The development of the South Carolina Coastal Information Network and portal site: Bringing training opportunities and educational resources to coastal community officials and the public

The South Carolina Coastal Information Network (SCCIN) emerged as a result of a number of coastal outreach institutions working in partnership to enhance coordination of the coastal community outreach efforts in South Carolina. This organized effort, led by the S.C. Sea Grant Consortium and its Extension Program, includes partners from federal and state agencies, regional government agencies, and private organizations seeking to coordinate and/or jointly deliver outreach programs that target coastal community constituents. The Network was officially formed in 2006 with the original intention of fostering intra-and inter- agency communication, coordination, and cooperation. Network partners include the S.C. Sea Grant Consortium, S.C. Department of Health and Environmental Control – Office of Ocean and Coastal Resource Management and Bureau of Water, S.C. Department of Natural Resources – ACE Basin National Estuarine Research Reserve, North Inlet-Winyah Bay National Estuarine Research Reserve, Clemson University Cooperative Extension Service and Carolina Clear, Berkeley-Charleston-Dorchester Council of Governments, Waccamaw Regional Council of Governments, Urban Land Institute of South Carolina, S.C. Department of Archives and History, the National Oceanic and Atmospheric Administration – Coastal Services Center and Hollings Marine Laboratory, Michaux Conservancy, Ashley-Cooper Stormwater Education Consortium, the Coastal Waccamaw Stormwater Education Consortium, the S.C. Chapter of the U.S. Green Building Council, and the Lowcountry Council of Governments. (PDF contains 3 pages)

Issues of HIV/AIDS/ health among the fisher communities of Lake Albert and Kyoga

The fisheries resources of Lakes Albert and Kyoga present a high potential for economic growth, food, employment and foreign earnings. However, livelihoods appear to be compromised with the emergence and rapid spread of HIV/AIDS in the fisher communities of L. Albert and Kyoga. HIV/AIDS is considered a silent epidemic that is unique, posing a great challenge to the fisheries managers, health service providers, development planners and the resource users themselves. Fishers have high HIV prevalence, as well as AIDS-related illnesses and mortality rates. The high HIV prevalence rates among the fishing communities in Uganda is between 10-40% compared to the national rates which lie between 6% and 7%. This indicates that the national programmes have not adequately addressed the plight of the fishing communities of Lakes Albert, and Kyoga and the consequences have been devastating. Men and women living in fishing villages across the world have been found to be between five and ten times more vulnerable to the disease than other communities (Tarzan et al 2005, FAO, 2007). The present prevalence rates among the fishing communities stands at 10 to 40 % (LVFO, 2008). Meanwhile the same fishing communities are the essential labour for the Lakes’ fishery industry which is thriving nationally and internationally. That resource potentially can alleviate poverty and the HIV/AIDS threat. Fishing communities are the hidden victims of the disease, mixing patterns with the general population could act as a reservoir of infection that could spill over into the general population to drive the epidemic. On L. Albert, a quarter of the fisher folk were HIV-positive by 1992 compared to 4% in a nearby Agricultural village. Since then, there have been no targeted studies to address or monitor the prevalence rates eight years later, yet the multiplicity factor is high. HIV/AIDS can be linked to unsustainable fisheries, as the labour force available would not go to deep waters to fish, instead would fish in the shallow waters as a coping mechanism. A further effect is the loss to National and local economies and reduced nutritional security for the wider population. HIV/AIDS remains a significant challenge that has created a mosaic of complexity in the fishery sector. This needs to be addressed. It is, therefore, paramount that a comprehensive study was under taken to address this pandemic and the phenomenon of HIV/AIDS based on the study objectives. 1. To determine the trend in HIV/AIDS infection among fishing communities and the factors affecting it 2. To assess the impacts of HIV/AIDS on fish production and the implications for fisheries management.

Later Life Consequences of Subteratogenic Exposure to a Complex PAH Mixture in the Atlantic Killifish (Fundulus heteroclitus)

Subteratogenic and other low-level chronic exposures to toxicant mixtures are an understudied threat to environmental and human health. It is especially important to understand the effects of these exposures for contaminants, such as polycyclic aromatic hydrocarbons (PAHs) a large group of more than 100 individual compounds, which are important environmental (including aquatic) contaminants. Aquatic sediments constitute a major sink for hydrophobic pollutants, and studies show PAHs can persist in sediments over time. Furthermore, estuarine systems (namely breeding grounds) are of particular concern, as they are highly impacted by a wide variety of pollutants, and estuarine fishes are often exposed to some of the highest levels of contaminants of any vertebrate taxon. Acute embryonic exposure to PAHs results in cardiac teratogenesis in fish, and early life exposure to certain individual PAHs and PAH mixtures cause heart alterations with decreased swimming capacity in adult fish. Consequently, the heart and cardiorespiratory system are thought to be targets of PAH mixture exposure. While many studies have investigated acute, teratogenic PAH exposures, few studies have longitudinally examined the impacts of subtle, subteratogenic PAH mixture exposures, which are arguably more broadly applicable to environmental contamination scenarios. The goal of this dissertation was to highlight the later-life consequences of early-life exposure to subteratogenic concentrations of a complex, environmentally relevant PAH mixture.

A unique population of Fundulus heteroclitus (the Atlantic killifish or mummichog, hereafter referred to as killifish), has adapted to creosote-based polycyclic aromatic hydrocarbons (PAHs) found at the Atlantic Wood Industries (AW) Superfund site in the southern branch of the Elizabeth River, VA, USA. This killifish population survives in a site heavily contaminated with a mixture of PAHs from former creosote operations. They have developed resistance to the acute toxicity and teratogenic effects caused by the mixture of PAHs in sediment from the site. The primary goal of this dissertation was to compare and contrast later-life outcomes of early-life, subteratogenic PAH mixture exposure in both the Atlantic Wood killifish (AW) and a naïve reference population of killifish from King’s Creek (KC; a relatively uncontaminated tributary of the Severn River, VA). Killifish from both populations were exposed to subteratogenic concentrations of a complex PAH-sediment extract, Elizabeth River Sediment Extract (ERSE), made by collecting sediment from the AW site. Fish were reared over a 5-month period in the laboratory, during which they were examined for a variety of molecular, physiological and behavioral responses.

The central aims of my dissertation were to determine alterations to embryonic gene expression, larval swimming activity, adult behavior, heart structure, enzyme activity, and swimming/cardiorespiratory performance following subteratogenic exposure to ERSE. I hypothesized that subteratogenic exposure to ERSE would impair cardiac ontogenic processes in a way that would be detectable via gene expression in embryos, and that the misregulation of cardiac genes would help to explain activity changes, behavioral deficits, and later-life swimming deficiencies. I also hypothesized that fish heart structure would be altered. In addition, I hypothesized that the AW killifish population would be resistant to developmental exposures and perform normally in later life challenges. To investigate these hypotheses, a series of experiments were carried out in PAH-adapted killifish from Elizabeth River and in reference killifish. As an ancillary project to the primary aims of the dissertation, I examined the toxicity of weaker aryl hydrocarbon receptor (AHR) agonists in combination with fluoranthene (FL), an inhibitor of cytochrome P4501A1 (CYP1A1). This side project was conducted in both Danio rerio (zebrafish) and the KC and AW killifish.

Embryonic gene expression was measured in both killifish populations over an ERSE dose response with multiple time points (12, 24, 48, and 144 hours post exposure). Genes known to play critical roles in cardiac structure/development, cardiac function, and angiogenesis were elevated, indicating cardiac damage and activation of cardiovascular repair mechanisms. These data helped to inform later-life swimming performance and cardiac histology studies. Behavior was assessed during light and dark cycles in larvae of both populations following developmental exposure to ERSE. While KC killifish showed activity differences following exposure, AW killifish showed no significant changes even at concentrations that would cause overt cardiac toxicity in KC killifish. Juvenile behavior experiments demonstrated hyperactivity following ERSE exposure in KC killifish, but no significant behavioral changes in AW killifish. Adult swimming performance via prolonged critical swimming capacity (Ucrit) demonstrated performance costs in the AW killifish. Furthermore, swimming performance decline was observed in KC killifish following exposure to increasing dilutions of ERSE. Lastly, cardiac histology suggested that early-life exposure to ERSE could result in cardiac structural alteration and extravasation of blood into the pericardial cavity.

Responses to AHR agonists resulted in a ranking of relative potency for agonists, and determined which agonists, when combined with FL, caused cardiac teratogenesis. These experiments showed interesting species differences for zebrafish and killifish. To probe mechanisms responsible for cardiotoxicity, a CYP1A-morpholino and a AHR2-morpholino were used to mimic FL effects or attempt to rescue cardiac deformities respectively. Findings suggested that the cardiac toxicity elicited by weak agonist + FL exposure was likely driven by AHR-independent mechanisms. These studies stand in contrast to previous research from our lab showing that moderate AHR agonist + FL caused cardiac toxicity that can be partially rescued by AHR-morpholino knockdown.

My findings will form better characterization of mechanisms of PAH toxicity, and advance our understanding of how subteratogenic mixtures of PAHs exert their toxic action in naïve killifish. Furthermore, these studies will provide a framework for investigating how subteratogenic exposures to PAH mixtures can impact aquatic organismal health and performance. Most importantly, these experiments have the potential to help inform risk assessment in fish, mammals, and potentially humans. Ultimately, this research will help protect populations exposed to subtle PAH-contamination.

Using the opinions of coronary heart disease patients in designing a health education booklet for use in general practice consultations.

Objective This study explored how coronary heart disease (CHD) patients’ views would inform the design of an information booklet aimed at providing patients and practitioners with a resource to help influence positively patients’ health behaviour outcomes. Methods Opinions of patients (N=23) with CHD about their information needs, particularly lifestyle advice, were explored using a qualitative approach in four general practices. This information was used in designing a booklet for a pilot study intervention aimed at promoting healthy lifestyle behaviours and medication adherence among people with CHD. Subsequent focus groups explored patients’ (N=17) opinions about the booklet’s ‘fitness for purpose’; semi-structured interviews with practitioners (N=10) examined their views on the booklet’s usefulness. Results In initial focus groups patients identified gaps in their information provision regarding coping with stress, available local community support and medication purpose. A booklet, prepared on the basis of previous literature, was modified to address these gaps. Pilot study patients were satisfied with the re-designed booklet and practitioners reported that its use in consultations enabled change implementation and facilitated patients’ understanding of connections between lifestyle and health outcomes. Conclusion Acknowledging the opinions of CHD patients in producing health information booklets which emphasised a patient centred approach supported practitioner-patient partnerships for choosing healthy lifestyle choices.

Evaluation of a partnership between primary and secondary care providing an accessible Level 1 sexual health service in the community

Comprehensive testing for asymptomatic sexually transmitted infections in Northern Ireland has traditionally been provided by genitourinary medicine clinics. As patient demand for services has increased while budgets have remained limited, there has been increasing difficulty in accommodating this demand. In May 2013, the newly commissioned specialist Sexual Health service in the South Eastern Trust sought to pilot a new model of care working alongside a GP partnership of 12 practices. A training programme to enable GPs and practice nurses to deliver Level 1 sexual health care to heterosexual patients aged >16 years, in accordance with the standards of BASHH, was developed. A comprehensive care pathway and dedicated community health advisor supported this new model with close liaison between primary and secondary care. Testing for Chlamydia, gonorrhoea, HIV and syphilis was offered. The aims of the pilot were achieved, namely to provide accessible, cost-effective sexual health care within a framework of robust clinical governance. Furthermore, it uncovered a high positivity rate for Chlamydia, especially in young men attending their general practice, and demonstrated a high level of patient satisfaction. Moreover the capacity of secondary care to deliver Levels 2 and 3 services was increased.

Does Cost-Effectiveness Analysis Have a Role in US Managed Care Drug Formularies? An Empirical Study of Utilization, Costs, Outcomes, and Elasticity of Demand of a Value-Based Formulary

Thesis (Ph.D.)--University of Washington, 2015

Étude comparative du fonctionnement dans la communauté des jeunes adultes schizophrènes et de leurs pairs sans psychopathologie

La schizophrénie est un trouble mental qui touche environ un pour cent de la population et dont les symptômes et troubles associés affectent la capacité des individus à fonctionner dans la communauté. Dans la dernière décennie, des services spécialisés dans la détection et l’intervention précoce dès le premier épisode psychotique ont été implantés dans plusieurs pays. Or, ces services ont surtout ciblé, jusqu’ici, la réduction des symptômes et de la demande de soins. Les difficultés fonctionnelles des jeunes adultes schizophrènes justifient que les services qui leur sont destinés misent également sur la réadaptation et l’amélioration du fonctionnement dans la communauté. Les besoins, priorités et préférences de cette population, ainsi que l’impact des particularités développementales du jeune âge adulte sur leur fonctionnement, sont méconnus. Cette étude propose de documenter le fonctionnement dans la communauté des jeunes adultes schizophrènes au stade du premier épisode psychotique et de le comparer à celui de leurs pairs sans psychopathologie. L’utilisation d’un modèle théorique de réadaptation, le modèle de Compétence, permet de conceptualiser le fonctionnement sous l’angle de la relation personne-environnement. Ce projet s’inscrit dans une approche de recherche synthétique ; le devis préconisé est une étude de cas multiples avec l’utilisation de méthodes mixtes (qualitatives et quantitatives), selon un modèle concurrent de triangulation (Creswell & Plano Clark, 2007). Les résultats mettent en lumière des différences entre les deux groupes dans les domaines des relations sociales et conjugales, du cheminement académique et de l’indépendance résidentielle et financière. Les données qualitatives, analysées selon le modèle de la théorisation ancrée (Glaser & Strauss, 1967), permettent de comprendre les processus sociaux impliqués dans l’accomplissement des tâches développementales au jeune âge adulte, ainsi que les conditions personnelles et systémiques sous-jacentes. Les résultats soulignent l’importance d’adapter les services résidentiels aux particularités développementales, de favoriser le soutien aux études et d’inclure les amis et les pairs dans la réadaptation des personnes touchées. Cette thèse permet à la fois d’identifier les besoins et priorités de cette population, de donner une voix aux jeunes adultes schizophrènes dans l’élaboration des services qui leur sont destinés et d’examiner les enjeux méthodologiques reliés à l’utilisation d’un devis mixte en recherche clinique.

Retombées du cirque social (Cirque du Soleil) en contexte de réadaptation sur la participation sociale de jeunes adultes avec déficiences physiques en transition vers la vie active : étude qualitative

Introduction : Les adolescents avec déficiences physiques en transition vers la vie adulte éprouvent des difficultés à établir une participation sociale optimale. Cette étude explore les retombées d'un programme de cirque social sur la participation sociale de ces jeunes selon leur point de vue et celui de leurs parents. Méthode : Étude qualitative exploratoire d’orientation phénoménologique. Neuf personnes avec déficiences physiques, âgées de 18 et 25 ans, ont participé au programme pendant neuf mois. Données recueillies : perceptions de leur qualité de participation sociale à partir d’entrevues semi-structurées en pré, mi-temps et post-intervention avec les participants et un de leurs parents. Le guide d’entrevue validé est ancré sur le Modèle du développement humain- Processus de production du handicap - 2 (HDM-PPH2). L’enregistrement audio des entretiens a été transcrit en verbatim. Le contenu a été analysé avec le logiciel Nvivo 9 à travers une grille de codage préalablement validée (co-codage, codage-inverse). Résultats : Corpus de 54 entrevues. L’âge moyen des jeunes était de 20,0 ± 1,4 années et de 51 ± 3,6 années pour les parents. Selon tous, la participation sociale des jeunes adultes a été optimisée, surtout sur le plan de la communication, des déplacements, des relations interpersonnelles, des responsabilités et de la vie communautaire. La perception de soi et les habiletés sociales, également améliorées, ont favorisé une plus grande auto-efficacité. Conclusion : Cette étude soutient donc le potentiel du cirque social comme approche novatrice et probante en réadaptation physique pour cette population, et appuie la pertinence d’autres études rigoureuses mesurant les diverses retombées possibles et identifiées.

Redimensionamiento programa académico de campo, promoción de la salud y prevención de la enfermedad con énfasis en salud pública

Objetivo: generar el redimensionamiento del programa académico de campo, promoción de la salud y prevención de la enfermedad con énfasis en salud pública en la Universidad del Rosario, con el fin de considerar los retos actuales de formación de recurso humano y el contexto nacional e internacional. Método: revisión documental. Resultados: los objetos de estudio y enfoques praxiológicos de las ciencias de la salud se han transformado a lo largo de la historia, generando un impacto en la formación de recurso humano. De esta manera, disciplinas como la fisioterapia, cuyo objeto de estudio es el movimiento corporal humano, reconocen la importancia de ampliar su marco disciplinar, considerando conceptos como las capacidades, libertades, oportunidades, participación y, por lo tanto, calidad de vida y desarrollo humano, con la meta de reorientar sus acciones desde enfoques biologicistas y reduccionistas hacia enfoques históricosociales, integrales y complejos, que permitan a los fisioterapeutas en formación desarrollar capacidades, destrezas y competencias para su desempeño en áreas de la salud pública. Conclusiones: desde las ciencias de salud se requiere la transformación en la formación de recurso humano, para afrontar la problemática de la salud pública de una manera global y transectorial, desarrollando competencias ciudadanas, abogacía, participación y responsabilidad social en los estudiantes. Palabras clave: salud pública, fisioterapia, formación de recurso humano.

El modelo integral y su aplicación en terapia

La presente monografía es una revisión de la literatura frente a los postulados fundamentales del modelo integral propuesto por Ken Wilber y la aplicación de dicho modelo a la psicoterapia. Se presentan cada una de los elementos que sostienen esta meta-perspectiva tales como cuadrantes, niveles, líneas, y estados, y la forma en que cada uno de ellos se relaciona con la psicoterapia integral. Se abordan a continuación temas como los diferentes niveles de terapia, las etapas del desarrollo de la identidad, las patologías típicas en cada una de ellas y las posibles intervenciones para manejarlas, el rol que posee el terapeuta y algunos otros campos de aplicación del modelo integral a terapias grupales y al asesoramiento.

La estructura y funcionalidad de los sistemas en el modelo de Bronfenbrenner y su utilidad en entornos empresariales

El proyecto será desarrollado en base al modelo ecológico del desarrollo humano, (Bronfenbrenner, 1999) partiendo desde la explicación y conceptualización del modelo en términos generales, guiando la investigación hacia un ámbito organizacional en donde se podrá aplicar la teoría descrita por Bronfenbrenner y así, determinar cuál es la estructura y funcionalidad de los sistemas en el modelo además de establecer qué utilidad tiene en entornos empresariales por medio del análisis de los múltiples sistemas, relaciones, interacciones y efectos que tienen y que desarrollan las empresas u organizaciones en el transcurso de su vida. A lo largo de la investigación se hará referencia a diferentes conceptos relacionados tanto con el modelo como con el mundo en que se desarrollan las organizaciones, tales como clusters, sistemas, sectores, estrategias, marketing relacional, comunidad, interacciones, influencias, entre otros; los cuales permitirán acercar lo mayor posible el modelo de Bronfenbrenner al mundo empresarial y lograr desarrollar de mejor manera la intención de aplicar el modelo al mundo organizacional.

Loss of Methylation at H19 DMD Is Associated with Biallelic Expression and Reduced Development in Cattle Derived by Somatic Cell Nuclear Transfer

Although cloning of mammals has been achieved successfully, the percentage of live offspring is very low because of reduced fetal size and fewer implantation sites. Recent studies have attributed such pathological conditions to abnormal reprogramming of the donor cell used for cloning. The inability of the oocyte to fully restore the differentiated status of a somatic cell to its pluripotent and undifferentiated state is normally evidenced by aberrant DNA methylation patterns established throughout the genome during development to blastocyst. These aberrant methylation patterns are associated with abnormal expression of imprinted genes, which among other genes are essential for normal embryo development and gestation. We hypothesized that embryo loss and low implantation rates in cattle derived by somatic cell nuclear transfer (SCNT) are caused by abnormal epigenetic reprogramming of imprinted genes. To verify our hypothesis, we analyzed the parental expression and the differentially methylated domain (DMD) methylation status of the H19 gene. Using a parental-specific analysis, we confirmed for the first time that H19 biallelic expression is tightly associated with a severe demethylation of the paternal H19 DMD in SCNT embryos, suggesting that these epigenetic anomalies to the H19 locus could be directly responsible for the reduced size and low implantation rates of cloned embryos in cattle.