Rocky Mountain spotted fever (RMSF) transmitted by the brown dog tick (Rhipicephalus sanguineus sensu lato) has emerged as a significant public health risk on American Indian reservations in eastern ...Arizona. During 2003-2012, more than 250 RMSF cases and 19 deaths were documented among Arizona's American Indian population. The high case fatality rate makes community-level interventions aimed at rapid and sustained reduction of ticks urgent. Beginning in 2012, a two year pilot integrated tick prevention campaign called the RMSF Rodeo was launched in a ∼ 600-home tribal community with high rates of RMSF. During year one, long-acting tick collars were placed on all dogs in the community, environmental acaricides were applied to yards monthly, and animal care practices such as spay and neuter and proper tethering procedures were encouraged. Tick levels, indicated by visible inspection of dogs, tick traps and homeowner reports were used to monitor tick presence and evaluate the efficacy of interventions throughout the project. By the end of year one, <1% of dogs in the RMSF Rodeo community had visible tick infestations five months after the project was started, compared to 64% of dogs in Non-Rodeo communities, and environmental tick levels were reduced below detectable levels. The second year of the project focused on use of the long-acting collar alone and achieved sustained tick control with fewer than 3% of dogs in the RMSF Rodeo community with visible tick infestations by the end of the second year. Homeowner reports of tick activity in the domestic and peridomestic setting showed similar decreases in tick activity compared to the non-project communities. Expansion of this successful project to other areas with Rhipicephalus-transmitted RMSF has the potential to reduce brown dog tick infestations and save human lives.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Coxiella burnetii is a zoonotic pathogen that causes Q fever in humans and is transmitted primarily from infected goats, sheep, or cows. Q fever typically presents as an acute febrile illness; ...however, individuals with certain predisposing conditions, including cardiac valvulopathy, are at risk for chronic Q fever, a serious manifestation that may present as endocarditis. In response to a cluster of Q fever cases detected by public health surveillance, we evaluated C. burnetii infection in a community that operates a large-scale cow and goat dairy. A case was defined as an individual linked to the community with a C. burnetii phase II IgG titer ≥ 128. Of 135 participants, 47 (35%) cases were identified. Contact with or close proximity to cows, goats, and their excreta was associated with being a case (relative risk 2.7, 95% confidence interval 1.3-5.3). Cases were also identified among individuals without cow or goat contact and could be related to windborne spread or tracking of C. burnetii on fomites within the community. A history of injection drug use was reported by 26/130 (20%) participants; follow-up for the presence of valvulopathy and monitoring for development of chronic Q fever may be especially important among this population.
Ultrasound-guided regional anesthesia (UGRA) has become the criterion standard of regional anesthesia practice. Ultrasound-guided regional anesthesia teaching programs often use simulation, and ...guidelines have been published to help guide URGA education. This systematic review aimed to examine the effectiveness of simulation-based education for the acquisition and maintenance of competence in UGRA.
Studies identified in MEDLINE, EMBASE, CINAHL, Cochrane Central Register of Controlled Trials, and ERIC were included if they assessed simulation-based UGRA teaching with outcomes measured at Kirkpatrick level 2 (knowledge and skills), 3 (transfer of learning to the workplace), or 4 (patient outcomes). Two authors independently reviewed all identified references for eligibility, abstracted data, and appraised quality.
After screening 176 citations and 45 full-text articles, 12 studies were included. Simulation-enhanced training improved knowledge acquisition (Kirkpatrick level 2) when compared with nonsimulation training. Seven studies measuring skill acquisition (Kirkpatrick level 2) found that simulation-enhanced UGRA training was significantly more effective than alternative teaching methods or no intervention. One study measuring transfer of learning into the clinical setting (Kirkpatrick level 3) found no difference between simulation-enhanced UGRA training and non-simulation-based training. However, this study was discontinued early because of technical challenges. Two studies examined patient outcomes (Kirkpatrick level 4), and one of these found that simulation-based UGRA training improved patient outcomes compared with didactic teaching.
Ultrasound-guided regional anesthesia knowledge and skills significantly improved with simulation training. The acquired UGRA skills may be transferred to the clinical setting; however, further studies are required to confirm these changes translate to improved patient outcomes.
Purpose - The purpose of this research is to investigate development competitions in England in order to uncover any shortcomings and point to improvements. A "development competition" is a sale by ...tender of publicly-owned land with development potential where bidders also submit designs.Design methodology approach - First, an interview survey of local authorities in north-east England; second an interview survey with developers in north-east England; third a questionnaire survey of local authority estates officers and fourth an interview survey with London based property consultants.Findings - Despite their theoretical attractions, some competitions have problems. Conflict exists between professions and agencies. Development competitions encounter difficulties between developer appointment and construction which may lead to delay or the developer pulling out.Research limitations implications - The data collected are biased in favour of the financial property perspective. Further research is therefore still required.Practical implications - Despite its practical significance, no literature exists on this specific topic. The results reveal delays, disputes and sub-optimal use of resources. Further research is needed leading to new official guidance covering all aspects of this process.Originality value - Large numbers of competitions are held in the UK each year. The disposal of sites in this way has become more significant due to the concentration of activity on brown-field land. In future, the need to assemble urban land using compulsory purchase powers is likely to make competitions more frequent. These results, which highlight best practice, will be of interest to all professional people involved.
Late Diagnosis of HIV in Northern IrelandSEJ Todd, E Walker, M Hunter, CM Donnelly, WW Dinsmore, CR Emerson, SP Quah, EJ McCartyDepartment of Genito-Urinary Medicine, Belfast HSC Trust, Royal ...Victoria Hospital, BelfastBackground: Late HIV diagnoses (CD4 count <350 cells/mm3at diagnosis) across UK declined from 57% (2004) to 39% (2015) however a review within our region in 2013-14 revealed much higher proportion of late diagnoses than UK average, with multiple missed opportunities for testing in majority cases. Data was presented at educational meetings and feedback given to clinicians when delay in diagnosis occurred. We sought to assess impact on late diagnoses and mortality within our population.Methods: Retrospective chart analysis of new diagnoses from March 2015-February 2016 (Period 2) to determine proportion of late diagnosis, missed opportunities for testing and mortality. Comparison made with results of previous review during July 2013-June 2014 (Period 1). Results: 76 new diagnoses during period 1; 71 in period 2. Late diagnosis decreased from 59% (45/76) to 49% (35/71). Proportion diagnosed through GUM increased from 20% to 34%. Remainder diagnosed in other specialities, most commonly general medicine. Mode of transmission in period 1 and 2 respectively; MSM 49% vs71%, heterosexual 47% vs 23%, IVDU 7% vs 11%. Prior to diagnosis, number patients presenting to other settings with clinical indicator diseases significantly decreased from 84% (38/45) in period 1 to 49% (17/35) period 2. Mortality more than halved from 7% (4/45) in period 1 to 3% (1/35) period 2.Conclusion: Whilst there has been a decrease in number of late diagnoses and mortality rate, the proportion being diagnosed late remains higher than other UK regions. Opportunities for early testing are still being missed and ongoing education required.
Mixing Methods in Psychology Zazie Todd, Brigitte Nerlich, Suzanne McKeown, David D. Clarke
2004, 20040802, 2004-04-01, 2004-08-02
eBook
Can qualitative and quantitative methods be combined effectively in psychology? What are the practical and theoretical issues involved? Should different criteria be used to judge qualitative and ...quantitative research? The acceptance of qualitative research methods in psychology has lead to a split between qualitative and quantitative methods and has raised questions about how best to assess the validity of research practice. While the two approaches have traditionally been seen as competing paradigms, more recently, researchers have begun to argue that the divide is artificial. Mixing Methods in Psychology looks in detail at the problems involved in attempting to reconcile qualitative and quantitative methods both within and across subjects. All angles of the debate are discussed, covering areas as diverse as health, education, social, clinical and economic psychology. The contributors, who are some of the leading figures in the field, present theoretical and methodological guidance as well as practical examples of how quantitative and qualitative methods can be fruitfully combined. By aiming to bridge the gap between the two methods, this book reveals how each can inform the other to produce more accurate theories and models of human behaviour. This groundbreaking text will be essential reading for students and researchers wishing to combine methods, or for anyone who simply wants to get a better understanding of the debate.
Part 1: Theoretical and Historiographical Foundations. Z. Todd, B. Nerlich, S. McKeown, Introduction. B. Nerlich, Coming Full (Hermeneutic) Circle: The Controversy about Psychological Methods. K. Henwood, Reinventing Validity: Reflections on Principles and Practices from Beyond the Quality-Quantity Debate. Part 2: Mixing It Up. R. Harre, D. Crystal, Discursive Analysis and the Interpretation of Statistics. D.D. Clarke, 'Structured Judgement Methods' -The Best of Both Worlds? P. Stenner, R. Stainton Rogers, Q Methodology and Qualiquantology: The Example of Discriminating between Emotions. Part 3: Examples of Mixed Method Research. S. Chilton, J. Covey, L. Hopkins, M. Jones-Lee, G. Loomes, N. Pidgeon, A. Robinson, A. Spencer, Valuing the 'Value' of Life: A Case of Constructed Preference? K. Vann, M. Cole, Method and Methodology in Interpretive Studies of Cognitive Life. Z. Todd, M. Lobeck, Integrating Survey and Focus Group Research: A Case-Study of Attitudes of English and German Language Learners. Part 4: Mixed Methods Within the Discipline. A. Miller, Educational Psychology or Difficult Pupil Behaviour: Qualitative, Quantitative or Mixed Methods? P. Nicholson, Taking Quality Seriously: The Case for Qualitative Feminist Psychology in the Context of Quantitative Clinical Research on Postnatal Depression. Z. Todd, B. Nerlich, Future Directions.
The Nature of Technology Clough, Michael P; Olson, Joanne K; Niederhauser, Dale S
2013, 2013-09-03
eBook
Meaningful technology education is far more than learning how to use technology. It entails an understanding of the nature of technology--what technology is, how and why technology is developed, how ...individuals and society direct, react to, and are sometimes unwittingly changed by technology. This book places these and other issues regarding the nature of technology in the context of learning, teaching and schooling. The nature of technology and its impact on education must become a significant object of inquiry among educators. This book is intended to stimulate thinking and action among teachers, teacher educators, and education researchers.
PDF
