Examining the Relationship between School Climate and Peer Victimization among Students in Military-Connected Public Schools

In the Iraq and Afghanistan war context, studies have found that military-connected youth—youth with parents and/or siblings serving in the military—have higher rates of school victimization than their nonmilitary-connected peers. A positive school climate—where students perceive high levels of school connectedness, caring relationships and high expectations from adults, and meaningful participation—is associated with lower rates of victimization in secondary public schools. Based on a survey of 7th, 9th, and 11th grade students (n=14,493) enrolled in six military-connected school districts (districts that have a significant proportion of military-connected students), this study explores victimization rates and the role of school climate, deployment, and school transitions in the victimization of military-connected students and their civilian peers. The findings indicate that deployment and school transitions were significant predictors of physical violence and nonphysical victimization. In addition, multiple school climate factors were significantly associated with physical violence and non-physical victimization. The authors conclude with a discussion of future directions for research on school climate, victimization, and military-connected youth

Interannual and Subdecadal Variability in the Nutrient Geochemistry of the Cariaco Basin

The CARIACO Ocean Time Series program has made monthly measurements of oxygen, nutrients, and carbon system parameters (∑CO2, alkalinity, pH) in the Cariaco Basin since 1996. At the same time, sediment traps have collected settling particles at four to five depths ranging from 150 to 1,200 m. The depth of the transition from oxic to anoxic conditions has fluctuated dramatically over the time series due to changes in the occurrence of Caribbean water intrusions into the deep basin. Nutrient concentrations in the deep basin have increased steadily with time in a proportion reflective of the elemental ratios in the settling organic matter, although N:P ratios in the water column (approximately 16:1) differ from ratios in the accumulating nutrients (11:1) and the settling flux (ranging between 5:1 and 12.5:1). This difference is likely due to changes in the source material for remineralization, either because of sizeable ecosystem changes or changes in the relative importance of the terrestrial input of inorganic P or scavenging of P by mineral precipitation near the oxic/anoxic interface. Alternatively, there may have been changes in the degree of preferential remineralization of P

The definition, classification, and prognosis of chronic kidney disease: a KDIGO Controversies Conference report

The definition and classification for chronic kidney disease was proposed by the National Kidney Foundation Kidney Disease Outcomes Quality Initiative (NKF-KDOQI) in 2002 and endorsed by the Kidney Disease: Improving Global Outcomes (KDIGO) in 2004. This framework promoted increased attention to chronic kidney disease in clinical practice, research and public health, but has also generated debate. It was the position of KDIGO and KDOQI that the definition and classification should reflect patient prognosis and that an analysis of outcomes would answer key questions underlying the debate. KDIGO initiated a collaborative meta-analysis and sponsored a Controversies Conference in October 2009 to examine the relationship of estimated glomerular filtration rate (GFR) and albuminuria to mortality and kidney outcomes. On the basis of analyses in 45 cohorts that included 1,555,332 participants from general, high-risk, and kidney disease populations, conference attendees agreed to retain the current definition for chronic kidney disease of a GFR <60ml/min per 1.73m2 or a urinary albumin-to-creatinine ratio >30mg/g, and to modify the classification by adding albuminuria stage, subdivision of stage 3, and emphasizing clinical diagnosis. Prognosis could then be assigned based on the clinical diagnosis, stage, and other key factors relevant to specific outcomes. KDIGO has now convened a workgroup to develop a global clinical practice guideline for the definition, classification, and prognosis of chronic kidney disease

Airborne particulate matter exposure and urinary albumin excretion: The Multi-Ethnic Study of Atherosclerosis

Objectives: Understanding mechanistic pathways linking airborne particle exposure to cardiovascular health is important for causal inference and setting environmental standards. We evaluated whether urinary albumin excretion, a subclinical marker of microvascular function which predicts cardiovascular events, was associated with ambient particle exposure. Methods: Urinary albumin and creatinine were measured among members of the Multi-Ethnic Study of Atherosclerosis at three visits during 2000-2004. Exposure to PM2.5 and PM10 (g/m3) was estimated from ambient monitors for one month, two months and two decades before visit one. We regressed recent and chronic (20 year) PM exposure on urinary albumin/creatinine ratio (UACR) (mg/g) and microalbuminuria at first exam, controlling for age; race/ethnicity; sex; smoking; secondhand smoke exposure; body mass index; and dietary protein (n=3,901). We also evaluated UACR changes and development of microalbuminuria between the first, and second and third visits which took place at 1.5 to 2 year intervals in relation to chronic PM exposure prior to baseline using mixed models. Results: Chronic and recent particle exposures were not associated with current UACR nor microalbuminuria {per 10 g/m3 increment of chronic PM10 exposure, mean difference in log UACR = -0.02 (CI: -0.07, 0.03) and relative probability of having microalbuminuria = 0.92 (CI: 0.77, 1.08)} We found only weak evidence that albuminuria was accelerated among those chronically exposed to particles: each 10 g/m3 increment in chronic PM10 exposure was associated with a 1.14 relative probability of developing microalbuminuria over 3-4 years, though 95% confidence intervals (CI) included the null (0.96, 1.36). Conclusions: UACR is not a strong mechanistic marker for air pollution¡¦s possible influence on cardiovascular health in this sample.http://deepblue.lib.umich.edu/bitstream/2027.42/57886/1/Airborne particulate matter exposure and urinary albumin excretion THe Multi Ethnic Study if Atherosclerosis.pd

Long-term exposure to ambient particulate matter and prevalence of subclinical atherosclerosis in the Multiethnic Study of Atherosclerosis (MESA)

http://deepblue.lib.umich.edu/bitstream/2027.42/57884/1/Long Term Exposure to Ambient Particulate Matter and Prevalance of Subclinical Athersclerosis in the Multiethnic Study of Atherosclerosis .pd

Association of Mild to Moderate Chronic Kidney Disease With Venous Thromboembolism Pooled Analysis of Five Prospective General Population Cohorts

BACKGROUND: Recent findings suggest that chronic kidney disease (CKD) may be associated with increased risk of venous thromboembolism (VTE). Given the high prevalence of mild-to-moderate CKD in the general population, in depth analysis of this association is warranted. METHODS AND RESULTS: We pooled individual participant data from five community-based cohorts from Europe (HUNT2, PREVEND and Tromsø study) and United States (ARIC and CHS study) to assess the association of estimated glomerular filtration rate (eGFR), albuminuria and CKD with objectively verified VTE. To estimate adjusted hazard ratios (HRs) for VTE, categorical and continuous spline models were fit using Cox regression with shared-frailty or random-effect meta-analysis. A total of 1,178 VTE events occurred over 599,453 person-years follow-up. Relative to eGFR 100 mL/min/1.73m(2), HRs for VTE were 1.29 (95%CI, 1.04-1.59) for eGFR 75, 1.31 (1.00-1.71) for 60, 1.82 (1.27-2.60) for 45 and 1.95 (1.26-3.01) for 30 mL/min/1.73m(2). Compared with albumin-creatinine ratio (ACR) of 5.0 mg/g, the HRs for VTE were 1.34 (1.04-1.72) for 30 mg/g, 1.60 (1.08-2.36) for 300 mg/g and 1.92 (1.19-3.09) for 1000 mg/g. There was no interaction between clinical categories of eGFR and ACR (P=0.20). The adjusted HR for CKD defined as eGFR <60 mL/min/1.73m(2) or albuminuria ≥30 mg/g (vs. no CKD) was 1.54 (95%CI, 1.15-2.06). Associations were consistent in subgroups according to age, gender, and comorbidities as well as for unprovoked versus provoked VTE. CONCLUSIONS: Both eGFR and ACR are independently associated with increased risk of VTE in the general population, even across the normal eGFR and ACR ranges

Recent exposure to particulate matter and C-reactive protein concentration in the Multiethnic Study of Atherosclerosis (MESA)

http://deepblue.lib.umich.edu/bitstream/2027.42/55422/1/Diez Roux et al Sep 2006 Recent exposure to particulate matter and C-reactive protein concentration in the multi-ethnic study of atherosclerosis.pd

Specialist training in Fiji: Why do graduates migrate, and why do they remain? A qualitative study

<p>Abstract</p> <p>Background</p> <p>Specialist training was established in the late 1990s at the Fiji School of Medicine. Losses of graduates to overseas migration and to the local private sector prompted us to explore the reasons for these losses from the Fiji public workforce.</p> <p>Methods</p> <p>Data were collected on the whereabouts and highest educational attainments of the 66 Fiji doctors who had undertaken specialist training to at least the diploma level between 1997 and 2004. Semistructured interviews focusing on career decisions were carried out with 36 of these doctors, who were purposively sampled to include overseas migrants, temporary overseas trainees, local private practitioners and public sector doctors.</p> <p>Results</p> <p>120 doctors undertook specialist training to at least the diploma level between 1997 and 2004; 66 of the graduates were Fiji citizens or permanent residents; 54 originated from other countries in the region. Among Fiji graduates, 42 completed a diploma and 24 had either completed (21) or were enrolled (3) in a master's programme. Thirty-two (48.5%) were working in the public sectors, four (6.0%) were temporarily training overseas, 30.3% had migrated overseas and the remainder were mostly in local private practice. Indo-Fijian ethnicity and non-completion of full specialist training were associated with lower retention in the public sectors, while gender had little impact. Decisions to leave the public sectors were complex, with concerns about political instability and family welfare predominating for overseas migrants, while working conditions not conducive to family life or frustrations with career progression predominated for local private practitioners. Doctors remaining in the public sectors reported many satisfying aspects to their work despite frustrations, though 40% had seriously considered resigning from the public service and 60% were unhappy with their career progression.</p> <p>Conclusion</p> <p>Overall, this study provides some support for the view that local or regional postgraduate training may increase retention of doctors. Attention to career pathways and other sources of frustration, in addition to encouragement to complete training, should increase the likelihood of such programmes' reaching their full potentials.</p