Preparing for operation GRITROCK : military medical ethics challenges encountered in the planning stages of the UK Ebola response mission

In early September 2014, Médecins sans Frontières (MSF) took the unusual step of calling on governments to deploy military, as well as civilian, assets to help combat the Ebola Virus Disease (EVD) epidemic raging in West Africa (MSF, 2014). The UK government announced a package of aid in response to the outbreak, including the deployment of military experts, targeted primarily on Sierra Leone. (Gov.UK 2014) The scale of the outbreak and the responses to it attracted comment from many quarters and raised ethical issues. We were interested in the ethical challenges that would confront the troops on the ground in Sierra Leone, particularly those who were healthcare professionals. We successfully secured UK funding council research funds to explore these challenges. During the preparatory stages of this project, however, it became clear that ethical decisions had also been made during the planning stages of the deployment in anticipation of issue that may be faced on the deployment. These planning issues are of interest in their own right, even though they fell outside the aims of our project, and we explore of some these in this chapter

Measurement of cardiorespiratory fitness in children from two commonly used field tests after accounting for body fatness and maturity

Body fat and maturation both influence cardiorespiratory fitness, however few studies have taken these variables into account when using field tests to predict children's fitness levels. The purpose of this study was to determine the relationship between two field tests of cardiorespiratory fitness (20 m Maximal Multistage Shuttle Run [20-MST], 550 m distance run [550-m]) and direct measurement of VO2max after adjustment for body fatness and maturity levels. Fifty-three participants (25 boys, 28 girls, age 10.6 ± 1.2 y, mean ± SD) had their body fat levels estimated using bioelectrical impedance (16.6% ± 6.0% and 20.0% ± 5.8% for boys and girls, respectively). Participants performed in random order, the 20-MST and 550-m run followed by a progressive treadmill test to exhaustion during which gas exchange measures were taken. Pearson correlation coefficient analysis revealed that the participants' performance in the 20-MST and 550-m run were highly correlated to VO2 max obtained during the treadmill test to exhaustion (r = 0.70 and 0.59 for 20-MST and 550-m run, respectively). Adjusting for body fatness and maturity levels in a multivariate regression analysis increased the associations between the field tests and VO2max (r = 0.73 for 20-MST and 0.65 for 550-m). We may conclude that both the 20-MST and the 550-m distance run are valid field tests of cardiorespiratory fitness in New Zealand 8-13 year old children and incorporating body fatness and maturity levels explains an additional 5-7% of the variance. © Editorial Committee of Journal of Human Kinetics

Medical students' attitudes towards and perceptions of the Primary Health Care approach

Includes bibliographical references (p. 229-246).The aim of this research was to provide an understanding of medical students' attitudes towards and perceptions of the PHC approach, and this was done using mainly qualitative methods, namely focus groups, interviews, and one questionnaire. This research also investigated students' views of the way in which the PHC approach was taught, their understanding of the PHC approach, what could influence students' views of the PHC approach, the appropriateness of the PHC approach in South Africa, their opinions of the fact that UCT has a PHC-driven MBChB curriculum, their views of the role of doctors in the PHC approach, and a number of other related issues. The main findings were that students enter their medical degree with an expectation of a biomedical emphasis and a lecture-based curriculum

"How do we look?": discourses of truth and reconciliation in select Manitoba school divisions

Since the publication of the TRC’s Calls to Action, Manitoba school divisions must publish yearly Continuous Improvement Plans (CIPs) and Community Reports (CRs) as an accountability measure to report on progress toward reconciliation. Divisions, as organizational entities, use particular language in their documents to align with the goals of Truth and Reconciliation in order to maintain their reputation and relationships with education stakeholders. This study has one major research question: What discourses of Truth and Reconciliation appear to be constructed by Manitoba school divisions? Concepts, perspectives and methodologies from Indigenous scholarship, including ethical relationality and Indigenous Métissage, inform a Critical Discourse Analysis (CDA) of CIPs and CRs from school divisions from each of the five Treaty territories in Manitoba. Organizational Impression Management (OIM) is used as a theory to understand the motives of each division and how they wish to be perceived by the public. Themes emerging from the data include the prevalence of “achievement gap” discourse, individual vs. collective responsibility for facilitating education for reconciliation, and presenting reconciliation as foundational vs. additive in divisional priorities. Recommendations for practice include consistency in terminology, and a pedagogical and linguistic shift away from “achievement gaps” to “education debts.”February 2023Manitoba Graduate Scholarship (Province of Manitoba) Tri-Council Top-Up Award (SSHRC) University of Manitoba Graduate Fellowship (University of Manitoba

The impact of computer-based interventions with and without primary language support on reading skills of English language learners

Reading is the most important skill that English Language (EL) learners acquire in school (Slavin & Cheung, 2005). Success in reading has been shown to impact many areas of student social and economic opportunities (Peregoy & Boyle, 2005). Students who come to school with limited English proficiency have greater difficulty learning to read in English (Freeman & Freeman, 2004). With the rise in the number of EL learning students in schools, school districts are compelled to find ways to teach English literacy skills to students with primary languages other than English; This study had two purposes. The first purpose was to determine the impact of the Lexia Primary Reading Program (Lexia, 2004), a computer-based reading program, on the English reading skills of first grade students whose primary language is Spanish. The second purpose was to determine how the language of instruction (i.e., Spanish or English) provided by the Lexia Primary Reading Program impacts the English reading skills of EL learners; Forty-one first-grade EL students whose primary language is Spanish participated in this study. Of the 41 first-grade students, 16 were male and 25 were female. Students were assigned to three groups. Students in the experimental groups received computer-based instruction from Lexia Primary Reading Program (Lexia, 2004). One of the experimental groups received English oral language instructions while the other experimental group received Spanish oral language instructions. Students in the comparison group received an equal amount of computer time with non-literacy based instruction; Lexia Primary Reading Program (Lexia, 2004) was effective at increasing literacy skills in some of the areas measured (i.e., oral language, picture vocabulary, letter-word identification, and passage comprehension). Passage comprehension was the only area that showed a difference relative to the language of instruction provided. This study answered several important questions regarding literacy skills of EL learners

The effect of self-sorting and co-assembly on the mechanical properties of low molecular weight hydrogels

Self-sorting in low molecular weight hydrogels can be achieved using a pH triggered approach. We show here that this method can be used to prepare gels with different types of mechanical properties. Cooperative, disruptive or orthogonal assembled systems can be produced. Gels with interesting behaviour can be also prepared, for example self-sorted gels where delayed switch-on of gelation occurs. By careful choice of gelator, co-assembled structures can also be generated, which leads to synergistic strengthening of the mechanical properties

Spinal cord injuries in South African Rugby Union (1980-2007)

Objectives and design. To address an apparent increase in the number of rugby-related spinal cord injuries (SCIs) in South Africa, a retrospective case-series study was conducted on injuries that occurred between 1980 and 2007. We aimed to identify preventable causes to reduce the overall rate of SCIs in South African rugby. Methods. We identified 264 rugby-related SCIs. A structured questionnaire was used, and it was possible to obtain information on a total of 183 players, including 30 who had died. Results. SCIs increased in number in the 1980s and in 2006. Forwards sustained 76% of all SCIs, and club players 60%. Players aged 17 had the highest number of SCIs. In only 50% of cases were medical personnel present at the time of injury, and 49% of injured players waited longer than 6 hours for acute management. Of players with an SCI, 61% had a catastrophic outcome after 12 months, including 8% who died during that time; 65% received no financial compensation; and only 29% of players had medical aid or health insurance. Conclusion. A register of all rugby-related SCIs in South Africa is essential to monitor the magnitude of the problem, identify potential risk factors, and formulate appropriate preventive interventions. The lack of reliable denominator data limits calculation of incident rates. Players from previously disadvantaged communities in particular suffered the consequences of limited public health care resources and no financial compensation

Impact of a primary school-based nutrition and physical activity intervention on learners in Kwazulu-Natal, South Africa: A pilot study

Background. The opportunity for children to be physically active during school hours is rapidly decreasing in selected schools. This study evaluated the effects of a nutrition and physical activity (NAP) intervention incorporated within the school curriculum. Study design and methods. A prospective empirical pilot study with an intervention and an assessment of pre- and post-intervention fitness. Learners completed a NAP questionnaire and participated in a battery of fitness tests before and after intervention. Setting. A purposive sample of four primary schools in KwaZulu-Natal was selected by the provincial Department of Health. Interventions. The NAP intervention was designed to introduce various methods of physical activity and healthy nutritional habits within the school's existing curriculum. Classroom-based intervention materials were developed to provide cost-effective and, more importantly, a sustainable intervention. Results. Post-intervention results showed a significant increase (p<0.05) in the average number of sports participated in by each learner during physical education / life orientation periods. Learners were motivated to participate in physical activity including games and sports during break times. A general increase in after-school activities from pre- to post-intervention per learner was noted. Conclusion. A school-based physical activity and nutrition intervention programme has the potential to increase the physical activity of learners and to a lesser degree their nutritional behaviour

Standing up against office sitting: A study protocol.

BACKGROUND: Sedentary behaviour is associated with cardiometabolic diseases amongst office-bound workers, mostly through extended sitting and engaging in low-energy-demanding activities during work hours. The aim of this study is to assess the effectiveness of standing desks and healthy messages on cardiovascular parameters in a cohort of office-based workers and to explore the perceptions of these workers about the suitability of this intervention to lower occupation-related sedentariness. METHODS/DESIGN: The protocol will use a mixed-methods study design. Phase 1 of this study is a 12-month, single blinded, randomised controlled trial, which will include baseline, 3-month, 6-month and 12-month post-intervention assessments of plausible cardiometabolic risk biomarkers in office-bound workers at a South African credit and information management company. These biomarkers include anthropometry, sedentary behaviour and physical activity, sleep duration, blood pressure, glucose, glycated haemoglobin (HbA1c), lipid profile and cardiorespiratory fitness. Participants will be randomised into an intervention or control group. The intervention group will be provided with an adjustable sit-stand desk and receive weekly health-promoting messages for the intervention period. Phase 2 will use focus group discussions conducted post-intervention to explore the study participants' perceptions of the effectiveness of the intervention. Cardiometabolic risk biomarkers and changes in these variables will be compared between the intervention group and the control group at the four time points using descriptive and inferential statistics. DISCUSSION: Regression analysis will be undertaken to determine the association of cardiometabolic risk biomarkers with cardiometabolic diseases. A thematic content analysis approach will be used to explore emerging themes from focus group discussions. PROTOCOL IDENTIFICATION: Pan African Clinical Trial Registry, PACTR201911656014962