376 research outputs found

    There’s No Place Like a Refugee Camp? Urban Planning and Participation in the Camp Context

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    The past half-century of urban studies has demonstrated that the design of human settlements is a potent tool of governance. Active involvement in place shaping has also been shown to be a key empowerment mechanism for citizens and a strong means of creating cohesion in communities. Internally displaced persons (IDPs) and refugee camps are a unique form of human habitation, temporary spaces created “between war and city.” Drawing from urban planning theory, camp management tools, and migrant narratives, this paper will explore the dynamics of the spatial relationship between camp residents and the international governance bodies who manage them. As we will demonstrate, this approach offers important insights into how the relationships between camp residents and aid agencies are negotiated, and the implications for governance in societies camp inhabitants later (re)settle in.Les Ă©tudes d’urbanisme des cinquante derniĂšres annĂ©es ont dĂ©montrĂ©s que la planification d’établissements humains est un outil potentiel de gouvernance. Il a Ă©tĂ© Ă©galement montrĂ© que l’organisation active de l’espace peut ĂȘtre un mĂ©canisme d’implication des citoyens et un moyen puissant de crĂ©er les cohĂ©sions communautaires. Les camps de personnes dĂ©placĂ©es localement et de rĂ©fugiĂ©s sont une forme spĂ©cifique d’habitation humaine, correspondant Ă  des espaces crĂ©Ă©s temporairement « Ă  mi-chemin entre la ville et la guerre ». En se basant sur des thĂ©ories de planification urbaine, des outils de gestion de camp, et des rĂ©cits de migrants, cet article explore les dynamiques des relations spatiales entre les rĂ©sidents de camp et les organisations gouvernementales internationales qui les gĂšrent. On y montre que cette approche permet de mieux saisir comment se dĂ©roule les relations entre les rĂ©sidents de camp et les agences humanitaires, ainsi que les consĂ©quences que cela implique pour la gouvernance des sociĂ©tĂ©s dans les-quelles s’installent ensuite ces rĂ©sidents de camps

    Participant Comfort with and Application of Inquiry-Based Learning: Results from 4-H Volunteer Training

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    This article explores how a one-time training designed to support learning transfer affected 4-H volunteers\u27 comfort levels with the training content and how comfort levels, in turn, affected the volunteers\u27 application of tools and techniques learned during the training. Results of a follow-up survey suggest that the training participants experienced increases in comfort with guiding inquiry-based learning and achieved high levels of application of the tools and techniques presented during the training. The data indicate that providing participants with opportunities during training to experience tools and build skills by practicing techniques helps them more effectively guide learning in the future

    Comparison of a new multiplex real-time PCR with the Kato Katz thick smear and copro-antigen ELISA for the detection and differentiation of Taenia spp. in human stools

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    Background : Taenia solium, the cause of neurocysticercosis (NCC), has significant socioeconomic impacts on communities in developing countries. This disease, along with taeniasis is estimated to infect 2.5 to 5 million people globally. Control of T. solium NCC necessitates accurate diagnosis and treatment of T. solium taeniasis carriers. In areas where all three species of Taenia tapeworms (T. solium, Taenia saginata and Taenia asiatica) occur sympatrically, conventional microscope-and copro-antigen based diagnostic methods are unable to distinguish between these three Taenia species. Molecular diagnostic tools have been developed to overcome this limitation; however, conventional PCR-based techniques remain unsuitable for large-scale deployment in community-based surveys. Moreover, a real-time PCR (qPCR) for the discrimination of all three species of Taenia in human stool does not exist. This study describes the development and validation of a new triplex Taq-Man probe-based qPCR for the detection and discrimination of all three Taenia human tapeworms in human stools collected from communities in the Central Highlands of Vietnam. The diagnostic characteristics of the test are compared with conventional Kato Katz (KK) thick smear and copro-antigen ELISA (cAgELISA) method utilizing fecal samples from a community based cross-sectional study. Using this new multiplex real-time PCR we provide an estimate of the true prevalence of taeniasis in the source population for the community based cross-sectional study. Methodology/Principal findings : Primers and TaqMan probes for the specific amplification of T. solium, T. saginata and T. asiatica were designed and successfully optimized to target the internal transcribed spacer I (ITS-1) gene of T. solium and the cytochrome oxidase subunit I (COX-1) gene of T. saginata and T. asiatica. The newly designed triplex qPCR (T3qPCR) was compared to KK and cAgELISA for the detection of Taenia eggs in stool samples collected from 342 individuals in Dak Lak province, Central Highlands of Vietnam. The overall apparent prevalence of taeniasis in Dak Lak province was 6.72% (95% confidence interval (CI) [3.94-9.50]) in which T. solium accounted for 1.17% (95% CI [0.37-3.17]), according to the T3qPCR. There was sympatric presence of T. solium, T. saginata and T. asiatica. The T3qPCR proved superior to KK and cAgELISA for the detection and differentiation of Taenia species in human feces. Diagnostic sensitivities of 0.94 (95% credible interval (CrI) [0.88-0.98]), 0.82 (95% CrI [0.58-0.95]) and 0.52 (95% CrI [0.07-0.94]), and diagnostic specificities of 0.98 (95% CrI [0.94-1.00]), 0.91 (95% CrI [0.85-0.96]) and 0.99 (95% CrI [0.96-1.00]) were estimated for the diagnosis of taeniasis for the T3qPCR, cAgELISA and KK thick smear in this study, respectively. Conclusions : T3qPCR is not only superior to the KK thick smear and cAgELISA in terms of diagnostic sensitivity and specificity, but it also has the advantage of discriminating between species of Taenia eggs in stools. Application of this newly developed T3qPCR has identified the existence of all three human Taenia tapeworms in Dak Lak province and proves for the first time, the existence of T. asiatica in the Central Highlands and the south of Vietnam

    First evidence for a latitudinal body mass effect in extant Crocodylia and the relationships of their reproductive characters

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    Relationships between distribution patterns and body size have been documented in many endothermic taxa. However, the evidence for these trends in ectotherms generally is equivocal, and there have been no studies of effects in crocodylians specifically. Here, we examine the relationship between latitudinal distribution and body mass in 20 extant species of crocodylians, as well as the relationships between seven important reproductive variables. Using phylogenetically independent contrasts to inform generalized linear models, we provide the first evidence of a latitudinal effect on adult female body mass in crocodylians. In addition, we explore the relationships between reproductive variables including egg mass, hatchling mass and clutch size. We report no correlation between egg mass and clutch size, upholding previously reported within-species trends. We also find no evidence of a correlation between measures of latitudinal range and incubation temperature, contrasting with the trends found in turtles

    Exploring the role of pain as an early predictor of category 2 pressure ulcers: a prospective cohort study

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    Objective To explore pressure area related pain as a predictor of category ≄2 pressure ulcer (PU) development. Design Multicentre prospective cohort study. Setting UK hospital and community settings. Participants inclusion Consenting acutely ill patients aged ≄18 years, defined as high risk (Braden bedfast/chairfast AND completely immobile/very limited mobility; pressure area related pain or; category 1 PU). Exclusion Patients too unwell, unable to report pain, 2 or more category ≄2 PUs. Follow-up Twice weekly for 30 days. Primary and secondary outcome measures Development and time to development of one or more category ≄2 PUs. Results Of 3819 screened, 1266 were eligible, 634 patients were recruited, 32 lost to follow-up, providing a 602 analysis population. 152 (25.2%) developed one or more category ≄2 PUs. 464 (77.1%) patients reported pressure area related pain on a healthy, altered or category 1 skin site of whom 130 (28.0%) developed a category ≄2 PU compared with 22 (15.9%) of those without pain. Full stepwise variable selection was used throughout the analyses. (1) Multivariable logistic regression model to assess 9 a priori factors: presence of category 1 PU (OR=3.25, 95% CI (2.17 to 4.86), p<0.0001), alterations to intact skin (OR=1.98, 95% CI (1.30 to 3.00), p=0.0014), pressure area related pain (OR=1.56, 95% CI (0.93 to 2.63), p=0.0931). (2) Multivariable logistic regression model to account for overdispersion: presence of category 1 PU (OR=3.20, 95% CI (2.11 to 4.85), p<0.0001), alterations to intact skin (OR=1.90, 95% CI (1.24 to 2.91), p=0.0032), pressure area related pain (OR=1.85, 95% CI (1.07 to 3.20), p=0.0271), pre-existing category 2 PU (OR=2.09, 95% CI (1.35 to 3.23), p=0.0009), presence of chronic wound (OR=1.66, 95% CI (1.06 to 2.62), p=0.0277), Braden activity (p=0.0476). (3) Accelerated failure time model: presence of category 1 PU (AF=2.32, 95% CI (1.73 to 3.12), p<0.0001), pressure area related pain (AF=2.28, 95% CI (1.59 to 3.27), p<0.0001). (4) 2-level random-intercept logistic regression model: skin status which comprised 2 levels (versus healthy skin); alterations to intact skin (OR=4.65, 95% CI (3.01 to 7.18), p<0.0001), presence of category 1 PU (OR=17.30, 95% CI (11.09 to 27.00), p<0.0001) and pressure area related pain (OR=2.25, 95% CI (1.53 to 3.29), p<0.0001). Conclusions This is the first study to assess pain as a predictor of category ≄2 PU development. In all 4 models, pain emerged as a risk factor associated with an increased probability of category ≄2 PU development

    Buckle up safely: a cluster randomised trial to evaluate the effectiveness of a pre-school based program to increase appropriate use of child restraints

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    BACKGROUND: Road traffic crashes for car occupants are a leading cause of death and serious injury in children from high and middle income countries globally. Correct use of appropriate child restraints can significantly reduce death and serious injury but there is a need for well powered trials to examine effectiveness of programs to increase optimal child restraint practices. The aim of this trial is to examine the effectiveness of a comprehensive intervention to increase the use of appropriate child restraints, and decrease incorrect use of child restraints in pre-school aged children traveling in cars. METHODS AND DESIGN: A cluster randomised controlled trial will be conducted, involving 28 pre-school or childcare centres in low income areas of Sydney, Australia, over one calendar year. The intervention is an educational program involving an in-service for centre staff, distribution of educational materials to parents, a parent workshop demonstrating restraint use, subsidised restraints for parents in need, and vouchers for a free restraint checking service. Blinded assessors will observe restraint use at all centres at the end of the calendar year. Data will be analysed on an intention-to-treat basis; the primary analysis will compare the proportion of each of the two outcome measures (use of appropriate restraints, and incorrect use of restraints) at each centre between intervention and control groups. Detailed process evaluation will be conducted, including examination of implementation and utilisation of various elements of the program by both centres and families. DISCUSSION: This assessor blinded cluster randomised trial is powered to provide credible evidence about the efficacy of an education and distribution program in a pre-school setting to increase appropriate use, and decrease incorrect use of child restraints. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry ACTRN12609000612213

    Protocol paper for the ‘Harnessing resources from the internet to maximise outcomes from GP consultations (HaRI)’ study: a mixed qualitative methods study

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    Introduction Many patients now turn to the internet as a resource for healthcare information and advice. However, patients’ use of the internet to manage their health has been positioned as a potential source of strain on the doctor–patient relationship in primary care. The current evidence about what happens when internet-derived health information is introduced during consultations has relied on qualitative data derived from interview or questionnaire studies. The ‘Harnessing resources from the internet to maximise outcomes from GP consultations (HaRI)’ study combines questionnaire, interview and video-recorded consultation data to address this issue more fully. Methods and analysis Three data collection methods are employed: preconsultation patient questionnaires, video-recorded consultations between general practitioners (GP) and patients, and semistructured interviews with GPs and patients. We seek to recruit 10 GPs practising in Southeast England. We aim to collect up to 30 patient questionnaires and video-recorded consultations per GP, yielding up to 300. Up to 30 patients (approximately three per participating GP) will be selected for interviews sampled for a wide range of sociodemographic characteristics, and a variety of ways the use of, or information from, the internet was present or absent during their consultation. We will interview all 10 participating GPs about their views of online health information, reflecting on their own usage of online information during consultations and their patients’ references to online health information. Descriptive, conversation and thematic analysis will be used respectively for the patient questionnaires, video-recorded consultations and interviews. Ethics and dissemination Ethical approval has been granted by the London–Camden & Kings Cross Research Ethics Committee. Alongside journal publications, dissemination activities include the creation of a toolkit to be shared with patients and doctors, to guide discussions of material from the internet in consultation
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