Evaluation of the Nurse Family Partnership in North Carolina

This is the periodic update on the evaluation of the Nurse Family Partnership program in North Carolina focused on the priority health outcomes of women and infants. During this period, we refined our methodology to more precisely estimate the effect of NFP participation on the health of women and children. In this report, we will report the estimated effect of participation on birthweight, gestational age, NICU admission, and breastfeeding initiation. We will also discuss the differential treatment effect of participation by maternal race as well as variation in estimation between statewide, county and hospital level analysis.As previously reported, this study focuses on NFP participants in North Carolina and proximal health outcomes as well as health care costs. This study is limited by its relatively small sample size used to analyze uncommon outcomes, suggesting the ability to detect programmatic effects may be limited. In other words, because of the relatively small sample, a priori we might expect to conclude there is no effect when there truly is

Air temperature and inflammatory and coagulation responses in men with coronary or pulmonary disease during the winter season

Background and Objective Air temperature changes are associated with increased cardiovascular and respiratory risk, but the roles of inflammatory and coagulation markers are not well understood. We investigated the associations between temperature and several blood markers in patients with coronary heart disease (CHD) and pulmonary disease (PD). Methods Two studies were conducted in Erfurt, Germany, over two successive winters. 578 and 381 repeated blood measurements were collected from 57 CHD and 38 PD patients, respectively. Data on patient characteristics and disease history were gathered at baseline. Meteorological data were collected from existing networks. Associations were analysed using additive mixed models with random patient effects. Effect modification by diabetes status was investigated only in CHD patients, as only two PD patients had diabetes. Results Mean daily air temperature varied between -13 degrees C and 16 degrees C in both study periods. A 10 degrees C decrease in the 5-day temperature average before blood withdrawal led to an increase in platelet counts (% change from the mean: 3.0%, 95% CI 0.6% to 5.5%) and fibrinogen (5.5%, 1.3% to 9.7%), no change in C-reactive protein in PD patients, and a decrease in C-reactive protein in CHD patients. A 2-day delayed increase in factor VII associated with temperature decrease was seen in CHD patients (4.9%; 0.7% to 9.2%), while PD patients showed no effect. `Effects in CHD patients without diabetes' into `Effects on factor VII in CHD patients without diabetes'. Conclusions This study suggests that temperature decrease is associated with change in several blood parameters. The complex interplay of blood markers at low temperature may contribute to the observed association between cold and cardiovascular mortality and morbidity

Kinetics governing phase separation of nanostructured Sn_xGe_(1–x) alloys

We have studied the dynamic phenomenon of Sn_xGe_(1–x)/Ge phase separation during deposition by molecular beam epitaxy on Ge(001) substrates. Phase separation leads to the formation of direct band gap semiconductor nanowire arrays embedded in Ge oriented along the [001] growth direction. The effect of strain and composition on the periodicity were decoupled by growth on Ge(001) and partially relaxed Si_yGe_(1–y)/Ge(001) virtual substrates. The experimental results are compared with three linear instability models of strained film growth and find good agreement with only one of the models for phase separation during dynamic growth

An Art-based Case Study: Reflections on End of Life from a Husband, Artist and Caregiver

This study explores the reflective processes of Scottish artist, Norman Gilbert, as he created twenty-five drawings depicting his wife, Pat Gilbert, as she lay dying following an Alzheimer’s-related stroke. Norman, ninety-one, had drawn Pat regularly over their sixty-five-year marriage. One week after Pat died, Norman was interviewed by a family friend to chronicle his reflections on the drawings. The drawings along with the interview transcript are analyzed qualitatively as a case study. Norman’s Hospital Drawings of Pat transform what was initially a private experience into a shared comprehension of end of life and bereavement

Strategic environmental assessment: assessing the environmental impact of biotechnology

Poverty reduction, Agricultural research, Environmental protection, Genetically modified organisms, Crops, Agricultural biotechnology Research, Investments, Strategic Environmental Assessment,

Analysis for biotechnology innovations using Strategic Environmental Assessment (SEA):

" Meeting the food needs of the world's growing population while reducing poverty and protecting the environment is a major global challenge. Genetically modified crops appear to provide a promising option to deal with this challenge. However there is a need to make strategic decisions on how to spend limited agricultural research funds in order to achieve a maximum impact with regard to finding sustainable solutions to end hunger and poverty. In international development institutions, there is growing interest in the potential use of Strategic Environmental Assessment (SEA) as part of a research based Environmental Management System (EMS) to promote mainstreaming of environmental considerations in policy development. SEA was developed as an approach to integrate environmental considerations at a policy level, where alternatives environmental policies can be evaluated. In this paper, we propose using SEA in a policy research and priority setting process regarding new technologies, taking the development of Genetically Modified Organisms (GMOs) as an example. We propose that this method would be a useful tool for the international agricultural research centers of the Consultative Group for International Agricultural Research (CGIAR), streamlining business processes, strengthening accountability, sharpening the research agenda it supports, fostering broader partnerships, and increasing the relevance and impact of CGIAR research in achieving international development goals. Currently international law requires only Environmental Impact Assessments (EIAs) of specific biotechnology projects. The incorporation of environmental considerations only at the level of specific projects precludes the adoption of alternative environmental policies. In this review, we outline an SEA approach currently being considered at the International Food Policy Research Institute (IFPRI) for use in evaluating biotechnology policies. SEA may be a useful tool to inform the evaluation of biotechnology policies and priorities by taking account of information on the economic, social, and environmental benefits, cost and risks of adopting those policies." Authors' AbstractRisk, Strategic Environmental Assessment, Genetically modified organisms, Living modified organisms,

A low cost photodiode sun sensor for CubeSat and planetary micro-rover

This paper presents the development of low-cost methodologies to determine the attitude of a small, CubeSat-class satellite and a microrover relative to the sun's direction. The use of commercial hardware and simple embedded designs has become an effective path for university programs to put experimental payloads in space for minimal cost, and the development of sensors for attitude and heading determination is often a critical part. The development of two compact and efficient but simple coarse sun sensor methodologies is presented in this research. A direct measurement of the solar angle uses a photodiode array sensor and slit mask. Another estimation of the solar angle uses current measurements from orthogonal arrays of solar cells. The two methodologies are tested and compared on ground hardware. Testing results show that coarse sun sensing is efficient even with minimal processing and complexity of design for satellite attitude determination systems and rover navigation systems

Ordinal Probit Functional Regression Models with Application to Computer-Use Behavior in Rhesus Monkeys

Research in functional regression has made great strides in expanding to non-Gaussian functional outcomes, however the exploration of ordinal functional outcomes remains limited. Motivated by a study of computer-use behavior in rhesus macaques (\emph{Macaca mulatta}), we introduce the Ordinal Probit Functional Regression Model or OPFRM to perform ordinal function-on-scalar regression. The OPFRM is flexibly formulated to allow for the choice of different basis functions including penalized B-splines, wavelets, and O'Sullivan splines. We demonstrate the operating characteristics of the model in simulation using a variety of underlying covariance patterns showing the model performs reasonably well in estimation under multiple basis functions. We also present and compare two approaches for conducting posterior inference showing that joint credible intervals tend to out perform point-wise credible. Finally, in application, we determine demographic factors associated with the monkeys' computer use over the course of a year and provide a brief analysis of the findings

Exploring the relationship between geriatric patients and their carers through portraiture: giving, receiving, observing & witnessing care (GROWing Care)

The process of creating a portrait relies on a series of intimate interactions. Portraits, even those that depict a single individual, are a visual testament to a relationship. Portrait sitters are required to engage with artists in the creation of their personal visual narrative. As viewers of a portrait, we are invited to actively participate in other’s stories, to observe, to question, even stare. This process is integral to the portraits evolving meaning. Giving, receiving, observing & witnessing care (GROWing Care), the case study presented in this manuscript, draws on these multiple exchanges to explore the experience of dementia and portraiture among older adults and their partners in care as they work with artist/researcher Mark Gilbert, and geriatrician, Kenneth Rockwood

WASH in the market house - a situation analysis of water, sanitation and hygiene services in market places in Vanuatu

This report presents the results of research undertaken in thirteen fresh produce markets in the Republic of Vanuatu, located in Lakatoro (Malekula island), Luganville (Santo) and Port Vila (Efate) (Figure 1). The overarching research objective was to better understand the water, sanitation and hygiene (WASH) situation in a variety market places, from central market houses through to smaller satellite markets, in order to identify WASH-related COVID-19 vulnerabilities, the types and effectiveness of preparation and protection measures undertaken in market places thus far, and to explore their impacts on market vendors. Since the beginning of the pandemic there has been, as of June, 2021, just three active COVID-19 cases in Vanuatu - all of which have been detected in quarantine. Despite there being no community transmission of COVID-19 in Vanuatu to date, the pandemic has had a substantial impact on the country. The State of Emergency border lockdown and cessation of tourism has led to an economic recession, resulting in major job losses in the two main tourist centres of Port Vila and Luganville. Additionally, local and international remittances have greatly decreased. Whilst the government have implemented some economic support measures for small business this does not include market vendors. In response to the threat of COVID-19 the government have instigated a variety of public health measures that have directly impacted markets. These include an increased focus on hygiene (e.g. the installation of handwashing stations), social distancing guidelines, restricted selling hours and, in many but not all locales, a one-day-market rule whereby vendors are no longer permitted to sleep at markets. Combined with a general drop in demand for fresh produce due to the economic down turn, these measures are disproportionally impacting women, who make -up over 90% of market vendors. Results from this study affirm that vendors' income has decreased by half or more, with the greatest decrease experienced in Port Vila. Elsewhere in the world, the COVID-19 pandemic has disrupted the availability of affordable and nutritional food services, and there has been some concern that this may occur in Pacific Island Countries and Territories (e.g. United Nations, 2020a). Recent research from Solomon Islands has identified increased food insecurity in both rural and urban areas (Wairiu et al, 2020). Markets are one of the top three sources of food for Port Vila residents (World Vision Vanuatu, 2018) and there is a fear that if markets closed, prices increase and/or food supplies where disrupted, this would detrimentally impact urban residents - many of whom are already amongst the most socio-economically vulnerable in the country (VNSO, 2013). Whilst this study did not gather household level data (and hence cannot ascertain if household food insecurity has risen ) the data suggests that from a food systems perspective the impact of the COVID-19 pandemic has thus far been on the demand, rather than the production and supply, side