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1.
Nature ; 587(7833): 210-213, 2020 11.
Artículo en Inglés | MEDLINE | ID: mdl-33177669

RESUMEN

Light elements were produced in the first few minutes of the Universe through a sequence of nuclear reactions known as Big Bang nucleosynthesis (BBN)1,2. Among the light elements produced during BBN1,2, deuterium is an excellent indicator of cosmological parameters because its abundance is highly sensitive to the primordial baryon density and also depends on the number of neutrino species permeating the early Universe. Although astronomical observations of primordial deuterium abundance have reached percent accuracy3, theoretical predictions4-6 based on BBN are hampered by large uncertainties on the cross-section of the deuterium burning D(p,γ)3He reaction. Here we show that our improved cross-sections of this reaction lead to BBN estimates of the baryon density at the 1.6 percent level, in excellent agreement with a recent analysis of the cosmic microwave background7. Improved cross-section data were obtained by exploiting the negligible cosmic-ray background deep underground at the Laboratory for Underground Nuclear Astrophysics (LUNA) of the Laboratori Nazionali del Gran Sasso (Italy)8,9. We bombarded a high-purity deuterium gas target10 with an intense proton beam from the LUNA 400-kilovolt accelerator11 and detected the γ-rays from the nuclear reaction under study with a high-purity germanium detector. Our experimental results settle the most uncertain nuclear physics input to BBN calculations and substantially improve the reliability of using primordial abundances to probe the physics of the early Universe.

2.
BMC Oral Health ; 24(1): 195, 2024 Feb 06.
Artículo en Inglés | MEDLINE | ID: mdl-38321444

RESUMEN

BACKGROUND: Urgent dental care may be the only place where many people, especially vulnerable groups, access care. This presents an opportunity for delivery of a behavioural intervention promoting planned dental visiting, which may help address one of the factors contributing to a socio-economic gradient in oral health. Although we know that cueing events such as having a cancer diagnosis may create a 'teachable moment' stimulating positive changes in health behaviour, we do not know whether delivering an opportunistic intervention in urgent dental care is feasible and acceptable to patients. METHODS: The feasibility study aimed to recruit 60 patients in a Dental Hospital and dental practices delivering urgent care within and outside working hours. Follow-up was by telephone, e mail and post over 4 months. RESULTS: Although the recruitment window was shortened because of COVID-19, of 47 patients assessed for eligibility, 28 were enrolled (70.1% of screened patients provided consent). A relatively high proportion were from disadvantaged backgrounds (46.4%, 13/28 receiving State benefits). Retention was 82.1% (23/28), which was also the rate of completion of the Oral Health Impact Profile co-primary outcome. The other primary outcome involved linking participant details at recruitment, with centrally-held data on services provided, with 84.6% (22/26) records partly or fully successfully matched. All intervention participants received at least some of the intervention, although we identified aspects of dental nurse training which would improve intervention fidelity. CONCLUSIONS: Despite recruitment being impacted by the pandemic, when the majority of clinical trials experienced reduced rates of recruitment, we found a high recruitment and consenting rate, even though patients were approached opportunistically to be enrolled in the trial and potentially receive an intervention. Retention rates were also high even though a relatively high proportion had a low socio-economic background. Therefore, even though patients may be in pain, and had not anticipated involvement before their urgent care visit, the study indicated that this was a feasible and acceptable setting in which to position an opportunistic intervention. This has the potential to harness the potential of the 'teachable moment' in people's lives, and provide support to help address health inequalities. TRIAL REGISTRATION: ISRCTN 10,853,330 07/10/2019.


Asunto(s)
COVID-19 , Humanos , Estudios de Factibilidad , Encuestas y Cuestionarios , Atención Ambulatoria , Atención Odontológica
3.
Phys Rev Lett ; 131(16): 162701, 2023 Oct 20.
Artículo en Inglés | MEDLINE | ID: mdl-37925687

RESUMEN

The ^{12}C/^{13}C ratio is a significant indicator of nucleosynthesis and mixing processes during hydrogen burning in stars. Its value mainly depends on the relative rates of the ^{12}C(p,γ)^{13}N and ^{13}C(p,γ)^{14}N reactions. Both reactions have been studied at the Laboratory for Underground Nuclear Astrophysics (LUNA) in Italy down to the lowest energies to date (E_{c.m.}=60 keV) reaching for the first time the high energy tail of hydrogen burning in the shell of giant stars. Our cross sections, obtained with both prompt γ-ray detection and activation measurements, are the most precise to date with overall systematic uncertainties of 7%-8%. Compared with most of the literature, our results are systematically lower, by 25% for the ^{12}C(p,γ)^{13}N reaction and by 30% for ^{13}C(p,γ)^{14}N. We provide the most precise value up to now of 3.6±0.4 in the 20-140 MK range for the lowest possible ^{12}C/^{13}C ratio that can be produced during H burning in giant stars.

4.
Spinal Cord ; 61(8): 436-440, 2023 08.
Artículo en Inglés | MEDLINE | ID: mdl-37120699

RESUMEN

STUDY DESIGN: Cohort study. Retrospective analysis of T2-weighted magnetic resonance images (MRIs) and clinical documentation. OBJECTIVES: To evaluate the relationship between the presence/absence and widths of midsagittal tissue bridges and walking ability among veterans with cervical, predominantly chronic SCI. SETTING: University research and hospital setting. METHODS: T2-weighted midsagittal MRIs of 22 United States veterans with cervical spinal cord injuries were examined. The presence/absence of midsagittal tissue bridges were determined, and the widths of present ventral and dorsal tissue bridges were measured. Midsagittal tissue bridge characteristics were related to each participant's ability to walk based off examination of clinical documentation. RESULTS: Fourteen of the analyzed participant images revealed the presence of midsagittal tissue bridges. Ten of those individuals (71%) possessed overground walking ability. The 8 individuals with no apparent tissue bridges were all unable to walk. There was a significant correlation between walking and widths of ventral midsagittal tissue bridges (r = 0.69, 95%CI: 0.52, 0.92, p < 0.001), as well as dorsal midsagittal tissue bridges (r = 0.44, 95%CI: 0.15, 0.73, p = 0.039). CONCLUSION: The evaluation of midsagittal tissue bridges may be useful in various rehabilitation settings to help inform patients' plan of care, allocation of neuromodulatory resources, and appropriate stratification into research cohorts.


Asunto(s)
Traumatismos de la Médula Espinal , Humanos , Traumatismos de la Médula Espinal/diagnóstico por imagen , Estudios Retrospectivos , Estudios de Cohortes , Caminata , Imagen por Resonancia Magnética/métodos , Médula Espinal
5.
J Cancer Educ ; 38(2): 467-475, 2023 04.
Artículo en Inglés | MEDLINE | ID: mdl-35112296

RESUMEN

Ideal efforts for cancer prevention would include lifestyle modifications along with routine, age-eligible cancer screening. Employing an asset-based approach within vulnerable populations already engaging in at least one healthy behavior (i.e., physical activity) may be an ideal way to further reduce cancer risk across peer groups with low cancer screening rates. Guided by the theory of planned behavior (TPB), the aim of this study was to identify constructs associated with cancer screening intentions among young to middle aged adults for influencing educational and behavioral interventions designed to promote cancer prevention. A cross-sectional, web-based survey was utilized to assess attitudes, subjective norms, perceived behavioral control, and intention to screen for cancer among physically active adults aged 18-49 years. Descriptive and bivariate analyses were conducted to characterize the sample, and hierarchical linear regression analyses were conducted to assess the influence of sociodemographic variables and TPB constructs on cancer screening intentions. Age, female sex, reporting a routine doctor's visit, reported knowledge of physical activity as a lifestyle behavior to reduce cancer risk, and an increased number of motivating factors for engaging in physical activity were significantly associated with higher cancer screening intention (P < 0.001). With the addition of TPB constructs (i.e., subjective norms and perceived behavioral control), the final analytic model accounted for 31% of the variance in intention to screen for cancer. Findings suggest that the TPB could be used to tailor or design asset-based, cancer education interventions to effectively promote age-eligible cancer screenings among physically active adults. Educational content to increase social support for cancer screening and enhance perceived behavioral control to complete screening is essential in this population.


Asunto(s)
Intención , Neoplasias , Persona de Mediana Edad , Adulto , Humanos , Femenino , Detección Precoz del Cáncer , Estudios Transversales , Encuestas y Cuestionarios , Neoplasias/diagnóstico , Neoplasias/prevención & control
6.
Phys Rev Lett ; 127(15): 152701, 2021 Oct 08.
Artículo en Inglés | MEDLINE | ID: mdl-34677992

RESUMEN

One of the main neutron sources for the astrophysical s process is the reaction ^{13}C(α,n)^{16}O, taking place in thermally pulsing asymptotic giant branch stars at temperatures around 90 MK. To model the nucleosynthesis during this process the reaction cross section needs to be known in the 150-230 keV energy window (Gamow peak). At these sub-Coulomb energies, cross section direct measurements are severely affected by the low event rate, making us rely on input from indirect methods and extrapolations from higher-energy direct data. This leads to an uncertainty in the cross section at the relevant energies too high to reliably constrain the nuclear physics input to s-process calculations. We present the results from a new deep-underground measurement of ^{13}C(α,n)^{16}O, covering the energy range 230-300 keV, with drastically reduced uncertainties over previous measurements and for the first time providing data directly inside the s-process Gamow peak. Selected stellar models have been computed to estimate the impact of our revised reaction rate. For stars of nearly solar composition, we find sizeable variations of some isotopes, whose production is influenced by the activation of close-by branching points that are sensitive to the neutron density, in particular, the two radioactive nuclei ^{60}Fe and ^{205}Pb, as well as ^{152}Gd.

7.
Eur J Neurol ; 26(1): 58-65, 2019 01.
Artículo en Inglés | MEDLINE | ID: mdl-30051542

RESUMEN

BACKGROUND AND PURPOSE: Research indicates that patients with myotonic dystrophy type 1 (DM1) are at increased risk of cancer and early death. Family data may provide insights given DM1 phenotypic heterogeneity, the broad range of non-muscular manifestations and the usual delays in the diagnosis of DM1. METHOD: Family history data were collected from 397 genetically and/or clinically confirmed DM1 patients (respondents) enrolled in the US or UK myotonic dystrophy registries. Standardized mortality ratios were calculated for DM1 first-degree relatives (parents, siblings and offspring) by their reported DM1 status (affected, unaffected or unknown). For cancer-related analyses, mixed effects logistic regression models were used to evaluate factors associated with cancer development in DM1 families, including familial clustering. RESULTS: A total of 467 deaths and 337 cancers were reported amongst 1737 first-degree DM1 relatives. Mortality risk amongst relatives reported as DM1-unaffected was comparable to that of the general population [standardized mortality ratio (SMR) 0.82, P = 0.06], whilst significantly higher mortality risks were noted in DM1-affected relatives (SMR = 2.47, P < 0.0001) and in those whose DM1 status was unknown (SMR = 1.60, P < 0.0001). In cancer risk analyses, risk was higher amongst families in which the DM1 respondent had cancer (odds ratio 1.95, P = 0.0001). Unknown DM1 status in the siblings (odds ratio 2.59, P = 0.004) was associated with higher cancer risk. CONCLUSION: There is an increased risk of death, and probably cancer, in relatives with DM1 and in those whose DM1 status is unknown. This suggests a need to perform a careful history and physical examination, supplemented by genetic testing, to identify family members at risk for DM1 and who might benefit from disease-specific clinical care and surveillance.


Asunto(s)
Distrofia Miotónica/epidemiología , Neoplasias/epidemiología , Análisis por Conglomerados , Familia , Femenino , Pruebas Genéticas , Humanos , Masculino , Persona de Mediana Edad , Distrofia Miotónica/genética , Distrofia Miotónica/mortalidad , Neoplasias/genética , Neoplasias/mortalidad , Examen Físico , Sistema de Registros , Medición de Riesgo , Encuestas y Cuestionarios , Análisis de Supervivencia , Reino Unido/epidemiología , Estados Unidos/epidemiología
9.
Phys Rev Lett ; 121(17): 172701, 2018 Oct 26.
Artículo en Inglés | MEDLINE | ID: mdl-30411966

RESUMEN

The ^{22}Ne(p,γ)^{23}Na reaction, part of the neon-sodium cycle of hydrogen burning, may explain the observed anticorrelation between sodium and oxygen abundances in globular cluster stars. Its rate is controlled by a number of low-energy resonances and a slowly varying nonresonant component. Three new resonances at E_{p}=156.2, 189.5, and 259.7 keV have recently been observed and confirmed. However, significant uncertainty on the reaction rate remains due to the nonresonant process and to two suggested resonances at E_{p}=71 and 105 keV. Here, new ^{22}Ne(p,γ)^{23}Na data with high statistics and low background are reported. Stringent upper limits of 6×10^{-11} and 7×10^{-11} eV (90% confidence level), respectively, are placed on the two suggested resonances. In addition, the off-resonant S factor has been measured at unprecedented low energy, constraining the contributions from a subthreshold resonance and the direct capture process. As a result, at a temperature of 0.1 GK the error bar of the ^{22}Ne(p,γ)^{23}Na rate is now reduced by 3 orders of magnitude.

10.
Phys Rev Lett ; 117(14): 142502, 2016 Sep 30.
Artículo en Inglés | MEDLINE | ID: mdl-27740778

RESUMEN

The ^{17}O(p,α)^{14}N reaction plays a key role in various astrophysical scenarios, from asymptotic giant branch stars to classical novae. It affects the synthesis of rare isotopes such as ^{17}O and ^{18}F, which can provide constraints on astrophysical models. A new direct determination of the E_{R}=64.5 keV resonance strength performed at the Laboratory for Underground Nuclear Astrophysics (LUNA) accelerator has led to the most accurate value to date ωγ=10.0±1.4_{stat}±0.7_{syst} neV, thanks to a significant background reduction underground and generally improved experimental conditions. The (bare) proton partial width of the corresponding state at E_{x}=5672 keV in ^{18}F is Γ_{p}=35±5_{stat}±3_{syst} neV. This width is about a factor of 2 higher than previously estimated, thus leading to a factor of 2 increase in the ^{17}O(p, α)^{14}N reaction rate at astrophysical temperatures relevant to shell hydrogen burning in red giant and asymptotic giant branch stars. The new rate implies lower ^{17}O/^{16}O ratios, with important implications on the interpretation of astrophysical observables from these stars.

11.
Poult Sci ; 95(4): 736-48, 2016 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-26769272

RESUMEN

Controversy has developed as to whether or not pin-metered water lines or water troughs are more appropriate for Pekin ducks. We hypothesized that water troughs would show improved duck body conditions and environmental quality compared to pin-metered water lines. To test this hypothesis, we housed ducks in 2 barns, one with water lines and one with water troughs. Water troughs were constructed to meet RSPCA guidelines for number and density of ducks and with recently described verandas. Ducks were divided into 4 pens per barn (n=1,000 ducks/pen). The study was then repeated (n=8 pens per water source) in a cross-over design so the barns each contained the opposite water source to the first experiment. We scored the ducks' body condition using an established scoring rubric and analyzed using SAS Proc GLM-Mix as binomial data. Ducks housed with water troughs showed higher (thus worse condition; P<0.001) scores for eyes, nostrils, feather quality, feather cleanliness, and foot pads. We also compared water condition, water quality, and duck mortality using a Student t test for both water sources each week. We found that the water troughs showed higher iron (P<0.001), nitrites (P<0.001), pH (P<0.01), and bacterial growth (P<0.001). The bacterial growth was shown to have higher (P<0.001)E. coli, coliforms, and Staphylococcusin the water troughs. Water lines typically showed no bacterial growth in culture-based assays. Ducks housed with water troughs used greater (P=0.001) volumes of water compared to ducks housed with water lines. Ducks with water troughs also showed a greater percent (P=0.008) mortality at all ages compared to ducks with water lines. These data suggest that water troughs may not be beneficial for duck welfare and could adversely impact both environment and duck or human health.


Asunto(s)
Crianza de Animales Domésticos/métodos , Agua Potable/análisis , Patos/fisiología , Calidad del Agua , Abastecimiento de Agua/métodos , Bienestar del Animal , Animales , Agua Potable/microbiología , Estado de Salud , Indiana , Longevidad , Distribución Aleatoria
12.
Phys Rev Lett ; 115(25): 252501, 2015 Dec 18.
Artículo en Inglés | MEDLINE | ID: mdl-26722918

RESUMEN

The ^{22}Ne(p,γ)^{23}Na reaction takes part in the neon-sodium cycle of hydrogen burning. This cycle affects the synthesis of the elements between ^{20}Ne and ^{27}Al in asymptotic giant branch stars and novae. The ^{22}Ne(p,γ)^{23}Na reaction rate is very uncertain because of a large number of unobserved resonances lying in the Gamow window. At proton energies below 400 keV, only upper limits exist in the literature for the resonance strengths. Previous reaction rate evaluations differ by large factors. In the present work, the first direct observations of the ^{22}Ne(p,γ)^{23}Na resonances at 156.2, 189.5, and 259.7 keV are reported. Their resonance strengths are derived with 2%-7% uncertainty. In addition, upper limits for three other resonances are greatly reduced. Data are taken using a windowless ^{22}Ne gas target and high-purity germanium detectors at the Laboratory for Underground Nuclear Astrophysics in the Gran Sasso laboratory of the National Institute for Nuclear Physics, Italy, taking advantage of the ultralow background observed deep underground. The new reaction rate is a factor of 20 higher than the recent evaluation at a temperature of 0.1 GK, relevant to nucleosynthesis in asymptotic giant branch stars.

13.
Phys Rev Lett ; 114(25): 251102, 2015 Jun 26.
Artículo en Inglés | MEDLINE | ID: mdl-26197115

RESUMEN

Neutrons produced by the carbon fusion reaction (12)C((12)C,n)(23)Mg play an important role in stellar nucleosynthesis. However, past studies have shown large discrepancies between experimental data and theory, leading to an uncertain cross section extrapolation at astrophysical energies. We present the first direct measurement that extends deep into the astrophysical energy range along with a new and improved extrapolation technique based on experimental data from the mirror reaction (12)C((12)C,p)(23)Na. The new reaction rate has been determined with a well-defined uncertainty that exceeds the precision required by astrophysics models. Using our constrained rate, we find that (12)C((12)C,n)(23)Mg is crucial to the production of Na and Al in pop-III pair instability supernovae. It also plays a nonnegligible role in the production of weak s-process elements, as well as in the production of the important galactic γ-ray emitter (60)Fe.

14.
J Evol Biol ; 28(9): 1682-90, 2015 09.
Artículo en Inglés | MEDLINE | ID: mdl-26135011

RESUMEN

Abiotic environmental heterogeneity can promote the evolution of diverse resource specialists, which in turn may increase the degree of host-parasite specialization. We coevolved Pseudomonas fluorescens and lytic phage ϕ2 in spatially structured populations, each consisting of two interconnected subpopulations evolving in the same or different nutrient media (homogeneous and heterogeneous environments, respectively). Counter to the normal expectation, host-parasite specialization was significantly lower in heterogeneous compared with homogeneous environments. This result could not be explained by dispersal homogenizing populations, as this would have resulted in the heterogeneous treatments having levels of specialization equal to or greater than that of the homogeneous environments. We argue that selection for costly generalists is greatest when the coevolving species are exposed to diverse environmental conditions and that this can provide an explanation for our results. A simple coevolutionary model of this process suggests that this can be a general mechanism by which environmental heterogeneity can reduce rather than increase host-parasite specialization.


Asunto(s)
Interacciones Huésped-Parásitos , Modelos Teóricos , Fagos Pseudomonas/fisiología , Pseudomonas fluorescens/virología , Evolución Biológica , Fagos Pseudomonas/genética , Pseudomonas fluorescens/genética , Selección Genética
15.
Pediatr Hematol Oncol ; 32(8): 525-8, 2015.
Artículo en Inglés | MEDLINE | ID: mdl-26606160

RESUMEN

The reported long-term outcome of endemic Burkitt lymphoma (eBL) patients who present with paraplegia is largely unknown. Records of BL patients treated with comparable short-interval cyclophosphamide chemotherapy schedules between 2004 and 2014 at three Baptist mission hospitals in Cameroon were reviewed. Survivors were followed up and examined at home or in hospital. Eighty-seven of 948 (9.2%) patients had paraplegia at diagnosis. The survival rate in eBL patients with paraplegia at diagnosis was 33% (n = 29) after follow-up of between 2 and 96 (median 40) months. Seven patients (24%) had neurological sequelae and needed rehabilitation. There was no relationship between the duration of symptoms (<2, 2-4, >4 weeks) and the survival rate or the risk to have neurological sequelae. The survival rate and risk for sequelae were similar in patients with confirmed St. Jude stage III and IV diseases.


Asunto(s)
Linfoma de Burkitt/mortalidad , Linfoma de Burkitt/terapia , Enfermedades Endémicas , Paraplejía/mortalidad , Paraplejía/rehabilitación , Adolescente , Linfoma de Burkitt/patología , Camerún/epidemiología , Niño , Preescolar , Supervivencia sin Enfermedad , Femenino , Estudios de Seguimiento , Humanos , Masculino , Paraplejía/etiología , Tasa de Supervivencia
16.
Eur J Dent Educ ; 19(3): 131-9, 2015 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-25142286

RESUMEN

BACKGROUND: This study evaluated service-learning programme's impact on senior dental students' attitude towards community service at Virginia Commonwealth University (VCU) School of Dentistry. Experience gained through service-learning in dental school may positively impact dental students' attitude towards community service that will eventually lead into providing care to the underserved. MATERIALS AND METHODS: Two surveys (pre- and post-test) were administered to 105 senior dental students. For the first survey (post-test), seventy-six students of 105 responded and reported their attitude towards community service immediately after the service-learning programme completion. Three weeks later, 56 students of the 76 responded to the second survey (retrospective pre-test) and reported their recalled attitude prior to the programme retrospectively. RESULTS: A repeated-measure mixed-model analysis indicated that overall there was improvement between pre-test and post-test. Scales of connectedness, normative helping behaviour, benefits, career benefits and intention showed a significant pre-test and post-test difference. An association between attitude towards community service and student characteristics such as age, gender, ethnicity and volunteer activity was also examined. Only ethnicity showed an overall significant difference. White dental students appear to have a differing perception of the costs of community service. CONCLUSIONS: The service-learning programme at VCU School of Dentistry has positively impacted senior dental students' attitude towards community service.


Asunto(s)
Actitud del Personal de Salud , Odontología Comunitaria , Servicios de Salud Comunitaria , Estudiantes de Odontología/psicología , Adulto , Educación en Odontología , Femenino , Humanos , Intención , Masculino , Encuestas y Cuestionarios , Virginia , Voluntarios/psicología
17.
Public Health ; 128(6): 515-24, 2014 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-24923994

RESUMEN

OBJECTIVES: Despite the growing significance of health literacy to public health, relatively little is known about how organizational capacity may be improved for planning, implementing and sustaining health literacy interventions. This study aimed to connect decision makers in a public health agency with evidence of how organizational capacity may be improved for delivering health literacy services. STUDY DESIGN: A rapid realist review of published and grey literature was conducted by a partnership between the Public Health Agency of Canada (PHAC) and the InSource Research Group. METHODS: Realist review methodology attempts to understand what works for whom under what circumstances, and is characterized by its focus on strategies/interventions, contexts, mechanisms and their relationship to outcome. This review was completed in collaboration with a reference panel (comprised of a broad range of PHAC representatives) and an expert panel. Literature searching was conducted using three databases supplemented with bibliographic hand searches and articles recommended by panels. Data were extracted on key variables related to definitions, strategies/interventions associated with increased organizational capacity, contextual factors associated with success (and failure), mechanisms activated as a result of different strategies and contexts, key outcomes, and evidence cited. RESULTS: Strategies found to be associated with improved organizational capacity for delivering health literacy services may be classified into three domains: (1) government action; (2) organizational/practitioner action; and (3) partnership action. Government action includes developing policies to reinforce social norms; setting standards for education; conducting research; and measuring health literacy levels. Organizational/practitioner action relates to appropriate models of leadership (both high-level government engagement and distributed leadership). Innovative partnership action includes collaborations with media outlets, those producing electronic materials, community organizations and school-based programs. Contextual factors for success include positive leadership models, interorganizational relationships, and a culture committed to experimentation and learning. Potential mechanisms activated by strategies and contextual factors include increased visibility and recognition of health literacy efforts, enthusiasm and momentum for health literacy activities, reduced cognitive dissonance between vision and action, a sense of ownership for health literacy data, and creation of a common language and understanding. CONCLUSIONS: Government initiated interventions and policies are powerful strategies by which organizational capacity to improve health literacy may be affected. Using the foundations created by the government policy environment, organizations may improve the impact of health literacy interventions through supported distributed leadership.


Asunto(s)
Creación de Capacidad/organización & administración , Alfabetización en Salud , Administración en Salud Pública , Canadá , Humanos
18.
S Afr Med J ; 114(7): e2040, 2024 Jul 01.
Artículo en Inglés | MEDLINE | ID: mdl-39041515

RESUMEN

Ciara Goslett's account of childhood tuberculosis (TB) sheds light on the challenges faced by children diagnosed with TB in South Africa (SA). Children are particularly vulnerable to TB infection and to dangerous forms of disseminated TB such as TB meningitis, which can cause death or major lifelong disability. They have distinct challenges with diagnosis, and TB treatment for adults is not necessarily child- friendly. In the absence of a child-friendly formulation, adult tablets are broken into the correct dosage and used to treat children. Crushed and dissolved in water, the pieces are not very palatable for children. There are therefore issues that may be neglected if the voices of children are not included in the TB response in SA. These include delays in the development and accessibility of child-friendly medication, vaccine shortages and a lack of educational support for hospitalised children under school-going age. Some positive progress has been made through the establishment of the paediatric working group in the TB Think Tank, and SA's contribution to pivotal childhood TB research studies. Additional steps could be the inclusion of children's feedback in community-led monitoring efforts and engagement between child TB activists and the SA TB Caucus, a collective of parliamentarians.


Asunto(s)
Tuberculosis , Humanos , Sudáfrica/epidemiología , Niño , Adolescente , Tuberculosis/epidemiología , Antituberculosos/uso terapéutico , Accesibilidad a los Servicios de Salud
19.
J Dent Res ; : 220345241247028, 2024 Jul 12.
Artículo en Inglés | MEDLINE | ID: mdl-38993043

RESUMEN

Adequate and transparent reporting is necessary for critically appraising published research. Yet, ample evidence suggests that the design, conduct, analysis, interpretation, and reporting of oral health research could be greatly improved. Accordingly, the Task Force on Design and Analysis in Oral Health Research-statisticians and trialists from academia and industry-identified the minimum information needed to report and evaluate observational studies and clinical trials in oral health: the OHStat Guidelines. Drafts were circulated to the editors of 85 oral health journals and to Task Force members and sponsors and discussed at a December 2020 workshop attended by 49 researchers. The guidelines were subsequently revised by the Task Force's writing group. The guidelines draw heavily from the Consolidated Standards for Reporting Trials (CONSORT), Strengthening the Reporting of Observational Studies in Epidemiology (STROBE), and CONSORT harms guidelines and incorporate the SAMPL guidelines for reporting statistics, the CLIP principles for documenting images, and the GRADE indicating the quality of evidence. The guidelines also recommend reporting estimates in clinically meaningful units using confidence intervals, rather than relying on P values. In addition, OHStat introduces 7 new guidelines that concern the text itself, such as checking the congruence between abstract and text, structuring the discussion, and listing conclusions to make them more specific. OHStat does not replace other reporting guidelines; it incorporates those most relevant to dental research into a single document. Manuscripts using the OHStat guidelines will provide more information specific to oral health research.

20.
JDR Clin Trans Res ; : 23800844241247029, 2024 Jul 12.
Artículo en Inglés | MEDLINE | ID: mdl-38993046

RESUMEN

Adequate and transparent reporting is necessary for critically appraising research. Yet, evidence suggests that the design, conduct, analysis, interpretation, and reporting of oral health research could be greatly improved. Accordingly, the Task Force on Design and Analysis in Oral Health Research-statisticians and trialists from academia and industry-empaneled a group of authors to develop methodological and statistical reporting guidelines identifying the minimum information needed to document and evaluate observational studies and clinical trials in oral health: the OHstat Guidelines. Drafts were circulated to the editors of 85 oral health journals and to Task Force members and sponsors and discussed at a December 2020 workshop attended by 49 researchers. The final version was subsequently approved by the Task Force in September 2021, submitted for journal review in 2022, and revised in 2023. The checklist consists of 48 guidelines: 5 for introductory information, 17 for methods, 13 for statistical analysis, 6 for results, and 7 for interpretation; 7 are specific to clinical trials. Each of these guidelines identifies relevant information, explains its importance, and often describes best practices. The checklist was published in multiple journals. The article was published simultaneously in JDR Clinical and Translational Research, the Journal of the American Dental Association, and the Journal of Oral and Maxillofacial Surgery. Completed checklists should accompany manuscripts submitted for publication to these and other oral health journals to help authors, journal editors, and reviewers verify that the manuscript provides the information necessary to adequately document and evaluate the research.

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