Hepatitis C transmission and treatment as prevention - The role of the injecting network

Background: The hepatitis C virus (HCV) epidemic is a major health issue; in most developed countries it is driven by people who inject drugs (PWID). Injecting networks powerfully influence HCV transmission. In this paper we provide an overview of 10 years of research into injecting networks and HCV, culminating in a network-based approach to provision of direct-acting antiviral therapy. Methods: Between 2005 and 2010 we followed a cohort of 413 PWID, measuring HCV incidence, prevalence and injecting risk, including network-related factors. We developed an individual-based HCV transmission model, using it to simulate the spread of HCV through the empirical social network of PWID. In addition, we created an empirically grounded network model of injecting relationships using exponential random graph models (ERGMs), allowing simulation of realistic networks for investigating HCV treatment and intervention strategies. Our empirical work and modelling underpins the TAP Study, which is examining the feasibility of community-based treatment of PWID with DAAs. Results: We observed incidence rates of HCV primary infection and reinfection of 12.8 per 100 person-years (PY) (95%CI: 7.7-20.0) and 28.8 per 100 PY (95%CI: 15.0-55.4), respectively, and determined that HCV transmission clusters correlated with reported injecting relationships. Transmission modelling showed that the empirical network provided some protective effect, slowing HCV transmission compared to a fully connected, homogenous PWID population. Our ERGMs revealed that treating PWID and all their contacts was the most effective strategy and targeting treatment to infected PWID with the most contacts the least effective. Conclusion: Networks-based approaches greatly increase understanding of HCV transmission and will inform the implementation of treatment as prevention using DAAs

The influence of source attractiveness on self-perception and advertising effectiveness for 6- to 7-year-old children

The objective of this article is to examine the effects of using attractive peer models in advertising for 6- to 7-year-old children. This age is important in children’s development, as children of that age are not yet fully aware of the persuasive intent of advertising, are more focused on perceptual than on cognitive information in ads and are more focused on irrelevant rather than relevant ad information. More insights are therefore needed about whether attractive advertising models influence self-perception and advertising effectiveness of children this young, in order to help policy makers, parents and advertisers understand these effects. Two experimental studies are presented in which children are exposed to ads with peer models. Results show that when children of 6- to 7-year-old rate advertising models as being more attractive, advertising effectiveness raises, but children’s perceived self-worth and children’s perceived physical attractiveness are unaffected. We conclude that 6- to 7- year-old children use model attractiveness as a perceptual cue to rate ads but are not yet using comparisons with these models to evaluate themselves

So what difference does it make? Mapping the outcomes of citizen engagement

Over the last two decades, the idea that citizen engagement and participation can contribute to improved governance and development outcomes has been mainstreamed in development policy and discourse. Yet despite the normative beliefs that underpin this approach, the impact of participation on improved democratic and developmental outcomes has proved difficult to assess. Where previous research studies have attempted to demonstrate impact, they tend to be limited to single interventions, a small number of country contexts or by various conceptual and methodological constraints. In this paper, we report on a meta-case study analysis of a ten-year research programme on citizenship, participation and accountability which analysed a nonrandomised sample of 100 research studies of four types of citizen engagement in 20 countries. By mapping the observable effects of citizen participation through a close reading of these studies, we created a typology of four democratic and developmental outcomes, including (a) the construction of citizenship, (b) the strengthening of practices of participation, (c) the strengthening of responsive and accountable states, and (d) the development of inclusive and cohesive societies. We find that citizen participation produces positive effects across these outcome types, though in each category there are also examples of negative outcomes of citizen participation. We also find that these outcomes vary according to the type of citizen engagement and to political context. These findings have important implications for the design of and support for participatory programmes meant to improve state responsiveness and effectiveness

Development of a Training Needs Assessment for an Education Scholarship Fellowship in Emergency Medicine

At the 2012 Academic Emergency Medicine consensus conference, “Education Research in Emergency Medicine: Opportunities, Challenges, and Strategies for Success,” a breakout session convened to discuss postgraduate fellowship training in emergency medicine ( EM ), which would focus on education research. Graduates will form a growing cadre of education scholars who conduct and publish quality education research. This proceedings article reports the consensus findings of a breakout session subgroup whose goal was to construct a needs assessment for the proposed 2‐year education scholarship fellowship. The authors describe, based on expert and participant consensus, a framework for a large‐scale, mixed‐methods needs assessment for such a fellowship.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/95526/1/acem12035.pd

Happy being me in the UK: A controlled evaluation of a school-based body image intervention with pre-adolescent children

This study evaluated an adapted version of 'Happy Being Me', a school-based body image intervention, with girls and boys aged 10-11 years. Forty-three children participated in a three-week intervention, and 45 children formed a control group. Both groups completed measures of body satisfaction, risk factors for negative body image, eating behaviors, self-esteem, and intervention topic knowledge, at baseline, post-intervention, and 3-month follow-up. For girls, participation in the intervention resulted in significant improvements in body satisfaction, appearance-related conversations, appearance comparisons, eating behaviors and intervention topic knowledge at post-intervention, although only the change in body satisfaction was maintained. There was also a significant decrease in internalization of cultural appearance ideals from baseline to follow-up. For boys, participation in the intervention resulted in significant improvements in internalization and appearance comparisons at post-intervention; however, neither of these changes were sustained at follow-up. There were no improvements in the control group over time. © 2013 Elsevier Ltd

Defining A Core Curriculum for Education Scholarship Fellowships in Emergency Medicine

A trained cadre of medical education scholars with a focus on methodologically sound research techniques is needed to ensure development of innovations that can be translated to educational practice, rigorous evaluation of instructional strategies, and progress toward improving patient care outcomes. Most established educational programs are aimed at existing faculty members and focus primarily on the development of teaching and leadership skills. At the 2012 Academic Emergency Medicine ( AEM ) consensus conference, “Education Research in Emergency Medicine: Opportunities, Challenges, and Strategies for Success,” a breakout session was convened to develop training recommendations for postgraduate fellowship programs in medical education scholarship that would enable residency graduates to join academic faculties armed with the skills needed to perform research in medical education. Additionally, these graduates would enjoy the benefits of established mentorships. A group of 23 medical education experts collaborated to address the following objectives: 1) construct a formal needs assessment for fellowship training in medical education scholarship in emergency medicine ( EM ), 2) compare and contrast current education scholarship programs in both EM and non‐ EM specialties, and 3) develop a set of core curriculum guidelines for specialized fellowship training in medical education scholarship in EM . Fellowship‐trained faculty need to be proficient in learner instruction and assessment, organizational leadership, curriculum development, educational methodology, and conducting generalizable hypothesis‐driven research to improve patient care.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/94579/1/acem12036.pd

The Third wave in globalization theory

This essay examines a proposition made in the literature that there are three waves in globalization theory—the globalist, skeptical, and postskeptical or transformational waves—and argues that this division requires a new look. The essay is a critique of the third of these waves and its relationship with the second wave. Contributors to the third wave not only defend the idea of globalization from criticism by the skeptics but also try to construct a more complex and qualified theory of globalization than provided by first-wave accounts. The argument made here is that third-wave authors come to conclusions that try to defend globalization yet include qualifications that in practice reaffirm skeptical claims. This feature of the literature has been overlooked in debates and the aim of this essay is to revisit the literature and identify as well as discuss this problem. Such a presentation has political implications. Third wavers propose globalist cosmopolitan democracy when the substance of their arguments does more in practice to bolster the skeptical view of politics based on inequality and conflict, nation-states and regional blocs, and alliances of common interest or ideology rather than cosmopolitan global structures

Silent Trace Eliminates Differential Eyeblink Learning in Abstinent Alcoholics

Chronic alcoholism has profound effects on the brain, including volume reductions in regions critical for eyeblink classical conditioning (EBCC). The current study challenged abstinent alcoholics using delay (n = 20) and trace (n = 17) discrimination/reversal EBCC. Comparisons revealed a significant difference between delay and trace conditioning performance during reversal (t (35) = 2.08, p < 0.05). The difference between the two tasks for discrimination was not significant (p = 0.44). These data support the notion that alcoholics are increasingly impaired in the complex task of reversing a previously learned discrimination when a silent trace interval is introduced. Alcoholics’ impairment in flexibly altering learned associations may be central to their continued addiction

Species identity and human consumption of beaked whales in the Gilbert Islands, Republic of Kiribati

We investigated the species identity and local use of cetaceans on the Gilbert Islands, Republic of Kiribati. Working with the Kiribati Ministry of Environment, Lands and Agricultural Development and Fisheries Division, we visited the islands of Tarawa, Tabiteuea (North), Butaritari and Onotoa from June to July 2009, and collected 24 bones, bone fragments or teeth attributed to recent strandings. The mitochondrial DNA control region or cytochrome b was successfully amplified from 12 bones or bone fragments and used to identify four species: Mesoplodon sp. representing a new species or subspecies of beaked whale, the dense-beaked whale Mesoplodon densirostris, Cuvier’s beaked whale Ziphius cavirostris and the pygmy sperm whale Kogia breviceps. This is the first confirmed identification of the dense-beaked, Cuvier’s and pygmy sperm whales from the Gilbert Islands. All specimens were reportedly used for human consumption.Keywords: Molecular taxonomy, DNA surveillance, Biodiversity, Marine bushmeat, Subsistenc

Beta-binomial model for meta-analysis of odds ratios

In meta-analysis of odds ratios ({\OR}s), heterogeneity between the studies is usually modelled via the additive random effects model (REM). An alternative, multiplicative random effects model for {\OR}s uses overdispersion. The multiplicative factor in this overdispersion model (ODM) can be interpreted as an intra-class correlation (ICC) parameter. This model naturally arises when the probabilities of an event in one or both arms of a comparative study are themselves beta-distributed, resulting in beta-binomial distributions. We propose two new estimators of the ICC for meta-analysis in this setting. One is based on the inverted Breslow-Day test, and the other on the improved gamma approximation by Kulinskaya and Dollinger (2015, p. 26) to the distribution of Cochran's $Q$. The performance of these and several other estimators of ICC on bias and coverage is studied by simulation. Additionally, the Mantel-Haenszel approach to estimation of odds ratios is extended to the beta-binomial model, and we study performance of various ICC estimators when used in the Mantel-Haenszel or the inverse-variance method to combine odds ratios in meta-analysis. The results of the simulations show that the improved gamma-based estimator of ICC is superior for small sample sizes, and the Breslow-Day-based estimator is the best for $n\geq100$. The Mantel-Haenszel-based estimator of {\OR} is very biased and is not recommended. The inverse-variance approach is also somewhat biased for {\OR}s\neq1, but this bias is not very large in practical settings. Developed methods and R programs, provided in the Web Appendix, make the beta-binomial model a feasible alternative to the standard REM for meta-analysis of odds ratios