1,253 research outputs found

    Ethical Concerns of and Risk Mitigation Strategies for Crowdsourcing Contests and Innovation Challenges: Scoping Review.

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    BACKGROUND: Crowdsourcing contests (also called innovation challenges, innovation contests, and inducement prize contests) can be used to solicit multisectoral feedback on health programs and design public health campaigns. They consist of organizing a steering committee, soliciting contributions, engaging the community, judging contributions, recognizing a subset of contributors, and sharing with the community. OBJECTIVE: This scoping review describes crowdsourcing contests by stage, examines ethical problems at each stage, and proposes potential ways of mitigating risk. METHODS: Our analysis was anchored in the specific example of a crowdsourcing contest that our team organized to solicit videos promoting condom use in China. The purpose of this contest was to create compelling 1-min videos to promote condom use. We used a scoping review to examine the existing ethical literature on crowdsourcing to help identify and frame ethical concerns at each stage. RESULTS: Crowdsourcing has a group of individuals solve a problem and then share the solution with the public. Crowdsourcing contests provide an opportunity for community engagement at each stage: organizing, soliciting, promoting, judging, recognizing, and sharing. Crowdsourcing poses several ethical concerns: organizing-potential for excluding community voices; soliciting-potential for overly narrow participation; promoting-potential for divulging confidential information; judging-potential for biased evaluation; recognizing-potential for insufficient recognition of the finalist; and sharing-potential for the solution to not be implemented or widely disseminated. CONCLUSIONS: Crowdsourcing contests can be effective and engaging public health tools but also introduce potential ethical problems. We present methods for the responsible conduct of crowdsourcing contests

    Overview on Patient Centricity in Cancer Care

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    Successful implementation of treatment in cancer care partially depends on how patients’ perspectives are taken into account, as preferences of health care professionals and patients may differ. Objectives of this exploratory research were I) to identify patient preferences and values (PPVs) in cancer care as indicated by patient organizations (POs), II) to determine how these PPVs are captured in cancer care guidelines and III) to review how guidelines take into account these PPVs. Based on a survey developed and completed by 19 POs, a literature review was conducted to analyse how patient perspectives are incorporated in oncology treatment guidelines. Based on survey results traditional health technology assessment value propositions of oncology care, such as extended life, treatment-free remission and pain reduction, were also highly rated by POs. However, the heterogeneity of cancer PPVs were clearly reflected in the survey results. PPVs in cancer care guidelines were mostly limited to those micro-level aspects that are strictly related to health care provision, such as side-effects and comorbidities. Patient experience, emotional support and convenience of care were relatively neglected fields in the reviewed guidelines. Patient engagement was rarely presented in the guideline development phase. POs believe that patients should be encouraged to take an active role in their own care due to the heterogeneity of cancer patients and PPVs. Even if patient-centricity is a leading paradigm in cancer policy, based on our research it is not yet standard practice to include patients or POs at all appropriate levels of decision-making processes that are related to their health and well-being. Patient engagement should be an integral part of cancer care decision-making. This complexity must be reflected throughout policy making, avoiding a population level ‘one-size-fits-all’ solution

    A Cepheid Distance to NGC 4603 in Centaurus

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    In an attempt to use Cepheid variables to determine the distance to the Centaurus cluster, we have obtained images of NGC 4603 with the Hubble Space Telescope on 9 epochs using WFPC2 and the F555W and F814W filters. This galaxy has been suggested to lie within the ``Cen30'' portion of the cluster and is the most distant object for which this method has been attempted. Previous distance estimates for Cen30 have varied significantly and some have presented disagreements with the peculiar velocity predicted from redshift surveys, motivating this investigation. Using our observations, we have found 61 candidate Cepheid variable stars; however, a significant fraction of these candidates are likely to be nonvariable stars whose magnitude measurement errors happen to fit a Cepheid light curve of significant amplitude for some choice of period and phase. Through a maximum likelihood technique, we determine that we have observed 43 +/- 7 real Cepheids and that NGC 4603 has a distance modulus of 32.61 +0.11/-0.10 (random, 1 sigma) +0.24/-0.25 (systematic, adding in quadrature), corresponding to a distance of 33.3 Mpc. This is consistent with a number of recent estimates of the distance to NGC 4603 or Cen30 and implies a small peculiar velocity consistent with predictions from the IRAS 1.2 Jy redshift survey if the galaxy lies in the foreground of the cluster.Comment: Accepted for publication in the Astrophysical Journal. 17 pages with 17 embedded figures and 3 tables using emulateapj.sty. Additional figures and images may be obtained from http://astro.berkeley.edu/~marc/n4603

    ‘Do you really want me to tell ya!’ critical learning in engaging young people in contact with the justice system as peer educators with social work students

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    This paper outlines and evaluates an active and experiential learning project, which gave young people involved with the justice system, a voice as peer educators engaging with social work students outside of the traditional educational institution. The project had two key interconnecting elements. Firstly, by engaging a hidden population of young people in a realistic and meaningful way, it enabled them to share their experiences, and allowed students to understand the complexity of what it means to be socially excluded. Secondly, through this active participation process the young people began to see education as a desirable goal. The project took place over three months and included 10 social work students and 13 young people involved with the justice system. Creative use of multimedia facilitated production of a learning resource to capture the young people’s lived experiences with statutory social work and justice systems. Young people were fundamentally challenged in their beliefs about themselves being involved in education to achieve a qualification. Students were challenged in their creativity and versatility responding to the task, when collaborating with ‘hard to reach’ young people. They were furthermore challenged in terms of their attitudes and assumptions in relation to offending and social justice

    Metal oxide–zeolite composites in transformation of methanol to hydrocarbons : do iron oxide and nickel oxide matter?

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    The methanol-to-hydrocarbon (MTH) reaction has received considerable attention as utilizing renewable sources of both value-added chemicals and fuels becomes a number one priority for society. Here, for the first time we report the development of hierarchical zeolites (ZSM-5) containing both iron oxide and nickel oxide nanoparticles. By modifying the iron oxide (magnetite, Fe3O4) amounts, we are able to control the catalyst activity and the product distribution in the MTH process. At the medium Fe3O4 loading, the major fraction is composed of C9–C11 hydrocarbons (gasoline fraction). At the higher Fe3O4 loading, C1–C4 hydrocarbons prevail in the reaction mixture, while at the lowest magnetite loading the major component is the C5–C8 hydrocarbons. Addition of Ni species to Fe3O4–ZSM-5 leads to the formation of mixed Ni oxides (NiO/Ni2O3) positioned either on top of or next to Fe3O4 nanoparticles. This modification allowed us to significantly improve the catalyst stability due to diminishing coke formation and disordering of the coke formed. The incorporation of Ni oxide species also leads to a higher catalyst activity (up to 9.3 g(methanol)/(g(ZSM-5) × h)) and an improved selectivity (11.3% of the C5–C8 hydrocarbons and 23.6% of the C9–C11 hydrocarbons), making these zeolites highly promising for industrial applications

    Genome Copy Number Regulates Inclusion Expansion, Septation, and Infectious Developmental Form Conversion in Chlamydia trachomatis

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    DNA replication is essential for the growth and development of Chlamydia trachomatis, however it is unclear how this process contributes to and is controlled by the pathogen's biphasic lifecycle. While inhibitors of transcription, translation, cell division, and glucose-6-phosphate transport all negatively affect chlamydial intracellular development, the effects of directly inhibiting DNA polymerase have never been examined. We isolated a temperature sensitive dnaE mutant (dnaEts ) that exhibits a ∼100-fold reduction in genome copy number at the non-permissive temperature (40°C), but replicates similarly to the parent at the permissive temperature of 37°C. We measured higher ratios of genomic DNA nearer the origin of replication than the terminus in dnaEts at 40°C, indicating that this replication deficiency is due to a defect in DNA polymerase processivity. dnaEts formed fewer and smaller pathogenic vacuoles (inclusions) at 40°C, and the bacteria appeared enlarged and exhibited defects in cell division. The bacteria also lacked both discernable peptidoglycan and polymerized MreB, the major cell division organizing protein in Chlamydia responsible for nascent peptidoglycan biosynthesis. We also found that absolute genome copy number, rather than active genome replication, was sufficient for infectious progeny production. Deficiencies in both genome replication and inclusion expansion reversed when dnaEts was shifted from 40°C to 37°C early in infection, and intragenic suppressor mutations in dnaE also restored dnaEts genome replication and inclusion expansion at 40°C. Overall, our results show that genome replication in C. trachomatis is required for inclusion expansion, septum formation, and the transition between the microbe's replicative and infectious forms.SIGNIFICANCE Chlamydiae transition between infectious, extracellular elementary bodies (EBs) and non-infectious, intracellular reticulate bodies (RBs). Some checkpoints that govern transitions in chlamydial development have been identified, but the extent to which genome replication plays a role in regulating the pathogen's infectious cycle has not been characterized. We show that genome replication is dispensable for EB to RB conversion, but is necessary for RB proliferation, division septum formation, and inclusion expansion. We use new methods to investigate developmental checkpoints and dependencies in Chlamydia that facilitate the ordering of events in the microbe's biphasic life cycle. Our findings suggest that Chlamydia utilizes feedback inhibition to regulate core metabolic processes during development, likely an adaptation to intracellular stress and a nutrient-limiting environment

    Zn2+ ion surface enrichment in doped iron oxide nanoparticles leads to charge carrier density enhancement

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    Here, we report the development of monodisperse Zn-doped iron oxide nanoparticles (NPs) with different amounts of Zn (ZnxFe3-xO4, 0 < x < 0.43) by thermal decomposition of a mixture of zinc and iron oleates. The as-synthesized NPs show a considerable fraction of wüstite (FeO) which is transformed to spinel upon 2 h oxidation of the NP reaction solutions. At any Zn doping amounts, we observed the enrichment of the NP surface with Zn2+ ions, which is enhanced at higher Zn loadings. Such a distribution of Zn2+ ions is attributed to the different thermal decomposition profiles of Zn and Fe oleates, with Fe oleate decomposing at much lower temperature than that of Zn oleate. The decomposition of Zn oleate is, in turn, catalyzed by a forming iron oxide phase. The magnetic properties were found to be strongly dependent on the Zn doping amounts, showing the saturation magnetization to decrease by 9 and 20% for x = 0.05 and 0.1, respectively. On the other hand, X-ray photoelectron spectroscopy near the Fermi level demonstrates that the Zn0.05Fe2.95O4 sample displays a more metallic character (a higher charge carrier density) than undoped iron oxide NPs, supporting its use as a spintronic material

    Quality of Life in Patients With Advanced Cancer: Differential Association With Performance Status and Systemic Inflammatory Response

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    Purpose: Quality of life is a key component of cancer care; however, the factors that determine quality of life are not well understood. The aim of this study was to examine the relationship between quality of life parameters, performance status (PS), and the systemic inflammatory response in patients with advanced cancer. Methods: An international biobank of patients with advanced cancer was analyzed. Quality of life was assessed at a single time point by using the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire C-30 (EORTC QLQ-C30). PS was assessed by using the Eastern Cooperative Oncology Group (ECOG) classification. Systemic inflammation was assessed by using the modified Glasgow Prognostic Score (mGPS), which combines C-reactive protein and albumin. The relationship between quality of life parameters, ECOG PS, and the mGPS was examined. Results: Data were available for 2,520 patients, and the most common cancers were GI (585 patients [22.2%]) and pulmonary (443 patients [17.6%]). The median survival was 4.25 months (interquartile range, 1.36 to 12.9 months). Increasing mGPS (systemic inflammation) and deteriorating PS were associated with deterioration in quality-of-life parameters (P &lt; .001). Increasing systemic inflammation was associated with deterioration in quality-of-life parameters independent of PS. Conclusion: Systemic inflammation was associated with quality-of-life parameters independent of PS in patients with advanced cancer. Further investigation of these relationships in longitudinal studies and investigations of possible effects of attenuating systemic inflammation are now warranted

    From PALSA PLUS to PALM PLUS: adapting and developing a South African guideline and training intervention to better integrate HIV/AIDS care with primary care in rural health centers in Malawi

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    <p>Abstract</p> <p>Background</p> <p>Only about one-third of eligible HIV/AIDS patients receive anti-retroviral treatment (ART). Decentralizing treatment is crucial to wider and more equitable access, but key obstacles are a shortage of trained healthcare workers (HCW) and challenges integrating HIV/AIDS care with other primary care. This report describes the development of a guideline and training program (PALM PLUS) designed to integrate HIV/AIDS care with other primary care in Malawi. PALM PLUS was adapted from PALSA PLUS, developed in South Africa, and targets middle-cadre HCWs (clinical officers, nurses, and medical assistants). We adapted it to align with Malawi's national treatment protocols, more varied healthcare workforce, and weaker health system infrastructure.</p> <p>Methods/Design</p> <p>The international research team included the developers of the PALSA PLUS program, key Malawi-based team members and personnel from national and district level Ministry of Health (MoH), professional associations, and an international non-governmental organization. The PALSA PLUS guideline was extensively revised based on Malawi national disease-specific guidelines. Advice and input was sought from local clinical experts, including middle-cadre personnel, as well as Malawi MoH personnel and representatives of Malawian professional associations.</p> <p>Results</p> <p>An integrated guideline adapted to Malawian protocols for adults with respiratory conditions, HIV/AIDS, tuberculosis, and other primary care conditions was developed. The training program was adapted to Malawi's health system and district-level supervision structure. PALM PLUS is currently being piloted in a cluster-randomized trial in health centers in Malawi (ISRCTN47805230).</p> <p>Discussion</p> <p>The PALM PLUS guideline and training intervention targets primary care middle-cadre HCWs with the objective of improving HCW satisfaction and retention, and the quality of patient care. Successful adaptations are feasible, even across health systems as different as those of South Africa and Malawi.</p
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