Health professionals and the contingent body: social determinants in the curriculum.

Health professionals and the contingent body: social determinants in the curriculum Background Health professional education situates health workers within an objectivist biomedical model. Yet workers are also expected to provide patient centred care to a significant proportion of people who have worse health outcomes associated with the social determinants of health. This study asks how health professionals are educated and what are some of the consequences? Summary of work The qualitative study interviewed 17 health professionals in order to explore how they were educated and some of the consequences of that through a lens of critical pedagogy, reflexivity, poststructural feminist critiques of education and Foucault’s theories of power/knowledge. Ethics approval was gained through Murdoch University. Results Participants expressed a slippage of the objectivist self with both themselves and patients. Their language of choice, control, individuality and the struggle to link abstract theorizing of biomedicine especially in relation to the social determinants of health and their own lived experience was apparent. Strategies to implement and understand social determinants of health only seemed to reinforce the ontological divide and the need for translation. Discussions and Conclusion The split between subjectivity and objectivity amplifies the ‘Othering’ that occurs in the biomedical curriculum and practice. This leaves health professionals unprepared to work with poverty and deprivation, and apparently less able to self-regulate effectively. In spite of evidence to the contrary, and experiencing suffering themselves, health professionals were unable to re-imagine how this could be different. Take home message Health professionals’ selves and bodies are tied up with their patients in a messy temporal space that seems to co-produce the contingent body. Narratives of trauma seem to be a way of managing the ontological gap between health as a definitive state and healing as a durative process located in time and space

Spin asymmetries A1 and structure functions g1 of the proton and the deuteron from polarized high energy muon scattering.

Adeva B, Akdogan T, Arik E, et al. Spin asymmetries A(1) and structure functions g(1) of the proton and the deuteron from polarized high energy muon scattering. Phys.Rev. D. 1998;58(11): 112001.We present the final results of the spin asymmetries A(1) and the spin structure functions g(1) of the proton and the deuteron in the kinematic range 0.0008 < x < 0.7 and 0.2 < Q(2) < 100 GeV2. For the determination of A(1), in addition to the usual method which employs inclusive scattering events and includes a large radiative background at low x, we use a new method which minimizes the radiative background by selecting events with at least one hadron as well as a muon in the final state. We find that this hadron method gives smaller errors for x < 0.02, so it is combined with the usual method to provide the optimal set of results. [S0556-2821(98)07017-9]

Population‐based cohort study of outcomes following cholecystectomy for benign gallbladder diseases

Background The aim was to describe the management of benign gallbladder disease and identify characteristics associated with all‐cause 30‐day readmissions and complications in a prospective population‐based cohort. Methods Data were collected on consecutive patients undergoing cholecystectomy in acute UK and Irish hospitals between 1 March and 1 May 2014. Potential explanatory variables influencing all‐cause 30‐day readmissions and complications were analysed by means of multilevel, multivariable logistic regression modelling using a two‐level hierarchical structure with patients (level 1) nested within hospitals (level 2). Results Data were collected on 8909 patients undergoing cholecystectomy from 167 hospitals. Some 1451 cholecystectomies (16·3 per cent) were performed as an emergency, 4165 (46·8 per cent) as elective operations, and 3293 patients (37·0 per cent) had had at least one previous emergency admission, but had surgery on a delayed basis. The readmission and complication rates at 30 days were 7·1 per cent (633 of 8909) and 10·8 per cent (962 of 8909) respectively. Both readmissions and complications were independently associated with increasing ASA fitness grade, duration of surgery, and increasing numbers of emergency admissions with gallbladder disease before cholecystectomy. No identifiable hospital characteristics were linked to readmissions and complications. Conclusion Readmissions and complications following cholecystectomy are common and associated with patient and disease characteristics

Functional Substitution by TAT-Utrophin in Dystrophin-Deficient Mice

James Ervasti and colleagues show that injection of a truncated form of utrophin transduced all tissues examined, integrated with members of the dystrophin complex, and reduced serum levels of creatine kinase in a mouse model of muscular dystrophy

Weight-Loss Maintenance in Overweight Individuals One to Five Years Following Successful Completion of a Commercial Weight Loss Program

OBJECTIVE: To determine weight loss maintenance among participants in a commercial weight loss program (Weight Watchers) who had reached their goal weights 1-5 y previously. DESIGN: A national sample (n=1002) was surveyed by phone to obtain demographic and weight-related information. An oversample (n=258) was recruited and weighed in person to develop a correction factor for self-reported weights in the national sample. RESULTS: Based on corrected weights, weight regain from 1 to 5 y following weight loss ranged between 31.5 and 76.5%. At 5 y, 19.4% were within 5 lb of goal weight, 42.6% maintained a loss of 5% or more, 18.8% maintained a loss of 10% or more, and 70.3% were below initial weight. CONCLUSIONS: These results are not directly comparable to those obtained in clinical settings because of differences in the populations studied. Nonetheless, they suggest that the long-term prognosis for weight maintenance among individuals who reach goal weight in at least one commercial program is better than that suggested by existing research

Identification of retinoic acid-regulated nuclear matrix-associated protein as a novel regulator of gastric cancer

Background: Retinoic acid-regulated nuclear matrix-associated protein (RAMP) is a WD40 repeat-containing protein that is involved in various biological functions, but little is known about its role in human cancer. This study aims to delineate the oncogenic role of RAMP in gastric carcinogenesis

Associating Facial Expressions and Upper-Body Gestures with Learning Tasks for Enhancing Intelligent Tutoring Systems

Learning involves a substantial amount of cognitive, social and emotional states. Therefore, recognizing and understanding these states in the context of learning is key in designing informed interventions and addressing the needs of the individual student to provide personalized education. In this paper, we explore the automatic detection of learner’s nonverbal behaviors involving hand-over-face gestures, head and eye movements and emotions via facial expressions during learning. The proposed computer vision-based behavior monitoring method uses a low-cost webcam and can easily be integrated with modern tutoring technologies. We investigate these behaviors in-depth over time in a classroom session of 40 minutes involving reading and problem-solving exercises. The exercises in the sessions are divided into three categories: an easy, medium and difficult topic within the context of undergraduate computer science. We found that there is a significant increase in head and eye movements as time progresses, as well as with the increase of difficulty level. We demonstrated that there is a considerable occurrence of hand-over-face gestures (on average 21.35%) during the 40 minutes session and is unexplored in the education domain. We propose a novel deep learning approach for automatic detection of hand-over-face gestures in images with a classification accuracy of 86.87%. There is a prominent increase in hand-over-face gestures when the difficulty level of the given exercise increases. The hand-over-face gestures occur more frequently during problem-solving (easy 23.79%, medium 19.84% and difficult 30.46%) exercises in comparison to reading (easy 16.20%, medium 20.06% and difficult 20.18%)

Evaluating a screener to quantify PTSD risk using emergency care information: a proof of concept study

Stress and Psychopatholog

Correction to: Evaluating a screener to quantify PTSD risk using emergency care information: a proof of concept study

Stress and Psychopatholog

Assessing the Carcinogenic Potential of Low-Dose Exposures to Chemical Mixtures in the Environment: The Challenge Ahead

Lifestyle factors are responsible for a considerable portion of cancer incidence worldwide, but credible estimates from the World Health Organization and the International Agency for Research on Cancer (IARC) suggest that the fraction of cancers attributable to toxic environmental exposures is between 7% and 19%. To explore the hypothesis that low-dose exposures to mixtures of chemicals in the environment may be combining to contribute to environmental carcinogenesis, we reviewed 11 hallmark phenotypes of cancer, multiple priority target sites for disruption in each area and prototypical chemical disruptors for all targets, this included dose-response characterizations, evidence of low-dose effects and cross-hallmark effects for all targets and chemicals. In total, 85 examples of chemicals were reviewed for actions on key pathways/mechanisms related to carcinogenesis. Only 15% (13/85) were found to have evidence of a dose-response threshold, whereas 59% (50/85) exerted low-dose effects. No dose-response information was found for the remaining 26% (22/85). Our analysis suggests that the cumulative effects of individual (non-carcinogenic) chemicals acting on different pathways, and a variety of related systems, organs, tissues and cells could plausibly conspire to produce carcinogenic synergies. Additional basic research on carcinogenesis and research focused on low-dose effects of chemical mixtures needs to be rigorously pursued before the merits of this hypothesis can be further advanced. However, the structure of the World Health Organization International Programme on Chemical Safety \u27Mode of Action\u27 framework should be revisited as it has inherent weaknesses that are not fully aligned with our current understanding of cancer biology