bluuebunny/crossref_metadata_2025 huggingface dataset:
Changes in blood pressure among patients in the Ontario Telehomecare programme: An observational longitudinal cohort study
Authors: Sahakyan Yeva , Abrahamyan Lusine , Shahid Nida , Stanimirovic Alexandra , Pechlivanoglou Petros , Mitsakakis Nicholas , Ryan Welson , Krahn Murray , Rac Valeria E
Published: May 2017

Background

The objective of this study was to investigate the changes in blood pressure among patients enrolled in the Telehomecare programme in Ontario, Canada.

Methods

This observational study utilised a prospective longitudinal cohort design, including patients with heart failure and chronic obstructive pulmonary disease enrolled in the Ontario Telehomecare programme from July 2012 to July 2015. The outcome of interest was change in mean (biweekly) systolic and diastolic blood pressure levels over a six-month period. Patient data were extracted from the Ontario Telemedicine Network database, and analysed using generalised linear mixed model procedures.

Results

Overall, we analysed data for 3513 patients. Patients were on average 74.1 ± 11.4 years of age; almost half were men, 62% had heart failure, 55% chronic obstructive pulmonary disease and 29% diabetes. At baseline, the mean systolic and diastolic blood pressure levels were 130.4 ± 19.1 mmHg and 72.2 ± 12.5 mmHg for the total sample. At six months, the adjusted reduction in systolic and diastolic blood pressure values were 4.0 mmHg (95% confidence interval: −4.5 to −3.5) and 2.7 mmHg (95% confidence interval: −3.1 to −2.4), respectively. In a subgroup of 1220 patients with uncontrolled blood pressure at baseline (systolic/diastolic blood pressure of 150.7 ± 10.2 mmHg/80.2 ± 13.5 mmHg) the adjusted reduction in systolic blood pressure was 12.5 mmHg (95% confidence interval: −13.4 to −11.6) and in diastolic blood pressure was 7.1 mmHg (95% confidence interval: −7.8 to −6.5) over the six-month period.

Conclusions

Blood pressure levels were significantly reduced in patients enrolled in the Telehomecare programme, with changes being more pronounced in patients with uncontrolled blood pressure. The sustainability of decreased blood pressure on other clinical outcomes needs further evaluation.
Playful Subversions: Young children and tablet use
Authors: Fróes Isabel Cristina Gonçalves , Tosca Susana
Published: May 2017

Drawing on data from empirical studies of small children (4- to 8-year-olds) using tablets in educational settings, we explore the ways they resist the expected use of the various applications in order to invent their own forms of interaction. We propose the category of playful subversion to conceptualize the different kinds of technology appropriation and the pleasures of playful tinkering. We identify four aspects of playful subversion in relation to tablets – invention, definition, assignation, and performance – and argue for a less normative understanding of children’s interactions with technology.
Riskvärdering av Alkohol: En Litteraturgenomgång Med Särskild Tonvikt På Ett Kvinnoperspektiv
Authors: Thakker Kerstin Damström
Published: May 2017

This article illustrates the association between alcohol exposure and the risk of developing alcohol-related problems, the different types of dose-response curves, and the particular female susceptibility. The extensive discussion on the interpretation of the J-shaped association between alcohol consumption and coronary heart disease is reviewed. Present knowledge shows that the beneficial health effects of moderate drinking are limited to minor subgroups in the general population. The possible net beneficial health effects of moderate drinking may also be achieved in less risky ways by refraining from smoking, eating less dietary fat, and engaging in regular exercise. The guidelines given in risk evaluations published over the last decade have become successively more restrictive. During this time increasing attention has been drawn to the risks associated with ‘social’ and ‘moderate’ drinking. It has been pointed out that for the moderate drinker various psycho-social problems – especially in the area of productivity and relations – are more likely to develop than organ damage.
Wildlife corridors in india
Authors: Srivastava Raghav , Tyagi Richa
Published: May 2017

Wildlife corridors, used by various species to migrate, breed and feed, are increasingly becoming relevant as essential tools for wildlife conservation. Rapid increase in industrial and infrastructural development, especially around forests, has resulted in widespread habitat fragmentation and isolation. Added to this, the growing development (for tourism, linear infrastructure etc.) around protected areas, and the altered de facto boundaries of these, have exacerbated this need. There is, however, no ‘hard’ statutory recognition afforded in India to wildlife corridors in spite of their established relevance in ecological conservation. Nor is there a strict prohibition on development within, and around important corridors in India. Even so, wildlife corridors have found passing mention in certain conservation law and guidelines framed thereunder, which seek to protect wildlife habitat and reduce human – wildlife conflict. These extant legal spaces have largely proved ineffective in the protection and conservation of corridors, and corridor protection and management continues to be a dormant legal space in India.

This paper seeks to analyse the various barriers to corridor conservation and management, and whether the existing legal measures are underutilised in providing legal protection to wildlife corridors, without the need of a parallel institutional framework. Through an understanding of the criticality of corridors to wildlife conservation, the adequacy of existing legal structures has been examined by the authors, and recommendations made for augmenting the current legal framework with more concrete strategies.
The Relationship Between Internalized Homophobia and Intimate Partner Violence in Same-Sex Relationships: A Meta-Analysis
Authors: Badenes-Ribera Laura , Sánchez-Meca Julio , Longobardi Claudio
Published: May 2017

A meta-analysis was conducted to investigate the association between internalized homophobia and intimate partner violence (IPV) perpetration and victimization in same-sex relationships. The literature search and the application of the inclusion criteria made it possible to identify 10 studies, 2 of which were excluded due to missing data. Therefore, eight studies were finally included in the meta-analysis. The results showed positive and statistically significant associations between internalized homophobia and IPV perpetration and victimization, indicating that higher levels of internalized homophobia were related to higher levels of IPV. Specifically, the pooled effect size for the relationship between internalized homophobia and IPV perpetration (all forms), it was r + = .147, 95% confidence interval (CI) = [.079, .214]; for the association between internalized homophobia and physical/sexual IPV perpetration, it was r + = .166, 95% CI [.109, .221]; p < .0001; for the relationship between internalized homophobia and psychological IPV perpetration, it was r + = .145, 95% CI [.073, .216]; and for the association between internalized homophobia and any type of IPV victimization, it was r + = .102, 95% CI [.030, .173]. Implications of these results for clinical practice and future research are discussed.
Childhood Maltreatment and the Risk for Criminal Justice Involvement and Victimization Among Homeless Individuals: A Systematic Review
Authors: Edalati Hanie , Nicholls Tonia L.
Published: May 2017

Homeless individuals are at higher risk of criminal justice involvement (CJI) and victimization compared to their housed counterparts. Exposure to childhood maltreatment (CM; e.g., abuse, neglect) is one of the most significant predictors of CJI and victimization among homeless populations. The aim of this systematic review was to synthesize current knowledge regarding the relationship between CM and CJI and victimization among homeless individuals. Guided by the preferred reporting items for systematic reviews and meta-analyses (PRISMA) methods, a systematic search was performed using PsycINFO, MEDLINE, Embase, Web of Science, and the Cumulative Index to Nursing and Allied Health Literature for published studies investigating the relationship between CM and CJI and victimization among homeless samples. We identified 20 studies that met the inclusion criteria. Findings showed that across the majority of studies, CM, and in particular childhood physical (CPA) and sexual (CSA) abuse, is associated with increased risk of both CJI and victimization, regardless of various important factors (e.g., sociodemographic characteristics, psychiatric disorders, substance use). These findings support the need for prevention and treatment for “families at risk” (i.e., for intimate partner violence, child abuse and neglect) and also document the need for trauma-informed approaches within services for homeless individuals. Future research should focus on prospective designs that examine victimization and CJI in the same samples.
C-SAFE: A Computer-Delivered Sexual Health Promotion Program for Latinas
Authors: Klein Charles H. , Kuhn Tamara , Altamirano Midori , Lomonaco Carmela
Published: May 2017

This article describes the development and evaluation of C-SAFE (Sexual Awareness for Everyone), a computer-delivered sexual health promotion program for Latinas. We first describe the process of adapting an evidence-based, group-level intervention into an individually administered computer-delivered program. We then present the methods and results of a randomized control trial with 321 Latinas in California and Florida to test C-SAFE’s preliminary efficacy in reducing sexual health risk. We found no statistically significant differences between the two conditions at a six-month follow-up in terms of sexual behaviors or attitudes toward sexually transmitted infections and condoms, although C-SAFE women reported fewer days in the past month when their mental health was not good (p = .02). C-SAFE condition women also reported more satisfaction than control condition women in their assessment of information presentation (on a scale of 1 = poor and 5 = excellent; C-SAFE = 4.45 vs. control = 4.25, p = .053) and having learned something new (C-SAFE = 95.1% vs. control = 79.3%, χ2 < 0.001), with utility of content for Latinas approaching significance (C-SAFE = 4.50 vs. control = 4.31, p = .058). In conclusion we discuss the importance of teachable moments, matching of delivery modalities to implementation contexts, and possible directions for evidence-based sexual health promotion programs given the current sexual health landscape.
Validating Dose Uncertainty Estimates Produced by AUTODIRECT: An Automated Program to Evaluate Deformable Image Registration Accuracy
Authors: Kim Hojin , Chen Josephine , Phillips Justin , Pukala Jason , Yom Sue S. , Kirby Neil
Published: May 2017

Deformable image registration is a powerful tool for mapping information, such as radiation therapy dose calculations, from one computed tomography image to another. However, deformable image registration is susceptible to mapping errors. Recently, an automated deformable image registration evaluation of confidence tool was proposed to predict voxel-specific deformable image registration dose mapping errors on a patient-by-patient basis. The purpose of this work is to conduct an extensive analysis of automated deformable image registration evaluation of confidence tool to show its effectiveness in estimating dose mapping errors. The proposed format of automated deformable image registration evaluation of confidence tool utilizes 4 simulated patient deformations (3 B-spline-based deformations and 1 rigid transformation) to predict the uncertainty in a deformable image registration algorithm’s performance. This workflow is validated for 2 DIR algorithms (B-spline multipass from Velocity and Plastimatch) with 1 physical and 11 virtual phantoms, which have known ground-truth deformations, and with 3 pairs of real patient lung images, which have several hundred identified landmarks. The true dose mapping error distributions closely followed the Student t distributions predicted by automated deformable image registration evaluation of confidence tool for the validation tests: on average, the automated deformable image registration evaluation of confidence tool–produced confidence levels of 50%, 68%, and 95% contained 48.8%, 66.3%, and 93.8% and 50.1%, 67.6%, and 93.8% of the actual errors from Velocity and Plastimatch, respectively. Despite the sparsity of landmark points, the observed error distribution from the 3 lung patient data sets also followed the expected error distribution. The dose error distributions from automated deformable image registration evaluation of confidence tool also demonstrate good resemblance to the true dose error distributions. Automated deformable image registration evaluation of confidence tool was also found to produce accurate confidence intervals for the dose–volume histograms of the deformed dose.
Dual-Energy SPECT and the Development of Peptide p5+14 for Imaging Amyloidosis
Authors: Wall Jonathan S. , Kennel Stephen J. , Martin Emily B.
Published: May 2017

Amyloidosis is associated with a number of rare diseases and is characterized by the deposition, in abdominothoracic organs and peripheral nerves, of extracellular protein fibrils, which leads to dysfunction and severe morbidity. Effective clinical evaluation and management of patients with systemic amyloidosis are hampered by the lack of a noninvasive, quantitative method for detecting whole-body amyloid load. We have used a battery of assays including dual-energy SPECT imaging and comparative effectiveness studies in support of translation of a synthetic polybasic peptide, p5+14, as a novel radiotracer for visualization of amyloidosis by molecular imaging. These data provide support for a phase 1 positron emission tomography/computed tomography imaging trial of this reagent, labeled with iodine-124, in patients with all forms of systemic amyloidosis.
Nepotism and the Jackson County School Board
Authors: Heisler William , Hanlin Lesa
Published: May 2017

In 2015, the superintendent of the Jackson County School District revised the existing nepotism policy, and, subsequently, his wife was hired to a newly created position of director of innovation at a salary nearly twice the average paid to teachers in the district. Because of community reaction, the Jackson County School Board met in special session to address the situation. This case, presented in three sequential parts, raises a number of questions: When does nepotism exist? What constitutes unethical behavior on the part of a school district leader? How should a school superintendent react when confronted by alleged misconduct? How should a school board proceed when faced with community outrage? How can a school board regain public trust? This case can be useful in graduate courses to generate discussion of ethical behavior and the consequences of unethical behavior in educational leadership and administration.
Retaliatory Teacher Transfer or Meeting a District Need?
Authors: DeLuca Thomas A. , Novak Joseph C. , Cocolis Angelo
Published: May 2017

After being involuntarily transferred from a suburban middle school near his home to an urban school facing many challenges, this case describes a series of events that led to a veteran teacher’s termination. Upon claiming he was wrongfully terminated, the case narrative ends just prior to the teacher’s hearing before the board of education, where the quality of two principals’ documentation serves as key evidence for both parties.
Childhood maltreatment and inflammation among pregnant women with gestational diabetes mellitus: A pilot study
Authors: Bublitz Margaret , De La Monte Suzanne , Martin Susan , Larson Lucia , Bourjeily Ghada
Published: May 2017

Background

Women with childhood maltreatment histories are at increased risk for adverse birth outcomes. Mechanisms explaining this link are poorly understood. Past research is limited by sampling pregnant women at low risk for adverse maternal and neonatal outcomes.

Methods

This pilot study was a secondary data analysis of 24 women with gestational diabetes mellitus; 17% of the sample also reported a maltreatment history. Women provided a blood sample to measure inflammatory cytokines and insulin resistance, and saliva samples to measure diurnal cortisol. Birth outcomes for past and current pregnancies were recorded.

Results

Histories of maltreatment were associated with elevated interleukin-15 and a marginally greater incidence of preterm delivery in current and past pregnancies.

Conclusions

This pilot study was the first to demonstrate an association between childhood maltreatment history and inflammatory cytokine levels in pregnant women diagnosed with gestational diabetes mellitus.
Optimisation of the surfboard fin shape using computational fluid dynamics and genetic algorithms
Authors: Sakellariou Konstantinos , Rana Zeeshan A , Jenkins Karl W
Published: May 2017

During the sport of wave surfing, the fins on a surfboard play a major role in the overall performance of the surfer. This article presents the optimisation of a surfboard fin shape, using coupled genetic algorithms with the FLUENT® solver, aiming at the maximisation of the lift per drag ratio. The design-variable vector includes six components namely the chord length, the depth and the sweep angle of the fin as well as the maximum camber, the maximum camber position and the thickness of the hydrofoil (the four-digit NACA parametrization). The Latin hypercube sampling technique is utilised to explore the design space, resulting in 42 different fin designs. Fin and control volume models are created (using CATIA® V5) and meshed (unstructured using ANSYS® Workbench). Steady-state computations were performed using the FLUENT SST k−ω (shear stress transport k−ω) turbulence model at the velocity of 10 m/s and 10° angle of attack. Using the obtained lift and drag values, a response surface based model was constructed with the aim to maximise the lift-to-drag ratio. The optimisation problem was solved using the genetic algorithm provided by the MATLAB® optimisation toolbox and the response surface based model was iteratively improved. The resultant optimal fin design is compared with the experimental data for the fin demonstrating an increase in lift-to-drag ratio by approximately 62% for the given angle of attack of 10°.
Prehospital triage of patients suffering severe dyspnoea using N-terminal pro-brain natriuretic peptide, the PreBNP trial: a randomised controlled clinical trial
Authors: Bøtker Morten T , Jørgensen Maren T , Stengaard Carsten , Seidenfaden Sophie-Charlott , Tarpgaard Mona , Granfeldt Asger , Mortensen Tanja Ø , Grøfte Thorbjørn , Friesgaard Kristian D , Mærkedahl Rikke , Pedersen Anette B , Lundorff Simon , Hansen Troels Martin , Kirkegaard Hans , Christensen Erika F , Terkelsen Christian J
Published: May 2017

Purpose:

The purpose of this study was to examine whether the addition of brain natriuretic peptide measurement to the routine diagnostic work-up by prehospital critical care team physicians improves triage in patients with severe dyspnoea.

Methods:

Prehospital critical care team physicians randomly assigned patients older than 18 years with severe dyspnoea to routine diagnostic work-up or diagnostic work-up with incorporated point-of-care N-terminal pro-brain natriuretic peptide (NT-proBNP) measurement. The primary endpoint was the proportion of patients with dyspnoea of primary cardiac origin triaged directly to a department of cardiology.

Results:

A total of 747 patients were randomly assigned and 711 patients consented to participate, 350 were randomly assigned to the NT-proBNP group and 361 to the routine work-up group. NT-proBNP was measured in 90% (315/350) of patients in the NT-proBNP group and in 19% (70/361) of patients in the routine work-up group. There was no difference in the proportion of patients with dyspnoea of primary cardiac origin triaged directly to a department of cardiology between the NT-proBNP group and the routine work-up group (75% vs. 69%, P=0.22) in the intention-to-treat analysis. Sensitivity analysis according to the de facto diagnostics performed showed results consistent with this. No differences in hospital length of stay, intensive care unit admission rates or mortality between the NT-proBNP group and the routine work-up group were observed.

Conclusion:

Routine supplementary point-of-care measurement of NT-proBNP in patients with severe dyspnoea did not improve triage of patients with dyspnoea primarily caused by heart disease. ClinicalTrials.gov identifier NCT02050282.
Are coups good for democracy? A response to Miller (2016)
Authors: Derpanopoulos George , Frantz Erica , Geddes Barbara , Wright Joseph
Published: May 2017

This article responds to “Reanalysis: Are coups good for democracy?” (Miller MK (2016) Reanalysis: Are coups good for democracy? Research and Politics 3(4): ) We make clear to readers that Miller (2016) re-reports findings that we originally reported in the Appendix to our original article. We then discuss the advantages and disadvantages of different estimators and re-state Miller’s main point with a visual presentation of how regime-case and country fixed effects estimators differ in this application.
The Role of the Public Health Training Centers in Advancing Public Health Department Accreditation
Authors: Walkner Laurie , Uden-Holman Tanya M. , Moody Jeneane , Harris Joy
Published: May 2017

In the past few years, the drive for public health department accreditation has continued to build momentum. As the Centers for Disease Control and Prevention notes, “Engaging in accreditation catalyzes quality and performance improvement within all public health programs and can help health departments be better prepared to proactively respond to emerging and reemerging health challenges”. Many organizations support accreditation efforts, including the Public Health Training Centers (PHTCs), which have been providing workforce development support since 1999. This article describes how one PHTC, the Midwestern Public Health Training Center, has supported capacity building for accreditation in partnership with other state-based organizations through the development of three major accreditation readiness activities: accreditation workshops, informational videos on Public Health Accreditation Board standards and measures, and competency-based workforce development assessments. Given the current and emerging public health challenges, the need for a well-prepared workforce is more important than ever to strengthen the public health system, and by engaging in activities to meet the accreditation standards, public health departments will be better positioned to respond to these challenges. PHTCs will continue to have a critical role in capacity building for accreditation.
Distance Education And Learning: An Innovative Approach to Extending Workforce Training Capacity
Authors: Alperin Melissa , Lloyd Laura M. , McCormick Lisa C. , Bergland Brita , Carvalho Michelle , Tripathi Manish , Patel Arti B. , Miner Kathleen R.
Published: May 2017

The mission of the Region IV (R-IV) Public Health Training Center (PHTC), headquartered at the Rollins School of Public Health at Emory University in Atlanta, Georgia, is to develop and implement programming to train public health professionals in the U.S. Department of Health and Human Services Region IV. The emphasis on public health accreditation, as well as the reality of high personnel turnover and a workforce with little formal training, point to the need for PHTCs that provide workforce training. PHTCs use distance-based education to reach those in need of training by minimizing or eliminating cost and travel barriers. However, many experienced public health trainers who are able to provide effective and engaging trainings in person lack the knowledge and skills necessary to adapt existing curricula to a distance format. Distance Education And Learning (DEAL) is an online course designed by the R-IV PHTC to increase the capacity of public health trainers to teach in the distance learning environment. The course includes four 3-hour synchronous online sessions with additional asynchronous presession and intersession activity requirements. This article describes the development and implementation of the DEAL course, including how it is used by the R-IV PHTC to increase the number of public health trainers with the skills needed to develop and implement distance-based training, which thereby builds the training capacity within the region and addresses issues of sustainability.
Strategic Approach to Assess Training Needs Across a Diverse Region
Authors: McCormick Lisa C. , Reel Justine J. , Alperin Melissa , Lloyd Laura M. , Miner Kathleen R.
Published: May 2017

The mission of the Region IV (R-IV) Public Health Training Center (PHTC), headquartered at the Rollins School of Public Health at Emory University in Atlanta, GA, is to develop and implement programming to train and educate public health professionals in U.S. Department of Health and Human Services Region IV. To identify public health workforce development needs, the R-IV PHTC created a systematic process that included the implementation of a variety of strategies, to gain insights from each state within the diverse region. Conducting regular needs assessments is an integral step to ensure trainings are relevant and meet the needs of public health professionals. To this end, the PHTC employed a mixed methods approach to gather information on both competency-based and non–competency-based training needs, as well as training needs within R-IV’s content focus area of infectious disease. In R-IV there is great variability between the structures of the state and local health departments (e.g., some centralized, some decentralized), each of which faces different funding challenges and works with different service delivery models and regulatory authorities. Moreover, states have diverse populations (e.g., races, urban/rural, migrant/refugees, tribal, Appalachian) and face a wide range of public health priority concerns. Health departments were found to be at different stages of readiness to undertake a training needs assessment due to a number of issues, including their stage of pursuing Public Health Accreditation Board accreditation and recent participation in other needs assessment efforts. The R-IV PHTC approach to assessing training needs within this challenging environment is described.
Supporting Peer Learning Networks for Case-Based Learning in Public Health: Experience of the Rocky Mountain Public Health Training Center With the ECHO Training Model
Authors: Scallan Elaine , Davis Sarah , Thomas Fred , Cook Christine , Thomas Kory , Valverde Patricia , Kazanjian Michael , Byers Tim
Published: May 2017

Extension for Community Healthcare Outcomes (ECHO) is a model for professional training and support now being used widely in clinical health care. ECHO provides training for health care professionals in their own communities by creating peer learning groups connected by live bidirectional video communications. Topic experts lead the sessions, but most of the learning occurs through case presentations and consultations. Although similar to telemedicine, ECHO differs in that the responsibility for patient care remains with the primary care learners. The Rocky Mountain Public Health Training Center—which supports training for the public health workforce in the six-state region of Colorado, Utah, Wyoming, Montana, and North and South Dakota—has adapted the ECHO health care model for public health training, using the ECHO learning principles of creating and supporting peer learning networks connected by live bidirectional video, and employing a case-based learning approach. The public health ECHO trainings are facilitated by subject matter experts, focus on real-life public health challenges, and use programs or scenarios within communities as “cases.” This article looks at early success in using the ECHO model for public health training on topics such as local public health agency quality improvement, patient navigation, food safety, tobacco control, obesity prevention, tuberculosis management, and HIV prevention. The Rocky Mountain Public Health Training Center continues to refine its implementation of the ECHO learning model across a wide range of public health and population health topics and shows great promise as a framework for regional public health training.
Enhancing Public Health Practice Through a Regional Student Field Placement Program
Authors: Carvalho Michelle , McCormick Lisa C. , Lloyd Laura M. , Miner Kathleen R. , Alperin Melissa
Published: May 2017

Experiential learning links knowledge to real practice through seasoned mentor support, professional reflection, and hands-on experience in authentic work environments. While academic public health programs seek to train the future workforce, the current workforce has a critical need for training as well. The Region IV Public Health Training Center’s Pathways to Practice Scholar program gives public health students the opportunity to apply knowledge to competency-based experiences while fulfilling the current workforce’s short- and long-term human resource needs. Placements are offered in all eight states of the region to broaden opportunities for both agencies and student scholars. On completion of the program, scholars are required to submit an executive summary, reflection statement, photos of the experience, and a draft abstract suitable for submission to a professional conference. Since 2015, 36 scholars have been placed in positions across Region IV, 11 in states other than those of their home universities. Students were placed at state, local, and tribal health departments; area health education centers (AHECs); and other agencies (e.g., primary care settings), and the most common work plan domains selected by scholars were analytic/assessment, policy development/program planning, and leadership/systems thinking skills. Scholars’ perceived confidence increased across all domains with the highest increases in financial planning/management and cultural competency. Program implementation and evaluation findings are described, including types of projects, differences in confidence in performing competency domains, and confidence and interest in working with underserved populations. Evaluation findings indicate that the Region IV Public Health Training Center scholars increased their confidence in performing practice competencies while providing support for public health agencies serving underserved populations.
More Than Just an Intern: Utilizing the Post-Graduate Medical Education Model to Increase the Value of Field Placement Experiences for Public Health Program Graduates
Authors: Dreyzehner John , Williams Christian , Harkness Eric
Published: May 2017

Internships and field placements are a critical component of public health education in that they help ensure that future public health workers are able to apply theory and concepts to practice. However, developing successful practice-based experiences is dependent on both public health agencies and academic institutions collaborating to identify the competencies students should possess on entry into the field. It also takes considerable time and resources from public health departments to make these field placements successful. Seeking to innovate on existing field placement models in an effort to provide a rich relationship between students and practitioners, the Tennessee Department of Health has developed a new fellowship experience for recent graduates of public health programs that draws on the multidisciplinary aspects of post-graduate medical education. The Commissioner’s Fellowship in Public Health provides recent graduates an opportunity for practical high-level experiential learning in place of—or prior to—additional academic work. The program has two overarching goals: (1) to address emerging needs of public health in the areas of health policy and primary prevention while providing leadership, professional opportunities, and practical experience to recent graduates that will serve as a foundation for a career in public health; and (2) to provide a high level, diverse, and extended post-graduate population health experience prior to committing to a particular field.
Overall survival in patients with lung cancer using a web-application-guided follow-up compared to standard modalities: Results of phase III randomized trial.
Authors: Denis Fabrice , Lethrosne Claire , Pourel Nicolas , Molinier Olivier , Pointreau Yoann , Domont Julien , Bourgeois Hugues Pierre , Senellart Helene , Tremolieres Pierre , Lizee Thibaut , Bennouna Jaafar , Urban Thierry , El Kouri Claude , Charron Alexandre , Septans Anne-Lise , Balavoine Magali , Rolley Cyrielle , Landry Sebastien , Solal-Celigny Philippe , Letellier Christophe
Published: May 2017

LBA9006

Background: We developed a web-application for an early detection of symptomatic relapse, complications and early supportive care in high-risk lung cancer patients between visits. A dynamical analysis of the weekly self-reported symptoms automatically triggered physician visit. Methods: We performed a national multi-institutional phase 3 prospective randomized study to compare web-application follow-up (experimental arm) for which patient’s self-scored symptoms that were weekly sent (between planned visits) to the oncologist and a clinical routine assessment with a CT-scan (every 3-6 months or at investigator’s discretion - standard arm). High risk lung cancer patients without progression and with a 0-2 performance status (PS) after an initial treatment were included. Maintenance chemotherapy or TKI therapy were allowed. In the experimental arm, an email alert was sent to the oncologist when some predefined clinical criteria were fulfilled: an imaging was then quickly prescribed. Early supportive cares were provided if adequate. The primary endpoint was to detect an improvement of 12% in 9 months survival in favor of the experimental arm (α = 5%, β = 20%, unilateral test). The boundary for declaring superiority with respect to overall survival at the pre-planned interim analysis was a p-value of less than 0.006. The PS at relapse, the quality of life (QOL) and cost-effectiveness were also investigated. Results: 121 patients were included in the intent-to-test survival analysis (90% were stage III/IV, median age: 65 y): 60 (61) in the experimental (standard) arms with equivalent baseline characteristics. Median follow-up was 9 months. Median overall survival in months was 19 (11.8), p=0.0014 (n  =  121; HR  =  0.33; 95 % CI, 0.16-0.67) and the PS at the first relapse was 0-1 for 81.5% (35.3%) of the patients (p<0.001) in the experimental (standard) arm. Conclusions: This trial shows a significant survival improvement using Web-application-guided follow-up that allowed better PS at relapse, earlier supportive care and reduction of routine imaging. QOL and cost analysis results will be presented during the meeting. Clinical trial information: NCT02361099.
Underuse of Radiation Therapy After Breast Conservation Surgery in Puerto Rico: A Puerto Rico Central Cancer Registry–Health Insurance Linkage Database Study
Authors: Chance William W. , Ortiz-Ortiz Karen J. , Liao Kai-Ping , Zavala Zegarra Diego E. , Stauder Michael C. , Giordano Sharon H. , Tortolero-Luna Guillermo , Guadagnolo B. Ashleigh
Published: May 2017

Purpose

To identify rates of postoperative radiation therapy (RT) after breast conservation surgery (BCS) in women with stage I or II invasive breast cancer treated in Puerto Rico and to examine the sociodemographic and health services characteristics associated with variations in receipt of RT.

Methods

The Puerto Rico Central Cancer Registry–Health Insurance Linkage Database was used to identify patients diagnosed with invasive breast cancer between 2008 and 2012 in Puerto Rico. Claims codes identified the type of surgery and the use of RT. Logistic regression models were used to examine the independent association between sociodemographic and clinical covariates.

Results

Among women who received BCS as their primary definitive treatment, 64% received adjuvant RT. Significant predictors of RT after BCS included enrollment in Medicare (odds ratio [OR], 2.14; 95% CI, 1.46 to 3.13; P ≤ .01) and dual eligibility for Medicare and Medicaid (OR, 1.61; 95% CI, 1.14 to 2.27; P < .01). In addition, it was found that RT was more likely to have been received in certain geographic locations, including the Metro-North (OR, 2.20; 95% CI, 1.48 to 3.28; P < .01), North (OR, 1.78; 95% CI, 1.20 to 2.64; P < .01), West (OR, 4.04; 95% CI, 2.61 to 6.25; P < .01), and Southwest (OR, 2.79; 95% CI, 1.70 to 4.59; P < .01). Furthermore, patients with tumor size > 2.0 cm and ≤ 5.0 cm (OR, 0.61; 95% CI, 0.40 to 0.93; P = .02) and those with tumor size > 5.0 cm (OR, 0.37; 95% CI, 0.15 to 0.92; P = .03) were found to be significantly less likely to receive RT.

Conclusion

Underuse of RT after BCS was identified in Puerto Rico. Patients enrolled in Medicare and those who were dually eligible for Medicaid and Medicare were more likely to receive RT after BCS compared with patients with Medicaid alone. There were geographic variations in the receipt of RT on the island.
Effect of diet quality and ambient temperature on the use of torpor by two species of neotropical nectar-feeding bats
Authors: Ayala-Berdon Jorge , Vázquez-Fuerte Rommy , Beamonte-Barrientos René , Schondube Jorge E.
Published: May 2017

Neotropical bats use torpor as a strategy to save energy when they experience a low energy intake and/or low ambient temperature (Ta). Digestive physiology limits the energy intake of several glossophaginid bats, and could play an important role in the onset of torpor in these tropical animals. We measured the effect that diet quality and Ta had on the use of torpor by the nectar-feeding bats Glossophaga soricina and Leptonycteris yerbabuenae. Captive bats were fed with 5% (low) or 35% (high) sucrose solutions while exposed to two different Ta (17.7 and 23.2°C; low Ta and high Ta) in four different treatments: (1) high sucrose:high Ta, (2) high sucrose:low Ta, (3) low sucrose:high Ta and (4) low sucrose:low Ta. We measured their energy intake, changes in body mass (ΔMb) and skin temperature (Tskin) as response variables. Energy intake (in 10 h) was limited when both species fed on 5% sucrose, but body mass gain was only affected in G. soricina. Energy intake and Ta had a negative effect on the minimum Tskin of both species, and ΔMb affected the time that G. soricina used torpor. Both species remained normothermic on the high sucrose:high Ta treatment, but used torpor on the other three treatments. Bats used torpor during their resting and activity periods. Leptonycteris yerbabuenae spent more time in torpor in the low sucrose:high Ta treatment, while G. soricina used this strategy for longer periods of time in the high sucrose:low Ta treatment. We found that diet quality and Ta played an important role in the use of torpor by nectar-feeding bats.
Heme Iron Coordination Structure of Heme Transport Protein HutB from Vibrio Cholerae
Authors: Uchida Takeshi , Funamizu Takumi , Ogura Mariko , Ishimori Koichiro
Published: May 2017

HutB is a putative heme transport protein located in the periplasmic space in Vibrio cholerae. Here, we purified HutB and characterized its heme binding properties. An analysis of the Soret band showed that there are two types of heme binding geometries depending on the heme concentration: 404-nm species are dominant at lower concentrations of heme, and 394-nm species dominate at higher concentrations. Moreover, a mutational study revealed that either Tyr65 or Tyr198 binds heme with the help of histidine, a property shared with another V. cholerae heme transport protein, HutX, despite the absence of sequence similarity, indicating that HutB acts as a heme transport protein in the periplasm.
Behavior-Based Advertising
Authors: Shen Qiaowei , Miguel Villas-Boas J.
Published: May 2017

This paper considers the effect of firms sending advertising messages to consumers based on their past purchase behavior. If past purchase behavior on a product category is positively correlated with a consumer having high preferences in another category, a firm may want to advertise more intensively to those consumers that purchased the former category, if possible. This paper finds that this can lead to lower prices in the initial category if the annoyance of receiving advertising is large, and to higher prices if the annoyance of receiving advertising is not too large, as consumers expect a possible additional surplus from the category affected by behavior-based advertising. If receiving advertising does not yield too much annoyance to consumers, firms end up better off due to both higher prices and the increased demand of better matching of advertising. Behavior-based advertising may also lead firms to sell less in the initial category than without behavior-based advertising, as a way to be able to better target the most valuable consumers. If the consumer annoyance of receiving advertising is large, firms may end up serving only a few consumers initially, as attracting more consumers requires prices that are too low, and the initial consumers are attracted because of the possibility of lower prices in the following period. The paper also investigates the effects of joint behavior-based pricing and advertising, and of different firms benefiting from the purchase information.

This paper was accepted by Matthew Shum, marketing.
Nursing a critically ill tetanus patient in an intensive care unit in Zambia
Authors: Carter Chris , Viveash Sue
Published: May 2017

The global incidence of tetanus has been gradually reducing. Improvements in vaccination and health education programmes and the World Health Organization campaign to eradicate maternal and neonatal tetanus have all resulted in fewer presentations globally. Unfortunately, tetanus mortality remains a significant problem for many developing countries, owing to inadequate vaccination programmes or to conflict or humanitarian disasters during which vaccination programmes are stopped or there is sporadic cover. This case study explores the care of a tetanus patient in an intensive care unit in Zambia, a lower-middle-income country in sub-Saharan Africa.
Nurses: A Voice to Lead
Authors: Hughes Frances
Published: May 2017

The International Council of Nurses celebrates nurses' contributions to the Sustainable Development Goals
Introducing a device to assist in the application of anti-embolism stockings
Authors: Thomas Nicola , Bennett Neomi
Published: May 2017

Using a device to help with the application and removal of anti-embolism stockings, often called thromboembolic deterrent stockings (TEDS), can potentially facilitate greater adherence to the use of stockings, and potentially reduce the risk of deep-vein thrombosis (DVT). This article describes a quality improvement project which used the Plan, Do, Study, Act (PDSA) cycle to facilitate the introduction of a device to aid in the application of thromboembolic deterrent stockings in an orthopaedic ward. The project findings showed that Neo-slip®, a product designed to facilitate the use of compression stockings, can be effectively introduced into an orthopaedic ward, with positive feedback from both staff and patients.
Protecting whistleblowers against discrimination in the NHS
Authors: Glasper Alan
Published: May 2017

Emeritus Professor Alan Glasper, from the University of Southampton, discusses new Department of Health proposals to prohibit discrimination against former whistleblowers when they apply for another job in the NHS
Religion, spirituality and belief: is this the business of nurses?
Authors: Scammell Janet
Published: May 2017

Janet Scammell, Associate Professor (Nursing), Bournemouth University, considers whether nurses receive sufficient education on religion and spirituality in pre-registration education
FLEXIBILITY ASSESSMENT TO MITIGATE COMPLEXITY: TRUCKS PRODUCTION ANALYSIS
Authors: Muniz Jr Jorge , Nascimento Luis Oliveira , Martins Henrique Rocha , Rangel Luis Alberto Duncan
Published: May 2017

New products are continuously developed in order to support customized demands. Flexibility supports customized demands, low costs, and agility, but it remains a challenge with regards to high-volume and high-diversity complexity as observed in trucks production. This research aims to discuss an assessment approach based on AHP application to rank flexibility projects. It is a multi-criteria decision method based on the Analytic Hierarchy Process (AHP). Decision-makers (88 managers) from different truck plant areas (production, logistics, quality, sales and finance) were interviewed and asked to consider lean thinking, mass customization, and agility to rank flexibility improvement projects that aim to reduce time-to-market and increase company competitiveness increase.https://doi.org/10.13033/ijahp.v9i1.404
EVALUATION OF CUSTOMER RELATIONSHIP MANAGEMENT (CRM) SYSTEMS FOR SMALL SERVICE BUSINESSES
Authors: Agredo Shannon , Mu Enrique , Vella Catherine
Published: May 2017

Although several Customer Relationship Management (CRM) evaluation frameworks have been developed in the past years, they are usually complex, oriented toward large organizations and from the firm’s perspective only. This study proposes a CRM evaluation model which is simple for a small business to use and takes into account three different perspectives: the business, the staff and the customer. The need for this model arose when one of the co-authors had to evaluate and select a CRM system suitable for a small business. Also, although the evaluation will be done within the context of a specific business, this model and the multiple perspective approach can be used with minimum modifications as an evaluation and reference tool for other CRM decision-makers in small service businesses. https://doi.org/10.13022/ijahp2017.v9.is1.473
IJAHP Editor Valentina Ferretti in the News
Authors: Mu Enrique
Published: May 2017

Valentina Ferretti, our IJAHP News and Events editor, is in the news herself. She has been invited to teach at The Guardian’s One-Day MBA master class...https://doi.org/10.13022/ijahp2017.v9.is1.474
Deleuzions of ecohorror: Weighing Al Gore’s ecostrategy against The Day of the Triffids
Authors: Morgart James
Published: May 2017

Despite the intriguing insights of ecocriticism and rising academic interest in ecocriticism over the past two decades, many ecostrategies have remained on the outskirts of mainstream culture. One of the most successful attempts at broaching mainstream discourse has been the liberal ecology of Al Gore, most notably through his film An Inconvenient Truth by Guggenheim (2006). Gore’s warnings of an impending apocalypse were shortly followed by a spike in the production of ecohorror films such as The Ruins by Smith (2008), The Happening by Shyamalan (2008), and a remake of The Day of the Triffids (2009). By examining Gore’s ecostrategy in contrast to The Day of the Triffids in the framework of Deleuze and Guattari’s rhizomatic concepts of the refrain and reterritorialization, this article asserts that the film’s theme offers a superior strategy to Gore’s liberal ecology. Finally, the article encourages ecocriticism to take further steps in engaging with horror and tangentially asserts that an ecophilosophy built on Deleuze and Guattari’s theoretical work ought to be actively considered in ecocriticism at large.