Recent Cancer Screening Among Women: A Critical Evaluation of Why Canadians aren’t Getting Regular Clinical Breast Exams and Pap Tests

Preventive cancer screening is effective for early detection of many cancers, however many Canadians fail to participate in screening programs. This paper critically evaluates the results of an analysis of Canadian Community Health Survey data relating to women‟s cancer screening behaviours. The most commonly reported reasons by Canadian women for not being screened by clinical breast exams (CBE) and Pap tests are discussed in relation to their ability to provide insight into why women do not participate in cancer screening. Limitations of current data on cancer screening behaviours are discussed along with recommendations for their improvement. &nbsp

Evaluación para la implementación de un proyecto de gestión integral de residuos sólidos en el municipio de Constanza provincia La Vega, Rep. Dom.

Castellano: Este documento estudia como son manejados los Residuos Municipales en la República Dominicana, con la finalidad de conocer los factores necesarios para contribuir a la reducción de los aspectos negativos que provoca la mala gestión de estos y así poder aplicar una propuesta de mejora para este sistema. La Gestión de los residuos en el país se basa en la disposición de estos en vertederos no controlados, una de las principales fuentes de contaminación aérea, del suelo y los recursos hídricos. Por otro lado el país cuenta con un mercado activo de reciclaje de materiales inorgánicos que en su mayoría son recolectados en los vertederos. La separación de los residuos es muy importante para el reciclaje de materia orgánica y la obtención compost de calidad. Como no existe un sistema de separación en origen en el país, no existen muchas iniciativas relacionadas a esta técnica. La implementación de un proyecto de gestión integral de residuos en el país busca optimizar el uso de los recursos utilizando medidas y técnicas adaptadas al contexto económico social y ambiental de una población. El municipio seleccionado para el caso de estudio es Constanza, ubicado en la Cordillera Central de la isla. Una zona potencial para la reintegración de los residuos como materia prima, en sectores como la Agricultura. En Constanza hay una fuerte producción agrícola en la que existe un alto consumo de agroquímicos que pueden ser reducidos mediante la aplicación de compost generado de la valorización de los residuos municipales. En una primera fase del proyecto se reciclaran también los residuos plásticos que serán llevados a la planta de reciclaje más cercana. Este proyecto busca promover un cambio en las formas convencionales de eliminar los residuos y reducir la alta presión en el vertedero Municipal de Constanza. La implementación del proyecto generaría nuevas oportunidades de trabajo formal dentro de la cadena de gestión del servicio. Uno de los puntos clave seria la concientización de la población para participar en la gestión de los residuos. La falta de estudios en campo limita la evaluación exacta. El alcance del proyecto esta reducido a las necesidades y procesos que se deben llevar a cabo para la implementación.English: This document studies how Municipal Waste is handled the in the Dominican Republic, with the purpose to know the necessary actions to reduce the negative aspects that causes the bad waste management and apply a proposal of improvement for this system. The waste management in the country is based in the disposal of these in uncontrolled landfills, one of the main sources of aerial, soil and water pollution. The country does counts with an active market of recycling inorganic materials that in his majority are collected from the landfills. Separation of the residues is very important for the recycling of organic matter and obtaining quality compost. As there is no source separation system in the country, not many initiatives exist related to this technique. The implementation of a project for integral waste management in the country looks for to optimize the use of the resources using measures and techniques adapted to the social economic and environmental context. The municipality selected for the case of study is Constanza, situated in the Central Mountain Range of the island. A potential zone for the reintegration of the waste as raw material, in sectors like the Agriculture. Since Constanza is a strong agricultural producer in which exists a high consumption of agrochemicals that can be reduced by means of the application of compost generated from the valorization of the municipal waste. In a first phase of the project recycled also the plastic waste that they will be brought to the plant of recycling more next.This project looks for to promote a change in the conventional shapes to delete the waste and reduce the high pressure in the Municipal dump of Constanza. The implementation of the project would generate new opportunities of formal job posts in the chain of management of the service. One of the key points would be the raise the awareness of the population to take part in the management of the waste. The fault in field studies limits the exact evaluation. The scope of the project is reduced to the needs and processes that are needed to carry out for the implementation.Català: En aquest document anem a estudiar com són manejats els Residus Municipals en la República Dominicana, amb la finalitat de conèixer els factors necessaris per contribuir a la reducció dels aspectes negatius que provoca la mala gestió d'aquests i així poder aplicar una proposta de millora per a aquest sistema. La Gestió dels residus al país es basa en la disposició d'aquests en abocadors no controlats, una de les principals fonts de contaminació aèria, del sòl i els recursos hídrics. D'altra banda país compta amb un mercat actiu de reciclatge de materials inorgànics que en la seva majoria són recol•lectats en els abocadors. La separació dels residus és molt important per al reciclatge de matèria orgànica i l'obtenció compost de qualitat. Com no existeix un sistema de separació en origen al país, no existeixen moltes iniciatives relacionades a aquesta tècnica. La implementació d'un projecte de gestió integral de residus al país busca optimitzar l'ús dels recursos utilitzant mesures i tècniques adaptades al context econòmic social i ambiental. El municipi seleccionat per al cas d'estudi és Constanza, situat en la Serralada Central de la illa. Una zona potencial per a la reintegració dels residus com a matèria primera, en sectors com l'Agricultura. A Constanza hi ha una forta producció agrícola en la qual existeix un alt consum de agroquímics que poden ser reduïts mitjançant l'aplicació de compost generat de la valorització dels residus municipals d'una població. En una primera fase del projecte es reciclessin també els residus plàstics que seran portats a la planta de reciclatge més propera. Aquest projecte busca promoure un canvi en les formes convencionals d'eliminar els residus i reduir l'alta pressió en l'abocador Municipal de Constanza. La implementació del projecte generaria noves oportunitats de treball formal dins de la cadena de gestió del servei. Un dels punts clau seria la conscienciació de la població per participar en la gestió dels residus. La falta d'estudis en camp limita l'avaluació exacta. L'abast del projecte aquesta reduït a les necessitats i processos que s'han de dur a terme per a la implementació

The science of citizen science: a systematic literature review on educational and scientific outcomes

Citizen Science is an ever-growing field of public engagement with science, and recent years have seen an increasing number of studies examining its potential. This study reviews this research to determine the educational and scientific outcomes of Citizen Science. A literature search produced 1,240 articles that were subsequently coded according to their main focus. Articles fell into one of three main categories: (a) empirical scientific articles, (b) narrative project descriptions, and (c) theoretical and technical conceptualizations. Hundred and forty-eight studies investigated educational outcomes of participation in Citizen Science such as effects on interest in science or motivation. These studies were examined further to assess the achievement of educational outcomes of Citizen Science. In terms of changing epistemological beliefs, for example, Citizen Science seems to have little effect. Overall, there is currently a lack of empirical studies to assess the educational outcomes comprehensively. In contrast, many empirical scientific articles answered research questions in different scientific disciplines based on Citizen Science data and many studies confirmed a high level of Citizen Science data quality providing information on the scientific outcomes. Implications for future research on Citizen Science are discussed

The UK needs a sustainable strategy for COVID-19

The UK is well into the second wave of COVID-19, with 60 051 lives lost to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection to date, according to provisional data from the&nbsp;Office for National Statistics. Official UK Government&nbsp;data&nbsp;show that cases have been rising exponentially since late August, 2020, with increases across all regions in England in recent weeks. &nbsp;As of Nov 4, 2020, the UK had 25 177 confirmed daily cases. These are almost certainly underestimates as between Oct 17 and Oct 23, 2020, England alone had 52 000 estimated daily cases. &nbsp;Estimates of the effective reproduction number in England vary between 1·1 and 1·6.</p

Impact of Capsular Switch on Invasive Pneumococcal Disease Incidence in a Vaccinated Population

BACKGROUND: Despite the dramatic decline in the incidence of invasive pneumococcal disease (IPD) observed since the introduction of conjugate vaccination, it is feared that several factors may undermine the future effectiveness of the vaccines. In particular, pathogenic pneumococci may switch their capsular types and evade vaccine-conferred immunity. METHODOLOGY/PRINCIPAL FINDINGS: Here, we first review the literature and summarize the available epidemiological data on capsular switch for S. pneumoniae. We estimate the weekly probability that a persistently carried strain may switch its capsule from four studies, totalling 516 children and 6 years of follow-up, at 1.5x10(-3)/week [4.6x10(-5)-4.8x10(-3)/week]. There is not enough power to assess an increase in this frequency in vaccinated individuals. Then, we use a mathematical model of pneumococcal transmission to quantify the impact of capsular switch on the incidence of IPD in a vaccinated population. In this model, we investigate a wide range of values for the frequency of vaccine-selected capsular switch. Predictions show that, with vaccine-independent switching only, IPD incidence in children should be down by 48% 5 years after the introduction of the vaccine with high coverage. Introducing vaccine-selected capsular switch at a frequency up to 0.01/week shows little effect on this decrease; yearly, at most 3 excess cases of IPD per 10(6) children might occur due to switched pneumococcal strains. CONCLUSIONS: Based on all available data and model predictions, the existence of capsular switch by itself should not impact significantly the efficacy of pneumococcal conjugate vaccination on IPD incidence. This optimistic result should be tempered by the fact that the selective pressure induced by the vaccine is currently increasing along with vaccine coverage worldwide; continued surveillance of pneumococcal populations remains of the utmost importance, in particular during clinical trials of the new conjugate vaccines

Towards a European Health Research and Innovation Cloud (HRIC)

The European Union (EU) initiative on the Digital Transformation of Health and Care (Digicare) aims to provide the conditions necessary for building a secure, flexible, and decentralized digital health infrastructure. Creating a European Health Research and Innovation Cloud (HRIC) within this environment should enable data sharing and analysis for health research across the EU, in compliance with data protection legislation while preserving the full trust of the participants. Such a HRIC should learn from and build on existing data infrastructures, integrate best practices, and focus on the concrete needs of the community in terms of technologies, governance, management, regulation, and ethics requirements. Here, we describe the vision and expected benefits of digital data sharing in health research activities and present a roadmap that fosters the opportunities while answering the challenges of implementing a HRIC. For this, we put forward five specific recommendations and action points to ensure that a European HRIC: i) is built on established standards and guidelines, providing cloud technologies through an open and decentralized infrastructure; ii) is developed and certified to the highest standards of interoperability and data security that can be trusted by all stakeholders; iii) is supported by a robust ethical and legal framework that is compliant with the EU General Data Protection Regulation (GDPR); iv) establishes a proper environment for the training of new generations of data and medical scientists; and v) stimulates research and innovation in transnational collaborations through public and private initiatives and partnerships funded by the EU through Horizon 2020 and Horizon Europe

Effects of Therapy in Oropharyngeal Dysphagia by Speech and Language Therapists: A Systematic Review

Medical and paramedical treatments should be evaluated according to current standards of evidence-based medicine. Evaluation of therapy in oropharyngeal dysphagia fits into this growing interest. A systematic review is given of the literature on the effects of therapy in oropharyngeal dysphagia carried out by speech therapists. Thus, the review excludes reports of surgical or pharmacological treatments. The literature search was performed using the electronic databases PubMed and Embase. All available inclusion dates up to November 2008 were used. The search was limited to English, German, French, Spanish, and Dutch publications. MESH terms were supplemented by using free-text words (for the period after January 2005). Fifty-nine studies were included. In general, statistically significant positive therapy effects were found. However, the number of papers was rather small. Moreover, diverse methodological problems were found in many of these studies. For most studies, the conclusions could not be generalized; comparison was hindered by the range of diagnoses, types of therapies, and evaluation techniques. Many questions remain about the effects of therapy in oropharyngeal dysphagia as performed by speech and language therapists. Although some positive significant outcome studies have been published, further research based on randomized controlled trials is needed

Aboveground biomass density models for NASA's Global Ecosystem Dynamics Investigation (GEDI) lidar mission

NASA's Global Ecosystem Dynamics Investigation (GEDI) is collecting spaceborne full waveform lidar data with a primary science goal of producing accurate estimates of forest aboveground biomass density (AGBD). This paper presents the development of the models used to create GEDI's footprint-level (similar to 25 m) AGBD (GEDI04_A) product, including a description of the datasets used and the procedure for final model selection. The data used to fit our models are from a compilation of globally distributed spatially and temporally coincident field and airborne lidar datasets, whereby we simulated GEDI-like waveforms from airborne lidar to build a calibration database. We used this database to expand the geographic extent of past waveform lidar studies, and divided the globe into four broad strata by Plant Functional Type (PFT) and six geographic regions. GEDI's waveform-to-biomass models take the form of parametric Ordinary Least Squares (OLS) models with simulated Relative Height (RH) metrics as predictor variables. From an exhaustive set of candidate models, we selected the best input predictor variables, and data transformations for each geographic stratum in the GEDI domain to produce a set of comprehensive predictive footprint-level models. We found that model selection frequently favored combinations of RH metrics at the 98th, 90th, 50th, and 10th height above ground-level percentiles (RH98, RH90, RH50, and RH10, respectively), but that inclusion of lower RH metrics (e.g. RH10) did not markedly improve model performance. Second, forced inclusion of RH98 in all models was important and did not degrade model performance, and the best performing models were parsimonious, typically having only 1-3 predictors. Third, stratification by geographic domain (PFT, geographic region) improved model performance in comparison to global models without stratification. Fourth, for the vast majority of strata, the best performing models were fit using square root transformation of field AGBD and/or height metrics. There was considerable variability in model performance across geographic strata, and areas with sparse training data and/or high AGBD values had the poorest performance. These models are used to produce global predictions of AGBD, but will be improved in the future as more and better training data become available

The number of tree species on Earth

One of the most fundamental questions in ecology is how many species inhabit the Earth. However, due to massive logistical and financial challenges and taxonomic difficulties connected to the species concept definition, the global numbers of species, including those of important and well-studied life forms such as trees, still remain largely unknown. Here, based on global groundsourced data, we estimate the total tree species richness at global, continental, and biome levels. Our results indicate that there are 73,000 tree species globally, among which ∼9,000 tree species are yet to be discovered. Roughly 40% of undiscovered tree species are in South America. Moreover, almost one-third of all tree species to be discovered may be rare, with very low populations and limited spatial distribution (likely in remote tropical lowlands and mountains). These findings highlight the vulnerability of global forest biodiversity to anthropogenic changes in land use and climate, which disproportionately threaten rare species and thus, global tree richness