Wildfires pose a significant and growing threat to human health. Current trends in climate change predict that wildfire occurrence and severity will increase in the near future, and therefore the adverse health effects associated with wildfire and its air quality effects are becoming increasingly relevant. Even with current efforts to stem future rises in temperature, wildfire activity will continue to increase due to lags in the climate system itself. Thus, in addition to the known increase in mortality, respiratory, and cardiovascular risks, there is a growing need to investigate other health outcomes associated with wildfire smoke exposure, especially their effect on pregnancy and birth outcomes. In order to provide a broad overview of the state of wildfire research on the topic of pregnancy and birth outcomes, this narrative review will summarize the existing literature on pregnancy and birth outcomes associated with wildfire smoke exposure, with consideration for the ambient air pollution literature that informs wildfire research. As research in this specific topic is still developing, a pattern of limitations to study designs is beginning to emerge, which will guide future research needs. Finally, practical considerations for implementing research findings into land management and public health policies that reduce wildfire exposure in order to mitigate the health risks associated with it will be explained.

Clostridium difficile is a clinically problematic pathogen and continues to persist within the healthcare system. Presentation of disease symptoms ranges from mild to severe diarrhoea, through to fulminant pseudomembranous colitis. Approximately 20% of patients will suffer from recurrent episodes and of all patients who die from C. difficile related causes, approximately 41% of death certificates mention C. difficile as an underlying cause of death, and this poses a significant burden on healthcare facilities. Three methods of investigation were employed to develop a more comprehensive understanding of both the host and isolate association with the outcomes of C. difficile infection; mortality and recurrence. These methods were; analysing patient clinical data to try and identify host markers of infection outcomes, evaluating C. difficile type association with infection outcomes, and genetically and phenotypically characterising the clinically relevant C. difficile isolates associated to these outcomes. During this study statistical analysis of clinical data revealed that there were four variables; white cell count, serum albumin, C-reactive protein and respiratory rate, which were prognostic of mortality in patients with C. difficile infection. Threshold levels of these variables were used to create a clinical prediction rule to classify patients with C. difficile infection who were more 'at risk' from mortality, with statistical significance in both a derivation and validation cohort. However, analysis was unable to determine variables prognostic of recurrent infection. Due to small sample sizes of some groups of isolates, no groups of C. difficile isolates were significantly associated with increased recurrent infection or mortality during this study. Some groups of isolates were associated with primary only infection and/or low mortality. There was a non-significant trend in particular C. difficile isolate groups being associated with infection outcome; a panel of representative isolates was therefore chosen to be characterised in more detail. Phenotypic and genetic analysis of a panel of sixteen C. difficile isolates revealed isolate specific differences in toxin production, conservation of transposable elements and SNP abundances, which may have played a role in infection outcome. Isolate motility and antibiotic resistance profiles were not statistically significantly different between isolates within a particular group of C. difficile types. One hypothesis from the collective results obtained during this study suggests that the phenotypic and genotypic changes in isolates may have facilitated differences in their interaction with the host. In turn, the host specific inflammatory response to the infecting C. difficile isolate may have played a role in host outcomes. Research conducted during this study has begun to assess which host specific responses may be important in determining the outcome of C. difficile infection, and which C. difficile isolate characteristics may in part also contribute. However, the assessment of both host and isolate association to infection outcomes would benefit from further investigation in a larger cohort, in order to prove or refute conclusively any hypothesises generated in this study.

Class of 2007 Abstract / Objectives: The purpose of this study was to evaluate the required didactic curriculum of the graduating class of 2007 of the University of Arizona College of Pharmacy by assessing the extent that it satisfied the Outcomes Expected document. The curriculum was evaluated specifically for the disease states of diabetes and hypertension, as well as general pharmacy areas. This also offered insight into which areas of the document needed to be addressed more completely in the pharmacy curriculum. Methods: This was a retrospective analysis using the graduating class of 2007 as a cohort for evaluating the competencies. Course materials from required courses were reviewed to identify components that were met. Results: When all components were analyzed, the curriculum addressed 85.2% of the outcomes expected. All but 1 component of Domain 1.0 was covered, 95.8% (23/24), and Domain 2.0 was completely covered (23/23). While Domain 3.0 was not addressed in the required curriculum, students may have experienced these competencies through extracurricular activities. Coverage of both disease specific topics, diabetes and hypertension, was evidenced identically with course material. All components specific to the disease state were covered 85.7% (18/21). Domain 1.0 was addressed 88.9% (16/18), Domain 2.0 was addressed 66.7% (2/3), and Domain 3.0 was not addressed in the documentation. Conclusions: The documented curriculum of the graduating class of 2007 at the University of Arizona College of Pharmacy did not fulfill all components in the Outcomes Expected document. While some areas may have been addressed, documentation was lacking. We encourage course directors to reevaluate their curriculum to ensure areas not evidenced with coverage are addressed. We also urge more stringent documentation of the areas that were not evidenced with documentation.

Student Number : 9110316P - M Ed research report - School of Education - Faculty of Humanities / This study seeks to establish if teaching Grade 7 Algebra accords with Outcomes Based Education [OBE] in a sample of three state primary schools in a province, South Africa. Following the methods of illuminative evaluation the researcher looked for ‘matches’ and ‘mismatches’ between what was planned in an OBE text with what ‘actually happens’ in classroom teaching to gauge if the shift to outcomes has taken place in teaching Mathematics in these schools, and make recommendations to improve. Data was collected using document analysis to establish how percentages was planned to be taught by teachers and using naturalistic observations with follow-up probing interviews to establish how this teaching actually took place in classrooms. The data was checked by questionnaire data seeking the views of educators doing this teaching. The data showed 5 Patterns in this teaching, one only according with planned OBE teaching, 2 other Patters where teaching was more-or-less as intended, and 2 further Patterns where teaching failed to accord with the OBE text. Just over half the teachers or 58% of the sample seemed to have shifted to OBE, and less than half or 42% of educators seem not to have done so. Primary amongst the findings is that educators failed to teach Mathematics conceptually first as planned, preferring in a variety of ways to omit conceptual explanations by way of introduction to lessons in favour of ‘guiding examples’, ‘group work’ and ‘report back’, ‘teacher and learner assessment’ and ‘concluding exercises’, the six categories which emerged for teaching in these lessons. The study recommends primarily that educators re-claim teaching Mathematics conceptually first, and prior to completing examples and giving exercises to learners. It concludes that fewer educators than expected seem to have shifted towards OBE teaching in these Mathematics classrooms, 6 years into the national innovation, C 2005.

MSc (Med), Epidemiology and Biostatistics, Faculty of Health Sciences, University of the Witwatersrand, 2009 / South Africa is ranked fourth on the list of 22 high-burden TB countries in the world. Intensifying the prevalence of TB in South Africa is the high TB/HIV co-infection rate, with 44% of new TB patients testing positive for HIV. This burden is intense for rural communities due to poverty and return of people with TB/HIV co-infection who previously migrated for employment. In rural South Africa, TB is the leading cause of mortality in HIV-infected persons, but limited information is available about predictors of death. This study measures TB treatment outcomes in Rixile clinic and assesses predictors of TB mortality. Rixile HIV clinic is based in Tintswalo hospital, Acornhoek, Bushbuckridge, Mpumalanga province. This current study uses secondary data collected through a prospective cohort study conducted by PHRU and RADAR from March 2003 to March 2008 on 3 to 6 monthly intervals. Chi-square and logistic regression statistical tests were used to assess predictors of TB Mortality. TB mortality among study participants was 62.5% during the pre-ARV rollout period (March 2003- October 2005), and treatment completion was 31.7%. Some 5.8% participants interrupted treatment during the pre-ARV rollout period as compared to 4.5% during the ARV rollout period (November 2005- March 2008). TB mortality among study participants was 7.5% during ARV rollout and treatment completion increased to 84.4%. Factors associated with TB mortality were age (p=0.006), sex (p=0.017), BMI (p< 0.001), marital status (p=0.004), education (p=0.03), alcoholic beverages consumption (p=0.04), and ARV treatment (p<0.001). However, only age, sex, and ARV treatment were found to predict TB mortality. The proportion of TB treatment completion was higher and TB mortality was lower during ARV roll-out compared to pre-ARV roll-out. Being at the age of 40 to 75 years, not being on ARV treatment and male sex predicts TB mortality in this population. There is a need to expand ARV treatment and intensify TB care services for older people, particularly males living with HIV in this rural community.

Class of 2007 Abstract / Objectives: To evaluate the impact of a training program in health outcomes and pharmacoeconomics (PE) to determine how it has impacted PE application in the workplace and what topics and teaching methods are most useful to participants. Methods: This study is a descriptive study of data obtained through a questionnaire that surveyed course participants from the 2005 and 2006 University of Arizona Health Outcomes and PharmacoEconomic Center training programs. Results: There were a total of 20 respondents from the two programs, 70% had a pharmacy background and 55% practice in a pharmaceutical industry setting. The respondents felt that lecture based workshops were the most helpful and 90% responded that the program enhanced their communication with colleagues regarding PE and outcomes research. Conclusions: The program participants benefited from participation in the training program and have integrated material from the training program into the workplace. Lecture and case-based workshops were the most useful teaching methods used in the training program.

The research analysed the performance differentials among schools with different pre-1994 history of administration and provisioning thus examining the changes in terms of equality of educational outcomes. The purpose of this research was to contribute to the further understanding of the effectiveness of post-1994 educational policy reforms in addressing educational inequalities of the past. The study found that not only were there statistically significant performance differentials between schools based on the pre-1994 education departments, these performance differentials remained significant throughout the period under study. The findings suggest that, overall, the performance differentials between schools that obtained in the pre-1994 era were continuing unabated. The study also found that there were significant performance differentials between schools within the former education departments and these were more significant in low performing former education departments. This suggested that schools within each of former education departments were not homogenous and more nuanced policy interventions were needed to ensure quality outcomes. The study recommends makes three main recommendations. These are - shift in methodological approach when dealing with education policy where a school as an institution at macro level will be a point of departure as opposed to macro-level approach where broad educational reforms are imposed on schools; education policies should be such that they mitigate the impact of socio-economic background on learner achievement and; that future research need to focus on more nuanced aspects on school effectiveness rather than lumping schools into large groups which may hide unique quality challenges that schools as institutions are facing.

The present study used a discounting task to evaluate how hypothetical treatment outcomes were discounter across successively greater probability values. Two discounting questionnaires were administered to thirty parents, half of which had a child with a disability. Delayed discounting of monetary rewards was assessed in relationship with probability discounting of hypothetical treatment outcomes. The questions on the probability discounting questionnaire consisted of asking participants to choose between a guaranteed percentage of symptom elimination or descending probability to eliminate all of their child’s symptoms. For example, “Which treatment outcome would you prefer for your child? (a) guaranteed elimination of 50% of symptoms or 30% chance to eliminate all symptoms.” Results showed a difference in the levels of discounting across the two groups of participants. Parents of children with disabilities discounted hypothetical monetary rewards more steeply while discounting hypothetical treatment outcomes less steeply compared to parents of children without disabilities. Exponential delay functions provided a strong fit for the monetary delayed function.

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This study examines the preparation during high school and post-secondary outcomes of students with disabilities. High school preparation consists of activities in which students participated during high school. Post-secondary outcomes relate to the current status of students following high school graduation in relation to the four major outcomes areas: (a) post-secondary education, (b) employment, (c) independent living, and (d) recreation and leisure. The target population included all students graduating from one school district in a mid-sized city in Texas. A stratified random sample of 228 students both with and without disabilities was selected. Post-secondary follow-up surveys, consisting of one survey administered prior to graduation and one survey administered six-months following graduation, were given to the participants. The response rate for the initial exit survey was 82.9% while the response rate for a post-school survey was 61.4%. Differences between groups were analyzed using loglinear analyses based upon educational setting, disability category, gender, ethnicity, and socio-economic status. In addition, a sub-study was completed to determine the level of agreement among students and teachers on a post-secondary readiness skill inventory. The findings indicated that differences among groups did exist in terms of both high school preparation and post-secondary outcomes. In terms of high school preparation, the participation among various groups produced few results that were significantly different. Statistically significant results occurred only with respect to extracurricular activity participation by educational setting and socio-economic status. Post-secondary outcome results produced more statistically significant findings than high school preparation. The variable of educational setting produced statistically significant post-secondary outcomes in the three areas of employment, post-secondary education, and recreation and leisure. Ethnicity was the next largest determinant to influence post-secondary outcomes, and statistically significant results were found for both post-secondary education and independent living. Socio-economic status produced statistically significant results for employment outcomes. The variable of gender produced no results that reached statistical significance. The last findings provided an analysis of the agreement between students and teachers in terms of a post-secondary readiness skill inventory. Overall students and teachers demonstrated a high level of congruency in which similar responses were indicated within 95% of the items.