136 research outputs found

    Developing priorities to achieve health equity through diabetes translation research: A concept mapping study

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    Introduction: The goal of diabetes translation research is to advance research into practice and ensure equitable benefit from scientific evidence. This study uses concept mapping to inform and refine future directions of diabetes translation research with the goal of achieving health equity in diabetes prevention and control. Research design and methods: This study used concept mapping and input from a national network of diabetes researchers and public health practitioners. Concept mapping is a mixed-method, participant-based process. First, participants generated statements by responding to a focus prompt ( Results: Ten clusters were identified containing between 6 and 12 statements from 95 total generated statements. The ranges of average importance and feasibility ratings for clusters were fairly high and narrow (3.62-4.09; 3.10-3.93, respectively). Clusters with the most statements in the go-zone quadrant (above average importance/feasibility) were Conclusions: This study created a framework of 10 priority areas to guide current and future efforts in diabetes translation research to achieve health equity. Themes rated as highly important and feasible provide the basis to evaluate current research support. Future efforts should explore how to best support innovative-targets, those rated highly important but less feasible

    A study of rural high school principalsā€™ perceptions as social justice leaders

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    This multisite case study explores how rural principals in high poverty schools in a Southern state that had identified themselves as social justice leaders perceived student diversity, specifically LGBTQ students, and how they sustained a socially-just school climate for all students. Using a qualitative approach lent itself to understanding the principalsā€™ descriptions of themselves as social justice leaders in their respective school and community contexts through their conversations (Creswell, 2007; Marshall & Rossman, 2016). The investigators drew from Theoharisā€™ (2007, 2009) and Bishopā€™s (2012) studies to serve as the theoretical framework guiding this study. The results indicated that the principals in this case study struggled with recognizing LGBTQ studentsā€™ needs and well-being. The findings in this study contain implications for pre-service preparation and in-service professional development programs to draw upon social justice leadership theory and research to inform leadership practices when addressing external and internal resistance. Moreover, this study recognizes the need for leadership preparation programs to integrate critical self-consciousness (Freire, 2000) with purposeful reflection (Webster-Smith, 2011) as essential to the development of the social justice leader

    Prioritizing Aquatic Science and Applications Needs in the Chesapeake Bay for a Space-Borne Hyperspectral Mission

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    The Chesapeake Bay is the largest estuary in North America, benefiting a growing population through its ecosystem services, fishing, recreations, and transportation routes. Studies indicate the health of the Bay as seen some improvement in recent years, yet threats to its health persist (e.g. warming, pollution nutrient run-off). Increasing human activities in coastal regions requires constant vigilance by agencies managing water quality, to ensure the safety of the population. Since April 2018, an interagency working group has been meeting monthly and a daylong workshop was convened with science and applications stakeholders around the overall theme of monitoring water quality from space. Current ocean color images indicate bloom locations used to guide in situ sampling efforts, despite limited spatial, spectral and temporal resolution. High resolution hyperspectral remote sensing provides a potential opportunity to measure additional indicators of ecological health and water quality. Assessing the needs of the aquatic user community around the Chesapeake Bay will inform science and applications recommendations during the current architecture study for a Surface Biology and Geology (SBG) Mission, as well as future scoping studies of other coastal and inland water bodies

    Creating a Professional Development Plan for a Simulation Consortium

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    As the United States struggles with health care reform and a nursing education system that inadequately prepares students for practice, dramatic advances in educational technology signal opportunities for both academic and practicing nurses to affect our profession as never before. Simulation technologies provide large and small institutions with the means to educate health care students and novice professionals effectively and efficiently through hands-on experience, but the costs of such a venture can be prohibitive. A simulation consortium offers a venue for different health care and educational institutions with shared goals to pool knowledge, monies, and labor toward health care education throughout a geographic area. This article details one Midwestern U.S. region's work in creating a professional development plan for a new simulation consortium

    Quantitative PET reporter gene imaging of CD8+ T cells specific for a melanoma-expressed self-antigen

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    Adoptive transfer (AT) T-cell therapy provides significant clinical benefits in patients with advanced melanoma. However, approaches to non-invasively visualize the persistence of transferred T cells are lacking. We examined whether positron emission tomography (PET) can monitor the distribution of self-antigen-specific T cells engineered to express an herpes simplex virus 1 thymidine kinase (sr39tk) PET reporter gene. Micro-PET imaging using the sr39tk-specific substrate 9-[4-[18F]fluoro-3-(hydroxymethyl)-butyl]guanine ([18F]FHBG) enabled the detection of transplanted T cells in secondary lymphoid organs of recipient mice over a 3-week period. Tumor responses could be predicted as early as 3 days following AT when a >25-fold increase of micro-PET signal in the spleen and 2-fold increase in lymph nodes (LNs) were observed in mice receiving combined immunotherapy versus control mice. The lower limit of detection was āˆ¼7 Ɨ 105 T cells in the spleen and 1 Ɨ 104 T cells in LNs. Quantification of transplanted T cells in the tumor was hampered by the sr39tk-independent trapping of [18F]FHBG within the tumor architecture. These data support the feasibility of using PET to visualize the expansion, homing and persistence of transferred T cells. PET may have significant clinical utility by providing the means to quantify anti-tumor T cells throughout the body and provide early correlates for treatment efficacy

    Zwitterionic PEG-PC hydrogels modulate the foreign body response in a modulus-dependent manner

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    Reducing the foreign body response (FBR) to implanted biomaterials will enhance their performance in tissue engineering. Poly(ethylene glycol) (PEG) hydrogels are increasingly popular for this application due to their low cost, ease of use, and the ability to tune their compliance via molecular weight and crosslinking densities. PEG hydrogels can elicit chronic inflammation in vivo, but recent evidence has suggested that extremely hydrophilic, zwitterionic materials and particles can evade the immune system. To combine the advantages of PEG-based hydrogels with the hydrophilicity of zwitterions, we synthesized hydrogels with co-monomers PEG and the zwitterion phosphorylcholine (PC). Recent evidence suggests that stiff hydrogels elicit increased immune cell adhesion to hydrogels, which we attempted to reduce by increasing hydrogel hydrophilicity. Surprisingly, hydrogels with the highest amount of zwitterionic co-monomer elicited the highest FBR we observed. Lowering the hydrogel modulus (165 kPa to 3 kPa), or PC content (20 wt% to 0 wt%), mitigated this effect. A high density of macrophages was found at the surface of implants associated with a high FBR, and mass spectrometry analysis of the proteins adsorbed to these gels implicated extracellular matrix, immune response, and cell adhesion protein categories as drivers of macrophage recruitment to these hydrogels. Overall, we show that modulus regulates macrophage adhesion to zwitterionic-PEG hydrogels, and demonstrate that chemical modifications to hydrogels should be studied in parallel with their physical properties to optimize implant design

    The effect of time since measles vaccination and age at first dose on measles vaccine effectiveness - A systematic review.

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    BACKGROUND: In settings where measles has been eliminated, vaccine-derived immunity may in theory wane more rapidly due to a lack of immune boosting by circulating measles virus. We aimed to assess whether measles vaccine effectiveness (VE) waned over time, and if so, whether differentially in measles-eliminated and measles-endemic settings. METHODS: We performed a systematic literature review of studies that reported VE and time since vaccination with measles-containing vaccine (MCV). We extracted information on case definition (clinical symptoms and/or laboratory diagnosis), method of vaccination status ascertainment (medical record or vaccine registry), as well as any biases which may have arisen from cold chain issues and a lack of an age at first dose of MCV. We then used linear regression to evaluate VE as a function of age at first dose of MCV and time since MCV. RESULTS: After screening 14,782 citations, we identified three full-text articles from measles-eliminated settings and 33 articles from measles-endemic settings. In elimination settings, two-dose VE estimates increased as age at first dose of MCV increased and decreased as time since MCV increased; however, the small number of studies available limited interpretation. In measles-endemic settings, one-dose VE increased by 1.5% (95% CI 0.5, 2.5) for every month increase in age at first dose of MCV. We found no evidence of waning VE in endemic settings. CONCLUSIONS: The paucity of data from measles-eliminated settings indicates that additional studies and approaches (such as studies using proxies including laboratory correlates of protection) are needed to answer the question of whether VE in measles-eliminated settings wanes. Age at first dose of MCV was the most important factor in determining VE. More VE studies need to be conducted in elimination settings, and standards should be developed for information collected and reported in such studies

    Chlamydia trachomatis, Mycoplasma genitalium, and Trichomonas vaginalis Infections in Men With Nongonococcal Urethritis: Predictors and Persistence After Therapy

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    Background. Chlamydia trachomatis (CT), Mycoplasma genitalium (MG), and Trichomonas vaginalis (TV) are sexually transmitted infections (STIs) associated with nongonococcal urethritis (NGU). We assessed their predictors and persistence after treatment
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