Carlisle Indian Industrial School

The Carlisle Indian School (1879–1918) was an audacious educational experiment. Capt. Richard Henry Pratt, the school’s founder and first superintendent, persuaded the federal government that training Native children to accept the white man’s ways and values would be more efficient than fighting deadly battles. The result was that the last Indian war would be waged against Native children in the classroom.More than 10,500 children from virtually every Native nation in the United States were taken from their homes and transported to Pennsylvania. Carlisle provided a blueprint for the federal Indian school system that was established across the United States and served as a model for many residential schools in Canada. The Carlisle experiment initiated patterns of dislocation and rupture far deeper and more profound and enduring than its initiators ever grasped.Carlisle Indian Industrial School offers varied perspectives on the school by interweaving the voices of students’ descendants, poets, and activists with cutting-edge research by Native and non-Native scholars. These contributions reveal the continuing impact and vitality of historical and collective memory, as well as the complex and enduring legacies of a school that still touches the lives of many Native Americans

Molecular characterization of serotype O foot-andmouth disease virus from pigs: Implications for multispecies approach to disease control in Uganda

In Uganda, where foot-and-mouth disease (FMD) control is mainly done through vaccination, constant monitoring of outbreaks and phylogenetic studies are important in designing effective disease control strategies. These efforts however, have mainly concentrated on cattle since they are the main visible disease hosts. In this study, the molecular characteristics of the VP1 coding sequences of the pigderived FMD virus and its phylogenetic relationship with other historical Ugandan FMD virus sequences are determined. Sixty seven samples were collected from three districts of south western Uganda and subjected to RT-PCR. Partial VP1 capsid protein coding sequences of 12 positive samples were amplified and sequenced using serotype specific primers. Eight sequences were successfully obtained, all of which were from domestic pigs. All samples were confirmed as belonging to serotype O using BLAST search. Phylogenetic analysis of the test sequences with selected sequences, showed a close relatedness (average of 3.77% pair-wise distance) to viruses isolated from central and western Uganda in the years 2005 and 2006 from cattle. These results show that domestic pigs in the western region of Uganda have been infected with the same circulating strain of FMDV and play a potentially important role in FMD maintenance and spread.Keywords: Foot-and-mouth disease (FMD), pig-derived FMDV sequence, persistence, domestic pigsAfrican Journal of Biotechnology Vol. 12(19), pp. 2547-255

Interventions for preventing falls in people with multiple sclerosis.

This is a protocol for a Cochrane Review (Intervention). The aim of this review is to evaluate the effectiveness of interventions designed to reduce the rate of falls in people with multiple sclerosis (MS). Specific objectives include comparing the effectiveness of single, multiple and multifactorial interventions designed to reduce the rate of falls in people with MS

Occupation recorded on certificates of death compared with self-report: the Atherosclerosis Risk in Communities (ARIC) Study

Abstract Background Death certificates are a potential source of sociodemographic data for decedents in epidemiologic research. However, because this information is provided by the next-of-kin or other proxies, there are concerns about validity. Our objective was to assess the agreement of job titles and occupational categories derived from death certificates with that self-reported in mid and later life. Methods Occupation was abstracted from 431 death certificates from North Carolina Atherosclerosis Risk in Communities Study participants who died between 1987 and 2001. Occupations were coded according to 1980 Bureau of Census job titles and then grouped into six 1980 census occupational categories. This information was compared with the self-reported occupation at midlife as reported at the baseline examination (1987–89). We calculated percent agreement using standard methods. Chance-adjusted agreement was assessed by kappa coefficients, with 95% confidence intervals. Results Agreement between death certificate and self-reported job titles was poor (32%), while 67% of occupational categories matched the two sources. Kappa coefficients ranged from 0.53 for technical/sales/administrative jobs to 0.68 for homemakers. Agreement was lower, albeit nonsignificant, for women (kappa = 0.54, 95% Confidence Interval, CI = 0.44–0.63) than men (kappa = 0.62, 95% CI = 0.54–0.69) and for African-Americans (kappa = 0.47, 95% CI = 0.34–0.61) than whites (kappa = 0.63, 95% CI = 0.57–0.69) but varied only slightly by educational attainment. Conclusion While agreement between self- and death certificate reported job titles was poor, agreement between occupational categories was good. This suggests that while death certificates may not be a suitable source of occupational data where classification into specific job titles is essential, in the absence of other data, it is a reasonable source for constructing measures such as occupational SES that are based on grouped occupational data

Evaluations of the effectiveness of a web-based graduate epidemiology course

An online epidemiology course was developed, implemented, and evaluated for graduate nursing students through the collaborative efforts of nursing faculty and information, education, and instructional design staff of the library at a health sciences university. This epidemiology course is a core curriculum course for graduate nursing students. The course was piloted with 14 students (one student in Romania); the initial online offering ran concurrently with a traditional classroom section. Extensive evaluation data were collected and analyzed to compare the effectiveness of the classroom and distance-learning formats. Areas of evaluation included objective measures, such as midterm and final examination scores and content analysis comparisons, as well as subjective ratings by the students of time commitments, course objectives, technical aspects of the web-based course, areas of satisfaction or dissatisfaction, and self-confidence regarding epidemiology and computer skills. Recommendations for course development, implementation, and evaluation for similar distance-learning courses will be included

Delirium detection tools show varying completion rates and positive score rates when used at scale in routine practice in general hospital settings: A systematic review

Background: Multiple short delirium detection tools have been validated in research studies and implemented in routine care, but there has been little study of these tools in real-world conditions. This systematic review synthesized literature reporting completion rates and/or delirium positive score rates of detection tools in large clinical populations in general hospital settings. // Methods: PROSPERO (CRD42022385166). Medline, Embase, PsycINFO, CINAHL, and gray literature were searched from 1980 to December 31, 2022. Included studies or audit reports used a validated delirium detection tool performed directly with the patient as part of routine care in large clinical populations (n ≥ 1000) within a general acute hospital setting. Narrative synthesis was performed. // Results: Twenty-two research studies and four audit reports were included. Tools used alone or in combination were the Confusion Assessment Method (CAM), 4 ‘A's Test (4AT), Delirium Observation Screening Scale (DOSS), Brief CAM (bCAM), Nursing Delirium Screening Scale (NuDESC), and Intensive Care Delirium Screening Checklist (ICDSC). Populations and settings varied and tools were used at different stages and frequencies in the patient journey, including on admission only; inpatient, daily or more frequently; on admission and as inpatient; inpatient post-operatively. Tool completion rates ranged from 19% to 100%. Admission positive score rates ranged from: CAM 8%–51%; 4AT 13%–20%. Inpatient positive score rates ranged from: CAM 2%–20%, DOSS 6%–42%, and NuDESC 5–13%. Postoperative positive score rates were 21% and 28% (4AT). All but two studies had moderate–high risk of bias. // Conclusions: This systematic review of delirium detection tool implementation in large acute patient populations found clinically important variability in tool completion rates, and in delirium positive score rates relative to expected delirium prevalence. This study highlights a need for greater reporting and analysis of relevant healthcare systems data. This is vital to advance understanding of effective delirium detection in routine care

Low-cost, high-resolution imaging for detecting cervical precancer in medically-underserved areas of Texas

OBJECTIVE: Cervical cancer rates in the United States have declined since the 1940\u27s, however, cervical cancer incidence remains elevated in medically-underserved areas, especially in the Rio Grande Valley (RGV) along the Texas-Mexico border. High-resolution microendoscopy (HRME) is a low-cost, in vivo imaging technique that can identify high-grade precancerous cervical lesions (CIN2+) at the point-of-care. The goal of this study was to evaluate the performance of HRME in medically-underserved areas in Texas, comparing results to a tertiary academic medical center. METHODS: HRME was evaluated in five different outpatient clinical settings, two in Houston and three in the RGV, with medical providers of varying skill and training. Colposcopy, followed by HRME imaging, was performed on eligible women. The sensitivity and specificity of traditional colposcopy and colposcopy followed by HRME to detect CIN2+ were compared and HRME image quality was evaluated. RESULTS: 174 women (227 cervical sites) were included in the final analysis, with 12% (11% of cervical sites) diagnosed with CIN2+ on histopathology. On a per-site basis, a colposcopic impression of low-grade precancer or greater had a sensitivity of 84% and a specificity of 45% to detect CIN2+. While there was no significant difference in sensitivity (76%, p = 0.62), the specificity when using HRME was significantly higher than that of traditional colposcopy (56%, p = 0.01). There was no significant difference in HRME image quality between clinical sites (p = 0.77) or medical providers (p = 0.33). CONCLUSIONS: HRME imaging increased the specificity for detecting CIN2+ when compared to traditional colposcopy. HRME image quality remained consistent across different clinical settings

Low-cost, high-resolution imaging for detecting cervical precancer in medically-underserved areas of Texas

OBJECTIVE: Cervical cancer rates in the United States have declined since the 1940\u27s, however, cervical cancer incidence remains elevated in medically-underserved areas, especially in the Rio Grande Valley (RGV) along the Texas-Mexico border. High-resolution microendoscopy (HRME) is a low-cost, in vivo imaging technique that can identify high-grade precancerous cervical lesions (CIN2+) at the point-of-care. The goal of this study was to evaluate the performance of HRME in medically-underserved areas in Texas, comparing results to a tertiary academic medical center. METHODS: HRME was evaluated in five different outpatient clinical settings, two in Houston and three in the RGV, with medical providers of varying skill and training. Colposcopy, followed by HRME imaging, was performed on eligible women. The sensitivity and specificity of traditional colposcopy and colposcopy followed by HRME to detect CIN2+ were compared and HRME image quality was evaluated. RESULTS: 174 women (227 cervical sites) were included in the final analysis, with 12% (11% of cervical sites) diagnosed with CIN2+ on histopathology. On a per-site basis, a colposcopic impression of low-grade precancer or greater had a sensitivity of 84% and a specificity of 45% to detect CIN2+. While there was no significant difference in sensitivity (76%, p = 0.62), the specificity when using HRME was significantly higher than that of traditional colposcopy (56%, p = 0.01). There was no significant difference in HRME image quality between clinical sites (p = 0.77) or medical providers (p = 0.33). CONCLUSIONS: HRME imaging increased the specificity for detecting CIN2+ when compared to traditional colposcopy. HRME image quality remained consistent across different clinical settings

Recommendations for a core outcome set for measuring standing balance in adult populations: a consensus-based approach

Standing balance is imperative for mobility and avoiding falls. Use of an excessive number of standing balance measures has limited the synthesis of balance intervention data and hampered consistent clinical practice.To develop recommendations for a core outcome set (COS) of standing balance measures for research and practice among adults.A combination of scoping reviews, literature appraisal, anonymous voting and face-to-face meetings with fourteen invited experts from a range of disciplines with international recognition in balance measurement and falls prevention. Consensus was sought over three rounds using pre-established criteria.The scoping review identified 56 existing standing balance measures validated in adult populations with evidence of use in the past five years, and these were considered for inclusion in the COS.Fifteen measures were excluded after the first round of scoring and a further 36 after round two. Five measures were considered in round three. Two measures reached consensus for recommendation, and the expert panel recommended that at a minimum, either the Berg Balance Scale or Mini Balance Evaluation Systems Test be used when measuring standing balance in adult populations.Inclusion of two measures in the COS may increase the feasibility of potential uptake, but poses challenges for data synthesis. Adoption of the standing balance COS does not constitute a comprehensive balance assessment for any population, and users should include additional validated measures as appropriate.The absence of a gold standard for measuring standing balance has contributed to the proliferation of outcome measures. These recommendations represent an important first step towards greater standardization in the assessment and measurement of this critical skill and will inform clinical research and practice internationally