. Otherwise, the number of LTs in the United States will decrease substantially over the next 15 years. In conclusion, the transplant community will need to accept inferior grafts and potentially worse posttransplant outcomes and/or develop new strategies for increasing organ donation and utilization in order to maintain the number of LTs at the current level

Evaluating the Dissemination and Implementation of a Community Health Worker-Based Community Wide Campaign to Improve Fruit and Vegetable Intake and Physical Activity among Latinos along the U.S.-Mexico Border

This study evaluated the dissemination and implementation of a culturally tailored community-wide campaign (CWC), Tu Salud ¡Si Cuenta! (TSSC), to augment fruit and vegetable (FV) consumption and physical activity (PA) engagement among low-income Latinos of Mexican descent living along the U.S.-Mexico Border in Texas. TSSC used longitudinal community health worker (CHW) home visits as a core vehicle to enact positive change across all socioecological levels to induce behavioral change. TSSC’s reach, effectiveness, adoption, implementation, and maintenance (RE-AIM) was examined. A dietary questionnaire and the Godin-Shepherd Exercise Questionnaire measured program effectiveness on mean daily FV consumption and weekly PA engagement, respectively. Participants were classified based on CHW home visits into “low exposure” (2–3 visits) and “high exposure” (4–5 visits) groups. The TSSC program reached low-income Latinos (n = 5686) across twelve locations. TSSC demonstrated effectiveness as, compared to the low exposure group, the high exposure group had a greater FV intake (mean difference = +0.65 FV servings daily, 95% CI: 0.53–0.77) and an increased PA (mean difference = +185.6 MET-minutes weekly, 95% CI: 105.9–265.4) from baseline to the last follow-up on a multivariable linear regression analysis. Multivariable logistic regression revealed that the high exposure group had higher odds of meeting both FV guidelines (adjusted odds ratio (AOR) = 2.03, 95% CI: 1.65–2.47) and PA guidelines (AOR = 1.36, 95% CI: 1.10–1.68) at the last follow-up. The program had a 92.3% adoption rate, with 58.3% of adopting communities meeting implementation fidelity, and 91.7% of communities maintaining TSSC. TSSC improved FV consumption and PA engagement behaviors among low-income Latinos region wide. CHW delivery and implementation funding positively influenced reach, effectiveness, adoption, and maintenance, while lack of qualified CHWs negatively impacted fidelit

Scaling a Community-Wide Campaign Intervention to Manage Hypertension and Weight Loss

Public health impacts can be achieved when evidence-based interventions are implemented to those most in need. Too often implementation never or slowly occurs. The community-wide campaign intervention Tu Salud ¡Si Cuenta! has evidence of improving health outcomes related to chronic disease among low-income, Latinos. Using the RE-AIM Framework, this study examined if the scaled-up version of the intervention is associated with improvements in hypertension and obesity in 12 locations. Each element of the RE-AIM framework was examined. For Effectiveness, we examined outcomes overall and by implementing location. We used linear and logistic regression to assess if exposure in the intervention was associated with improvement in hypertension and weight loss. Participants were stratified into low exposure (2-3 outreach visits) vs. high exposure (4-5 outreach visits). Based on the RE-AIM Framework, the intervention reached its intended population of low-income Latinos, demonstrated effectiveness in improving hypertension and obesity, was adopted at a high level in all but one site, was implemented with fidelity to the intervention model with moderate success across locations, and showed high maintenance over time. For effectiveness specifically, we found that out of 5,019 participants, 2,508 (50%) had a baseline hypertensive blood pressure (BP) reading. Of the 2,508, 1,245 (49.9%) recovered to normal blood pressure or pre-hypertension stage by last follow-up. After adjusting for baseline BP and potential confounders in multivariable linear regression models, the high exposure group had significantly more reduction in systolic BP (adjusted mean difference in % change = -0.96; p = 0.002) and diastolic BP (adjusted mean difference in % change = -1.61; p \u3c 0.0001) compared to the low exposure group. After controlling for baseline weight and other confounders, the high exposure group had significantly greater decrease in weight compared to the low exposure group (adjusted mean difference in % change = -1.28; p \u3c 0.0001). Results from the multivariable logistic regression models indicated that compared to the low exposure group the high exposure group was more likely to achieve a clinically significant minimum 5% weight loss [adjusted odds ratio (OR) = 2.97; p \u3c 0.0001). This study contributes evidence that a Community-Wide Campaign model holds promise for addressing hypertension and obesity among low-income Latinos

Expansion strategies of a mutual help organization

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/44029/1/10464_2004_Article_BF00937930.pd

Experiences from the ImageCLEF Medical Retrieval and Annotation Tasks

The medical tasks in ImageCLEF have been run every year from 2004-2018 and many different tasks and data sets have been used over these years. The created resources are being used by many researchers well beyond the actual evaluation campaigns and are allowing to compare the performance of many techniques on the same grounds and in a reproducible way. Many of the larger data sets are from the medical literature, as such images are easier to obtain and to share than clinical data, which was used in a few smaller ImageCLEF challenges that are specifically marked with the disease type and anatomic region. This chapter describes the main results of the various tasks over the years, including data, participants, types of tasks evaluated and also the lessons learned in organizing such tasks for the scientific community

Impact on diarrhoeal illness of a community educational intervention to improve drinking water quality in rural communities in Puerto Rico

<p>Abstract</p> <p>Background</p> <p>Waterborne disease is a major risk for small water supplies in rural settings. This study was done to assess the impact of an educational intervention designed to improve water quality and estimate the contribution of water to the incidence of diarrhoeal disease in poor rural communities in Puerto Rico a two-part study was undertaken.</p> <p>Methods</p> <p>An educational intervention was delivered to communities relying on community water supplies. This intervention consisted of student operators and administrators supervising and assisting community members who voluntarily "operate" these systems. These voluntary operators had no previous training and were principally concerned with seeing that some water was delivered. The quality of that water was not something they either understood or addressed. The impact of this intervention was measured through water sampling for standard bacteriological indicators and a frank pathogen. In addition, face-to-face epidemiological studies designed to determine the base-line occurrence of diarrhoeal disease in the communities were conducted. Some 15 months after the intervention a further epidemiological study was conducted in both the intervention communities and in control communities that had not received any intervention.</p> <p>Results</p> <p>Diarrhoeal illness rates over a four week period prior to the intervention were 3.5%. <it>Salmonella </it>was isolated from all of 5 distributed samples prior to intervention and from only 2 of 12 samples after the intervention. In the 15 months follow-up study, illness rates were lower in the intervention compared to control communities (2.5% <it>vs </it>3.6%%) (RR = 0.70, 95%CI 0.43, 1.15), though this was not statistically significant. However, in the final Poisson regression model living in an intervention system (RR = 0.318; 95%CI 0.137 - 0.739) and owning a dog (RR = 0.597, 95%CI 0.145 - 0.962) was negatively associated with illness. Whilst size of system (RR = 1.006, 95%CI 1.001 - 1.010) and reporting problems with sewage system (RR = 2.973, 95%CI 1.539 - 5.744) were positively associated with illness.</p> <p>Conclusions</p> <p>Educational interventions directed both at identified individuals and the community in general in small communities with poor water quality is a way of giving communities the skills and knowledge to manage their own drinking water quality. This may also have important and sustainable health benefits, though further research preferably using a randomised control trial design is needed.</p