Connecting dots to bridge the health disparities gap: Implementation of a scalable electronic medical record-integrated community referral intervention at the clinic visit

Health inequities are in-tractable, and they are well documented in the medical and public health literature. In the quest for health equity, health care stakeholders—providers, researchers, and policymakers—are increasingly recognizing that solutions to health and well-being must address the social determinants of health

Volume stabilization in a warped flux compactification model

We investigate the stability of the extra dimensions in a warped, codimension two braneworld that is based upon an Einstein-Maxwell-dilaton theory with a non-vanishing scalar field potential. The braneworld solution has two 3-branes, which are located at the positions of the conical singularities. For this type of brane solution the relative positions of the branes (the shape modulus) is determined via the tension-deficit relations, if the brane tensions are fixed. However, the volume of the extra dimensions (the volume modulus) is not fixed in the context of the classical theory, implying we should take quantum corrections into account. Hence, we discuss the one-loop effective potential of the volume modulus for a massless, minimally coupled scalar field.Comment: 25 pages, 8 figures, typos correcte

Convergence despite divergence: Views of academic and community stakeholders about the ethics of community-engaged research

Purpose: Stakeholder engagement and community-engaged research (CEnR) are recognized as approaches necessary to promote health equity. Few studies have examined variations in stakeholder perspectives on research ethics despite the potential for meaningful differences. Our study examines the association between stakeholders' characteristics and their perception of the importance of 15 stakeholder-developed CEnR ethical statements. Design: Quantitative analysis of close-ended Delphi survey. Participants: We recruited a national, non-random, purposive sample of people who were eligible if they endorsed conducting CEnR in public health or biomedical fields. Participants were recruited from publicly available information, professional email distributions, and snowball sampling. Main Outcome Measures: We designed our close-ended Delphi survey from the results of 15 CEnR ethical statements, which were developed from a consensus development workshop with academic and community stakeholders. Results: 259 participants completed the Delphi survey. The results demonstrated that stakeholders' characteristics (affiliation, ethnicity, number of CEnR relationships, and duration of CEnR partnerships) were not associated with their perception of the importance of 15 ethical statements. Conclusions: The strong agreement among stakeholders on these broad, aspirational ethical statements can help guide partnerships toward ethical decisions and actions. Continued research about variability among stakeholders' ethics perspectives is needed to bolster the capacity of CEnR to contribute to health equity

Casimir Energies for 6D Supergravities Compactified on T_2/Z_N with Wilson Lines

We compute (as functions of the shape and Wilson-line moduli) the one-loop Casimir energy induced by higher-dimensional supergravities compactified from 6D to 4D on 2-tori, and on some of their Z_N orbifolds. Detailed calculations are given for a 6D scalar field having an arbitrary 6D mass m, and we show how to extend these results to higher-spin fields for supersymmetric 6D theories. Particular attention is paid to regularization issues and to the identification of the divergences of the potential, as well as the dependence of the result on m, including limits for which m^2 A> 1 where A is the volume of the internal 2 dimensions. Our calculation extends those in the literature to very general boundary conditions for fields about the various cycles of these geometries. The results have potential applications towards Supersymmetric Large Extra Dimensions (SLED) as a theory of the Dark Energy. First, they provide an explicit calculation within which to follow the dependence of the result on the mass of the bulk states which travel within the loop, and for heavy masses these results bear out the more general analysis of the UV-sensitivity obtained using heat-kernel methods. Second, because the potentials we find describe the dynamics of the classical flat directions of these compactifications, within SLED they would describe the present-day dynamics of the Dark Energy.Comment: 40 pages, 7 figure

MSLED, Neutrino Oscillations and the Cosmological Constant

We explore the implications for neutrino masses and mixings within the minimal version of the supersymmetric large-extra-dimensions scenario (MSLED). This model was proposed in {\tt hep-ph/0404135} to extract the phenomenological implications of the promising recent attempt (in {\tt hep-th/0304256}) to address the cosmological constant problem. Remarkably, we find that the simplest couplings between brane and bulk fermions within this approach can lead to a phenomenologically-viable pattern of neutrino masses and mixings that is also consistent with the supernova bounds which are usually the bane of extra-dimensional neutrino models. Under certain circumstances the MSLED scenario can lead to a lepton mixing (PMNS) matrix close to the so-called bi-maximal or the tri-bimaximal forms (which are known to provide a good description of the neutrino oscillation data). We discuss the implications of MSLED models for neutrino phenomenology.Comment: 38 pages, 1 figure; Reposted with a few additional reference

A Cluster Randomized Trial of a Community-Based Intervention Among African-American Adults: Effects on Dietary and Physical Activity Outcomes

Evidence of the effectiveness of community-based lifestyle behavior change interventions among African-American adults is mixed. We implemented a behavioral lifestyle change intervention, Heart Matters, in two rural counties in North Carolina with African-American adults. Our aim was to evaluate the effect of Heart Matters on dietary and physical activity behaviors, self-efficacy, and social support. We used a cluster randomized controlled trial to compare Heart Matters to a delayed intervention control group after 6 months. A total of 143 African-American participants were recruited and 108 completed 6-month follow-up assessments (75.5%). We used mixed regression models to evaluate changes in outcomes from baseline to 6-month follow-up. The intervention had a significant positive effect on self-reported scores of encouragement of healthy eating, resulting in an increase in social support from family of 6.11 units (95% CI [1.99, 10.22]) (p <.01). However, intervention participants also had an increase in discouragement of healthy eating compared to controls of 5.59 units (95% CI [1.46, 9.73]) among family (p <.01). There were no significant differences in changes in dietary behaviors. Intervention participants had increased odds (OR = 2.86, 95% CI [1.18, 6.93]) of increased frequency of vigorous activity for at least 20 min per week compared to control participants (p <.05). Individual and group lifestyle behavior counseling can have a role in promoting physical activity levels among rural African-American adults, but more research is needed to identify the best strategies to bolster effectiveness and influence dietary change. Trial Registration Clinical Trials, NCT02707432. Registered 13 March 2016

To what extent do frameworks of reading development and the phonics screening check support the assessment of reading development in England?

The purpose of this article is to question the suitability of the phonics screening check in relation to models and theories of reading development. The article questions the appropriateness of the check by drawing on theoretical frameworks which underpin typical reading development. I examine the Simple View of Reading developed by Gough and Tunmer and Ehri’s model of reading development. The article argues that the assessment of children’s development in reading should be underpinned and informed by a developmental framework which identifies the sequential skills in reading development

Withdrawal of maintenance therapy for cytomegalovirus retinitis in AIDS patients exhibiting immunological response to HAART

BACKGROUND: Before the introduction of highly active antiretroviral therapy (HAART), CMV retinitis was a common complication in patients with advanced HIV disease and the therapy was well established; it consisted of an induction phase to control the infection with ganciclovir, followed by a lifelong maintenance phase to avoid or delay relapses. METHODS: To determine the safety of CMV maintenance therapy withdrawal in patients with immune recovery after HAART, 35 patients with treated CMV retinitis, on maintenance therapy, with CD4+ cell count greater than 100 cells/mm³ for at least three months, but almost all patients presented these values for more than six months and viral load < 30000 copies/mL, were prospectively evaluated for the recurrence of CMV disease. Maintenance therapy was withdrawal at inclusion, and patients were monitored for at least 48 weeks by clinical and ophthalmologic evaluations, and by determination of CMV viremia markers (antigenemia-pp65), CD4+/CD8+ counts and plasma HIV RNA levels. Lymphoproliferative assays were performed on 26/35 patients. RESULTS: From 35 patients included, only one had confirmed reactivation of CMV retinitis, at day 120 of follow-up. No patient returned positive antigenemia tests. No correlation between lymphoproliferative assays and CD4+ counts was observed. CONCLUSION: CMV retinitis maintenance therapy discontinuation is safe for those patients with quantitative immune recovery after HAART

Fine-mapping of prostate cancer susceptibility loci in a large meta-analysis identifies candidate causal variants

Prostate cancer is a polygenic disease with a large heritable component. A number of common, low-penetrance prostate cancer risk loci have been identified through GWAS. Here we apply the Bayesian multivariate variable selection algorithm JAM to fine-map 84 prostate cancer susceptibility loci, using summary data from a large European ancestry meta-analysis. We observe evidence for multiple independent signals at 12 regions and 99 risk signals overall. Only 15 original GWAS tag SNPs remain among the catalogue of candidate variants identified; the remainder are replaced by more likely candidates. Biological annotation of our credible set of variants indicates significant enrichment within promoter and enhancer elements, and transcription factor-binding sites, including AR, ERG and FOXA1. In 40 regions at least one variant is colocalised with an eQTL in prostate cancer tissue. The refined set of candidate variants substantially increase the proportion of familial relative risk explained by these known susceptibility regions, which highlights the importance of fine-mapping studies and has implications for clinical risk profiling. © 2018 The Author(s).Prostate cancer is a polygenic disease with a large heritable component. A number of common, low-penetrance prostate cancer risk loci have been identified through GWAS. Here we apply the Bayesian multivariate variable selection algorithm JAM to fine-map 84 prostate cancer susceptibility loci, using summary data from a large European ancestry meta-analysis. We observe evidence for multiple independent signals at 12 regions and 99 risk signals overall. Only 15 original GWAS tag SNPs remain among the catalogue of candidate variants identified; the remainder are replaced by more likely candidates. Biological annotation of our credible set of variants indicates significant enrichment within promoter and enhancer elements, and transcription factor-binding sites, including AR, ERG and FOXA1. In 40 regions at least one variant is colocalised with an eQTL in prostate cancer tissue. The refined set of candidate variants substantially increase the proportion of familial relative risk explained by these known susceptibility regions, which highlights the importance of fine-mapping studies and has implications for clinical risk profiling. © 2018 The Author(s).Peer reviewe