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Katzman DK, Boyer CB, Halpern CT, Ross DA, Berg TD, Santos TD, Ford CA. A Tribute to Charles E. Irwin, Jr., MD, Editor-In-Chief (2004-2019) and Supplements Editor (2019-2023) of the Journal of Adolescent Health. J Adolesc Health 2023; 73:799-800. [PMID: 37676192 DOI: 10.1016/j.jadohealth.2023.08.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 08/11/2023] [Indexed: 09/08/2023]
Affiliation(s)
- Debra K Katzman
- Hospital for Sick Children and University of Toronto, Toronto, Ontario, Canada.
| | - Cherrie B Boyer
- University of California San Francisco, San Francisco, California
| | - Carolyn T Halpern
- The University of North Carolina at Chapel Hill Gillings School of Global Public Health, Chapel Hill, North Carolina
| | - David Anthony Ross
- London School of Hygiene & Tropical Medicine, London, United Kingdom; World Health Organization, Geneva, Switzerland
| | - Tor D Berg
- University of Pennsylvania Perelman School of Medicine; and The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Teresa Dal Santos
- University of Pennsylvania Perelman School of Medicine; and The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Carol A Ford
- University of Pennsylvania Perelman School of Medicine; and The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
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Falconer Hall T, Bricknell MCM, Ross DA. Public health and military health. J Public Health (Oxf) 2022; 44:i88-i93. [DOI: 10.1093/pubmed/fdac101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 07/27/2022] [Accepted: 08/30/2022] [Indexed: 12/12/2022] Open
Abstract
Abstract
This paper summarizes the role of Public Health specialists within the UK Defence Medical Services (DMS). The armed forces have a need for expert advice on health improvement, health protection and healthcare public health. The first professor of military hygiene, Dr Edmund Parkes, was a leading pioneer in the public health movement of the late 19th century. Since then, the armed forces have evolved the term ‘hygiene’, though ‘health’, to ‘well-being’. Military doctors with an interest in medical administration and the health of populations have longstanding links with their civilian peers, through the Society of Medical Officers of Health and its successor the Faculty of Public Health. The specialty of Public Health in the armed forces is multidisciplinary, following the same educational pathway as civilian peers. The speciality has made important contributions during global health emergencies including the Ebola outbreak in 2014 and the recent COVID-19 pandemic. Although a small cadre, within the DMS and in the UK Public Health workforce, they have an important role in keeping our armed forces ready for operations. We celebrate the 50th anniversary of the Faculty of Public Health and expect that the DMS will contribute to the further development of the specialty.
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Affiliation(s)
- Thomas Falconer Hall
- Army Medical Services Support Unit, Robertson House, Army Medical Services , Camberley GU15 4NA, UK
| | - MCM Bricknell
- King’s Building, King’s College London, The Strand Conflict and Health Research Group, Department of War Studies, , WC2R 2LC, UK
| | - DA Ross
- Health Unit, Room 12, Robertson House , Army Medical Services, Camberley GU15 4NA, UK
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Laurenzi CA, Melendez-Torres GJ, Page DT, Vogel LS, Kara T, Sam-Agudu NA, Willis N, Ameyan W, Toska E, Ross DA, Skeen S. How Do Psychosocial Interventions for Adolescents and Young People Living With HIV Improve Adherence and Viral Load? A Realist Review. J Adolesc Health 2022; 71:254-269. [PMID: 35606252 DOI: 10.1016/j.jadohealth.2022.03.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 03/25/2022] [Accepted: 03/29/2022] [Indexed: 01/13/2023]
Abstract
PURPOSE Psychosocial interventions have the potential to support adolescents and young people living with HIV (AYPLHIV) to achieve better HIV outcomes. However, more evidence is needed to understand which interventions are most effective, and the mechanisms driving how they work in practice. METHODS We used realist methodologies to generate statements based on evidence from intervention studies and linked evidence included in a systematic review of psychosocial interventions for AYPLHIV. Key data were extracted from available sources to generate cases, including context-mechanism-outcome pathways. Higher level themes were refined iteratively to create a mid-range theory of how these interventions may work. RESULTS From 26 resulting cases, 8 statements were crafted, grouped into 3 overarching categories, to describe how these interventions worked. Interventions were overall found to set off mechanisms to improve adherence when (1) responding to individual-level factors to support AYPLHIV (via incorporating agency and empowerment, personalized and/or contextualized approaches, and self-care skills); (2) tailoring delivery strategies to address specific needs (via diverse strategies, longer duration, and digital delivery); and (3) providing supportive resources (via peer and broader support, and structural support and integration into existing services). DISCUSSION A collection of diverse mechanisms may individually or collectively drive improved outcomes for AYPLHIV engaged in psychosocial interventions. Recommendations for integrating our findings into practice are discussed.
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Affiliation(s)
- Christina A Laurenzi
- Institute for Life Course Health Research, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, South Africa.
| | - G J Melendez-Torres
- Peninsula Technology Assessment Group, University of Exeter, Exeter, United Kingdom
| | - Daniel T Page
- Institute for Life Course Health Research, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, South Africa
| | - Lodewyk Steyn Vogel
- Institute for Life Course Health Research, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, South Africa; Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Tashmira Kara
- Institute for Life Course Health Research, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, South Africa
| | - Nadia A Sam-Agudu
- Institute of Human Virology Nigeria, Abuja, Nigeria; Institute of Human Virology, University of Maryland School of Medicine, Baltimore, Maryland
| | | | - Wole Ameyan
- Global HIV, Hepatitis and Sexually Transmitted Infections Programmes, World Health Organization, Geneva, Switzerland
| | - Elona Toska
- Centre for Social Science Research, University of Cape Town, Cape Town, South Africa; Department of Sociology, University of Cape Town, Cape Town, South Africa; Department of Social Policy and Intervention, University of Oxford, Oxford, United Kingdom
| | - David Anthony Ross
- Child Health Initiative of the FIA Foundation, Bad Herrenalb, Baden-Wurttemberg, Germany
| | - Sarah Skeen
- Institute for Life Course Health Research, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, South Africa
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Gutierrez-Botero M, Ross DA, Van Amburgh ME. Formulating diets for intestinal unavailable nitrogen using blood meal in high-producing dairy cattle. J Dairy Sci 2022; 105:5738-5746. [PMID: 35570044 DOI: 10.3168/jds.2021-21730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Accepted: 03/17/2022] [Indexed: 11/19/2022]
Abstract
The high cost of protein feeds and growing concern for the environment have motivated dairy producers and nutritionists to focus their attention on reducing nitrogen (N) losses on dairy farms. It is well recognized that reducing the N content of cattle diets is the single most important factor to increase the efficiency of N use. However, effectively lowering the N content of diets requires the nutritionist to know the availability of N in feeds so as to not negatively affect milk production or overfeed N. To provide reliable data for nutritionists, a new assay to estimate unavailable N in the intestine (uN) was developed. To determine whether uN could be used as a replacement for acid detergent insoluble nitrogen (ADIN) in diet formulation, we conducted a replicated pen study to evaluate the effect of total-tract uN on the performance of high-producing dairy cattle. One hundred twenty-eight cattle that were 97 to 147 d in milk at the beginning of the experiment were allocated into 8 pens of 16 cows, and pens were randomly allocated to 2 dietary treatments. Cattle were fed 1 of 2 isonitrogenous and isocaloric diets that were also equal in neutral detergent fiber, deviating only in the inclusion of 2 different blood meals (BM) used in each diet. The uN contents of the 2 BM were 9% (low uN) and 34% (high uN) total N content as predicted by the assay, whereas when measured as ADIN, no difference in indigestibility was observed. The inclusion of BM was on an isonitrogenous basis, and the predicted difference in uN was 39 g/d or 5.8% of N intake, representing the formulated difference in available N between the 2 treatments. There was no effect of uN on dry matter or N intake, which averaged 27.3 kg/d and 668 g/d for both treatments, respectively. Milk yield and energy-corrected milk were 1.6 and 1.9 kg/d greater for cows fed the low uN diet compared with those fed the high uN diet. The lower uN diet was also associated with greater milk protein yield, greater milk fat yield, and greater milk urea N. The Cornell Net Carbohydrate and Protein System (version 6.5) was used to evaluate the application of the uN measurement by replacing ADIN in BM with the uN value in the inputs for the BM. All other cow and feed chemistry data were inputted as measured in the experiment. The predictions of metabolizable protein-allowable milk demonstrated that using the uN values in place of ADIN increased the accuracy of the prediction and enabled the model to predict the first-limiting nutrient provided all other feed, cattle, and management characteristics were also defined.
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Affiliation(s)
- M Gutierrez-Botero
- Department of Animal Science, Cornell University, 272 Morrison Hall, Ithaca, NY 14853
| | - D A Ross
- Department of Animal Science, Cornell University, 272 Morrison Hall, Ithaca, NY 14853
| | - M E Van Amburgh
- Department of Animal Science, Cornell University, 272 Morrison Hall, Ithaca, NY 14853.
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Plummer ML, Chan A, Kohl K, Taylor AB, Baltag V, Saewyc E, Ross DA. Results of a Global Survey of Experts to Categorize the Suitability of Interventions for Inclusion in School Health Services. J Adolesc Health 2021; 69:948-956. [PMID: 34167882 PMCID: PMC8631416 DOI: 10.1016/j.jadohealth.2021.05.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 05/11/2021] [Accepted: 05/12/2021] [Indexed: 11/17/2022]
Abstract
PURPOSE This global survey of experts assessed the suitability of different health-related interventions for inclusion in school health services (SHSs) to inform development of the World Health Organization global guideline on SHSs. METHODS A review of 138 global World Health Organization publications identified 406 health service interventions for 5- to 19-year-old individuals. These were consolidated, pretested, and pilot-tested in a questionnaire as 86 promotion, prevention, care, or treatment interventions. A total of 1,293 experts were identified through purposive sampling of journal databases and professional networks. In July 2019, experts were invited to complete the questionnaire online in Arabic, Chinese, English, French, Russian, or Spanish. Respondents categorized each intervention as essential, highly suitable, suitable, or unsuitable in SHSs (everywhere or in certain geographic areas only). They could also suggest interventions. RESULTS Interventions categorized most often as "Essential in SHSs everywhere" (70%-80%) are related to health promotion and health education. Clinical interventions categorized most often in this way (60%-68%) are related to immunization, screening, assessment, and general care. Interventions categorized most often as "Essential in SHSs in certain geographic areas only" (27%-49%) are related to immunization, mass drug administration, and health promotion. Interventions categorized most often as "Unsuitable in SHSs anywhere" (12%-14%) are related to screening of noncommunicable conditions. There were no important regional differences. Of 439 respondents from 81 countries, 188 suggested 378 additional interventions. Question order effect and/or purposive sampling biases may have influenced both quantitative and qualitative results for different types of intervention. CONCLUSIONS Favorable responses to almost all interventions supported their World Health Organization guideline inclusion but provided little guidance for intervention prioritization.
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Affiliation(s)
- Mary Louisa Plummer
- Department of Maternal, Newborn, Child and Adolescent Health and Ageing, World Health Organization (WHO), Geneva 27, Switzerland
| | - Ace Chan
- Stigma and Resilience Among Vulnerable Youth Centre (SARAVYC), University of British Columbia (UBC), Vancouver Campus, Vancouver, British Columbia, Canada
| | - Kid Kohl
- Department of Maternal, Newborn, Child and Adolescent Health and Ageing, World Health Organization (WHO), Geneva 27, Switzerland
| | - Ashley B. Taylor
- Stigma and Resilience Among Vulnerable Youth Centre (SARAVYC), University of British Columbia (UBC), Vancouver Campus, Vancouver, British Columbia, Canada
| | - Valentina Baltag
- Department of Maternal, Newborn, Child and Adolescent Health and Ageing, World Health Organization (WHO), Geneva 27, Switzerland.
| | - Elizabeth Saewyc
- SARAVYC and School of Nursing, UBC, Vancouver Campus, Vancouver, British Columbia, Canada
| | - David Anthony Ross
- Department of Maternal, Newborn, Child and Adolescent Health and Ageing, World Health Organization (WHO), Geneva 27, Switzerland
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Bularga A, Wereski R, Taggart C, Lowry M, Singh T, Lee KK, Anand A, Shah ASV, Ross DA, Perry MR, Dweck MR, Newby DE, Chapman AR, Mills NL. Mechanisms of myocardial injury and clinical outcomes in patients hospitalised with suspected COVID-19. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Myocardial injury is associated with adverse outcomes in patients with COVID-19. However, the prognostic role of myocardial injury in COVID-19 compared to other acute illnesses and the underlying mechanisms of injury are poorly understood.
Methods
In a prospective, multi-centre, cohort study conducted in secondary and tertiary care hospitals in Scotland, all consecutive patients with suspected COVID-19 underwent cardiac troponin (ARCHITECTSTAT high-sensitive troponin I (hs-cTnI) assay; Abbott Laboratories) testing in plasma that was surplus to clinical requirements. The results were not reported unless required by the attending clinician. We evaluated the prevalence of myocardial injury, mechanisms and outcomes in all patients. In those with any hs-cTnI concentration above the sex-specific 99th centile the diagnosis was adjudicated according to the 4th Universal Definition of Myocardial Infarction. The primary outcome of all-cause mortality was compared in those with and without myocardial injury and COVID-19 by cox regression adjusted for age, sex, renal function and co-morbidities.
Results
A total of 2,916 (median age 69 [interquartile range, IQR 54–79] years, 53% women) consecutive patients with suspected COVID-19 were followed up for 228 [IQR 203–249] days. Myocardial injury occurred in 26% (750/2,916) with a median troponin concentration of 66 [35–178] ng/L; the prevalence was 41% (46/112) and 25% (704/2,804) in those with and without COVID-19, respectively. The most common mechanism was acute non-ischaemic myocardial injury occurring in 80% (37/46) and 71% (502/704) of patients with and without COVID-19, respectively. Type 1 myocardial infarction (2% and 4%), type 2 myocardial infarction (7% and 14%) and chronic myocardial injury (11% and 11%) were less common and only one patient had confirmed myocarditis. In patients with myocardial injury mortality was increased compared to those without (P<0.001 log rank), whether they had COVID-19 (54% [25/46] versus 26% [17/66]) or not (35% [248/704] versus 14% [294/2100]). Myocardial injury was an independent predictor of death in all patients (adjusted hazard ratio [aHR] 2.04, 95% confidence interval [CI] 1.71 to 2.43), but this excess risk was not higher in patients with COVID-19 (aHR 1.58, 95% CI 0.75 to 3.15) compared to those without the condition (aHR 2.01, 95% CI 1.81 to 2.49).
Conclusion
Myocardial injury is common in hospitalised patients with suspected COVID-19 whether or not COVID-19 was the cause of their presentation. The majority of patients had acute non-ischaemic myocardial injury rather than a defined cardiac condition. Despite this the presence of myocardial injury was an independent predictor of death in all hospitalised patients.
Funding Acknowledgement
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): British Heart Foundation Kaplan-Meier curve for all-cause death
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Affiliation(s)
- A Bularga
- University of Edinburgh, Edinburgh, United Kingdom
| | - R Wereski
- University of Edinburgh, Edinburgh, United Kingdom
| | - C Taggart
- University of Edinburgh, Edinburgh, United Kingdom
| | - M Lowry
- University of Edinburgh, Edinburgh, United Kingdom
| | - T Singh
- University of Edinburgh, Edinburgh, United Kingdom
| | - K K Lee
- University of Edinburgh, Edinburgh, United Kingdom
| | - A Anand
- University of Edinburgh, Edinburgh, United Kingdom
| | - A S V Shah
- London School of Hygiene and Tropical Medicine, Department of Cardiology, London, United Kingdom
| | - D A Ross
- Western General Hospital, Regional Infectious Disease Unit, Edinburgh, United Kingdom
| | - M R Perry
- Western General Hospital, Regional Infectious Disease Unit, Edinburgh, United Kingdom
| | - M R Dweck
- University of Edinburgh, Edinburgh, United Kingdom
| | - D E Newby
- University of Edinburgh, Edinburgh, United Kingdom
| | - A R Chapman
- University of Edinburgh, Edinburgh, United Kingdom
| | - N L Mills
- University of Edinburgh, Edinburgh, United Kingdom
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Edmondson SJ, Ross DA. The postpartum abdomen: psychology, surgery and quality of life. Hernia 2021; 25:939-950. [PMID: 34309770 DOI: 10.1007/s10029-021-02470-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Accepted: 07/16/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE The postpartum abdomen presents significant challenges to the surgeon. It is anatomically complex, with often substantial symptomatic divarication of the rectus abdominis, affecting all anterior abdominal wall layers. This may lead to profound functional sequelae, and often, of more importance to patients, a significant physical deformity. The complex interplay of functional/physical symptoms can result in reduced quality of life (QoL) as well as negative body image/self-esteem. Postpartum women may seek abdominoplasty to address the whole scope of these concerns. Whilst techniques have evolved achieving such goals operatively, the impact of such surgery on QoL/mental health has yet to be established. METHODS We perform a comprehensive review of potential options of validated patient-reported outcome measures (PROMs) for consideration of use in postpartum women seeking abdominoplasty; in addition to discussing current driving factors for seeking surgery and associated ethics. RESULTS Pressure on postpartum women to return their abdominal wall contour to a pre-pregnant state is high. This poses important ethical considerations for surgeons. There are several well-established/validated PROMs used in body contouring in massive weight loss/bariatric population groups, including Body-Q and Body-QoL scales, but none yet specific to postpartum women. CONCLUSION PROMs use to enable establishment of the true value of abdominoplasty in postpartum women, not just in terms of functional/physical restoration, but also in terms of delivering a positive impact on patients' mental health and QoL, are important. Further research is needed to determine if those already developed are appropriate or whether a postpartum-specific PROM would be beneficial.
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Affiliation(s)
- S-J Edmondson
- Plastic and Reconstructive Surgery Department, The London Clinic, 20 Devonshire Place, London, W1G 6BW, England.
| | - D A Ross
- Plastic and Reconstructive Surgery Department, The London Clinic, 20 Devonshire Place, London, W1G 6BW, England
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Falconer Hall T, Ross DA. Establishing communicable disease surveillance systems. BMJ Mil Health 2021; 168:160-165. [PMID: 34035159 DOI: 10.1136/bmjmilitary-2021-001803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Revised: 05/01/2021] [Accepted: 05/07/2021] [Indexed: 11/03/2022]
Abstract
Humanitarian emergencies can result in an increase of communicable diseases, leading to a rise in mortality and/or morbidity in vulnerable populations. This requires a public health approach to re-establish control of communicable disease. Communicable disease surveillance systems play a key role, providing the information required for disease control measures, through systematic data collection, analysis, interpretation and dissemination. In humanitarian emergencies, they use the principles, practices and processes of wider surveillance systems, while being more focused on urgent priorities. However, communicable disease surveillance systems in humanitarian emergencies are constrained by multiple environmental, epidemiological and sociopolitical factors. Basic data collection, the bedrock of surveillance systems, can be extremely challenging and may require additional methods to estimate population size and prioritise diseases. Surveillance systems may be operating in conditions of weak state capacity with little physical or institutional infrastructure to support their operation. However, there are examples of successful self-sustaining disease surveillance systems in these circumstances, such as the deployment of WHO's Early Warning Alert and Response System in a Box. Individuals and organisations charged with establishing communicable disease surveillance systems in emergencies would be well advised to learn from recent examples of success, use the sources of planning guidance outlined in this article and seek advice from organisations with recent experience. This is a paper commissioned as a part of the Humanitarian and Disaster Relief Operations special issue of BMJ Military Health.
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Affiliation(s)
| | - D A Ross
- Worshipful Society of Apothecaries, London, UK
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Ford CA, Boyer CB, Gordon CM, Halpern CT, Ross DA. The Editors Respond. J Adolesc Health 2021; 68:221-222. [PMID: 33349357 DOI: 10.1016/j.jadohealth.2020.09.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Accepted: 09/16/2020] [Indexed: 10/22/2022]
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Falconer Hall T, Ross DA. Can the UK win back its collective memory of epidemics? BMJ Mil Health 2020; 167:73-74. [PMID: 32999085 DOI: 10.1136/bmjmilitary-2020-001634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/20/2020] [Indexed: 11/03/2022]
Affiliation(s)
| | - D A Ross
- Parkes Professor of Preventive Medicine, Army Medical Services, Camberley, UK
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Fessenden SW, Ross DA, Block E, Van Amburgh ME. Comparison of milk production, intake, and total-tract nutrient digestion in lactating dairy cattle fed diets containing either wheat middlings and urea, commercial fermentation by-product, or rumen-protected soybean meal. J Dairy Sci 2020; 103:5090-5101. [PMID: 32229110 DOI: 10.3168/jds.2019-17744] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Accepted: 01/29/2020] [Indexed: 11/19/2022]
Abstract
The objective of this study was to evaluate the effects of a commercially available fermentation by-product in a diet containing adequate rumen-degradable protein (RDP) on milk performance, intake, and total-tract nutrient digestion in lactating dairy cattle. Primiparous (n = 48) and multiparous (n = 144) lactating dairy cattle were stratified by milk production and randomly allocated into 12 pens containing 4 primiparous and 12 multiparous animals each. Cattle averaged 118 d in milk and 712 kg of body weight at trial start. Treatment diets, on a dry matter (DM) basis, consisted of 42% corn silage, 13% alfalfa hay and silage, 20% grain corn, and 25% protein premix containing either soybean meal, wheat middlings, and urea (SBM+U), soybean meal and fermentation by-product (SBM+F), or soybean meal and rumen-protected soybean meal (RP-SBM). All 3 diets provided a similar level (DM basis) of neutral detergent fiber analyzed using α-amylase and sodium sulfite and corrected for ash content (31%), crude protein (CP, 14.9%), starch (26%), and metabolizable energy (2.7 Mcal/kg), and differed in sources of RDP. The trial consisted of a 2-wk adaptation and covariate period during which all cows were fed the RP-SBM diet and covariate measurements were taken. Pens were then randomly allocated to treatments, and weekly measurements of milk production, intake, body weight, and condition score were taken for 10 wk. All data were analyzed using the Proc Mixed procedure in SAS (SAS Institute Inc., Cary, NC). Increased DM intake was observed for cows fed SBM+F compared with cows fed SBM+U and RP-SBM (28.3 vs. 26.9 and 26.7 kg/d, respectively). Cows fed SBM+F produced more energy-corrected milk (45.3 kg/d) compared with cows fed SBM+U and RP-SBM (43.6 and 43.7 kg/d, respectively). Milk protein yield was also increased in cows fed SBM+F. No differences were observed with body weight or condition score gain throughout the trial. Apparent total-tract digestibility of fiber was decreased in cows fed SBM+F, likely as a result of increased intake. Responses are consistent with previous research in our laboratory that demonstrated a decrease in ruminal CP degradation, leading to an increase in metabolizable protein supply in the small intestine. The fermentation by-product might be useful in diets containing adequate amounts of RDP from soybean meal or alfalfa. The results from this experiment demonstrate beneficial milk performance responses to fermentation by-product when fed with a source of RDP.
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Affiliation(s)
- S W Fessenden
- Department of Animal Science, Cornell University, Ithaca, NY 14850
| | - D A Ross
- Department of Animal Science, Cornell University, Ithaca, NY 14850
| | - E Block
- Arm and Hammer Animal Nutrition, Princeton, NJ 08543
| | - M E Van Amburgh
- Department of Animal Science, Cornell University, Ithaca, NY 14850.
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Engel DMC, Paul M, Chalasani S, Gonsalves L, Ross DA, Chandra-Mouli V, Cole CB, de Carvalho Eriksson C, Hayes B, Philipose A, Beadle S, Ferguson BJ. A Package of Sexual and Reproductive Health and Rights Interventions-What Does It Mean for Adolescents? J Adolesc Health 2019; 65:S41-S50. [PMID: 31761003 DOI: 10.1016/j.jadohealth.2019.09.014] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Accepted: 09/24/2019] [Indexed: 12/28/2022]
Abstract
This article analyzes the relevance of the comprehensive definition of sexual and reproductive health and rights (SRHR) to adolescents and identifies adolescent-specific implications for the implementation of an essential package of SRHR interventions. The delivery of a comprehensive approach to SRHR targeting adolescents is underpinned by five principles-equity, quality, accountability, multisectorality, and meaningful engagement. All SRHR interventions included in the package are relevant to adolescents, given the diversity of adolescents' SRHR needs and considering their specific attributes, circumstances, and experiences. Ensuring that this package is available, accessible, and acceptable to adolescents requires an approach that looks at adolescents as being biologically and socially distinct from other age groups and acknowledges that they face some specific barriers when accessing SRHR services. This article provides cross-cutting strategies for the implementation of a comprehensive approach to SRHR for adolescents and specific considerations in delivering each intervention in the package of essential SRHR interventions. To further implement the International Conference on Population and Development Programme of Action, a prerequisite for achieving the Sustainable Development Goals, SRHR interventions must be adolescent responsive, delivered through multiple platforms, leveraging multisectoral collaboration, and strengthening accountability and participation.
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Affiliation(s)
| | - Mandira Paul
- Technical Division, United Nations Population Fund, New York, New York
| | - Satvika Chalasani
- Technical Division, United Nations Population Fund, New York, New York
| | - Lianne Gonsalves
- Department of Reproductive Health and Research, World Health Organization/Human Reproduction Programme, Geneva, Switzerland
| | - David Anthony Ross
- Department of Maternal, Newborn, Child, and Adolescent Health, World Health Organization, Geneva, Switzerland
| | - Venkatraman Chandra-Mouli
- Department of Reproductive Health and Research, World Health Organization/Human Reproduction Programme, Geneva, Switzerland
| | | | | | - Brendan Hayes
- Global Financing Facility, World Bank, Washington, DC
| | - Anandita Philipose
- Eastern and Southern Regional Office, United Nations Population Fund, Johannesburg, South Africa
| | - Sally Beadle
- Section of Health and Education, United Nations Educational, Scientific and Cultural Organization, Paris, France
| | - B Jane Ferguson
- Independent Consultant, Adolescent Health and Development, Tannay, Switzerland
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Levinson J, Kohl K, Baltag V, Ross DA. Investigating the effectiveness of school health services delivered by a health provider: A systematic review of systematic reviews. PLoS One 2019; 14:e0212603. [PMID: 31188826 PMCID: PMC6561551 DOI: 10.1371/journal.pone.0212603] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Accepted: 05/27/2019] [Indexed: 01/08/2023] Open
Abstract
Schools are the only institution regularly reaching the majority of school-age children and adolescents across the globe. Although at least 102 countries have school health services, there is no rigorous, evidence-based guidance on which school health services are effective and should be implemented in schools. To investigate the effectiveness of school health services for improving the health of school-age children and adolescents, a systematic review of systematic reviews (overview) was conducted. Five databases were searched through June 2018. Systematic reviews of intervention studies that evaluated school-based or school-linked health services delivered by a health provider were included. Review quality was assessed using a modified Ballard and Montgomery four-item checklist. 1654 references were screened and 20 systematic reviews containing 270 primary studies were assessed narratively. Interventions with evidence for effectiveness addressed autism, depression, anxiety, obesity, dental caries, visual acuity, asthma, and sleep. No review evaluated the effectiveness of a multi-component school health services intervention addressing multiple health areas. From the limited amount of information available in existing systematic reviews, the strongest evidence supports implementation of anxiety prevention programs, indicated asthma education, and vision screening with provision of free spectacles. Additional systematic reviews are needed that analyze the effectiveness of comprehensive school health services, and specific services for under-researched health areas relevant for this population.
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Affiliation(s)
- Julia Levinson
- Institute for Medical Informatics, Biometrics and Epidemiology, Ludwig-Maximilians-Universität (LMU) Munich, Munich, Bavaria, Germany
| | - Kid Kohl
- Department of Maternal, Newborn, Child and Adolescent Health, World Health Organization, Geneva, Switzerland
| | - Valentina Baltag
- Department of Maternal, Newborn, Child and Adolescent Health, World Health Organization, Geneva, Switzerland
| | - David Anthony Ross
- Department of Maternal, Newborn, Child and Adolescent Health, World Health Organization, Geneva, Switzerland
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Affiliation(s)
- S Jackson
- Women in Ground Close Combat Review Army Personnel Research Capability, Senior Health Advisor Department, Andover, Hampshire, UK
| | - J Greeves
- Women in Ground Close Combat Review Army Personnel Research Capability, Senior Health Advisor Department, Andover, Hampshire, UK
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Gallagher KE, Kadokura E, Eckert LO, Miyake S, Mounier-Jack S, Aldea M, Ross DA, Watson-Jones D. Factors influencing completion of multi-dose vaccine schedules in adolescents: a systematic review. BMC Public Health 2016; 16:172. [PMID: 26895838 PMCID: PMC4759915 DOI: 10.1186/s12889-016-2845-z] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2015] [Accepted: 02/08/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Completion of multiple dose vaccine schedules is crucial to ensure a protective immune response, and maximise vaccine cost-effectiveness. While barriers and facilitators to vaccine uptake have recently been reviewed, there is no comprehensive review of factors influencing subsequent adherence or completion, which is key to achieving vaccine effectiveness. This study identifies and summarises the literature on factors affecting completion of multi-dose vaccine schedules by adolescents. METHODS Ten online databases and four websites were searched (February 2014). Studies with analysis of factors predicting completion of multi-dose vaccines were included. Study participants within 9-19 years of age were included in the review. The defined outcome was completion of the vaccine series within 1 year among those who received the first dose. RESULTS Overall, 6159 abstracts were screened, and 502 full texts were reviewed. Sixty one studies were eligible for this review. All except two were set in high-income countries. Included studies evaluated human papillomavirus vaccine, hepatitis A, hepatitis B, and varicella vaccines. Reported vaccine completion rates, among those who initiated vaccination, ranged from 27% to over 90%. Minority racial or ethnic groups and inadequate health insurance coverage were risk factors for low completion, irrespective of initiation rates. Parental healthcare seeking behaviour was positively associated with completion. Vaccine delivery in schools was associated with higher completion than delivery in the community or health facilities. Gender, prior healthcare use and socio-economic status rarely remained significant risks or protective factors in multivariate analysis. CONCLUSIONS Almost all studies investigating factors affecting completion have been carried out in developed countries and investigate a limited range of variables. Increased understanding of barriers to completion in adolescents will be invaluable to future new vaccine introductions and the further development of an adolescent health platform. PROSPERO reg# CRD42014006765.
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Affiliation(s)
- K E Gallagher
- Clinical Research Department, Faculty of Infectious Tropical Diseases, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK. .,Mwanza Intervention Trials Unit, The National Institute for Medical Research Mwanza Campus, PO Box 11936, Mwanza, Tanzania.
| | - E Kadokura
- Department of Epidemiology, University of Washington, 1959 NE Pacific Street, Health Sciences Building F-250, Box 357236, Seattle, WA, 98195-7236, USA.
| | - L O Eckert
- Departments of Obstetrics and Gynaecology and Global Health, University of Washington, 1959 NE Pacific Street, Health Sciences Building F-250, Box 357236, Seattle, WA, 98195-7236, USA.
| | - S Miyake
- Clinical Research Department, Faculty of Infectious Tropical Diseases, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.
| | - S Mounier-Jack
- Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK.
| | - M Aldea
- Infections and Cancer Unit, Cancer Epidemiology Research Programme, Catalan Institute of Oncology, Av. Gran Via de l'Hospitalet 199-203, Hospitalet de Llobregat, 08908, Barcelona, Spain. .,Bellvitge Institute of Biomedical Research (IDIBELL), Barcelona, Spain.
| | - D A Ross
- MRC Tropical Epidemiology Group, Faculty of Epidemiology and Population Health, London school of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.
| | - D Watson-Jones
- Clinical Research Department, Faculty of Infectious Tropical Diseases, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK. .,Mwanza Intervention Trials Unit, The National Institute for Medical Research Mwanza Campus, PO Box 11936, Mwanza, Tanzania.
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Quantick O, Roughton S, Ross DA. Anglo-French military sexual health conference. J ROY ARMY MED CORPS 2015. [DOI: 10.1136/jramc-2015-000560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Doyle AM, Changalucha J, Weiss HA, Watson-Jones D, Hayes RJ, Ross DA. PP68 Sexual risk behaviours among young people in rural mwanza, tanzania: is marriage protective? Br J Soc Med 2015. [DOI: 10.1136/jech-2015-206256.165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Van Amburgh ME, Collao-Saenz EA, Higgs RJ, Ross DA, Recktenwald EB, Raffrenato E, Chase LE, Overton TR, Mills JK, Foskolos A. The Cornell Net Carbohydrate and Protein System: Updates to the model and evaluation of version 6.5. J Dairy Sci 2015; 98:6361-80. [PMID: 26142847 DOI: 10.3168/jds.2015-9378] [Citation(s) in RCA: 166] [Impact Index Per Article: 18.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2015] [Accepted: 05/15/2015] [Indexed: 11/19/2022]
Abstract
New laboratory and animal sampling methods and data have been generated over the last 10 yr that had the potential to improve the predictions for energy, protein, and AA supply and requirements in the Cornell Net Carbohydrate and Protein System (CNCPS). The objectives of this study were to describe updates to the CNCPS and evaluate model performance against both literature and on-farm data. The changes to the feed library were significant and are reported in a separate manuscript. Degradation rates of protein and carbohydrate fractions were adjusted according to new fractionation schemes, and corresponding changes to equations used to calculate rumen outflows and postrumen digestion were presented. In response to the feed-library changes and an increased supply of essential AA because of updated contents of AA, a combined efficiency of use was adopted in place of separate calculations for maintenance and lactation to better represent the biology of the cow. Four different data sets were developed to evaluate Lys and Met requirements, rumen N balance, and milk yield predictions. In total 99 peer-reviewed studies with 389 treatments and 15 regional farms with 50 different diets were included. The broken-line model with plateau was used to identify the concentration of Lys and Met that maximizes milk protein yield and content. Results suggested concentrations of 7.00 and 2.60% of metabolizable protein (MP) for Lys and Met, respectively, for maximal protein yield and 6.77 and 2.85% of MP for Lys and Met, respectively, for maximal protein content. Updated AA concentrations were numerically higher for Lys and 11 to 18% higher for Met compared with CNCPS v6.0, and this is attributed to the increased content of Met and Lys in feeds that were previously incorrectly analyzed and described. The prediction of postruminal flows of N and milk yield were evaluated using the correlation coefficient from the BLUP (R(2)BLUP) procedure or model predictions (R(2)MDP) and the concordance correlation coefficient. The accuracy and precision of rumen-degradable N and undegradable N and bacterial N flows were improved with reduced bias. The CNCPS v6.5 predicted accurate and precise milk yield according to the first-limiting nutrient (MP or metabolizable energy) with a R(2)BLUP=0.97, R(2)MDP=0.78, and concordance correlation coefficient=0.83. Furthermore, MP-allowable milk was predicted with greater precision than metabolizable energy-allowable milk (R(2)MDP=0.82 and 0.76, respectively, for MP and metabolizable energy). Results suggest a significant improvement of the model, especially under conditions of MP limitation.
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Affiliation(s)
- M E Van Amburgh
- Department of Animal Science, Cornell University, Ithaca, NY 14850.
| | - E A Collao-Saenz
- Department of Animal Science, Federal University of Goiás, Jataí, Brazil 75800-970
| | - R J Higgs
- Department of Animal Science, Cornell University, Ithaca, NY 14850
| | - D A Ross
- Department of Animal Science, Cornell University, Ithaca, NY 14850
| | - E B Recktenwald
- Department of Animal Science, Cornell University, Ithaca, NY 14850
| | - E Raffrenato
- Department of Animal Sciences, Stellenbosch University, Stellenbosch, South Africa 7600
| | - L E Chase
- Department of Animal Science, Cornell University, Ithaca, NY 14850
| | - T R Overton
- Department of Animal Science, Cornell University, Ithaca, NY 14850
| | - J K Mills
- Elanco Animal Health, Canastota, NY 13032
| | - A Foskolos
- Department of Animal Science, Cornell University, Ithaca, NY 14850
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Balira R, Mabey D, Weiss H, Ross DA, Changalucha J, Watson-Jones D. The need for further integration of services to prevent mother-to-child transmission of HIV and syphilis in Mwanza City, Tanzania. Int J Gynaecol Obstet 2015; 130 Suppl 1:S51-7. [PMID: 25963906 DOI: 10.1016/j.ijgo.2015.04.016] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To assess the operational integration of maternal HIV testing and syphilis screening in Mwanza, Tanzania. METHODS Interviews were conducted with 76 health workers (HW) from three antenatal clinics (ANC) and three maternity wards in 2008-2009 and 1137 consecutive women admitted for delivery. Nine ANC health education sessions and client flow observations were observed. RESULTS Only 25.0% of HWs reported they had received training in both prevention of mother-to-child transmission (PMTCT) and syphilis screening. HIV and syphilis tests were sometimes performed in different rooms and results recorded in separate registers with different formats and the results were not always given by the same person. At delivery, most women had been tested for both HIV (79.4%) and syphilis (88.1%) during pregnancy. Of those not tested antenatally for each infection, 70.1% were tested for HIV at delivery but none for syphilis. CONCLUSION Integration of maternal HIV and syphilis screening was limited. Integrated care guidelines and related health worker training should address this gap.
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Affiliation(s)
- Rebecca Balira
- National Institute for Medical Research (NIMR), Mwanza, Tanzania.
| | - David Mabey
- London School of Hygiene and Tropical Medicine, London, UK
| | - Helen Weiss
- MRC Tropical Epidemiology Group, London School of Hygiene and Tropical Medicine, London, UK
| | - David Anthony Ross
- MRC Tropical Epidemiology Group, London School of Hygiene and Tropical Medicine, London, UK
| | - John Changalucha
- National Institute for Medical Research (NIMR), Mwanza, Tanzania
| | - Deborah Watson-Jones
- London School of Hygiene and Tropical Medicine, London, UK; Mwanza Intervention Trials Unit, NIMR, Mwanza, Tanzania
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Kaufman ZA, Braunschweig EN, Feeney J, Dringus S, Weiss H, Delany-Moretlwe S, Ross DA. Sexual risk behavior, alcohol use, and social media use among secondary school students in informal settlements in Cape Town and Port Elizabeth, South Africa. AIDS Behav 2014; 18:1661-74. [PMID: 24934651 DOI: 10.1007/s10461-014-0816-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
South Africa's HIV prevalence among young people remains among the highest in the world. A cross-sectional study was carried out in 2012 to estimate prevalences of sexual risk behavior and hazardous alcohol use (HAU) (via the Alcohol Use Disorder Identification Test) as well as to investigate potential associations between these outcomes and social media use. In all, 4485 students (mean age 15.66 years, SD 1.39) at 46 secondary schools in informal settlements in Cape Town and Port Elizabeth completed mobile-phone-assisted, self-administered baseline questionnaires within a cluster-randomized trial. In all, 312 females (12.5 %) and 468 males (23.5 %) screened positive for HAU (AOR = 1.98, 95 % CI 1.69-2.34). 730 males (39.9 %) and 268 females (11.8 %) reported having had two or more partners in the last year (AOR = 3.46, 95 % CI 2.87-4.16). Among females, having a Facebook account was associated with reported multiple partnerships in the last year (AOR = 1.81, 95 % CI 1.19-2.74), age-disparate sex in the last year (AOR = 1.96, 95 % CI 1.16-3.32) and HAU (AOR = 1.97, 95 % CI 1.41-2.74). Using Mxit-a popular mobile instant messaging application-was associated with higher odds of reported multiple partnerships in the last year among both males (AOR = 1.70, 95 % CI 1.35-2.14) and females (AOR = 1.45, 95 % CI 1.07-1.96) and with HAU among both males (AOR = 1.47, 95 % CI 1.14-1.90) and females (AOR = 1.50, 95 % CI 1.18-1.90). Further longitudinal and qualitative research should explore in more depth the observed links between social media and risk behavior.
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Affiliation(s)
- Z A Kaufman
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, Keppel St., London, WC1E 7HT, UK,
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Monteiro de Barros J, Ross DA. Did the Olympics need more drugs? A doctor's reflection on providing medical care during Op OLYMPICS. J ROY ARMY MED CORPS 2014; 160:232-5. [DOI: 10.1136/jramc-2013-000148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Recktenwald EB, Ross DA, Fessenden SW, Wall CJ, Van Amburgh ME. Urea-N recycling in lactating dairy cows fed diets with 2 different levels of dietary crude protein and starch with or without monensin. J Dairy Sci 2013; 97:1611-22. [PMID: 24377801 DOI: 10.3168/jds.2013-7162] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2013] [Accepted: 11/02/2013] [Indexed: 11/19/2022]
Abstract
Rumensin (monensin; Elanco Animal Health, Greenfield, IN) has been shown to reduce ammonia production and microbial populations in vitro; thus, it would be assumed to reduce ruminal ammonia production and subsequent urea production and consequently affect urea recycling. The objective of this experiment was to determine the effects of 2 levels of dietary crude protein (CP) and 2 levels of starch, with and without Rumensin on urea-N recycling in lactating dairy cattle. Twelve lactating Holstein dairy cows (107 ± 21 d in milk, 647 kg ± 37 kg of body weight) were fed diets characterized as having high (16.7%) or low (15.3%) CP with or without Rumensin, while dietary starch levels (23 vs. 29%) were varied between 2 feeding periods with at least 7d of adaptation between measurements. Cows assigned to high or low protein and to Rumensin or no Rumensin remained on those treatments to avoid carryover effects. The diets consisted of approximately 40% corn silage, 20% alfalfa hay, and 40% concentrate mix specific to the treatment diets, with 0.5 kg of wheat straw added to the high starch diets to enhance effective fiber intake. The diets were formulated using Cornell Net Carbohydrate and Protein System (version 6.1), and the low-protein diets were formulated to be deficient for rumen ammonia to create conditions that should enhance the demand for urea recycling. The high-protein diets were formulated to be positive for both rumen ammonia and metabolizable protein. Rumen fluid, urine, feces, and milk samples were collected before and after a 72-h continuous jugular infusion of (15)N(15)N-urea. Total urine and feces were collected during the urea infusions for N balance measurements. Milk yield and dry matter intake were improved in cows fed the higher level of dietary CP and by Rumensin. Ruminal ammonia and milk and plasma urea nitrogen concentrations corresponded to dietary CP concentration. As has been shown in vitro, Rumensin reduced rumen ammonia concentration by approximately 23% but did not affect urea entry rate or gastrointestinal entry rate. Urea entry rate averaged approximately 57% of total N intake for cattle with and without Rumensin, and gastrointestinal rate was similar at 43 and 42% of N intake for cattle fed and not fed Rumensin, respectively. The cattle fed the high-protein diet had a 25% increase in urea entry rate and no effect of starch level was observed for any recycling parameters. Contrary to our hypothesis, Rumensin did not alter urea production and recycling.
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Affiliation(s)
- E B Recktenwald
- Department of Animal Science, Cornell University, Ithaca, NY 14853
| | - D A Ross
- Department of Animal Science, Cornell University, Ithaca, NY 14853
| | - S W Fessenden
- Department of Animal Science, Cornell University, Ithaca, NY 14853
| | - C J Wall
- Department of Animal Science, Cornell University, Ithaca, NY 14853
| | - M E Van Amburgh
- Department of Animal Science, Cornell University, Ithaca, NY 14853.
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Doyle AM, Changalucha J, Weiss HA, Watson-Jones D, Hayes RJ, Zaba B, Ross DA. OP35 Sexual Risk Behaviour Among Young People in Rural Tanzania: Do those in Full-Time Education Practise Safer Sex? Br J Soc Med 2013. [DOI: 10.1136/jech-2013-203126.35] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Doyle AM, Changalucha J, Weiss HA, Watson-Jones D, Hayes RJ, Zaba B, Ross DA. P4.138 The Internal Consistency of Sexual Partnership Histories Reported by Young People in Rural Tanzania: Abstract P4.138 Table 1. Br J Vener Dis 2013. [DOI: 10.1136/sextrans-2013-051184.1035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Kaufman ZA, Kaufman EB, Dringus S, Weiss HA, Delany-Moretlwe S, Ross DA. P3.380 Baseline Results of a Cluster-Randomised Trial Assessing the Effectiveness of Sport-Based HIV Prevention in South African Schools. Br J Vener Dis 2013. [DOI: 10.1136/sextrans-2013-051184.0833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Kaufman ZA, Kaufman EB, Dringus S, Weiss HA, Delany-Moretlwe S, Ross DA. P3.387 Prevalence and Predictors of Rape Perpetration Among Male Secondary School Students in Peri-Urban Xhosa Communities in South Africa. Br J Vener Dis 2013. [DOI: 10.1136/sextrans-2013-051184.0840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Kaufman ZA, DeCelles J, Bhauti K, Weiss HA, Chaibva CN, Ross DA. P3.373 Male Circumcision Prevalence, Knowledge, Perceptions, and Intent Among Men in Bulawayo, Zimbabwe: A Cross-Sectional Study. Br J Vener Dis 2013. [DOI: 10.1136/sextrans-2013-051184.0826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Kaufman ZA, Hershow R, DeCelles J, Bhauti K, Dringus S, Delany-Moretlwe S, Ross DA. P3.321 Acceptability of Data Collection on Mobile Phones Using ODK Software For Self-Administered Sexual Behaviour Questionnaires. Br J Vener Dis 2013. [DOI: 10.1136/sextrans-2013-051184.0774] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Balira R, Watson-Jones D, Mabey D, Ross DA, Weiss H. P6.026 Lack of Integration of PMTCT Services and Maternal Syphilis Screening and Treatment in Mwanza City-Tanzania. Br J Vener Dis 2013. [DOI: 10.1136/sextrans-2013-051184.1180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Bastien S, Mason-Jones AJ, De Koker P, Mmbaga EJ, Ross DA, Mathews C. Herpes simplex virus type 2 infection as a biomarker for sexual debut among young people in sub-Saharan Africa: a literature review. Int J STD AIDS 2013; 23:761-6. [PMID: 23155093 DOI: 10.1258/ijsa.2012.011433] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Biological markers are needed in order to provide objective measures to validate self-reported sexual behaviour and interpret prevention trial data. In this review, we evaluated herpes simplex type 2 virus (HSV-2), one of the most prevalent sexually transmitted infections in sub-Saharan Africa as a biological marker of sexual debut. Based on our findings, we do not recommend using HSV-2 as a biomarker for sexual debut due to its low transmission probabilities and the fact that HSV-2 prevalence is not 100% among potential sexual partners. We recommend that the validation of alternative biological measures should be prioritized, and included in future studies and trials of interventions to reduce sexual health risk.
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Affiliation(s)
- S Bastien
- Institute for Basic Medical Sciences, Faculty of Medicine, University of Oslo, Domus Medica, Sognsvannsveien 9, 0372 Oslo, Norway.
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Naumann DN, Hughes EJ, Ross DA. Recruiting an infection. Is PVL-SA infection a growing risk in a military setting? J ROY ARMY MED CORPS 2012; 158:350-351. [PMID: 23402079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
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Ross DA, Bertele MV. Commentary. J ROY ARMY MED CORPS 2012. [DOI: 10.1136/jramc-158-01-10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Abstract
Flea bites can cause irritating symptoms, secondary infections, and may potentiate the spread of vector-borne disease. Flea infestation and bites may also cause significant psychological distress, and can reduce the morale and fighting fitness of deployed military personnel. The problem of flea infestation was highlighted during Op HERRICK 12 in two 'front line' Check Points (CPs) where the entire population of soldiers suffered from multiple symptoms due to flea infestation and bites. Several attempts at infestation control initially succeeded but later lead to recurrence. Such failure was due to the incomplete killing of all stages of the flea life cycle, and due to constraints on education, training, communication, and resupply in the isolated and austere environment of the CPs. A dedicated operation (designated Op Insecticide) was put into action in order to eradicate the problem and return the affected troops back to full fighting fitness. Op Insecticide was thorough, systematic and sustainable, and lead to an eradication of the flea infestation problem at the affected CPs.
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Kaufman ZA, Welsch RL, Erickson JD, Craig S, Adams LV, Ross DA. Effectiveness of a sports-based HIV prevention intervention in the Dominican Republic: a quasi-experimental study. AIDS Care 2011; 24:377-85. [PMID: 21933038 DOI: 10.1080/09540121.2011.608789] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Previous observational and quasi-experimental studies in sub-Saharan Africa have suggested the effectiveness of youth-targeted HIV prevention interventions using sport as an educational tool. No studies have yet assessed the effect of similar programs in the Caribbean. A quasi-experimental trial was conducted to assess the effectiveness of a sports-based intervention in six migrant settlements in the Puerto Plata Province of the Dominican Republic. A total of 397 structured interviews were conducted with 140 adolescents prior to, immediately following, and four months following 10-hour interventions using the Grassroot Soccer curriculum. Interview responses were coded, aggregated into composite scores, and analyzed using logistic regression, adjusting for baseline differences as well as age, sex, community, and descent. At post-intervention, significant differences were observed between groups in HIV-related knowledge (adjOR = 13.02, 95% CI = 8.26, 20.52), reported attitudes (adjOR = 12.01, 95% CI = 7.61, 18.94), and reported communication (adjOR = 3.13, 95% CI = 1.91, 5.12). These differences remained significant at four-month follow-up, though declines in post-intervention knowledge were observed in the Intervention group while gains in knowledge and reported attitudes were observed in the Control group. Results suggest that this sports-based intervention could play a valuable role in HIV prevention efforts in the Caribbean, particularly those targeting early adolescents. Further evaluation of sports-based interventions should include indicators assessing behavioral and biological outcomes, longer-term follow-up, a larger sample, randomization of study participants, and strenuous efforts to minimize loss-to-follow-up.
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Affiliation(s)
- Z A Kaufman
- Department of Anthropology, Dartmouth College, Hanover, NH, USA.
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Abstract
Proper reconstruction of the cranial base is imperative in preventing cerebrospinal fluid leakage and in the protection of vascular elements. Living pericranial flaps are often key elements in such reconstruction; however, trauma, previous surgery, or pathologic involvement can result in the loss of important parts of the pericranium. Techniques for utilizing pericranial flaps despite defects in the pericranium are described and case examples are given to illustrate these techniques.
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Ross DA, Marentette LJ, Moore CE, Switz KL. Craniofacial resection: decreased complication rate with a modified subcranial approach. Skull Base Surg 2011; 9:95-100. [PMID: 17171124 PMCID: PMC1656816 DOI: 10.1055/s-2008-1058155] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The authors have successfully utilized a modified subcranial approach to the anterior skull base, based upon the procedure first described by Joram Raveh, as an alternative to standard craniofacial resection. The complication rate of this procedure in 31 consecutive cases (28 tumors, 2 congenital malformations, and 1 mucocele) has been 19.4% with no permanent complications, no deaths, no new neurological deficits, no brain injuries, no infections, and no seizures. Minor complications without permanent sequelae included two cases of tension pnenmocephalus, a subdural hygroma, two transient cerebrospinal fluid leaks, and a case of bacterial meningitis secondary to fecal contamination of a lumbar drain in a child. Average length of hospitalization was 7.1 days (range 2 to 16 days). The overall complication rate is considerably below the complication rate for other reported craniofacial procedures. We describe the technique we have used and the results. The subcranial approach as described herein provides wide exposure of the anterior cranial base without brain retraction, does not require prolonged operating times or hospitalization, and has a potentially lower complication rate than reported for other transfrontal transbasal approaches.
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Abstract
A bathymetric and geophysical survey of the Red Sea rift valley between 21 degrees 10' and 21 degrees 30'N has defined three separate pools of hot brines. The brines and their associated heavy metals are believed to be periodically discharged from the eastern side of the largest deep, Atlantis II. Cores taken from the flanks of the deeps show repetitive cycles of sedimentation of hydrous amorphous iron oxides which fill most of Atlantis II Deep.
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Abstract
Three distinct sedimentary units, which can be correlated throughout the basin, occur in cores collected from the Black Sea. Carbon-14 ages help to define the recent sedimentary history of the Black Sea.
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Faughnan ME, Palda VA, Garcia-Tsao G, Geisthoff UW, McDonald J, Proctor DD, Spears J, Brown DH, Buscarini E, Chesnutt MS, Cottin V, Ganguly A, Gossage JR, Guttmacher AE, Hyland RH, Kennedy SJ, Korzenik J, Mager JJ, Ozanne AP, Piccirillo JF, Picus D, Plauchu H, Porteous MEM, Pyeritz RE, Ross DA, Sabba C, Swanson K, Terry P, Wallace MC, Westermann CJJ, White RI, Young LH, Zarrabeitia R. International guidelines for the diagnosis and management of hereditary haemorrhagic telangiectasia. J Med Genet 2009; 48:73-87. [PMID: 19553198 DOI: 10.1136/jmg.2009.069013] [Citation(s) in RCA: 652] [Impact Index Per Article: 43.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND HHT is an autosomal dominant disease with an estimated prevalence of at least 1/5000 which can frequently be complicated by the presence of clinically significant arteriovenous malformations in the brain, lung, gastrointestinal tract and liver. HHT is under-diagnosed and families may be unaware of the available screening and treatment, leading to unnecessary stroke and life-threatening hemorrhage in children and adults. OBJECTIVE The goal of this international HHT guidelines process was to develop evidence-informed consensus guidelines regarding the diagnosis of HHT and the prevention of HHT-related complications and treatment of symptomatic disease. METHODS The overall guidelines process was developed using the AGREE framework, using a systematic search strategy and literature retrieval with incorporation of expert evidence in a structured consensus process where published literature was lacking. The Guidelines Working Group included experts (clinical and genetic) from eleven countries, in all aspects of HHT, guidelines methodologists, health care workers, health care administrators, HHT clinic staff, medical trainees, patient advocacy representatives and patients with HHT. The Working Group determined clinically relevant questions during the pre-conference process. The literature search was conducted using the OVID MEDLINE database, from 1966 to October 2006. The Working Group subsequently convened at the Guidelines Conference to partake in a structured consensus process using the evidence tables generated from the systematic searches. RESULTS The outcome of the conference was the generation of 33 recommendations for the diagnosis and management of HHT, with at least 80% agreement amongst the expert panel for 30 of the 33 recommendations.
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Affiliation(s)
- M E Faughnan
- Division of Respirology, Department of Medicine, St Michael's Hospital, University of Toronto, Toronto, Ontario, Canada.
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Affiliation(s)
- D A Ross
- Army Medical Directorate, Slim Road, Camberley, GU15 4NA
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Lamb L, Ross DA, Lalloo DG, Green A, Morgan ER, Warrell DA. Management of venomous bites and stings in British Military Personnel deployed in Iraq, Afghanistan and Cyprus. J ROY ARMY MED CORPS 2008; 154:2-40. [PMID: 19530398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
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Plummer ML, Wight D, Wamoyi J, Nyalali K, Ingall T, Mshana G, Shigongo ZS, Obasi AIN, Ross DA. Are schools a good setting for adolescent sexual health promotion in rural Africa? A qualitative assessment from Tanzania. Health Educ Res 2007; 22:483-99. [PMID: 17018766 DOI: 10.1093/her/cyl099] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
African adolescents are at high risk of poor sexual health. School-based interventions could reach many adolescents in a sustainable and replicable way, if enrolment, funding and infrastructure are adequate. This study examined pupils', recent school leavers', parents' and teachers' views and experiences of rural Tanzanian primary schools, focusing on the implications for potential sexual health programmes. From 1999 to 2002, participant observation was conducted in nine villages for 158 person-weeks. Half of Year 7 pupils were 15-17 years old, and few went on to secondary school, suggesting that primary schools may be a good venue for such programmes. However, serious challenges include low enrolment and attendance rates, limited teacher training, little access to teaching resources and official and unofficial practices that may alienate pupils and their parents, e.g. corporal punishment, pupils being made to do unpaid work, forced pregnancy examinations, and some teachers' alcohol or sexual abuse. At a national level, improved teacher training and supervision are critical, as well as policies that better prevent, identify and correct undesired practices. At a programme level, intervention developers need to simplify the subject matter, introduce alternative teaching methods, help improve teacher-pupil and teacher-community relationships, and closely supervise and appropriately respond to undesired practices.
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Affiliation(s)
- Mary L Plummer
- Department of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK.
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Plummer ML, Wight D, Obasi AIN, Wamoyi J, Mshana G, Todd J, Mazige BC, Makokha M, Hayes RJ, Ross DA. A process evaluation of a school-based adolescent sexual health intervention in rural Tanzania: the MEMA kwa Vijana programme. Health Educ Res 2007; 22:500-12. [PMID: 17018767 DOI: 10.1093/her/cyl103] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
This study is a process evaluation of the school component of the adolescent sexual health programme MEMA kwa Vijana (MkV), which was implemented in 62 primary schools in rural Mwanza, Tanzania from 1999 to 2001. The MkV curriculum was a teacher-led and peer-assisted programme based on the Social Learning Theory. Process evaluation included observation of training sessions, monitoring and supervision, annual surveys of implementers, group discussions and 158 person-weeks of participant observation. Most teachers taught curriculum content well, but sometimes had difficulty adopting new teaching styles. Peer educators performed scripted dramas well, but were limited as informal educators and behavioural models. The intervention appeared successful in addressing some cognitions, e.g. knowledge of risks and benefits of behaviours, but not others, e.g. perceived susceptibility to risk. MkV shared the characteristics of other African school-based programmes found to be successful, and similarly found significant improvements in self-reported behaviour in surveys. However, a substantial proportion of MkV survey self-reports were inconsistent, there was no consistent impact on biological markers and extensive process evaluation found little impact on several key theoretical determinants of behaviour. Improvements in self-reported survey data alone may provide only a very limited-and perhaps invalid-indication of adolescent sexual health programme success.
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Affiliation(s)
- Mary L Plummer
- Department of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK.
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Short KA, Calman FMB, Ross DA, du Vivier AWP. Can radiotherapy cure radiation-induced skin cancer? Clin Exp Dermatol 2007; 32:109-11. [PMID: 17305917 DOI: 10.1111/j.1365-2230.2006.02266.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Obasi AI, Cleophas B, Ross DA, Chima KL, Mmassy G, Gavyole A, Plummer ML, Makokha M, Mujaya B, Todd J, Wight D, Grosskurth H, Mabey DC, Hayes RJ. Rationale and design of the MEMA kwa Vijana adolescent sexual and reproductive health intervention in Mwanza Region, Tanzania. AIDS Care 2007; 18:311-22. [PMID: 16809108 DOI: 10.1080/09540120500161983] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Large-scale innovative, integrated, multifaceted adolescent sexual and reproductive health (ASRH) interventions are urgently needed in sub-Saharan Africa. Implementation through schools and health facilities may maximize intervention coverage and sustainability, however the impact of the use of these structures on intervention content and delivery is not well documented. This paper describes the rationale and design of a large-scale multifaceted ASRH intervention, which was developed and evaluated over three years in rural communities in Mwanza Region, North West Tanzania. The intervention comprised community mobilization, participatory reproductive health education in primary schools, youth-friendly reproductive health services and community-based condom provision for youth. We examine the effect of socioeconomic, cultural and infrastructural factors on intervention content and implementation. This paper demonstrates the means by which such interventions can be feasibly and sustainably implemented to a high standard through existing government health and school structures. However, the use of these structures involves compromise on some key aspects of intervention design and requires the development of complementary strategies to access out-of-school youth and the wider community.
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Affiliation(s)
- A I Obasi
- The Liverpool School Tropical Medicine, Pembroke Place, Liverpool, L3 5QA.
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Roblin P, Alexiou T, Sabharwal T, Reidy J, Ross DA. Successful stent-graft placement for the treatment of a superior gluteal artery pseudoaneurysm in a patient following complex pelvic surgery. Br J Radiol 2007; 80:e7-10. [PMID: 17267470 DOI: 10.1259/bjr/21729994] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Aneurysms of the gluteal arteries are rare and were previously managed with open surgical procedures. Recently percutaneous embolisation techniques have helped reduce morbidity and mortality. A case is presented of a 63-year-old man who presented with haemorrhage and had developed a superior gluteal artery aneurysm following treatment for an invasive squamous cell carcinoma in the sacral area. There was concern that embolisation of the aneurysm might compromise the survival of the myocutaneous buttock rotation flaps that had been used for reconstruction. To overcome this, an endovascular stent was deployed to successfully close off the aneurysm whilst at the same time maintaining blood flow through the superior gluteal artery. Aneurysms in larger peripheral vessels have been managed with stents. However, this is the first reported case of this method of treatment being used in the management of gluteal artery aneurysms.
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Affiliation(s)
- P Roblin
- Department of Plastic Surgery, St Thomas' Hospital, Lambeth Road, London SE1 7EH, UK.
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Affiliation(s)
- S E James
- Department of Plastic and Reconstructive Surgery, St. Thomas' Hospital, London, United Kingdom
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