Qualitative Analysis of the Expanded Food and Nutrition Education Program’s 24-hour Dietary Recall

The Expanded Food and Nutrition Education Program (EFNEP) uses a group 24-hour dietary recall (Gr24HDR) to measure changes in diet quality. Participant perceptions of the tool can guide implementation practices used by EFNEP Extension staff. Focus group (FG) sessions were conducted in five states and transcripts analyzed following a framework analysis approach. According to FG participants, a range of factors, condensed into six themes with potential interactions, influence Gr24HDR including implementation processes and community settings. Findings inform overarching considerations EFNEP staff may take when collecting Gr24HDR data in the field to improve the evaluation process for participants

Demonstrating Impact Through Replicable Analysis: Implications of an Evaluation of Arkansas\u27s Expanded Food and Nutrition Education Program

The evaluation described in this article focused on the effectiveness of Arkansas\u27s Extension-based Expanded Food and Nutrition Education Program (EFNEP) but demonstrates an analytic approach that may be useful across Extension programs. We analyzed data from 1,810 Arkansas EFNEP participants\u27 entry and exit Behavior Checklists to assess reliability of the checklist tool and explore behavior changes. The results demonstrate continued effectiveness of Arkansas EFNEP in delivering impactful health-related programming. Details of our process may provide direction for program leaders in determining which programmatic areas need attention to improve outcomes and in identifying best practices within particular program areas

Causes of death among homeless people: a population-based cross-sectional study of linked hospitalisation and mortality data in England. [version 1; peer review: 2 approved]

Background: Homelessness has increased by 165% since 2010 in England, with evidence from many settings that those affected experience high levels of mortality. In this paper we examine the contribution of different causes of death to overall mortality in homeless people recently admitted to hospitals in England with specialist integrated homeless health and care (SIHHC) schemes.  Methods: We undertook an analysis of linked hospital admission records and mortality data for people attending any one of 17 SIHHC schemes between 1st November 2013 and 30th November 2016. Our primary outcome was death, which we analysed in subgroups of 10th version international classification of disease (ICD-10) specific deaths; and deaths from amenable causes. We compared our results to a sample of people living in areas of high social deprivation (IMD5 group). Results: We collected data on 3,882 individual homeless hospital admissions that were linked to 600 deaths. The median age of death was 51.6 years (interquartile range 42.7-60.2) for SIHHC and 71.5 for the IMD5 (60.67-79.0).  The top three underlying causes of death by ICD-10 chapter in the SIHHC group were external causes of death (21.7%; 130/600), cancer (19.0%; 114/600) and digestive disease (19.0%; 114/600).  The percentage of deaths due to an amenable cause after age and sex weighting was 30.2% in the homeless SIHHC group (181/600) compared to 23.0% in the IMD5 group (578/2,512). Conclusion: Nearly one in three homeless deaths were due to causes amenable to timely and effective health care. The high burden of amenable deaths highlights the extreme health harms of homelessness and the need for greater emphasis on prevention of homelessness and early healthcare interventions

Outcomes of specialist discharge coordination and intermediate care schemes for patients who are homeless: analysis protocol for a population-based historical cohort

Introduction People who are homeless often experience poor hospital discharge arrangements, reflecting ongoing care and housing needs. Specialist integrated homeless health and care provision (SIHHC) schemes have been developed and implemented to facilitate the safe and timely discharge of homeless patients from hospital. Our study aims to investigate the health outcomes of patients who were homeless and seen by a selection of SIHHC services. Methods and analysis Our study will employ a historical population-based cohort in England. We will examine health outcomes among three groups of adults: (1) homeless patients seen by specialist discharge schemes during their hospital admission; (2) homeless patients not seen by a specialist scheme and (3)admitted patients who live in deprived neighbourhoods and were not recorded as being homeless. Primary outcomes will be: time from discharge to next hospital inpatient admission; time from discharge to next accident and emergency attendance and 28-day emergency readmission. Outcome data will be generated through linkage to hospital admissions data (Hospital Episode Statistics) and mortality data for November 2013 to November 2016. Multivariable regression will be used to model the relationship between the study comparison groups and each of the outcomes. Ethics and dissemination Approval has been obtained from the National Health Service (NHS) Confidentiality Advisory Group (reference 16/CAG/0021) to undertake this work using unconsented identifiable data. Health Research Authority Research Ethics approval (REC 16/EE/0018) has been obtained in addition to local research and development approvals for data collection at NHS sites. We will feedback the results of our study to our advisory group of people who have lived experience of homelessness and seek their suggestions on ways to improve or take this work further for their benefit. We will disseminate our findings to SIHHC schemes through a series of regional workshops

Multi Random Projection Inner Product Encryption, Applications to Proximity Searchable Encryption for the Iris Biometric

Biometric databases collect people’s information and allow users to perform proximity searches (finding all records within a bounded distance of the query point) with few cryptographic protections. This work studies proximity searchable encryption applied to the iris biometric. Prior work proposed inner product functional encryption as a technique to build proximity biometric databases (Kim et al., SCN 2018). This is because binary Hamming distance is computable using an inner product. This work identifies and closes two gaps in using inner product encryption for biometric search: 1. Biometrics naturally use long vectors often with thousands of bits. Many inner product encryption schemes generate a random matrix whose dimension scales with vector size and have to invert this matrix. As a result, setup is not feasible on commodity hardware unless we reduce the dimension of the vectors. We explore state-of-the-art techniques to reduce the dimension of the iris biometric and show that all known techniques harm the accuracy of the resulting system. That is, for small vector sizes multiple unrelated biometrics are returned in the search. For length 64 vectors, at a 90% probability of the searched biometric being returned, 10% of stored records are erroneously returned on average. Rather than changing the feature extractor, we introduce a new cryptographic technique that allows one to generate several smaller matrices. For vectors of length 1024 this reduces the time to run setup from 23 days to 4 minutes. At this vector length, for the same 90% probability of the searched biometric being returned, .02% of stored records are erroneously returned on average. 2. Prior inner product approaches leak distance between the query and all stored records. We refer to these as distance-revealing. We show a natural construction from function hiding, secret-key, predicate, inner product encryption (Shen, Shi, and Waters, TCC 2009). Our construction only leaks access patterns and which returned records are the same distance from the query. We refer to this scheme as distance-hiding. We implement and benchmark one distance-revealing and one distance-hiding scheme. The distance-revealing scheme can search a small (hundreds) database in 4 minutes while the distance-hiding scheme is not yet practical, requiring 3.5 hours. As a technical contribution of independent interest, we show that our scheme can be instantiated using symmetric pairing groups reducing the cost of search by roughly a factor of three. We believe this analysis extends to other schemes based on projections to a random linear map and its inverse analyzed in the generic group model

The JCMT BISTRO Survey: Studying the Complex Magnetic Field of L43

We present observations of polarized dust emission at 850 μm from the L43 molecular cloud, which sits in the Ophiuchus cloud complex. The data were taken using SCUBA-2/POL-2 on the James Clerk Maxwell Telescope as a part of the BISTRO large program. L43 is a dense (NH 10 22 2 ~ –1023 cm−2) complex molecular cloud with a submillimeter-bright starless core and two protostellar sources. There appears to be an evolutionary gradient along the isolated filament that L43 is embedded within, with the most evolved source closest to the Sco OB2 association. One of the protostars drives a CO outflow that has created a cavity to the southeast. We see a magnetic field that appears to be aligned with the cavity walls of the outflow, suggesting interaction with the outflow. We also find a magnetic field strength of up to ∼160 ± 30 μG in the main starless core and up to ∼90 ± 40 μG in the more diffuse, extended region. These field strengths give magnetically super- and subcritical values, respectively, and both are found to be roughly trans-Alfvénic. We also present a new method of data reduction for these denser but fainter objects like starless cores

The impact of immediate breast reconstruction on the time to delivery of adjuvant therapy: the iBRA-2 study

Background: Immediate breast reconstruction (IBR) is routinely offered to improve quality-of-life for women requiring mastectomy, but there are concerns that more complex surgery may delay adjuvant oncological treatments and compromise long-term outcomes. High-quality evidence is lacking. The iBRA-2 study aimed to investigate the impact of IBR on time to adjuvant therapy. Methods: Consecutive women undergoing mastectomy ± IBR for breast cancer July–December, 2016 were included. Patient demographics, operative, oncological and complication data were collected. Time from last definitive cancer surgery to first adjuvant treatment for patients undergoing mastectomy ± IBR were compared and risk factors associated with delays explored. Results: A total of 2540 patients were recruited from 76 centres; 1008 (39.7%) underwent IBR (implant-only [n = 675, 26.6%]; pedicled flaps [n = 105,4.1%] and free-flaps [n = 228, 8.9%]). Complications requiring re-admission or re-operation were significantly more common in patients undergoing IBR than those receiving mastectomy. Adjuvant chemotherapy or radiotherapy was required by 1235 (48.6%) patients. No clinically significant differences were seen in time to adjuvant therapy between patient groups but major complications irrespective of surgery received were significantly associated with treatment delays. Conclusions: IBR does not result in clinically significant delays to adjuvant therapy, but post-operative complications are associated with treatment delays. Strategies to minimise complications, including careful patient selection, are required to improve outcomes for patients

Genetic mechanisms of critical illness in COVID-19.

Host-mediated lung inflammation is present1, and drives mortality2, in the critical illness caused by coronavirus disease 2019 (COVID-19). Host genetic variants associated with critical illness may identify mechanistic targets for therapeutic development3. Here we report the results of the GenOMICC (Genetics Of Mortality In Critical Care) genome-wide association study in 2,244 critically ill patients with COVID-19 from 208 UK intensive care units. We have identified and replicated the following new genome-wide significant associations: on chromosome 12q24.13 (rs10735079, P = 1.65 × 10-8) in a gene cluster that encodes antiviral restriction enzyme activators (OAS1, OAS2 and OAS3); on chromosome 19p13.2 (rs74956615, P = 2.3 × 10-8) near the gene that encodes tyrosine kinase 2 (TYK2); on chromosome 19p13.3 (rs2109069, P = 3.98 ×  10-12) within the gene that encodes dipeptidyl peptidase 9 (DPP9); and on chromosome 21q22.1 (rs2236757, P = 4.99 × 10-8) in the interferon receptor gene IFNAR2. We identified potential targets for repurposing of licensed medications: using Mendelian randomization, we found evidence that low expression of IFNAR2, or high expression of TYK2, are associated with life-threatening disease; and transcriptome-wide association in lung tissue revealed that high expression of the monocyte-macrophage chemotactic receptor CCR2 is associated with severe COVID-19. Our results identify robust genetic signals relating to key host antiviral defence mechanisms and mediators of inflammatory organ damage in COVID-19. Both mechanisms may be amenable to targeted treatment with existing drugs. However, large-scale randomized clinical trials will be essential before any change to clinical practice