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Previous school-based interventions have produced positive effects upon measures of children’s health and wellbeing but such interventions are often delivered by external experts which result in short-term effects. Thus, upskilling and expanding the resources available to classroom teachers could provide longer-term solutions. This paper presents a feasibility study of an online health resource (Healthy Schools Resource: HSR) developed to assist primary school teachers in the delivery of health-related education. Four schools (n = 2 intervention) participated in this study. Study feasibility was assessed by recruitment, retention and completion rates of several outcomes including height, weight, waist circumference, blood pressure and several metabolic markers including HDL-cholesterol, triglycerides, glucose and dietary knowledge following a 10-12-week intervention period. The process evaluation involved fidelity checks of teachers’ use of the HSR and post-intervention teacher interviews. A total of 614 consent forms were issued and 267 were returned (43%), of which, 201 confirmed consent for blood sampling (75%). Retention of children participating in the study was also high (96%). Of the 13 teachers who delivered the intervention to the children, four teachers were excluded from further analyses as they did not participate in the fidelity checks. Overall, teachers found the online resource facilitative of teaching health and wellbeing and several recommendations regarding the resource were provided to inform further evaluations. Recruitment and retention rates suggest that the teacher led intervention is feasible and acceptable to both teachers, parents and children. Initial findings provide promising evidence that given a greater sample size, a longer intervention exposure period and changes made to the resource, teachers’ use of HSR could enhance measures of health and wellbeing in children. [ABSTRACT FROM AUTHOR]

Introduction: In many sub-Saharan African countries, confronting the dual epidemic of HIV and NCDs is a public health priority especially in high HIV burden countries such as South Africa. Evidence shows that poor health as a consequence of NCDs and HIV among the workforce increases absenteeism and leads to decrease in productivity. However, the prevalence of these co-occurring chronic conditions and associated factors is unknown in the educator workforce. Improved understanding has implications for their management and wellbeing of educators. This paper reports the prevalence of selected NCDs and associated factors among HIV positive educators in South Africa using the 2015/6 survey of Educators in Public Schools in South Africa. Methods: This was a second-generation surveillance undertaken among educators in selected public schools in all nine provinces in South Africa. A multi-stage stratified cluster design with probability proportional to size sampling was used to draw a random sample of schools. Factors associated with presence of NCDs were determined using a multivariate backward stepwise logistic regression analysis. Results: A total of 1 365 schools were sampled within which 21 495 (85.5%) educators were interviewed. Out of 2691, HIV Positive educators that responded to the questions on NCDs, 36.9% reported having NCDs. The most commonly reported NCDs were high blood pressure (17.4%), and stomach ulcers (13.5%). The increased odds of reporting the presence of NCDs was significantly associated with being female than male [aOR = 1.5: 95% CI (1.1–1.9), p<0.002], age 45 to 54 years [aOR = 1.8: 95% CI (1.4–2.2), p = p<0.001], and age 55 years and older than those 18 to 24 years [aOR = 2.7: 95% CI (1.8–3.9), p<0.001). The decreased odds of reporting the presence of NCDs was significantly associated with not being absent from school for health reasons [aOR = 0.7: 95% CI (0.6–0.9), p = 0.003]. Conclusion: NCDs care and active screening should be an integral part of HIV programmes including interventions such as prevention, treatment, care and support amongst public school educators in SA. The education department will need to invest in health promotion intervention programmes to prevent and mitigate the negative impact of NCDs and HIV on the sector. [ABSTRACT FROM AUTHOR]

Adequate provision of safe water, basic sanitation, and hygiene (WASH) facilities and behavior change can reduce pupil absence and infectious disease. Increased drinking water quantity may also improve educational outcomes through the effect of hydration on attention, concentration, and short-term memory. A pilot study was conducted to adapt field measures of short-term cognitive performance and hydration, to evaluate levels of hydration, and to investigate the impact of providing supplementary drinking water on the cognitive performance of pupils attending water-scarce schools in rural Mali. Using a cross-over trial design, data were collected under normal school conditions (control condition) on one visit day; on the other, participants were given a bottle of water that was refilled throughout the day (water condition). Morning and afternoon hydration was assessed using specific gravity and urine color. Cognitive performance was evaluated using six paper-based tests. Three percent of pupils were dehydrated on the morning of each visit. The prevalence of dehydration increased in the afternoon, but was lower under the water condition. Although there was a trend indicating drinking water may improve cognitive test performance, as has been shown in studies in other settings, results were not statistically significant and were masked by a “practice effect.” [ABSTRACT FROM AUTHOR]

Objectives: To describe level of education and work participation among adults with congenital unilateral upper limb deficiency (CUULD) in Norway and to explore associations between work participation and demographic and clinical factors. Methods: Cross-sectional study. In 2012, a postal questionnaire was sent to 186 persons with congenital limb deficiency (CLD), age ≥ 20 years, registered at the TRS National Resource Center for Rare Disorders. In the original CLD study, 77 persons with CUULD responded. In this paper 64 persons with CUULD of working age (20–67 years) are included. Data on demographic factors as education level and work participation, and clinical factors including limb deficiency characteristics, chronic pain (Standardized Nordic Questionnaire), fatigue (Fatigue Severity Scale), physical and mental health (SF-36) were analyzed through descriptive and comparable statistics and logistic regression analyses. Results: Sixty-four persons participated, mean age 43.4 (SD 13.7; range 20–67 years), 45 were women. Education level >13 years was reported by 34. Forty- three of the 64 participants were employed, 21 were prematurely retired (disability benefits). 11 of the 43 employed, and 6 of the 21 prematurely retired had completed vocational education. Physically demanding occupations (work activities that required standing, walking and lifting) were reported by 25 of the 43 employed and 13 of the 21 prematurely retired. 17 of the 64 reported need for further adaptions in their workplaces. The strongest predictors of work participation were younger age (OR 0.86) and good physical health (OR 1.21). Conclusion: Two thirds of persons with CUULD were employed; while one third was prematurely retired and had left work earlier than expected. This suggests that persons with CUULD may experience challenges in work participation. Although levels of education were relatively high, several had chosen careers that required physical strain. Younger age and good physical health were the most important factors mediating work participation. [ABSTRACT FROM AUTHOR]

Attitudes and beliefs about menstruation can place restrictions on menstruating women and girls, limiting their ability to fully participate in community life, education and employment. This paper presents evidence on menstruation-related beliefs contributing to restrictive practices in Papua New Guinea (PNG), Solomon Islands (SI) and Fiji. Focus group discussions and interviews were undertaken with 307 adolescent girls, women and men in a rural and urban site in each country. Data were analysed using an inductive thematic approach. Participants described a range of attitudes and beliefs that restrict the behaviour of menstruating women and girls. Themes include the belief that menstrual blood is ‘dirty’; that when menstruating, girls and women can bring ‘bad luck’ to men; secrecy and shame associated with menstruation; and beliefs about the impact of certain behaviours on menstruation and health. Restrictive practices were more frequently reported in PNG and SI than Fiji, and more common in rural compared with urban sites. Some restrictions, such as avoidance of household chores, were perceived as desirable or driven by women themselves. However participants identified other restrictions, such as not being able to attend church or hygienically wash menstrual hygiene materials, as unwanted, in some cases impacting on participation in school, work and community life. Education initiatives guided by women and girls, implemented by local stakeholders and grounded in a sound understanding of specific contexts are needed to address discriminatory attitudes and beliefs that contribute to unwanted restrictions, and to support enabling attitudes and beliefs regarding menstruation. [ABSTRACT FROM AUTHOR]

Telomere length (TL) has been associated with a range of aging outcomes as well as mortality. Recent research has shown both high heritability (~70%) of TL as well as moderate spousal similarity (r~0.3) using European datasets. This paper explores the level of spousal concordance in telomere length in the Health and Retirement Study, a national sample of adults in the US. The results show that the spousal correlations are lower (r~0.11). Regression-based associations in TL in the US are low (beta~0.08) and also vary by the number of times respondents have been married, where spouses married a single time have higher associations in TL (beta~.12) than spouses married more once (beta~0.03). I also find variation in spousal TL association levels based on husband’s education level. These findings suggest the possibility of both assortative mating patterns related to telomere length as well as likelihood of shared environmental factors that cause TL similarity in people who are socially connected. [ABSTRACT FROM AUTHOR]

Introduction: During the 2014 Ebola Virus Disease (EVD) epidemic, the Ebola-Tx trial evaluated the use of convalescent plasma (CP) in Guinea. The effectiveness of plasmapheresis trials depends on the recruitment of plasma donors. This paper describes what motivated or deterred EVD survivors to donate CP, providing insights for future plasmapheresis trials and epidemic preparedness. Methods: This qualitative study, part of Ebola-Tx, researched and addressed emergent trial difficulties through interviewing, participant observation and focus group discussions. Sampling was theoretical and retroductive analysis was done in NVivo 10. Results: Willingness or hesitance to participate in plasma donation depended on factors at the interface of pre-existing social dynamics; the impact of the disease and the consequent emergency response including the trial set-up. For volunteers, motivation to donate was mainly related to the feeling of social responsibility inspired by having survived EVD and to positive perceptions of plasmapheresis technology despite still unknown trial outcomes. Conversely, confidentiality concerns when volunteering due to stigmatization of survivors and perceived decrease in vital strength and in antibodies when donating, leading to fears of loss in protection against EVD, were main deterrents. The dynamic (dis)trust in Ebola Response Actors and in other survivors further determined willingness to participate and lead to the emergence/decline of rumours related to blood stealing and treatment effectiveness. Historic inter-ethnic relations in the health care setting further defined volunteering along socio-economic and ethnic lines. Finally, lack of follow-up and of dedicated care further impacted on motivation to volunteer. Conclusions: Ebola-Tx was the first trial to solicit and evaluate blood-product donation as an experimental treatment on a large scale in Sub-Saharan Africa. An effective donation system requires directly engaging with emergent social barriers and providing an effective ethical response, including improved and transparent communication, effective follow-up after donation, assuring confidentiality and determining ethical incentives. [ABSTRACT FROM AUTHOR]

Collaboration among scientists has a major influence on scientific progress. Such collaboration often results from scientific meetings, where scientists gather to present and discuss their research and to meet potential collaborators. However, most scientific meetings have inherent biases, such as the availability of research funding or the selection bias of professional societies that make it difficult to study the effect of the meeting per se on scientific productivity. To evaluate the effects of scientific meetings on collaboration and progress independent of these biases, we conducted a study of the annual symposia held by the International Milk Genomics Consortium (IMGC) over a 12-year period. In our study, we conducted permutation testing to analyze the effectiveness of the IMGC in facilitating collaboration and productivity in a community of milk scientists who were meeting attendees relative to non-attendees. Using the number of co-authorships on published papers as a measure of collaboration, our analysis revealed that scientists who attended the symposium were associated with more collaboration than were scientists who did not attend. Furthermore, we evaluated the scientific progress of consortium attendees by analyzing publication rate and article impact. We found that IMGC attendees, in addition to being more collaborative, were also more productive and influential than were non-attendees who published in the same field. The results of our study suggest that the annual symposium encouraged interactions among disparate scientists and increased research productivity, exemplifying the positive effect of scientific meetings on both collaboration and progress. [ABSTRACT FROM AUTHOR]

Hearing loss is the most common sensory impairment, but limited studies focused on the association of socioeconomic status (SES) with hearing loss among adults of working age. This paper aimed to fill this gap among Chinese adults. We obtained data from Ear and Hearing Disorder Survey conducted in four provinces of China in 2014–2015. The survey was based on WHO Ear and Hearing Disorders Survey Protocol and 25,860 adults aged 25 to 59 years were selected in this study. Trained local examiners performed pure tone audiometry to screen people with hearing loss, and those who were screened positively for hearing loss were referred to audiologists to make final diagnosis. SES was measured by occupation, education and income. Results show after adjusting for SES measures and covariates, in urban areas, compared with white-collar workers, blue-collar workers and the unemployed were more likely to have hearing loss, with an odds ratio of 1.2 (95%CI: 1.0, 1.3) and 1.2 (95%CI: 1.0, 1.4), respectively. Compared with people with education of senior high school or above, those with junior high school, primary school and illiteracy had 1.6 (95%CI: 1.4, 1.8), 2.1(95%CI: 1.7, 2.5) and 2.6 (95%CI: 1.9, 3.7) times as likely to have hearing loss, respectively. In rural areas, the unemployed had 1.5 (95%CI: 1.0, 2.3) times the risk of hearing loss compared with white-collar workers, and illiterates had 1.6 (95%CI: 1.6, 2.1) times the risk of hearing loss compared with people with education of senior high school or above, after SES variables and covariates were taken into considerations. Income was not significantly associated with hearing loss in urban and rural areas. In conclusion, SES, in the form of occupation and education, was associated with hearing loss among working-aged population, and further studies are needed to explore the mechanism of such association. [ABSTRACT FROM AUTHOR]

Background: The goal of the global lymphatic filariasis (LF) program is to eliminate the disease as a public health problem by the year 2020. The WHO mapping protocol that is used to identify endemic areas in need of mass drug administration (MDA) uses convenience-based sampling. This rapid mapping has allowed the global program to dramatically scale up treatment, but as the program approaches its elimination goal, it is important to ensure that all endemic areas have been identified and have received MDA. In low transmission settings, the WHO mapping protocol for LF mapping has several limitations. To correctly identify the LF endemicity of woredas, a new confirmatory mapping tool was developed to test older school children for circulating filarial antigen (CFA) in settings where it is uncertain. Ethiopia is the first country to implement this new tool. In this paper, we present the Ethiopian experience of implementing the new confirmatory mapping tool and discuss the implications of the results for the LF program in Ethiopia and globally. Methods: Confirmatory LF mapping was conducted in 1,191 schools in 45 woredas, the implementation unit in Ethiopia, in the regions of Tigray, Amhara, Oromia, SNNP, Afar and Harari, where the results of previous mapping for LF using the current WHO protocol indicated that LF endemicity was uncertain. Within each woreda schools were selected using either cluster or systematic sampling. From selected schools, a total of 18,254 children were tested for circulating filarial antigen (CFA) using the immuno-chromatographic test (ICT). Results: Of the 18,254 children in 45 woredas who participated in the survey, 28 (0.16%) in 9 woredas tested CFA positive. According to the confirmatory mapping threshold, which is ≥2% CFA in children 9–14 years of age, only 3 woredas out of the total 45 had more CFA positive results than the threshold and thus were confirmed to be endemic; the remaining 42 woredas were declared non-endemic. These results drastically decreased the estimated total population living in LF-endemic woredas in Ethiopia and in need of MDA by 49.1%, from 11,580,010 to 5,893,309. Conclusion: This study demonstrated that the new confirmatory mapping tool for LF can benefit national LF programs by generating information that not only can confirm where LF is endemic, but also can save time and resources by preventing MDA where there is no evidence of ongoing LF transmission. [ABSTRACT FROM AUTHOR]

Engaged scholarship, a movement that has been growing steadily since 1995, offers a new way of bridging gaps between the university and civil society. Numerous papers and reports have been published since Boyer’s foundational discourse in 1996. Yet, beyond a growing interest in orienting universities’ missions, we observed a lack a formal definition and conceptualization of this movement. Based on a scoping review of the literature over the past 20 years, the objective of this article is to propose a conceptualization of engaged scholarship. More specifically, we define its values, principles, and processes. We conclude with a discussion of the implications of this new posture for faculty and students, as well as for the university as an institution. [ABSTRACT FROM AUTHOR]

Background: Bangladesh had one of the highest burdens of lymphatic filariasis (LF) at the start of the Global Programme to Eliminate Lymphatic Filariasis (GPELF) with an estimated 70 million people at risk of infection across 34 districts. In total 19 districts required mass drug administration (MDA) to interrupt transmission, and 15 districts were considered low endemic. Since 2001, the National LF Programme has implemented MDA, reduced prevalence, and been able to scale up the WHO standard Transmission Assessment Survey (TAS) across all endemic districts as part of its endgame surveillance strategy. This paper presents TAS results, highlighting the momentous geographical reduction in risk of LF and its contribution to the global elimination target of 2020. Methodology/Principal findings: The TAS assessed primary school children for the presence of LF antigenaemia in each district (known as an evaluation unit—EU), using a defined critical cut-off threshold (or ‘pass’) that indicates interruption of transmission. Since 2011, a total of 59 TAS have been conducted in 26 EUs across the 19 endemic MDA districts (99,148 students tested from 1,801 schools), and 22 TAS in the 15 low endemic non-MDA districts (36,932 students tested from 663 schools). All endemic MDA districts passed TAS, except in Rangpur which required two further rounds of MDA. In total 112 students (male n = 59; female n = 53), predominately from the northern region of the country were found to be antigenaemia positive, indicating a recent or current infection. However, the distribution was geographically sparse, with only two small focal areas showing potential evidence of persistent transmission. Conclusions/Significance: This is the largest scale up of TAS surveillance activities reported in any of the 73 LF endemic countries in the world. Bangladesh is now considered to have very low or no risk of LF infection after 15 years of programmatic activities, and is on track to meet elimination targets. However, it will be essential that the LF Programme continues to develop and maintain a comprehensive surveillance strategy that is integrated into the health infrastructure and ongoing programmes to ensure cost-effectiveness and sustainability. [ABSTRACT FROM AUTHOR]

Incomprehension and denial of the theory of evolution among high school students has been observed to also occur when teachers are not equipped to deliver a compelling case also for human evolution based on fossil evidence. This paper assesses the outcomes of a novel inquiry-based paleoanthropology lab teaching human evolution to high-school students. The inquiry-based Be a Paleoanthropologist for a Day lab placed a dozen hominin skulls into the hands of high-school students. Upon measuring three variables of human evolution, students explain what they have observed and discuss findings. In the 2013/14 school year, 11 biology classes in 7 schools in the Greater New Orleans area participated in this lab. The interviewed teacher cohort unanimously agreed that the lab featuring hominin skull replicas and stimulating student inquiry was a pedagogically excellent method of delivering the subject of human evolution. First, the lab’s learning path of transforming facts to data, information to knowledge, and knowledge to acceptance empowered students to themselves execute part of the science that underpins our understanding of deep time hominin evolution. Second, although challenging, the hands-on format of the lab was accessible to high-school students, most of whom were readily able to engage the lab’s scientific process. Third, the lab’s exciting and compelling pedagogy unlocked higher order thinking skills, effectively activating the cognitive, psychomotor and affected learning domains as defined in Bloom’s taxonomy. Lastly, the lab afforded students a formative experience with a high degree of retention and epistemic depth. Further study is warranted to gauge the degree of these effects. [ABSTRACT FROM AUTHOR]

People in different subgroups age at different rates. Surveys containing biomarkers can be used to assess these subgroup differences. We illustrate this using hand-grip strength to produce an easily interpretable, physical-based measure that allows us to compare characteristic-based ages across educational subgroups in the United States. Hand-grip strength has been shown to be a good predictor of future mortality and morbidity, and therefore a useful indicator of population aging. Data from the Health and Retirement Survey (HRS) were used. Two education subgroups were distinguished, those with less than a high school diploma and those with more education. Regressions on hand-grip strength were run for each sex and race using age and education, their interactions and other covariates as independent variables. Ages of identical mean hand-grip strength across education groups were compared for people in the age range 60 to 80. The hand-grip strength of 65 year old white males with less education was the equivalent to that of 69.6 (68.2, 70.9) year old white men with more education, indicating that the more educated men had aged more slowly. This is a constant characteristic age, as defined in the Sanderson and Scherbov article “The characteristics approach to the measurement of population aging” published 2013 in Population and Development Review. Sixty-five year old white females with less education had the same average hand-grip strength as 69.4 (68.2, 70.7) year old white women with more education. African-American women at ages 60 and 65 with more education also aged more slowly than their less educated counterparts. African American men with more education aged at about the same rate as those with less education. This paper expands the toolkit of those interested in population aging by showing how survey data can be used to measure the differential extent of aging across subpopulations. [ABSTRACT FROM AUTHOR]