Online Social Networks to the Rescue: Fulfilling the Ten Essential Public Health Services

Budget cuts and shortages in the public health workforce have contributed to the reduction of public health services in 91% of state health departments (SHDs). To adjust for these changes, health departments must discover novel ways to deliver essential public health services to their constituents. Researchers conducted a retrospective analysis of the content published on SHDs’ Twitter pages to determine if online social networks were used to fulfill the ten essential public health services. While 42 SHDs had a Twitter page, the volume and content of tweets varied. Although tweets were posted that related to all ten of the essential public health services, nearly half of the tweets represented essential service three, which is to inform, educate, and empower people about health. SHDs can and should do more to use these resources to try to fulfill all ten of the essential public health services in order to deliver needed services to a community even when faced with a reduced budget and workforce

Accuracy and Applicability of Resting Metabolic Rate Prediction Equations Differ for Women Across the Lifespan

Background: Nutrition clinicians need accurate and reliable resting metabolic rate (RMR) assessments to determine energy needs and an appropriate nutrition care plan. Material/Methods: This cross-sectional study compared the accuracy of eight RMR prediction equations (Harris-Benedict, Robertson and Reid, Cunningham 1980, FAO/WHO/UNU, Owen, Mifflin-St. Jeor, Cunningham 1991, and Nelson) to measured RMR by indirect calorimetry among young (n=57; age: 25±3 years), midlife (n=57; age: 44±3 years), and older (n=46; age: 68±5 years) women. Paired t-tests examined differences between predicted and measured RMR. Statistical analyses were conducted using SPSS (version 21), with significance defined as p<0.05. Bland-Altman plots displayed prediction bias and agreement. Prediction accuracy was defined when predicted RMR was ±10% of measured RMR. Serum thyroid stimulating hormone and follicle stimulating hormone concentrations were measured to assess thyroid function and ovarian reserve, respectively. Results: The difference between predicted and measured RMR ranged from +0.6% (Owen) to +17.7% (Cunningham 1980) for the young, -2.8% (Nelson) to +18.1% (Cunningham 1980) midlife, and +2.8 (Nelson) to +26.7% (Cunningham 1980) older women. For the young women, only the Owen equation predicted RMR similar to measured RMR (p=0.905). For the older women, only the Nelson equation predicted RMR similar to measured RMR (p=0.051). All estimates using prediction equations were significantly different from measured values for midlife women. Conclusion: Many RMR prediction equations have limited applicability for women at difference stages of the lifespan, thus impacting patient outcomes. Additional research is necessary to determine the appropriateness of RMR prediction equations among women of all ages

Left ventricular outcomes following multivessel PCI vs. infarct artery-only PCI in patients with acute STEMI: the Glasgow PRAMI CMR sub-study

No abstract available

The use of reflective diaries in end of life training programmes: a study exploring the impact of self-reflection on the participants in a volunteer training programme

BACKGROUND: A training programme was developed and delivered to a cohort of volunteers who were preparing for a unique role to provide companionship to dying patients in the acute hospital setting. This comprehensive programme aimed to provide an opportunity for participants to fully understand the nature and responsibilities of the role, whilst also allowing sufficient time to assess the qualities and competencies of participants for their ongoing volunteering role. Participants completed reflective diaries throughout the training course to record their ongoing thoughts and feelings. The purpose of this paper is to present a phenomenological analysis of these entries to understand participants’ experiences, perceptions and motivations. METHOD: The wider study was structured into three phases. Phase 1 was the delivery of a 12 week, bespoke training programme; Phase 2 involved a 26 week pilot implementation of the Care of the Dying Volunteer Service and Phase 3 was the research evaluation of the training and implementation which would inform the further development of the training programme. Self-reflection is a common component of End of Life training programmes and volunteers in this study completed a reflective diary after participation in each of the training sessions. A thematic analysis was undertaken to explore and understand the participants’ experience, perceptions and motivations in relation to their participation in the training. RESULTS: All 19 volunteers completed the reflective diaries. From a potential 228 diary entries over the 12 week training programme, 178 diary entries were submitted (78 %). The following key themes were identified: Dying Alone and the importance of being present, Personal loss and the reconstruction of meaning, Self-Awareness and Personal growth, Self-preservation and Coping strategies and group unity/cohesion. CONCLUSIONS: The participants in this study demonstrated that they were able to use the diaries as an appropriate medium for reflection. Their reflections were also instrumental in the ongoing revision and development of the training programme. Analysis of their entries illustrated that the diaries could provide the opportunity for a reappraisal of their world view and personal philosophy around death and dying. Further research is undoubtedly required, however this paper suggests that self-reflection in this way, supports preparation in honing the appropriate attitudes and qualities required to work in this role

Investigation of the Environmental and Socio-Economic Characteristics of Counties with a High Asthma Burden to Focus Asthma Action in Utah

Rising adult asthma prevalence (AAP) rates and asthma emergency room (AER) visits constitute a large burden on public health in Utah (UT), a high-altitude state in the Great Basin Desert, USA. This warrants an investigation of the characteristics of the counties with the highest asthma burden within UT to improve allocation of health resources and for planning. The relations between several predictor environmental, health behavior and socio-economic variables and two health outcome variables, AAP and AER visits, were investigated for UT’s 29 counties. Non-parametric statistical comparison tests, correlation and linear regression analysis were used to determine the factors significantly associated with AER visits and AAP. Regression kriging with Utah small area data (USAD) as well as socio-economic and pollution data enabled local Moran’s I cluster analysis and the investigation of moving correlations between health outcomes and risk factors. Results showed the importance of desert/mining dust and socio-economic status as AAP and AER visits were greatest in the south of the state, highlighting a marked north–south divide in terms of these factors within the state. USAD investigations also showed marked differences in pollution and socio-economic status associated with AAP within the most populous northern counties. Policies and interventions need to address socio-economic inequalities within counties and between the north and south of the state. Fine (PM2.5) and coarse (PM10) particulate matter monitors should be installed in towns in central and southern UT to monitor air quality as these are sparse, but in the summer, air quality can be worse here. Further research into spatiotemporal variation in air quality within UT is needed to inform public health interventions such as expanding clean fuel programs and targeted land-use policies. Efforts are also needed to examine barriers to routine asthma care

Infarct size and left ventricular remodelling after preventive percutaneous coronary intervention

Objective: We hypothesised that, compared with culprit-only primary percutaneous coronary intervention (PCI), additional preventive PCI in selected patients with ST-elevation myocardial infarction with multivessel disease would not be associated with iatrogenic myocardial infarction, and would be associated with reductions in left ventricular (LV) volumes in the longer term. Methods: In the preventive angioplasty in myocardial infarction trial (PRAMI; ISRCTN73028481), cardiac magnetic resonance (CMR) was prespecified in two centres and performed (median, IQR) 3 (1, 5) and 209 (189, 957) days after primary PCI. Results: From 219 enrolled patients in two sites, 84% underwent CMR. 42 (50%) were randomised to culprit-artery-only PCI and 42 (50%) were randomised to preventive PCI. Follow-up CMR scans were available in 72 (86%) patients. There were two (4.8%) cases of procedure-related myocardial infarction in the preventive PCI group. The culprit-artery-only group had a higher proportion of anterior myocardial infarctions (MIs) (55% vs 24%). Infarct sizes (% LV mass) at baseline and follow-up were similar. At follow-up, there was no difference in LV ejection fraction (%, median (IQR), (culprit-artery-only PCI vs preventive PCI) 51.7 (42.9, 60.2) vs 54.4 (49.3, 62.8), p=0.23), LV end-diastolic volume (mL/m2, 69.3 (59.4, 79.9) vs 66.1 (54.7, 73.7), p=0.48) and LV end-systolic volume (mL/m2, 31.8 (24.4, 43.0) vs 30.7 (23.0, 36.3), p=0.20). Non-culprit angiographic lesions had low-risk Syntax scores and 47% had non-complex characteristics. Conclusions: Compared with culprit-only PCI, non-infarct-artery MI in the preventive PCI strategy was uncommon and LV volumes and ejection fraction were similar

Connectivity Series at RIT- Developing & Delivering an Effective Professional Development Workshop Series for Women Faculty in STEM

In science, technology, engineering and math (STEM) disciplines within the United States; women faculty are underrepresented within many disciplines including engineering, computer science, and physics. At a large private university, RIT, the ADVANCE institutional transformation project (supported by NSF Award No. 1209115), referred to as Advance RIT, aims to increase the representation and advancement of women STEM faculty (which includes social and behavioral sciences, SBS) by removing barriers to resources that support career success and by creating new interventions and resources. This paper reports on the design, delivery and evaluation of a professional development workshop series, called the Connectivity Series, which is a vital initiative within this large-scale, multi-year, strategic institutional transformation project. The workshop series consists of programs to promote the recruitment, retention, and advancement of women faculty. The project team developed workshop themes based upon the results of a faculty climate survey and a literature review as part of a previously conducted NSF ADVANCE funded self-study (0811076). Project researchers created the Connectivity Series for all tenure-track women faculty on campus as well as targeted workshops for women of color and deaf and hard of hearing women faculty. All disciplines represented within the university (STEM and non-STEM) have been identified as the target audience for workshop offerings due to the high prevalence of STEM disciplines within the university. Program assessment and evaluation results are presented. In addition, a sustainability plan is outlined for continuation of these targeted workshops beyond the five-year grant funding period

Infarct burden following multivessel PCI vs. infarct-only PCI in patients with acute STEMI: the Glasgow PRAMI CMR sub-study

Background: In the Preventive Angioplasty in Myocardial Infarction trial (PRAMI; ISRCTN73028481), immediate multivessel PCI (MV-PCI) of non-IRA (infarct related artery) lesions in patients with acute ST elevation myocardial infarction (STEMI) and multivessel coronary disease (MVD) improved long term prognosis. We assessed infarct distribution and size in a pre-specified cardiac magnetic resonance (CMR) sub-study.<p></p> Methods: In this single centre prospective sub-study, PRAMI participants were invited to undergo 1.5 Tesla CMR 1 week and 1 year after primary PCI. The CMR scans were analysed using semi-automated software by a clinician blinded to treatment group assignment and clinical outcomes. The presence and extent of infarction were assessed quantitatively with late gadolinium enhancement (LGE) imaging (Gadovist, 0.1 mmol/kg). The infarct was delineated as an area of myocardial enhancement (cm2) using a signal intensity threshold of >5SDs above a remote region, and expressed as a % of total LV mass. The incidence of new LGE in non-infarct related artery territories at baseline and 1 year were assessed. Data were analysed by an independent statistician.<p></p> Results: Of 465 randomised trial participants in 6 UK hospitals, 138 (30%) were enrolled in Glasgow. Of these 80 patients underwent CMR 1 week post primary PCI of whom 41 (51%) were in the multi-vessel PCI group and 39 (49%) were in the IRA-only group. At 1 year, 69 (86%) patients had a follow up CMR scan. Infarct size and distribution are described in Table 1

Abdominal massage plus advice, compared with advice only, for neurogenic bowel dysfunction in MS:a RCT

This project was funded by the National Institute for Health Research Health TechnologyPeer reviewedPublisher PD

Public Complaints Reflect Rat Relative Abundance Across Diverse Urban Neighborhoods

Preventing infestations of rats is crucial for minimizing property damage and the transmission of rat-associated pathogens to humans. Due to the logistical challenges in assessing rat abundance over large areas, public officials must often use the number of public rat complaints to estimate the relative abundance of rats and the subsequent need for rodent control. However, the likelihood of reporting complaints may be driven by socioeconomic factors and therefore may not accurately reflect rat abundance. In this study, we tested whether the number of rat complaints reflect rat relative abundance and if rat complaints and abundance are higher in alleys with greater levels of harborage, food attractants, and poor structural integrity. We conducted this study in Chicago, IL, USA where public rat complaints have risen by 39% from 2008 up to 45,887 in 2017, and where socioeconomic factors vary considerably across neighborhoods. We assessed municipal rat complaints, census data, and land cover data for 77 community areas across Chicago. In collaboration with pest management professionals, we trapped brown rats (Rattus norvegicus) in alleys in 13 community areas that varied from low to high measures of household income and urban development. At trapping sites, we recorded signs of rat activity, attractants, and infrastructure condition. Based on candidate model comparisons using linear models, we found that rat complaints were most associated with rat trap success. Rat trap success was most associated with increasing complaints, percent of rented housing units, and decreasing vacant land. At a local scale, alleys with more complaints and higher trap success also had more uncontained garbage. Our results demonstrate that, at least in Chicago, public reporting can serve as a useful tool to identify areas of greater rat activity for targeted control efforts. Our study also suggests the need for habitat modification to minimize access to attractants. Finally, our results highlight how partnerships between researchers and private practitioners can facilitate large-scale projects on rat infestation risks in urban areas