Scaffolding women coaches' development: A program to build coaches' competence and confidence

Research continues to demonstrate the under representation of women coaches and that barriers outweigh support. The purpose of this practical article is to describe the process undertaken by a National Governing Body of Sport (NGB) to deliver a learning and development programme to support women hockey coaches in Scotland, the Women in Coaching (WiC) programme. Our aim is to share understanding about this example of good practice to provide insight and direction for change that can enhance the experiences and provisions of coach education and development for women coaches. First, we explain the use of scaffolding as a concept to capture the approach adopted in the programme to bring together a range of learning situations (e.g., coach education, workshops, systematic observation of coaching practice, mentoring). We then describe and discuss the evidence gathered to inform programme development (i.e., workforce analysis, interviews with coaches). Next the delivery of the programme and assessment of its impact are discussed (i.e., pre-post self-perceptions, players’ perceptions, coaching behaviours, reflective survey). Finally we present best practices based on the lessons learned from our involvement with the programme over the past six years

Exploring the Promises of Intersectionality for Advancing Women\u27s Health Research

Women’s health research strives to make change. It seeks to produce knowledge that promotes action on the varietyof factors that affect women’s lives and their health. As part of this general movement, important strides havebeen made to raise awareness of the health effects of sex and gender. The resultant base of knowledge has beenused to inform health research, policy, and practice. Increasingly, however, the need to pay better attention to theinequities among women that are caused by racism, colonialism, ethnocentrism, heterosexism, and able-bodism, isconfronting feminist health researchers and activists. Researchers are seeking new conceptual frameworks that cantransform the design of research to produce knowledge that captures how systems of discrimination or subordinationoverlap and “articulate” with one another. An emerging paradigm for women’s health research is intersectionality.Intersectionality places an explicit focus on differences among groups and seeks to illuminate variousinteracting social factors that affect human lives, including social locations, health status, and quality of life. Thispaper will draw on recently emerging intersectionality research in the Canadian women’s health context in orderto explore the promises and practical challenges of the processes involved in applying an intersectionality paradigm.We begin with a brief overview of why the need for an intersectionality approach has emerged within thecontext of women’s health research and introduce current thinking about how intersectionality can inform andtransform health research more broadly. We then highlight novel Canadian research that is grappling with thechallenges in addressing issues of difference and diversity. In the analysis of these examples, we focus on a largelyuninvestigated aspect of intersectionality research - the challenges involved in the process of initiating and developingsuch projects and, in particular, the meaning and significance of social locations for researchers and participantswho utilize an intersectionality approach. The examples highlighted in the paper represent important shiftsin the health field, demonstrating the potential of intersectionality for examining the social context of women’slives, as well as developing methods which elucidate power, create new knowledge, and have the potential toinform appropriate action to bring about positive social change

Aeroallergens, Allergic Disease, and Climate Change: Impacts and Adaptation

Recent research has shown that there are many effects of climate change on aeroallergens and thus allergic diseases in humans. Increased atmospheric carbon dioxide concentration acts as a fertilizer for plant growth. The fertilizing effects of carbon dioxide, as well as increased temperatures from climate change, increase pollen production and the allergen content of pollen grains. In addition, higher temperatures are changing the timing and duration of the pollen season. As regional climates change, plants can move into new areas and changes in atmospheric circulation can blow pollen- and spore-containing dust to new areas, thus introducing people to allergens to which they have not been exposed previously. Climate change also influences the concentrations of airborne pollutants, which alone, and in conjunction with aeroallergens, can exacerbate asthma or other respiratory illnesses. The few epidemiological analyses of meteorological factors, aeroallergens, and allergic diseases demonstrate the pathways through which climate can exert its influence on aeroallergens and allergic diseases. In addition to the need for more research, there is the imperative to take preventive and adaptive actions to address the onset and exacerbation of allergic diseases associated with climate variability and change

Development and Validation of a Sepsis Course for Burn Intensive Care Unit Nurses

Sepsis is the most common cause of death in burn patients. Optimal recovery from sepsis requires early recognition and prompt treatment. When sepsis is suspected or detected, the 2016 Surviving Sepsis Campaign guidelines endorse immediate initiation of the Hour-1 Sepsis Bundle. Unfortunately, a random audit of hospital system compliance with the Centers for Medicare and Medicaid Services sepsis core measure was less than 50%. A 2019 performance improvement project uncovered delays in antibiotic administration, and a search of scientific and burn center literature did not elucidate a course that educated burn intensive care nurses about sepsis. The purpose of this project was to develop and validate a sepsis course for burn intensive care unit nurses. The American Burn Association’s 2007 sepsis consensus, the 2016 Surviving Sepsis Campaign guidelines, the 2018 Hour-1 Sepsis Bundle, organization policies, and current research contributed to the development of the sepsis course. Theoretical foundations for the course included the ADDIE approach and adult learning theory. A panel of experts evaluated and validated instructional materials using 2 surveys: a modified survey validated rubric for expert panel and a course evaluation survey. An aggregate mean of 3.92 and a median of 4 on the validated rubric for expert panel (a 4-point Likert scale) validated the post-course test. A thematic analysis of panelist responses helped validate course content. These results demonstrated that current research and experiential knowledge might be combined to create a burn-specific sepsis course. The sepsis course may improve staff compliance with the Hour-1 Sepsis Bundle and create positive social change for nursing staff and burn patients

Prediction & Model Evaluation for Space-Time Data

Evaluation metrics for prediction error, model selection and model averaging on space-time data are understudied and poorly understood. The absence of independent replication makes prediction ambiguous as a concept and renders evaluation procedures developed for independent data inappropriate for most space-time prediction problems. Motivated by air pollution data collected during California wildfires in 2008, this manuscript attempts a formalization of the true prediction error associated with spatial interpolation. We investigate a variety of cross-validation (CV) procedures employing both simulations and case studies to provide insight into the nature of the estimand targeted by alternative data partition strategies. Consistent with recent best practice, we find that location-based cross-validation is appropriate for estimating spatial interpolation error as in our analysis of the California wildfire data. Interestingly, commonly held notions of bias-variance trade-off of CV fold size do not trivially apply to dependent data, and we recommend leave-one-location-out (LOLO) CV as the preferred prediction error metric for spatial interpolation.Comment: 15 pages, 5 figure

Differential respiratory health effects from the 2008 northern California wildfires: A spatiotemporal approach

AbstractWe investigated health effects associated with fine particulate matter during a long-lived, large wildfire complex in northern California in the summer of 2008. We estimated exposure to PM2.5 for each day using an exposure prediction model created through data-adaptive machine learning methods from a large set of spatiotemporal data sets. We then used Poisson generalized estimating equations to calculate the effect of exposure to 24-hour average PM2.5 on cardiovascular and respiratory hospitalizations and ED visits. We further assessed effect modification by sex, age, and area-level socioeconomic status (SES). We observed a linear increase in risk for asthma hospitalizations (RR=1.07, 95% CI=(1.05, 1.10) per 5µg/m3 increase) and asthma ED visits (RR=1.06, 95% CI=(1.05, 1.07) per 5µg/m3 increase) with increasing PM2.5 during the wildfires. ED visits for chronic obstructive pulmonary disease (COPD) were associated with PM2.5 during the fires (RR=1.02 (95% CI=(1.01, 1.04) per 5µg/m3 increase) and this effect was significantly different from that found before the fires but not after. We did not find consistent effects of wildfire smoke on other health outcomes. The effect of PM2.5 during the wildfire period was more pronounced in women compared to men and in adults, ages 20–64, compared to children and adults 65 or older. We also found some effect modification by area-level median income for respiratory ED visits during the wildfires, with the highest effects observed in the ZIP codes with the lowest median income. Using a novel spatiotemporal exposure model, we found some evidence of differential susceptibility to exposure to wildfire smoke

Landscape of Epidermal Growth Factor Receptor Heterodimers in Brain Metastases

HER2+ breast cancer patients have an elevated risk of developing brain metastases (BM), despite adjuvant HER2-targeted therapy. The mechanisms underpinning this reduced intracranial efficacy are unclear. We optimised the in situ proximity ligation assay (PLA) for detection of the high-affinity neuregulin-1 receptor, HER2-HER3 (a key target of pertuzumab), in archival tissue samples and developed a pipeline for high throughput extraction of PLA data from fluorescent microscope image files. Applying this to a large BM sample cohort (n = 159) showed that BM from breast, ovarian, lung and kidney cancers have higher HER2-HER3 levels than other primary tumour types (melanoma, colorectal and prostate cancers). HER2 status, and tumour cell membrane expression of pHER2(Y1221/1222) and pHER3(Y1222) were positively, but not exclusively, associated with HER2-HER3 frequency. In an independent cohort (n = 78), BM had significantly higher HER2-HER3 levels than matching primary tumours (p = 0.0002). For patients who had two craniotomy procedures, HER2-HER3 dimer levels were lower in the consecutive lesion (n = 7; p = 0.006). We also investigated the effects of trastuzumab and pertuzumab on five different heterodimers in vitro: HER2-EGFR, HER2-HER4, HER2-HER3, HER3-HER4, HER3-EGFR. Treatment significantly altered the absolute frequencies of individual complexes in SKBr3 and/or MDA-MB-361 cells, but in the presence of neuregulin-1, the overall distribution was not markedly altered, with HER2-HER3 and HER2-HER4 remaining predominant. Together, these findings suggest that markers of HER2 and HER3 expression are not always indicative of dimerization, and that pertuzumab may be less effective at reducing HER2-HER3 dimerization in the context of excess neuregulin