Association Between Fire-Related Particulate Matter Exposure and Childhood Asthma in Peru: A Burden of Disease Assessment

We explore the connection between exposure to particulate matter from forest fire emissions in the Peruvian Amazon and pediatric asthma incidence. The bulk of research and media coverage surrounding the Amazon Rainforest fires has focused on important environmental issues, yet the direct impact that these fires have on the health of children living nearby remains underexplored. We conducted a burden of disease assessment using publicly available data to estimate the number of incident pediatric asthma cases attributable to long term exposure to ambient particulate matter smaller than 2.5 microns (PM2.5) resulting from increased forest fires in the Peruvian Amazon. Our model compares pediatric asthma burden that would have resulted from a more “typical'' fire year, such as 2009, with that from 2016, a severe fire year, by applying PM2.5 concentrations from each of those years to the same 2016 population. We estimate that 75,160 (95 % CI 28,638, 121,682) pediatric asthma cases in 2016 were attributable to PM2.5, whereas counterfactually applying the 2009 PM2.5 concentrations would have resulted in 9,636 (95 % CI 5,657, 13,615) fewer attributable cases. Thus, our results suggest that increased forest fire emissions have led to a notable increase in pediatric asthma burden in Peru

Evaluation of Online Consumer Health Information for Idiopathic Scoliosis Identified by a Google Search

Introduction. This study sought to assess the quality of online consumerhealth information about idiopathic scoliosis. Previous studiesshowed that quality of online health information varies and oftenlacks adherence to expert recommendations and guidelines. Nevertheless,72% of internet users seek health information online. A 2005analysis of online scoliosis information found that the informationwas limited and of poor quality. Methods. Two reviewers vetted the top 10 websites resulting from aGoogleTM search for “scoliosis.” Content was organized into categoriesand rated by three physician evaluators using a 1 - 5 scale basedon quality, accuracy, completeness of information, readability, andwillingness to recommend. Additional information, such as numberof ads and Flesch-Kinkaid reading level, also was collected. Results. The average overall physician score was 47.6 (75 possible).All websites included content that was mostly accurate but varied incompleteness. Physicians unanimously recommended Mayo Clinic,MedicineNet, and Kids Health; none recommended the GoogleTMKnowledge Graph. The Scoliosis Research Society website reachedthe highest overall physician score. Readability ranged from 7th gradeto college level; only that of Kids Health was below 10th grade level. Conclusions. Most essential information provided by the websiteswas accurate and generally well rated by physicians. Website rankingby physicians was inconsistent with the ranking order by GoogleTM,indicating that health seekers reviewing the top GoogleTM-rankedwebsites may not be viewing the websites rated highest by physicians.Physicians should consider patient literacy in website recommendations,as many have an above average literacy level.Kans J Med 2018;11(4):95-101

Addressing Barriers to Universal Screening for Social, Emotional, and Behavioral Risk in Elementary Schools

Early identification of students in need of additional support in the classroom is an important structure for school districts to have in place. Universal screening for social-emotional and behavioral (SEB) risk is one method that schools can use to identify students in need of SEB support and to begin early intervention programing. Unfortunately, recommendations about universal screening and resources for universal screening for SEB risk are limited. As a result, barriers to screening are increased and interventions are delayed – sometimes indefinitely -- for those who need them most. This paper discusses the barriers and challenges experienced by elementary schools (grades K-5) in one school district in the South across a three-year consultative study. This district was supported by the researchers in identifying an appropriate SEB screener, in disseminating the screener, and in ensuring accuracy in its completion. Across the three years, data were evaluated from previous years, and recommendations to improve the district’s screening initiative were made by the lead consultant and school psychology graduate students. Over time, positive changes were noted in screening practices, but it is evident that more work needs to be done. Specific solutions and future implications for early childhood are discussed

Reviews of theoretical frameworks: challenges and judging the quality of theory application.

Background Rigorous reviews of available information, from a range of resources, is required to support medical and health educators in their decision making related to their educational practice. Aim The aim of the paper is to highlight the importance of a review of theoretical frameworks specifically to supplement reviews that focus on a synthesis of the empirical evidence alone. Establishing a shared understanding of theory as a concept is highlighted as a challenge to these types of review and some practical strategies to achieving this are presented. The paper also introduces the concept of theoretical quality to the methodology of literature reviews, arguing that a critique of how theory is applied should complement the methodological appraisal of the literature in a review. Method We illustrate the challenge of establishing a shared meaning of theory through reference to experiences of an on-going review of this kind conducted in the field of interprofessional education (IPE) and use a high scoring paper selected in this review to illustrate how theoretical quality can be assessed. We focus on theories that apply to IPE curriculum design but the findings are transferable to all reviews of theoretical frameworks. Findings In reaching a shared understanding of theory as a concept, practical strategies that promote experiential and practical ways of knowing (e.g. small group work and piloting of all phases of the review protocol) are required in addition to more propositional ways of sharing knowledge. Concepts of parsimony, testability, operational adequacy and empirical adequacy are explored as concepts that establish theoretical quality. Conclusions Reviews of theoretical frameworks used in medical education are required to inform educational practice. Review teams should make time and effort to reach a shared understanding of the term theory. Theory reviews, and reviews more widely, should add an assessment of theory application to the protocol of their review method.

Report on CTSA Consortium Use of the Community Engagement Consulting Service: Carter-Edwards et al. ·Community Engagement Consultation Service

The CTSA Community Engagement Consultative Service (CECS) is a national partnership designed to improve community engaged research (CEnR) through expert consultation. This report assesses the feasibility of CECS and presents findings from 2008–2009

Rearrangement processes and structural variations show evidence of selection in oesophageal adenocarcinomas

Oesophageal adenocarcinoma (OAC) provides an ideal case study to characterize large-scale rearrangements. Using whole genome short-read sequencing of 383 cases, for which 214 had matched whole transcriptomes, we observed structural variations (SV) with a predominance of deletions, tandem duplications and inter-chromosome junctions that could be identified as LINE-1 mobile element (ME) insertions. Complex clusters of rearrangements resembling breakage-fusion-bridge cycles or extrachromosomal circular DNA accounted for 22% of complex SVs affecting known oncogenes. Counting SV events affecting known driver genes substantially increased the recurrence rates of these drivers. After excluding fragile sites, we identified 51 candidate new drivers in genomic regions disrupted by SVs, including ETV5, KAT6B and CLTC. RUNX1 was the most recurrently altered gene (24%), with many deletions inactivating the RUNT domain but preserved the reading frame, suggesting an altered protein product. These findings underscore the importance of identification of SV events in OAC with implications for targeted therapies.</p

Rearrangement processes and structural variations show evidence of selection in oesophageal adenocarcinomas

Oesophageal adenocarcinoma (OAC) provides an ideal case study to characterize large-scale rearrangements. Using whole genome short-read sequencing of 383 cases, for which 214 had matched whole transcriptomes, we observed structural variations (SV) with a predominance of deletions, tandem duplications and inter-chromosome junctions that could be identified as LINE-1 mobile element (ME) insertions. Complex clusters of rearrangements resembling breakage-fusion-bridge cycles or extrachromosomal circular DNA accounted for 22% of complex SVs affecting known oncogenes. Counting SV events affecting known driver genes substantially increased the recurrence rates of these drivers. After excluding fragile sites, we identified 51 candidate new drivers in genomic regions disrupted by SVs, including ETV5, KAT6B and CLTC. RUNX1 was the most recurrently altered gene (24%), with many deletions inactivating the RUNT domain but preserved the reading frame, suggesting an altered protein product. These findings underscore the importance of identification of SV events in OAC with implications for targeted therapies.</p