190 research outputs found

    Influencing Student Beliefs about Poverty and Health through Interprofessional Community-Based Educational Experiences

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    Background: Pre-licensure students from medicine, physical therapy, kinesiology, nursing, and social work participated in a population health project at the University of Saskatchewan. We assessed the effect of this interactive, interprofessional, community-based educational experience on students’ attitudes and beliefs about poverty and health.Methods and Findings: Participants (N = 119) completed two measures at the beginning and end of the five-week project: the 37-item Attitudes toward Poverty Scale (APS) and the 8-item Beliefs about the Relationship between Poverty and Health (BRPH). APS scores showed a modest significant increase toward more positive attitudes over time (F(1, 110) = 7.97, p < .01). On the BRPH, participants agreed significantly less at Week 5 with two behavioral explanations (F(1, 114) = 5.07, p < .05; F(1, 114) = 11.00, p < .01) and one structural explanation (F(1, 112) = 11.09, p < .01) about relationships between poverty and health. There was some evidence that face-to-face interactions with community members had more impact than a simulation exercise. Students gave positive evaluations of the interprofessional format of the project. Attrition effects may limit the interpretation of these results.Conclusions: Results demonstrate that brief interprofessional community-based learning experiences can positively influence students’ attitudes and beliefs about the relationship between poverty and health

    Advancing the future of physical activity guidelines in Canada: an independent expert panel interpretation of the evidence

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    The Canadian Society for Exercise Physiology, in partnership with the Public Health Agency of Canada, has initiated a review of their physical activity guidelines to promote healthy active living for Canadian children, youth, adults and older adults; previous guidelines were released in 2002, 2002, 1998 and 1999 respectively. Several background papers from this project were published recently and provide foundation evidence upon which to base new guidelines. Furthermore, comprehensive systematic reviews were completed to ensure a rigorous evaluation of evidence informing the revision of physical activity guidelines for asymptomatic populations. The overall guideline development process is being guided and assessed by the AGREE II instrument. A meeting of experts was convened to present the evidence complied to inform the guideline revisions. An independent expert panel was assembled to review the background materials and systematic reviews; listen to the presentations and discussions at the expert meeting; ask for clarification; and produce the present paper representing their interpretation of the evidence including grading of the evidence and their identification of needs for future research. The paper includes also their recommendations for evidence-informed physical activity guidelines

    The impact of control strategies and behavioural changes on the elimination of Ebola from Lofa County, Liberia.

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    The Ebola epidemic in West Africa was stopped by an enormous concerted effort of local communities and national and international organizations. It is not clear, however, how much the public health response and behavioural changes in affected communities, respectively, contributed to ending the outbreak. Here, we analyse the epidemic in Lofa County, Liberia, lasting from March to November 2014, by reporting a comprehensive time line of events and estimating the time-varying transmission intensity using a mathematical model of Ebola transmission. Model fits to the epidemic show an alternation of peaks and troughs in transmission, consistent with highly heterogeneous spread. This is combined with an overall decline in the reproduction number of Ebola transmission from early August, coinciding with an expansion of the local Ebola treatment centre. We estimate that healthcare seeking approximately doubled over the course of the outbreak, and that isolation of those seeking healthcare reduced their reproduction number by 62% (mean estimate, 95% credible interval (CI) 59-66). Both expansion of bed availability and improved healthcare seeking contributed to ending the epidemic, highlighting the importance of community engagement alongside clinical intervention.This article is part of the themed issue 'The 2013-2016 West African Ebola epidemic: data, decision-making and disease control'

    Ventilatory responses after major surgery and high dependency care

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    BACKGROUND: Disturbed breathing during sleep, with episodic upper airway obstruction, is frequent after major surgery. Ventilatory responses to hypercapnia and hypoxia during episodes of airway obstruction are difficult to investigate because the usual measure, that of ventilation, has been attenuated by the obstruction. We simulated the blood gas stimulus associated with obstruction to allow investigation of the responses. METHODS: To assess ventilatory responses, we studied 19 patients, mean age 59 (19–79), first at discharge from high dependency care after major abdominal surgery and then at surgical review, ∼6 weeks later. Exhaled gas was analysed and inspired gas adjusted to simulate changes that would occur during airway obstruction. Changes in ventilation were measured over the following 45–70 s. Studies were done from air breathing if possible, and also from an increased inspired oxygen concentration. RESULTS: During simulated obstruction, hypercapnia developed similarly in all the test conditions. Arterial oxygen saturation decreased significantly more rapidly when the test was started from air breathing. The mean ventilatory response was 5.8 litre min(−2) starting from air breathing and 4.5 litre min(−2) with oxygen breathing. The values 6 weeks later were 5.9 and 4.3 litre min(−2), respectively (P=0.05, analysis of variance). There was no statistical difference between the responses starting from air and those on oxygen. CONCLUSIONS: After major surgery, ventilatory responses to hypercapnia and hypoxaemia associated with airway obstruction are small and do not improve after 6 weeks. With air breathing, arterial oxygen desaturation during simulated rebreathing is substantial

    Reduced Plasmodium vivax Erythrocyte Infection in PNG Duffy-Negative Heterozygotes

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    BACKGROUND: Erythrocyte Duffy blood group negativity reaches fixation in African populations where Plasmodium vivax (Pv) is uncommon. While it is known that Duffy-negative individuals are highly resistant to Pv erythrocyte infection, little is known regarding Pv susceptibility among heterozygous carriers of a Duffy-negative allele (+/−). Our limited knowledge of the selective advantages or disadvantages associated with this genotype constrains our understanding of the effect that interventions against Pv may have on the health of people living in malaria-endemic regions. METHODS AND FINDINGS: We conducted cross-sectional malaria prevalence surveys in Papua New Guinea (PNG), where we have previously identified a new Duffy-negative allele among individuals living in a region endemic for all four human malaria parasite species. We evaluated infection status by conventional blood smear light microscopy and semi-quantitative PCR-based strategies. Analysis of a longitudinal cohort constructed from our surveys showed that Duffy heterozygous (+/−) individuals were protected from Pv erythrocyte infection compared to those homozygous for wild-type alleles (+/+) (log-rank tests: LM, p = 0.049; PCR, p = 0.065). Evaluation of Pv parasitemia, determined by semi-quantitative PCR-based methods, was significantly lower in Duffy +/− vs. +/+ individuals (Mann-Whitney U: p = 0.023). Overall, we observed no association between susceptibility to P. falciparum erythrocyte infection and Duffy genotype. CONCLUSIONS: Our findings provide the first evidence that Duffy-negative heterozygosity reduces erythrocyte susceptibility to Pv infection. As this reduction was not associated with greater susceptibility to Pf malaria, our in vivo observations provide evidence that Pv-targeted control measures can be developed safely

    The properties of proton-proton interactions between 100 and 1000 GeV from a cosmic-ray experiment

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    Proton-proton interactions above 100 GeV have been studied in an experiment using cosmic-ray protons interacting in a liquid hydrogen target. From several hundred hydrogen interactions, it has been learned that: (a) the total inelastic pp cross section is not changing significantly with energy above 30 GeV; (b) the multiplicity distributions of charged prongs agree with a Poisson distribution in charged-particle pairs; (c) the average charged prong multiplicity increases as 1 n s; (d) the angular distribution of charged particles agrees with a c.m. momentum distribution of charged particles that varies as exp exp [-8 pT2-8x2] d3p/E (where X = pL/po) and a nucleon distribution that varies as 10x exp [-3 pT2] d3p/E for 0.05 < x < 0.85. Further properties of the angular distributions, characteristics of the ionization calorimeter, the cross section in iron, and other features of the data are reported.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/34084/1/0000363.pd
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