Set Of Research Studies Research Articles

Establishing evidence criteria for implementation strategies in the US: a Delphi study for HIV services

BackgroundThere are no criteria specifically for evaluating the quality of implementation research and recommending implementation strategies likely to have impact to practitioners. We describe the development and application of the Best Practices Tool, a set of criteria to evaluate the evidence supporting HIV-specific implementation strategies.MethodsWe developed the Best Practices Tool from 2022–2023 in three phases. (1) We developed a draft tool and criteria based on a literature review and key informant interviews. We purposively selected and recruited by email interview participants representing a mix of expertise in HIV service delivery, quality improvement, and implementation science. (2) The tool was then informed and revised through two e-Delphi rounds using a survey delivered online through Qualtrics. The first and second round Delphi surveys consisted of 71 and 52 open and close-ended questions, respectively, asking participants to evaluate, confirm, and make suggestions on different aspects of the rubric. After each survey round, data were analyzed and synthesized as appropriate; and the tool and criteria were revised. (3) We then applied the tool to a set of research studies assessing implementation strategies designed to promote the adoption and uptake of evidence-based HIV interventions to assess reliable application of the tool and criteria.ResultsOur initial literature review yielded existing tools for evaluating intervention-level evidence. For a strategy-level tool, additions emerged from interviews, for example, a need to consider the context and specification of strategies. Revisions were made after both Delphi rounds resulting in the confirmation of five evaluation domains – research design, implementation outcomes, limitations and rigor, strategy specification, and equity – and four evidence levels – best, promising, more evidence needed, and harmful. For most domains, criteria were specified at each evidence level. After an initial pilot round to develop an application process and provide training, we achieved 98% reliability when applying the criteria to 18 implementation strategies.ConclusionsWe developed a tool to evaluate the evidence supporting implementation strategies for HIV services. Although specific to HIV in the US, this tool is adaptable for evaluating strategies in other health areas.

Performance Analysis of Islamic Banking in Pakistan Using DEA Technical Efficiency and Maqasid-e-Shariah Index

Purpose: The goal of Islamic banking is to offer Shariah compliant products along with ultimate objective of high performance. We question whether Islamic banks are able to achieve the Shariah objectives as well as the efficiency. Design/Methodology/Approach: We use Maqasid-e-Shariah index (MSI) to assess the level of Shariah compliant and DEA technical efficiency score to measure the performance of Islamic banks in Pakistan. Results of efficiency and MSI scores are combined and plotted on four quadrants. Since the best bank is set as benchmark, the study provides relative results not absolute. Findings: The study has four main findings based on the results. Meezan Bank falls in quadrant 1 which achieves highest level of technical efficiency and high level of MSI score. Bank Islami and Al-barakah Bank fall in quadrant 2 which depicts that both banks achieve high technical efficiency but low MSI scores. Dubai Islamic Bank falls in quadrant 3 having low score in technical efficiency and high score in MSI. Quadrant 4 has the lowest level in both the technical efficiency and MSI. None of the banks falls in this quadrant. Although, Meezan Bank achieves the highest level of MSI, nevertheless all banks are required to improve the MSI scores. Originality/Significance: Large number of studies uses the DEA approach to measure the efficiency of Islamic banks. On the other hand, another set of research studies prefer MSI approach to determine the efficiency of Islamic banks. To the best of our knowledge, this is perhaps the first study in Pakistan, which uses both approaches to compare the technical efficiency and Maqasid-e-Shariah based efficiency of Islamic banks. Practical and Social Implications: Since all Islamic banks are meant to achieve highest possible level of Maqasid-e-Shariah, the management of these banks has to focus on improving MSI scores along with highest technical efficiency. In this regard, the paper provides insight to management, Shariah advisors and regulators in the performance of Islamic banking from both conventional and Shariah aspects.

Agricultural sciences and the environment: Reviewing recent technologies and innovations to combat the challenges of climate change, environmental protection, and food security

AbstractAgricultural production systems currently face multiple challenges: Climate change, natural resource depletion, and supply chain disruption, together with global population growth. As sustainable agriculture must simultaneously deliver myriad services (e.g. provide food security, maintain natural resources, retain and improve framers’ profitability, and sustain biodiversity), a systemic and multidisciplinary approach is thus needed. In this context, new technologies based on sensors, automatic machines, robots, and digital applications show much potential. The special section of the Agronomy Journal, entitled, “Agricultural and Biological Sciences: Plant, Soil, Animal and Environment Nutrient Management,” brings together a coherent set of research studies. All papers published in this special section address current, relevant topics for agriculture, biology and environmental sciences with a multidisciplinary approach aimed at generating new scientific information on digital technologies, bioinformatics, plant science, soil resources, agricultural waste, and environmentally conscious approaches. A total of 58 papers were submitted, each of which was evaluated by expert reviewers using a double‐blind reviewing process and 25 full text papers were accepted for publication in the special section. The present paper highlights the findings of the published papers, with the aim of bringing cutting‐edge innovation to applied research in agriculture and biology. The published papers here provide new knowledge and viable solutions for better performance in agricultural and biological sciences. New technologies will change the concept of farming and agribusiness making it more profitable, efficient, safer, attractive, simple, smart, and finally sustainable. Rural development and food security policies must support and finance the easiest possible access to new technologies for agricultural producers.

Abstract IA24: A modern data commons approach to advance population science

Abstract Since 2014, NCI has been building data science platforms to integrate genetic information about tumors with data on how patients respond to therapy. This work advances the 2011 Institute of Medicine recommendation to build a unified system to collect, integrate, and share cancer data from the widest possible set of research studies. NCI is working to fulfill this recommendation by establishing an NCI Cancer Research Data Commons (CRDC), virtual, expandable informatics infrastructure and data repositories, which are designed to support the work of the NCI intramural and extramural cancer research communities. The CRDC is a crucial component of a broader National Cancer Data Ecosystem that spans discovery research, patient participation, and population surveillance. The development of such an ecosystem was a key recommendation of the Cancer Moonshot Blue Ribbon Panel. NCI has been developing the Cancer Research Data Commons based on the understanding that big data emerging from research programs, precision medicine trials, and surveillance can be used to develop and inform models that predict how patients will response to treatment. Numerous NCI-funded programs will provide key data for this ecosystem, including a variety of discovery programs, clinical trials, cohort studies, and NCI’s Surveillance, Epidemiology, and End Results program (SEER), which is the most comprehensive source of population-based information in the country that includes stage of cancer, detailed characterization of the cancer including important biomarkers at the time of diagnosis, and performs active follow-up to determine patient survival data. The CRDC is designed to be as flexible as possible so that many types and sources of data can be accessed in a unified, interoperable manner. It is this data interoperability that facilitates novel insights into cancer biology and treatment. During the past several years, NCI has been developing key building blocks that comprise the CRDC. These building blocks include (i) Data Commons Nodes, which are repositories that house harmonized data from multiple programs; (ii) Cloud Resources, which provide workspaces, analysis capabilities, and access to elastic computing resources in commercial cloud environments; (iii) a Data Commons Framework (DCF), which is a set of modular, reusable services that maximize interoperability across cancer datatypes and repositories, increase sustainability, and reduce future resource cost; and (iv) semantics services to support data models, vocabularies, ontologies, data submission, and cross-domain queries. The modular design of the CRDC means that new services and components can be added flexibly, which allows for new data sources and new technologies to become integrated as they become available. The NCI Cancer Research Data Commons will serve as a platform for understanding fundamental cancer biology questions, including cancer initiation, progression, and recurrence, in ways that support new prevention, treatment, and surveillance strategies. Citation Format: Anthony Kerlavage. A modern data commons approach to advance population science [abstract]. In: Proceedings of the AACR Special Conference on Modernizing Population Sciences in the Digital Age; 2019 Feb 19-22; San Diego, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(9 Suppl):Abstract nr IA24.

Multimodality in critical language textbook analysis

ABSTRACT Increasingly, studies are taking account of multimodality when analyzing language textbooks. Due to the diversity of multimodal frameworks used in analyses, and the interdisciplinary nature of language textbook studies, conceptual differences arise that are important to discuss – which is the purpose of this paper. Specifically, I argue that multimodal analyses of language textbooks can be divided into two groups based on how they conceptualise meaning. One examines how textbooks’ textual-visual content encodes and communicates ideas about the world, treating meaning as representation. A second set of research studies is focused on how multimodal elements in textbooks foster interpersonal relations between text producers and readers, thus viewing the meaning textbooks communicate as interaction. While each approach is valid, I argue that neither places sufficient emphasis on the fact that textbooks are a didactic genre where learners’ engagement with any meaning is heavily guided. As such, critical textbook analysis should attempt to demonstrate the ideological nature of meaning-making by examining the interplay of multimodal representations, the interactive meaning of textbooks’ multimodal material as well as the pedagogic-didactic frame within which learners encounter them. The article utilises an example from a popular English as a foreign language textbook to illustrate these points.

Management of Pain after Caesarean Section and the Maternal Implications

Objective: Post-cesarean pain management affects both the mother and the newborn. Administration of intravenous acetaminophen is an accepted pain control treatment option. The aim of the study is to examine the effectiveness of IV Acetaminophen every 8 hours for the first 24 hours post-op in post-cesarean patients. Design: A prospective quantitative research study Setting: At the maternity ward Participants:102 women after cesarean section Intervention: All women treated according to a pain protocol of intravenous Acetaminophen. Pain was recorded with the Visual Analog Scale (VAS), and then patients were questioned 48 post-op about the pain experienced and its influence on functioning ability. Findings:The medication reduced pain level by 2-4 points on the VAS. Mean maximum pain reported in the first 24 hours was VAS=5.61, in the next 24 hours 4.54. However, mean maximum pain remembered by the patients was VAS=7.99 in the first 24 hours and 7.07 in the next 24 hours. Most women maintained that the medication helped to reduce their pain but that the pain hindered their ability to perform tasks such as moving and leaving the bed, caring for the newborn and breastfeeding. Key Conclusions: There is disparity between level of pain reported by women in ‘real time’ and that recalled in self-report 48 hours post-op. Despite pain alleviation by medication, functioning was still problematic. In addition to pain evaluation, function analysis is also necessary Implications for Practice: Pain evaluation is insufficient; evaluation and intervention of maternal function is also necessary.

Management of Pain after Caesarean Section and the Maternal Implications

Objective: Post-cesarean pain management affects both the mother and the newborn. Administration of intravenous acetaminophen is an accepted pain control treatment option. The aim of the study is to examine the effectiveness of IV Acetaminophen every 8 hours for the first 24 hours post-op in post-cesarean patients. Design: A prospective quantitative research study Setting: At the maternity ward Participants:102 women after cesarean section Intervention: All women treated according to a pain protocol of intravenous Acetaminophen. Pain was recorded with the Visual Analog Scale (VAS), and then patients were questioned 48 post-op about the pain experienced and its influence on functioning ability. Findings:The medication reduced pain level by 2-4 points on the VAS. Mean maximum pain reported in the first 24 hours was VAS=5.61, in the next 24 hours 4.54. However, mean maximum pain remembered by the patients was VAS=7.99 in the first 24 hours and 7.07 in the next 24 hours. Most women maintained that the medication helped to reduce their pain but that the pain hindered their ability to perform tasks such as moving and leaving the bed, caring for the newborn and breastfeeding. Key Conclusions: There is disparity between level of pain reported by women in ‘real time’ and that recalled in self-report 48 hours post-op. Despite pain alleviation by medication, functioning was still problematic. In addition to pain evaluation, function analysis is also necessary Implications for Practice: Pain evaluation is insufficient; evaluation and intervention of maternal function is also necessary.

Forest humus forms as a playground for studying aboveground-belowground relationships: Part 2, a case study along the dynamics of a broadleaved plain forest ecosystem

A set of research studies has been performed over a period of 10 years on the silvicultural cycle of an even-aged beech forest in Normandy, France. The striking results about both soil functioning (litter decomposition, N cycling, soil C stock) and soil biota (microorganisms, mesofauna, and macrofauna) are presented with the goal of developing an empirical model of the successional patterns of aboveground-belowground relationships in forests. Our purpose was to test the hypothesis stating that the best performance of this forest ecosystem, as high organic matter recycling and low biogenic element losses, is achieved in an ecological stage exhibiting limiting similarity in functional traits and maximizing traits complementary for both plant and soil communities. The present synthesis showed that this hypothesis seems to be confirmed for a late successional stage, i.e., a mature even-aged forest with a closed canopy. The most organized communities, on the basis of ecological requirement similarity, were found in 130 year-old stands. These stands also support the greatest values in microbial functional diversity, in soil C stock and in nitrogen mineralization. Nitrogen losses were the lowest in 95 year-old stands. We also provide some methodological advices for using humus forms for the study of aboveground-belowground relationships in forest ecosystems.

UDL and Intellectual Disability: What Do We Know and Where Do We Go?

As an instructional design framework that can be used to design curriculum for students with and without disabilities, Universal Design for Learning (UDL) has the potential to support meaningful inclusion of students with intellectual disability (ID) in general educational settings. This article presents an overview of the existing set of research studies on UDL application for students with ID in PreK-12 settings. The current body of research illustrates that UDL is being applied to instructional activities for students with ID to examine a variety of interventions (e.g., adapted stories for individual students, inclusive general education curriculum) and outcomes (e.g., interaction, perceptions, knowledge gains) in self-contained and general educational settings. It also identifies important questions for consideration in future research as the field seeks to determine how UDL guidelines can be applied to curriculum, used with evidence-based and effective practices, and used to support schoolwide initiatives inclusive of students with ID.

Successful Treatment of a Diamond-Blackfan Anemia (DBA) Patient with Eltrombopag

▪DBA is a rare bone marrow failure syndrome clinically defined by onset of hypoproliferative anemia in early childhood accompanied by a grossly normocellular bone marrow. With age, a significant fraction of patients progress to pancytopenia and a hypocellular bone marrow, with some increased risk of progression to leukemia. Autosomal dominant or sporadic heterozygous mutations in genes encoding for ribosomal subunit proteins have been etiologically linked to DBA. How loss of function mutations in ribosomal proteins results in selective loss of erythroid progenitors with variable severity is incompletely understood. Chronic transfusion therapy and corticosteroid treatment can alleviate anemia, but both cause severe long term toxicities. Hematopoietic stem cell transplantation, when available, is the only definitive treatment modality for the hematological manifestations, and the only known treatment for DBA patients once pancytopenia develops.Here we report on a 28 year old female patient diagnosed with DBA at age of one month based on clinical criteria. Recent mutational analysis identified a novel mutation in intron 4(c.356+3>C) of the RPS19 gene affecting a known splice donor site that has previously reported in DBA patients. She did not respond to corticosteroids and was maintained on transfusions. She failed various experimental therapies including danazol, hematopoietic growth factors including IL-3 and GM-CSF, and anti-thymocyte globulin/cyclosporine without sustained clinical response. After treatment with daclizumab in 2006 her transfusion requirements decreased for about 4 years. In 2012 she presented with progressive pancytopenia and hypocellular bone marrow without overt dysplasia, and normal cytogenetic analysis. She required red cell transfusions. The patient was enrolled in a clinical research protocol investigating the efficiency and safety of the thrombopoietin receptor agonist eltrombopag (EPAG) in patients with moderate aplastic anemia or those with bone marrow failure with unilineage cytopenia (ClinicalTrials.gov: NCT01328587). The study is designed as a non-randomized, phase II, dose modification study with the primary endpoint hematological response at 16 weeks. EPAG was administered at 50mg daily and escalated every 2 weeks by 25 mg to the maximal dose of 300mg daily. At response assessment the patient’s hemoglobin (Hgb) improved from 7.0g/dl to 8.9g/dl and platelets from 112K/ul to 171k/ul. She required no further transfusions, and was deemed a responder. EPAG was subsequently continued at the same dose level for an additional 6 months when the peripheral cells counts peaked at Hgb 11.9g/dl, platelets 251K/ul, ANC 3.19 K/ul, and EPAG was discontinued for protocol-defined robust response. After discontinuation of EPAG the patient’s hemoglobin steadily declined over a period of 8 months. EPAG was reinitiated at 300mg per protocol. Peripheral blood cell counts rapidly improved and the EPAG dose was slowly tapered. The patient is currently on EPAG 50mg daily with normal blood cell counts. We have not observed any EPAG related toxicities in our patient, and repeated cytogenetic studies on bone marrow documented a normal karyotype.To the best of our knowledge this is the first report documenting EPAG efficacy in a DBA patient. Trautman et al. (2012) previously reported a DBA patient that failed treatment with low dose EPAG after six months. Our observation warrants further systematic investigation of EPAG treatment for DBA patients within a clinical research study setting. [Display omitted] DisclosuresWinkler:GSK/Novartis: Research Funding. Townsley:Novartis: Research Funding. Desmond:Novartis: Honoraria. Dumitriu:GSK/Novartis: Research Funding. Grasmeder:GSK/Novartis: Research Funding. Young:GSK/Novartis: Research Funding. Dunbar:GSK/Novartis: Research Funding.

How do newly-qualified early childhood teachers in Aotearoa New Zealand critically reflect within constraints and possibilities of dominant discourses of early childhood teaching?

Early childhood practitioners' professionalism is a contested concept, with interpretations that include professionalisms based on qualifications, on accountability, on relational skills and on critical advocacy. Understandings of professionalism as situated in ecological frameworks rather than within individuals have led to the concept of a critical ecology, within which teachers critically reflect on and question professionalism at all levels of their professional ecosystem. Carmen Dalli has called for re-emergence of a critical ecology of the early childhood profession in Aotearoa New Zealand in challenging political contexts. This article explores two newly-qualified early childhood teachers' critical reflections about their subjectivities in a Master's thesis research study set in Aotearoa New Zealand. In the poststructural paradigm of this research, subjectivities comprise individuals' multiple, complex and dynamic self-understandings shaped by power relations within discourses. This article will draw on Michel Foucault's discourse theories to consider how these newly-qualified early childhood teachers in Aotearoa New Zealand critically reflect within constraints and possibilities of dominant discourses of early childhood teaching.International Research in Early Childhood Education, vol. 5, no. 1, p. 124-138

Art Integration Fosters Empathy in the Middle School Classroom

ABSTRACTIn this article, I highlight findings from a nine-day unit embedded within a larger, four-month long qualitative action research study set in a public middle school. My goal in conducting this research was examination of relationships between visual culture and art integration as a method of fostering students to find voice while taking risks. A collaborative process was central to the unit in which the non-art educator and I developed and taught persuasion using art and art history. Students engaged in creating collaborative ecological installations, the integration of visual culture bridged art and other curricular areas while creating spaces for authentic learning. Through making art, students built shared knowledge, engaged in safe discourse, and expressed empathy.

Implications for Scaling up Advanced Course Offerings and Takings: Evidence from Florida

This article summarizes a set of research studies that focus on high school course offerings, takings, and effects. Improving high school experiences and having students graduate from high school ready for college are national priorities under President Obama's Race to the Top initiative. Doing so by expanding access to advanced courses dates back a decade to President George W. Bush and the National Governors Association's efforts in the No Child Left Behind era. Courses are still seen as the gateway to higher student performance and access to college. From research done in collaboration with Dylan Conger and Mark Long, we found that taking more rigorous math courses increases students’ likelihood of being ready for college math, and that gaps in math course taking explain about one third of the gap between White and Black students and White and Hispanic students’ readiness for college. Advanced courses do matter—even taking just one advanced course improves students’ test scores, likelihood of graduating from high school, and likelihood of attending a four-year university. Schools, however, could do more to overcome the gap. We found that the best predictor of schools’ offering advanced courses was their having a critical mass of students with very high prior achievement. Resources, however, were not a factor.

Evidence-Based Practices for Children, Youth, and Young Adults with Autism Spectrum Disorder: A Comprehensive Review.

The purpose of this study was to identify evidenced-based, focused intervention practices for children and youth with autism spectrum disorder. This study was an extension and elaboration of a previous evidence-based practice review reported by Odom et al. (Prev Sch Fail 54:275-282, 2010b, doi: 10.1080/10459881003785506 ). In the current study, a computer search initially yielded 29,105 articles, and the subsequent screening and evaluation process found 456 studies to meet inclusion and methodological criteria. From this set of research studies, the authors found 27 focused intervention practices that met the criteria for evidence-based practice (EBP). Six new EBPs were identified in this review, and one EBP from the previous review was removed. The authors discuss implications for current practices and future research.

New aspects in the pathomechanism and diagnosis of the laryngopharyngeal reflux-clinical impact of laryngeal proton pumps and pharyngeal pH metry in extraesophageal gastroesophageal reflux disease.

To determine the laryngeal H+K+-ATPase and pharyngeal pH in patients with laryngopharyngeal reflux (LPR)-symptoms as well as to assess the symptom scores during PPI therapy. Endoscopy was performed to exclude neoplasia and to collect biopsies from the posterior cricoid area (immunohistochemistry and PCR analysis). Immunohistochemical staining was performed with monoclonal mouse antibodies against human H+K+-ATPase. Quantitative real-time RT-PCR for each of the H+K+-ATPase subunits was performed. The pH values were assessed in the aerosolized environment of the oropharynx (DxpH Catheter) and compared to a subsequently applied combined pH/MII measurement. Twenty patients with LPR symptoms were included. In only one patient, the laryngeal H+K+-ATPase was verified by immunohistochemical staining. In another patient, real-time RT-PCR for each H+K+-ATPase subunit was positive. Fourteen out of twenty patients had pathological results in DxpH, and 6/20 patients had pathological results in pH/MII. Four patients had pathological results in both functional tests. Nine out of twenty patients responded to PPIs. The laryngeal H+K+-ATPase can only be sporadically detected in patients with LPR symptoms and is unlikely to cause the LPR symptoms. Alternative hypotheses for the pathomechanism are needed. The role of pharyngeal pH-metry remains unclear and its use can only be recommended for patients in a research study setting.

Psychosocial interventions for suicidal ideation, plans, and attempts: A database of randomised controlled trials

BackgroundResearch in suicide prevention using psychosocial interventions is rapidly advancing. However, randomised controlled trials are published across a range of medical, psychological and sociology journals, and it can be difficult to locate a full set of research studies. In this paper, we present a database of randomised controlled outcome studies on psychosocial interventions targeting suicidal behaviour. The database is updated annually and can be accessed by contacting the corresponding author.DescriptionA comprehensive literature search of the major bibliographical databases (PsycINFO; PubMed; Cochrane Central Register of Controlled Trials) was conducted for articles published between 1800 to July 30 2013, and examined reference lists of previous relevant reviews and included papers to locate additional references. Studies were included if they featured a randomised controlled design in which the effects of a psychosocial intervention were compared to a control condition (no intervention, attention placebo, wait-list, treatment-as-usual [TAU]), another psychosocial intervention or a pharmacological intervention. In total, 12,250 abstracts were identified. Of these, 131 studies met eligibility criteria and were included. Each paper was then coded into categories of participant characteristics (age, gender, formal diagnosis, primary reason for recruitment); details of the intervention (recruitment setting, content, intervention setting, administering individual, delivery type, delivery format, delivery frequency, delivery length); and study characteristics (control and experimental conditions, primary outcome/s, secondary outcome/s, follow-up period). One paper has been published from the database using studies collected and coded prior to 2012.ConclusionThe database and listing of 131 studies is available for use by suicide prevention researchers. It provides a strong starting point for systematic reviews and meta-analyses of treatments and interventions. It will be updated yearly by researchers funded through the Australian National Health and Medical Research Council Centre for Research Excellence for Suicide Prevention (CRESP), located at the Black Dog Institute, Australia. This database adds to the evidence base of best-practice psychosocial interventions for suicidal behaviour and prevention.

Ongoing Trials of Simplified Antibiotic Regimens for the Treatment of Serious Infections in Young Infants in South Asia and Sub-Saharan Africa

Background:The current World Health Organization (WHO) recommendation for treatment of severe infection in young infants is hospitalization and parenteral antibiotic therapy. Hospital care is generally not available outside large cities in low- and middle-income countries and even when available is not acceptable or affordable for many families. Previous research in Bangladesh and India demonstrated that treatment outside hospitals may be possible.Research:A set of research studies with common protocols testing simplified antibiotic regimens that can be provided at the lowest-level health-care facility or at home are nearing completion. The studies are large individually randomized controlled trials that are set up in the context of a program, which provides home visits by community health workers to detect serious illness in young infants with assessment and treatment at an outpatient health facility near home. This article summarizes the policy implications of the research studies.Policy Implications:The studies are expected to result in information that would inform WHO guidelines on simple, safe and effective regimens for the treatment of clinical severe infection and pneumonia in newborns and young infants in settings where referral is not possible. The studies will also inform the inputs and process required to establish outpatient treatment of newborn and young infant infections at health facilities near the home. We expect that the information from research and the resulting WHO guidelines will form the basis of policy dialogue by a large number of stakeholders at the country level to implement outpatient treatment of neonatal infections and thereby reduce neonatal and infant mortality resulting from infection.

Latin America: ripe for cutting-edge research proposals for prevention and control of Helicobacter pylori

One of the greatest areas of scientific progress has been the identification of certain infectious agents that are implicated in the carcinogenic process. This new knowledge has had broad repercussions not only in the application of new primary prevention options, such as prophylactic vaccines, but also in the definition of infection biomarkers that can be used as screening alternatives or as prognostic markers for neoplasia. We now know that chronic infection with the pathogenic bacteria Helicobacter pylori (H. pylori) is associated with gastrointestinal tract disorders, ranging from chronic gastritis to gastric adenocarcinoma; there is also evidence of a possible association with gastric lymphoma and peptic ulcer. Published reports support the existence of geographic regions where this bacterium is endemic and where H. pylori colonization occurs at a very early age in populations living in precarious sanitary conditions. For this reason, gastric cancer is one of the most common cancers in the world in low-resource countries and, as noted in the accompanying articles [1, 2], one with great heterogeneity in terms of incidence and mortality in Latin America. As a result, this geographic region constitutes a fascinating setting for research and provides unique and important opportunities for gastric cancer prevention. From a public health perspective, there are currently two major lines of research and action in regard to H. pylori and gastric cancer. On the one hand, we should gain a more precise understanding of the natural history of H. pylori infection and, as a consequence, learn about the triggering mechanism(s) related to chronic exposure in the development of gastric adenocarcinoma. However, we also know that reducing future incidence of gastric cancer is possible by improving the living conditions of the general population from a hygienic perspective, as confirmed by Porras et al. [3] in this special edition. Evidence now exists, which established H. pylori as a part of normal human microbiota [4]. This line of work indicates that this bacterium has a special tropism for gastric mucosa, that strains with toxic potential exist, and that the bacteria secrete proteins such as vacA [5], which produce vacuolization in cultures of human epithelial cells as well as increased capacity to modify molecules. Given the existing evidence from biomedical and epidemiological research underscoring the high degree of genetic diversity in H. pylori [6], prevention is arguably very complex. Research groups in Latin America have generated an invaluable scientific tradition for generation of new hypotheses [7], evidence for interventions [8], and high-impact publications [9] related to the study of the carcinogenic process in gastroduodenal mucosa. Recently, a Latin American H. pylori research consortium was formed with the primary mission of evaluating effectiveness, feasibility, and cost of eradication using an antimicrobial regimen specifically for Latin America. Results are encouraging and demonstrate the technical and academic abilities of the participating groups [10]. They also indicate that treatment regimens for successful eradication need to be region-specific; thus, adopting successful treatment regimens from high-income countries may not be the best solution for lower-income countries. Adding to this line of work, results of a diverse set of research studies conducted in various regions of Latin America are presented in this special issue, which reveal the great heterogeneity that exists in the region. These publications include topics such as potential solutions for gastric cancer surveillance in low-resource countries [11], ecological data in support of the altitude–gastric cancer association [1], assessment of the utility of serologic biomarkers for risk of gastric cancer in three Latin American countries [2], confirmation of risk factors for H. pylori infection [3], and a meta-analysis of a variety of risk factors and gastric cancer risk [12]. The work presented in this special edition of the journal along with the recently formed consortium underscores the enormous potential that multi-centric regional studies have for addressing the magnitude of health problems, and even more important, identify solutions for prevention of future disease. These invaluable resources allow us to postulate new research hypotheses and to consolidate a regional group, which can contribute to improving therapeutic strategies for prevention and control of gastric cancer and build the foundation for evidence-based regional public policies aimed at improve the quality of life of the population.

Life Course as a Policy Lens: Challenges and Opportunities

This set of research studies on the life course as a policy lens springs from research and discussions over more than a year and a half among academic researchers and policy analysts. The six empirical studies in this special issue all rely on the life-course perspective to extend the reach of the perspective into areas with policy relevance that have not been examined previously with a life-course lens. The studies examine aboriginal health, social participation, housing instability and evictions, earnings trajectories, and late-life transitions. Key conclusions overall from the project are that (1) Canada may have an early lead in conceptual thinking on life course as a policy lens, giving us the momentum to push this advantage further; (2) the life-course perspective focuses less on individual trajectories and more on the ongoing interactions of individuals with social structures, particularly structures of inequality and life-course scripts; (3) the conceptualization of the life course as a tale of path dependency, gravity, and shocks focuses attention on social circumstances rather than on individual choices; (4) a life-course perspective for policy-makers is more realistic, more attuned to the reality experienced by social actors, and social actors accordingly recognize themselves in policies; and (5) the life-course perspective offers the possibility of making social actors, researchers, and policy-makers work more in tandem.

Life Course as a Policy Lens: Challenges and Opportunities

This set of research studies on the life course as a policy lens springs from research and discussions over more than a year and a half among academic researchers and policy analysts. The six empirical studies in this special issue all rely on the life-course perspective to extend the reach of the perspective into areas with policy relevance that have not been examined previously with a life-course lens. The studies examine aboriginal health, social participation, housing instability and evictions, earnings trajectories, and late-life transitions. Key conclusions overall from the project are that (1) Canada may have an early lead in conceptual thinking on life course as a policy lens, giving us the momentum to push this advantage further; (2) the life-course perspective focuses less on individual trajectories and more on the ongoing interactions of individuals with social structures, particularly structures of inequality and life-course scripts; (3) the conceptualization of the life course as a tale of path dependency, gravity, and shocks focuses attention on social circumstances rather than on individual choices; (4) a life-course perspective for policy-makers is more realistic, more attuned to the reality experienced by social actors, and social actors accordingly recognize themselves in policies; and (5) the life-course perspective offers the possibility of making social actors, researchers, and policy-makers work more in tandem.