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1.  Determinants of diabetes knowledge in a cohort of Nigerian diabetics 
Background
One of the consequences of the generational paradigm shift of lifestyle from the traditional African model to a more "western" standard is a replacement of communicable diseases by non-communicable or life style related diseases like diabetes. To address this trend, diabetes education along with continuous assessment of diabetes related knowledge has been advocated. Since most of the Nigerian studies assessing knowledge of diabetes were hospital-based, we decided to evaluate the diabetes related knowledge and its sociodemographic determinants in a general population of diabetics.
Methods
Diabetics (n = 184) attending the 2012 world diabetes day celebration in a Nigerian community were surveyed using a two part questionnaire. Section A elicited information on their demographics characteristics and participation in update courses, and exercise, while section B assessed knowledge of diabetes using the 14 item Michigan Diabetes Research and Training Centre's Brief Diabetes Knowledge Test.
Results
We found that Nigerian diabetics had poor knowledge of diabetes, with pervasive fallacies. Majority did not have knowledge of "diabetes diet", "fatty food", "free food", effect of unsweetened fruit juice on blood glucose, treatment of hypoglycaemia, and the average duration glycosylated haemoglobin (haemoglobin A1) test measures blood glucose. Attaining tertiary education, falling under the 51-60 years age group, frequent attendance at seminars/updates and satisfaction with education received, being employed by or formerly working for the government, and claiming an intermediate, or wealthy income status was associated with better knowledge of diabetes.
Conclusion
Nigerian diabetics' knowledge of diabetes was poor and related to age, level of education, satisfaction with education received, employment status and household wealth.
doi:10.1186/2251-6581-13-39
PMCID: PMC3984720  PMID: 24593904
Determinants; Knowledge; Sociodemographic; Diabetes; Nigeria
2.  Using Twitter for breast cancer prevention: an analysis of breast cancer awareness month 
BMC Cancer  2013;13:508.
Background
One in eight women will develop breast cancer in her lifetime. The best-known awareness event is breast cancer awareness month (BCAM). BCAM month outreach efforts have been associated with increased media coverage, screening mammography and online information searching. Traditional mass media coverage has been enhanced by social media. However, there is a dearth of literature about how social media is used during awareness-related events. The purpose of this research was to understand how Twitter is being used during BCAM.
Methods
This was a cross-sectional, descriptive study. We collected breast cancer- related tweets from 26 September - 12 November 2012, using Twitter’s application programming interface. We classified Twitter users into organizations, individuals, and celebrities; each tweet was classified as an original or a retweet, and inclusion of a mention, meaning a reference to another Twitter user with @username. Statistical methods included ANOVA and chi square. For content analysis, we used computational linguistics techniques, specifically the MALLET implementation of the unsupervised topic modeling algorithm Latent Dirichlet Allocation.
Results
There were 1,351,823 tweets by 797,827 unique users. Tweets spiked dramatically the first few days then tapered off. There was an average of 1.69 tweets per user. The majority of users were individuals. Nearly all of the tweets were original. Organizations and celebrities posted more often than individuals. On average celebrities made far more impressions; they were also retweeted more often and their tweets were more likely to include mentions. Individuals were more likely to direct a tweet to a specific person. Organizations and celebrities emphasized fundraisers, early detection, and diagnoses while individuals tweeted about wearing pink.
Conclusions
Tweeting about breast cancer was a singular event. The majority of tweets did not promote any specific preventive behavior. Twitter is being used mostly as a one-way communication tool. To expand the reach of the message and maximize the potential for word-of-mouth marketing using Twitter, organizations need a strategic communications plan to ensure on-going social media conversations. Organizations may consider collaborating with individuals and celebrities in these conversations. Social media communication strategies that emphasize fundraising for breast cancer research seem particularly appropriate.
doi:10.1186/1471-2407-13-508
PMCID: PMC4231612  PMID: 24168075
Social media; Breast cancer; Campaign; Twitter; Awareness
3.  Knowledge of insulin use and its determinants among Nigerian insulin requiring diabetes patients 
Background
Intensive insulin therapy is essential in the maintenance of strict glycemic control among insulin requiring patients with diabetes. However this presents a challenge in the face of the complexities associated with insulin use and also taking into consideration the potential dangers associated with inappropriate use. Insufficient knowledge of insulin use can result in preventable complications, adverse patient outcome, poor adherence to therapy and invariably poor glycemic control.
Methods
Insulin requiring diabetes patients (n = 54) attending the 2012 world diabetes day celebration in a Nigerian community were surveyed using a two part questionnaire. Section A elicited information on their demographics characteristics and participation in update courses, and exercise, while section B assessed knowledge of insulin use using the Michigan Diabetes Research and Training Centre's Brief Diabetes Knowledge Test. All participants who had a good grasp of English language or who could understand the contents of the questionnaire when it was explained to them, and were willing to participate in the study were assessed. Descriptive statistics of percentages was computed for the sociodemographic variables, previous education, satisfaction with education, involvement in regular exercise, knowledge of benefit of exercise and correct response to each question in section B. Analysis of variance (ANOVA) and independent t-test was used to determine the influence of sociodemographic variables on insulin use knowledge.
Results
Knowledge of insulin use is poor among insulin requiring patients with diabetes, with majority not conversant with such terms as ketoacidosis, insulin reaction and low blood sugar. Furthermore, they did not know how to modify their insulin dosage in relation to diet, exercise and infections (e.g. flu). Better knowledge of insulin use was associated with age, employment status, level of education attained, how frequent one reads/attends update courses and satisfaction with education received.
Conclusion
Poor knowledge of the causes and prevention of the ketoacidosis, insulin reaction and hypoglycemia increases their risk of developing them, which will invariably lead to poor adherence to insulin therapy. Therefore this study suggests a methodical, continuous and up-to-date tutelage if proper self management in terms of good glycemic control is to be achieved.
doi:10.1186/2251-6581-13-10
PMCID: PMC3933982  PMID: 24397956
Insulin use knowledge; Determinants of insulin use knowledge; Insulin-requiring diabetes patients; Nigerian
4.  21st Birthday Drinking and Associated Physical Consequences and Behavioral Risks 
Twenty-first birthday celebrations often involve dangerously high levels of alcohol consumption, yet little is known about risk factors for excessive drinking on this occasion. Participants (N = 150) from a larger prospective study who consumed at least one drink during their celebration completed questionnaires and semi-structured interviews about their 21st birthday within four days after the event. Assessments were designed to characterize 21st birthday alcohol use, adjusted for alcohol content, as well as situational/contextual factors (e.g., celebration location, peer influence) that contribute to event-level drinking. Participants reported an average of 10.85 drinks (9.76 adjusted drinks), with experienced drinkers consuming significantly more than relatively naïve drinkers who had no previous binge or drunken episodes. Men consumed more drinks, whereas age of first drunken episode and heavier drinking during the 3-months preceding the 21st birthday predicted higher estimated blood alcohol concentrations (eBACs) on the 21st birthday. Celebrating in bars and engaging in birthday-specific drinking traditions (free drinks at bars) explained additional variance in 21st birthday eBACs. Both physical consequences (e.g., blacking out or having a hangover) and behavioral risks (e.g., sexually provocative behaviors) were prevalent and were predicted by higher eBACs. Together these findings indicate that 21st birthday celebrations are associated with heavy drinking and a variety of physical consequences and behavioral risks.
doi:10.1037/a0025209
PMCID: PMC3232305  PMID: 21895347
21st birthday; alcohol; alcohol-related problems; behavioral risk; physical consequences
5.  Envisioning and Leading Organizational Transformation: One Organ Procurement Organization's Journey 
Cureus  null;8(11):e879.
Background: In 2012, one organ procurement organization (OPO) welcomed a new President and Chief Executive Officer (CEO). This OPO, LifeShare Transplant Donor Services of Oklahoma (LifeShare), had just celebrated its 25th anniversary in 2011. While LifeShare was well-established chronologically, growth in organ donors and organs transplanted from these donors had occurred at a much slower rate during the collaborative era and afterward (2003-2011) than the donor/transplant growth the United States (US), as a whole, had experienced.
While this performance had been stable, it was in the lower quartile of US OPOs on a per capita basis (organs transplanted per donor), and conversion rates were unremarkable. It was the sense of the OPO and donation service area (DSA) constituents that there was an opportunity for growth. It was under this premise that the new CEO was recruited in late 2011 and assumed leadership in February 2012.
Method: It important to note that the new CEO (the author) found LifeShare possessed numerous significant assets upon which to build. These included a strong core of committed and dedicated staff, a supportive Board, supportive transplant centers, and a strong state donor registry. Therefore, it was apparent that, while achieving the DSA's potential would require a transformation of the organization, the transformation did not necessarily require replacing core staff, often a common step undertaken by new chief executives.
Beginning in 2012, the CEO sought to transform both the culture and the operation of the organization by focusing on a short list of key strategies. Culturally, three primary initiatives were undertaken: leadership development, staff development, and establishing "organizational clarity". Operationally, the primary focus was identifying organ donor potential and then, based upon the opportunities for improvement, focusing on operational policies and practices. As LifeShare's team began to identify pockets of unrealized potential donors, recognized best practices were deployed to areas of opportunity, including responding to all vented referrals, implementation of dedicated family requestors, broadening of already-existing in-house coordinator programs, and aggressive expansion of the donors after cardiac death (DCD) program.
Results: From 2008 through 2011, the four years prior to the organization beginning its change journey, LifeShare recovered 344 organ donors from which 1,007 organs were transplanted in 48 months. During the first 48 months of the change journey (2012 through 2015), 498 organ donors (+44.8%) provided 1,536 organs transplanted (+52.5%). DCD donors increased from 22 to 91 (+413.4%) and brain death (BD) donors from 322 to 407 (+26.4%). While the rate of growth is slowing somewhat, the first eight months of 2016 continue to show a percentage growth over 2015 in double digits for both organ donors and organs transplanted.
Discussion: Clearly, our results have been transformed and continue to be transformed. A cultural foundation for both leadership and staff, combined with a single-minded focus on maximizing recovery of potential organ donors and maximizing transplantation of every potential organ, has allowed us to achieve exceptional growth rates on a scale that has resulted in more than 500 additional organs transplanted and lives saved over the last four years when compared to pre-change results.
doi:10.7759/cureus.879
PMCID: PMC5158310  PMID: 28003943
opo; organ donors; organs transplanted; organizational transformation; opo transformation; donor potential; change; oklahoma; dcd; transplantation
6.  The Impact of Celebrity Suicide on Subsequent Suicide Rates in the General Population of Korea from 1990 to 2010 
Journal of Korean Medical Science  2016;31(4):598-603.
The association between celebrity suicide and subsequent increase in suicide rates among the general population has been suggested. Previous studies primarily focused on celebrity suicides in the 2000s. To better understand the association, this study examined the impacts of celebrity suicides on subsequent suicide rates using the data of Korean celebrity suicides between 1990 and 2010. Nine celebrity suicides were selected by an investigation of media reports of suicide deaths published in three major newspapers in Korea between 1990 and 2010. Suicide mortality data were obtained from the National Statistical Office of Korea. Seasonal autoregressive integrated moving average models with intervention analysis were used to test the impacts of celebrity suicides, controlling for seasonality. Six of the 9 celebrity suicides had significant impacts on suicide rates both in the total population and in the same gender- or the same age-subgroups. The incident that occurred in the 1990s had no significant impact on the overall suicide rates, whereas the majority of the incidents in the 2000s had significant influences for 30 or 60 days following each incident. The influence of celebrity suicide was shown to reach its peak following the suicide death of a renowned actress in 2008. The findings may suggest a link between media coverage and the impact of celebrity suicide. Future studies should focus more on the underlying processes and confounding factors that may contribute to the impact of celebrity suicide on subsequent suicide rates.
Graphical Abstract
doi:10.3346/jkms.2016.31.4.598
PMCID: PMC4810344  PMID: 27051245
Suicide; Celebrity; Werther Effect
7.  Copycat Suicide Induced by Entertainment Celebrity Suicides in South Korea 
Psychiatry Investigation  2015;13(1):74-81.
Objective
Throughout the past several years, there have been a number of entertainment celebrity suicides in South Korea. The aim of this study was to investigate the clustering of suicides following celebrities' suicides in South Korea from 2005 to 2008, particularly according to certain characteristics.
Methods
Seven celebrity suicides were examined and defined using the Korean Integrated Newspaper Database System (KINDS) and from these, we considered four affected periods occurring 28 days after each celebrity's suicide. A Poisson time-series autoregression model was used to estimate the relative risk of the total suicide number for each affected period from 2005 to 2008. Logistic regression analysis was performed to investigate whether there were specific increases in the numbers of suicides in subgroups matching each celebrity.
Results
There were significant increases in the risk of suicide during the affected periods. Remarkable increases were found in the subgroups matching each celebrity, especially in the group in which all factors (sex, age, and method) were similar.
Conclusion
This study provides confirmation that a significant copycat effect was induced by these celebrities' suicides, especially among people who identified more with the celebrities. This implies that countermeasures for upright media coverage of celebrity suicides should be discussed and practiced properly in South Korea.
doi:10.4306/pi.2016.13.1.74
PMCID: PMC4701688  PMID: 26766949
Suicide; Risk factors; Imitative behavior; Mass media; Republic of Korea
8.  The Lime Tree School endeavour: healthy body, brain and heart 
Key messages
Partnership working helps to realise health, educational, social and organisational gain, eliminating boundaries and bringing about better outcomes for children and young people.
Efforts should always be focused on the pupil, the resident and the patient. Care or services should be tailor-made for individuals.
Leadership within organisations and communities is an essential ingredient in partnership endeavours.
Why this matters to me
I have always been concerned that organisational change within the NHS has done more to exaggerate the differences between and within organisations than celebrate the connections. I am often struck by the rationale that prevents people working together which is linked to how organisations are structured and how roles are defined (or restricted) by directorates rather than objectives. So the question is this, ‘Is it time to look outside of our organisational constructs to achieve a set of shared objectives using the resources of many?’
The provision of the school nursing service has always been part of our ‘regular’ commissioned schedule. It is a service that supports the personal, social and health element of the educational curriculum. So when the opportunity came to do more to break down the barriers between health and education and join with our partners to create the opportunity to deliver on a set of shared objectives, we grabbed it with both hands. Here was the chance to truly embed health into the curriculum and offer the children in our community the best possible start on their life journey. It was something that the Office of the Schools' Adjudicator obviously recognised too because they awarded the contract to our partnership in the face of stiff competition from an academy. Lime Tree Primary School has the best of all worlds – it is at the heart of its local community, promoting sustainability, wellbeing, lifelong learning and an active lifestyle, supported by 21st century facilities and technology. As the school nears the half-way mark in its first year of operation, we applaud the varied activities they have already experienced, from yoga to gardening on the rooftop allotment and even an Extreme Reading Competition, which saw the joint winners reading a book while doing a snowplough down a mountain and another one perched on an airport carousel. We don't know yet what 2013 will bring in our joint venture, but we are sure of one thing, it will be rewarding and we will be extremely proud of our involvement in this marvellous collaboration which aims to meet our shared objectives.
Imagine what fun pupils would have at a school where the head dresses up as Dennis the Menace for World Book Day? And equally beneficial to the school, where parents can achieve a sustainable win–win by donating unwanted clothing, which is then sold to recyclers to boost school funds? These are the values that sustain Lime Tree Primary, Kingston's newest school which opened its doors in September 2012. Central to the school's ethos is the unique partnership between health and education that has transformed this fledgling primary school into a real community asset. The problem was a real one facing many local authorities today: a rising birth rate and too few classroom places; a new build seemed the obvious solution – and a real opportunity. Local children, their families, residents and professionals were interviewed and their ideas translated into proposals for the new school. A magical learning environment for local youngsters was created, embodied by the school motto, which recognises that a healthy body sustains better learning, and better learning leads to enhanced health benefits. The school lives and breathes ‘Healthy Body, Brain and Heart’ and transfers this into all its daily activities. And what of the future? There is no doubt that this type of initiative could be adopted in other parts of the new NHS. Wouldn't it be marvellous if other examples of like collaboration could help us jointly tackle the challenges of modern-day living?
PMCID: PMC3960650  PMID: 25949696
community; education; healthcare; partnership; public health
9.  The Lime Tree School endeavour: healthy body, brain and heart 
London Journal of Primary Care  2013;5(1):111-113.
Key messages
Partnership working helps to realise health, educational, social and organisational gain, eliminating boundaries and bringing about better outcomes for children and young people.
Efforts should always be focused on the pupil, the resident and the patient. Care or services should be tailor-made for individuals.
Leadership within organisations and communities is an essential ingredient in partnership endeavours.
Why this matters to me
I have always been concerned that organisational change within the NHS has done more to exaggerate the differences between and within organisations than celebrate the connections. I am often struck by the rationale that prevents people working together which is linked to how organisations are structured and how roles are defined (or restricted) by directorates rather than objectives. So the question is this, ‘Is it time to look outside of our organisational constructs to achieve a set of shared objectives using the resources of many?’
The provision of the school nursing service has always been part of our ‘regular’ commissioned schedule. It is a service that supports the personal, social and health element of the educational curriculum. So when the opportunity came to do more to break down the barriers between health and education and join with our partners to create the opportunity to deliver on a set of shared objectives, we grabbed it with both hands. Here was the chance to truly embed health into the curriculum and offer the children in our community the best possible start on their life journey. It was something that the Office of the Schools' Adjudicator obviously recognised too because they awarded the contract to our partnership in the face of stiff competition from an academy. Lime Tree Primary School has the best of all worlds – it is at the heart of its local community, promoting sustainability, wellbeing, lifelong learning and an active lifestyle, supported by 21st century facilities and technology. As the school nears the half-way mark in its first year of operation, we applaud the varied activities they have already experienced, from yoga to gardening on the rooftop allotment and even an Extreme Reading Competition, which saw the joint winners reading a book while doing a snowplough down a mountain and another one perched on an airport carousel. We don't know yet what 2013 will bring in our joint venture, but we are sure of one thing, it will be rewarding and we will be extremely proud of our involvement in this marvellous collaboration which aims to meet our shared objectives.
Imagine what fun pupils would have at a school where the head dresses up as Dennis the Menace for World Book Day? And equally beneficial to the school, where parents can achieve a sustainable win–win by donating unwanted clothing, which is then sold to recyclers to boost school funds? These are the values that sustain Lime Tree Primary, Kingston's newest school which opened its doors in September 2012. Central to the school's ethos is the unique partnership between health and education that has transformed this fledgling primary school into a real community asset. The problem was a real one facing many local authorities today: a rising birth rate and too few classroom places; a new build seemed the obvious solution – and a real opportunity. Local children, their families, residents and professionals were interviewed and their ideas translated into proposals for the new school. A magical learning environment for local youngsters was created, embodied by the school motto, which recognises that a healthy body sustains better learning, and better learning leads to enhanced health benefits. The school lives and breathes ‘Healthy Body, Brain and Heart’ and transfers this into all its daily activities. And what of the future? There is no doubt that this type of initiative could be adopted in other parts of the new NHS. Wouldn't it be marvellous if other examples of like collaboration could help us jointly tackle the challenges of modern-day living?
PMCID: PMC4413711  PMID: 25949681
community; education; healthcare; partnership; public health
10.  On the occasion of world kidney day 2016; work together to better protect the kidney 
Journal of Nephropathology  2015;5(1):15-18.
Context: World kidney day is a yearly global alertness and education ceremony, held on the second Thursday in March.
Evidence Acquisition: Directory of open access journals (DOAJ), EMBASE, Google Scholar, PubMed, EBSCO, and Web of Science have been searched.
Results: Once again we reached to March 14, the world kidney day of 2016. This is the 10th anniversary of world kidney day, a program of the International Society of Nephrology (ISN) and the International Federation of Kidney Foundations (IFKF). World kidney day first began in 2006 and the worldwide campaign highlights a specific theme each year. The theme for 2015 was to invite everybody to drink a glass of water and give one, too, to celebrate their kidneys. This is a symbolic action to memorize that kidneys are vital organs and that they might be cared.
Conclusions: It is a manner to make individuals more conscious about their lifestyle choices. In this year, world kidney day will be celebrated on Thursday March 10, 2016. The theme for 2016 will highlight on renal disease and children.
doi:10.15171/jnp.2016.03
PMCID: PMC4790182  PMID: 27047805
Chronic renal failure; World kidney day; Acute kidney injury; Renoprotection
11.  Heart fossilization is possible and informs the evolution of cardiac outflow tract in vertebrates 
eLife  null;5:e14698.
Elucidating cardiac evolution has been frustrated by lack of fossils. One celebrated enigma in cardiac evolution involves the transition from a cardiac outflow tract dominated by a multi-valved conus arteriosus in basal actinopterygians, to an outflow tract commanded by the non-valved, elastic, bulbus arteriosus in higher actinopterygians. We demonstrate that cardiac preservation is possible in the extinct fish Rhacolepis buccalis from the Brazilian Cretaceous. Using X-ray synchrotron microtomography, we show that Rhacolepis fossils display hearts with a conus arteriosus containing at least five valve rows. This represents a transitional morphology between the primitive, multivalvar, conal condition and the derived, monovalvar, bulbar state of the outflow tract in modern actinopterygians. Our data rescue a long-lost cardiac phenotype (119-113 Ma) and suggest that outflow tract simplification in actinopterygians is compatible with a gradual, rather than a drastic saltation event. Overall, our results demonstrate the feasibility of studying cardiac evolution in fossils.
DOI: http://dx.doi.org/10.7554/eLife.14698.001
eLife digest
Modern research has majorly advanced our understanding of how the heart works, and has led to new therapies for cardiac diseases. However, little is known about how the heart has evolved throughout the history of animals with backbones – a group that is collectively referred to as vertebrates. This is partly because the heart is made from soft muscle tissue, which does not fossilize as often as harder tissues such as bones.
Even though fossils of soft tissues are rare, paleontologists have already unearthed fossils of other soft organs such as the stomach and umbilical cord. These discoveries suggested that there was hope of finding fossil hearts, and now Maldanis, Carvalho et al. have indeed discovered fossil hearts in two specimens of an extinct species of bony fish called Rhacolepis buccalis. These fish were alive over 113 million years ago during the Cretaceous period, in an area that is now modern-day Brazil.
Like all known vertebrates, these R. buccalis fossils have valves between the heart and the major artery that carries blood out of the heart. Such valves are vital because they prevent pumped blood from flowing back into the heart. However, oddly, R. buccalis fossils show five of these valves, which is more than any advanced bony fish that is alive today. Comparing this with the situation in other fish species suggests that vertebrate hearts gradually evolved to become progressively simpler.
This discovery shows that it is possible to study heart evolution with fossils. Maldanis, Carvalho et al. hope that their findings will stimulate researchers from all over the world to examine the fossils of well-preserved animals in search of clues to help reconstruct the major steps in the evolution of the vertebrate heart.
DOI: http://dx.doi.org/10.7554/eLife.14698.002
doi:10.7554/eLife.14698
PMCID: PMC4841765  PMID: 27090087
Cretaceous; cardiac; development; evolution; fossils; fishes; None
12.  Donor Funding for Newborn Survival: An Analysis of Donor-Reported Data, 2002–2010 
PLoS Medicine  2012;9(10):e1001332.
With recent increases in development assistance money for maternal and child health, Catherine Pitt and colleagues examine whether foreign aid specifically for newborns has changed, whether it's on par with the burden of newborn deaths worldwide, and how such funding can be tracked.
Background
Neonatal mortality accounts for 43% of global under-five deaths and is decreasing more slowly than maternal or child mortality. Donor funding has increased for maternal, newborn, and child health (MNCH), but no analysis to date has disaggregated aid for newborns. We evaluated if and how aid flows for newborn care can be tracked, examined changes in the last decade, and considered methodological implications for tracking funding for specific population groups or diseases.
Methods and Findings
We critically reviewed and categorised previous analyses of aid to specific populations, diseases, or types of activities. We then developed and refined key terms related to newborn survival in seven languages and searched titles and descriptions of donor disbursement records in the Organisation for Economic Co-operation and Development's Creditor Reporting System database, 2002–2010. We compared results with the Countdown to 2015 database of aid for MNCH (2003–2008) and the search strategy used by the Institute for Health Metrics and Evaluation. Prior to 2005, key terms related to newborns were rare in disbursement records but their frequency increased markedly thereafter. Only two mentions were found of “stillbirth” and only nine references were found to “fetus” in any spelling variant or language. The total value of non-research disbursements mentioning any newborn search terms rose from US$38.4 million in 2002 to US$717.1 million in 2010 (constant 2010 US$). The value of non-research projects exclusively benefitting newborns fluctuated somewhat but remained low, at US$5.7 million in 2010. The United States and the United Nations Children's Fund (UNICEF) provided the largest value of non-research funding mentioning and exclusively benefitting newborns, respectively.
Conclusions
Donor attention to newborn survival has increased since 2002, but it appears unlikely that donor aid is commensurate with the 3.0 million newborn deaths and 2.7 million stillbirths each year. We recommend that those tracking funding for other specific population groups, diseases, or activities consider a key term search approach in the Creditor Reporting System along with a detailed review of their data, but that they develop their search terms and interpretations carefully, taking into account the limitations described.
Please see later in the article for the Editors' Summary
Editors' Summary
Background
In 1990, 12 million children—most of them living in developing countries—died before they reached their fifth birthday. Faced with this largely avoidable loss of young lives, in 2000, world leaders set a target of reducing under-five mortality (deaths) to one-third of its 1990 level by 2015 as Millennium Development Goal 4 (MDG4); this goal, together with seven others, aims to eradicate extreme poverty globally. In recent years, progress towards reducing child mortality has accelerated but remains insufficient to achieve MDG4, in part, because progress towards reducing neonatal mortality—deaths during the first 28 days of life—has been particularly slow. Neonatal deaths now account for a greater proportion of global child deaths than in 1990—43% of the 7 million children who died before their fifth birthday in 2011 died during the neonatal period. The major causes of neonatal deaths are complications of preterm and term delivery and infections. Simple interventions such as improved hygiene at birth and advice on breastfeeding can substantially reduce neonatal deaths.
Why Was This Study Done?
To achieve MDG4, more must be done to prevent deaths among newborn babies. One reason that progress in reducing neonatal mortality is slow could be insufficient donor funding (aid) for newborn health. Previous analyses by, for example, Countdown to 2015 (which tracks coverage levels for health interventions that reduce maternal, newborn, and child mortality) indicate that donor funding has increased for maternal, newborn, and child health over the past decade, but how much of this aid directly benefits newborns is unknown. Here, the researchers develop a method for tracking aid flows for newborns and examine changes in this flow over the past decade by applying their new strategy to the Organisation for Economic Co-operation and Development (OECD) Creditor Reporting System (CRS) Aid Activity database. This database collects information about official development assistance for health given (disbursed) to developing countries by member countries of the OECD Development Assistance Committee, international organizations, and some private donors.
What Did the Researchers Do and Find?
The researchers developed a comprehensive set of search terms related to newborn survival by piloting it on the Countdown to 2015 official development assistance database, which covers the years 2003–2008. They then used their list of 24 key terms to search the CRS database from 2002 (the first year for which relatively complete disbursement data are available) to 2010 (the most recent year for which data are available) and classified each retrieved project according to whether its funding activities aimed to benefit newborns exclusively or to improve the health of other population groups as well. The researchers found that key terms related to newborns were rare in disbursement records before 2005 but that their frequency increased markedly thereafter. The total value of non-research disbursements (aid provided for programmatic or advocacy activities) that mentioned any newborn search terms increased from US$38.4 million in 2002 to US$717.1 million in 2010. The value of non-research projects that exclusively benefitted newborns fluctuated; in 2010, it was $US5.7 million. Finally, the US and United Nations Children's Fund (UNICEF) provided the largest value of non-research funding mentioning newborns and exclusively benefitting newborns, respectively.
What Do These Findings Mean?
These findings indicate that the value of aid disbursements mentioning newborns or an activity likely to benefit newborns increased 20-fold between 2002 and 2010 and constituted an increasing proportion of aid for maternal, newborn, and child health. Although this increase may partly reflect increased detail in aid disbursement reporting, it is also likely to reflect an increase in donor attention to newborn survival. The accuracy of these findings is likely to be affected by limitations in the search strategy and in the CRS database, which does not capture aid flows from emerging donors such as China or from many private foundations. Moreover, because these findings take no account of domestic expenditure, they do not provide a comprehensive estimate of the value of resources available in developing countries for newborn health. Nevertheless, investment in newborn survival is unlikely to be commensurate with global newborn mortality. Thus, an expansion of programmatic funding from donors as well as increased governmental support for newborn health in developing countries is urgently needed to catalyze the scale-up of cost-effective interventions to save newborn lives and to meet MDG4.
Additional Information
Please access these Web sites via the online version of this summary at http://dx.doi.org/10.1371/journal.pmed.1001332.
The United Nations Childrens Fund (UNICEF) works for children's rights, survival, development, and protection around the world; it provides information on Millennium Development Goal 4 and its Childinfo website provides detailed statistics about child survival and health, including the 2012 report of UN Inter-agency Group of Child Mortality Estimation; its Committing to Child Survival: a Promise Renewed webpage includes links to its 2012 progress report, to a video about progress made in reducing child deaths worldwide, and to stories about child survival in the field
The World Health Organization has information about Millennium Development Goal 4 and about maternal, newborn, child, and adolescent health (some information in several languages)
Countdown to 2015 provides additional information on maternal, newborn, and child survival, including its 2012 report Building a Future for Women and Children
The Healthy Newborn Network (HNN) is a community of more than 70 partner organizations addressing critical knowledge gaps for newborn health providing recent data on newborn survival and analyses of country programs
Information on and access to the Organisation for Economic Co-operation Development Creditor Reporting System Aid Activities database is available
Further information about the Millennium Development Goals is available
doi:10.1371/journal.pmed.1001332
PMCID: PMC3484125  PMID: 23118619
13.  Shivlilik burns: injuries resulting from traditional celebrations 
Introduction: In Konya, Turkey, the community celebrates the traditional ceremony of Shivlilik, which occurs on the first day of the seventh month in the lunar-based Hijri calendar. In the evening, people light bonfires of tires in the streets, and children and young people attempt to jump over the flames. Flame burns regularly occur due to falling. Attention should be given to preventing injuries such as these that are caused by social and regional customs. Methods: This retrospective study was carried out using data from the Konya Education and Research Hospital Burn Unit. Patients admitted to our hospital between June, 2009, and May, 2012, was evaluated. Results: Eleven patients were admitted to hospital with flame burns caused by jumping over fires on the days when the traditional Shivlilik ceremony was celebrated. The clinical data evaluated included the patient’s age and sex, the depth of the burn injury, the total burned surface area (TBSA), and the distribution of the burn areas. Conclusions: Serious flame burns occur because of the traditional Shivlilik ceremony. We must promote some changes in this ceremony in order to prevent these burns.
PMCID: PMC4620122  PMID: 26550532
Pediatric burn; traditional celebrations; flame
14.  Nighttime assaults: using a national emergency department monitoring system to predict occurrence, target prevention and plan services 
BMC Public Health  2012;12:746.
Background
Emergency department (ED) data have the potential to provide critical intelligence on when violence is most likely to occur and the characteristics of those who suffer the greatest health impacts. We use a national experimental ED monitoring system to examine how it could target violence prevention interventions towards at risk communities and optimise acute responses to calendar, holiday and other celebration-related changes in nighttime assaults.
Methods
A cross-sectional examination of nighttime assault presentations (6.01 pm to 6.00 am; n = 330,172) over a three-year period (31st March 2008 to 30th March 2011) to English EDs analysing changes by weekday, month, holidays, major sporting events, and demographics of those presenting.
Results
Males are at greater risk of assault presentation (adjusted odds ratio [AOR] 3.14, 95% confidence intervals [CIs] 3.11-3.16; P < 0.001); with male:female ratios increasing on more violent nights. Risks peak at age 18 years. Deprived individuals have greater risks of presenting across all ages (AOR 3.87, 95% CIs 3.82-3.92; P < 0.001). Proportions of assaults from deprived communities increase midweek. Female presentations in affluent areas peak aged 20 years. By age 13, females from deprived communities exceed this peak. Presentations peak on Friday and Saturday nights and the eves of public holidays; the largest peak is on New Year’s Eve. Assaults increase over summer with a nadir in January. Impacts of annual celebrations without holidays vary. Some (Halloween, Guy Fawkes and St Patrick’s nights) see increased assaults while others (St George’s and Valentine’s Day nights) do not. Home nation World Cup football matches are associated with nearly a three times increase in midweek assault presentation. Other football and rugby events examined show no impact. The 2008 Olympics saw assaults fall. The overall calendar model strongly predicts observed presentations (R2 = 0.918; P < 0.001).
Conclusions
To date, the role of ED data has focused on helping target nightlife police activity. Its utility is much greater; capable of targeting and evaluating multi-agency life course approaches to violence prevention and optimising frontline resources. National ED data are critical for fully engaging health services in the prevention of violence.
doi:10.1186/1471-2458-12-746
PMCID: PMC3490838  PMID: 22950487
Violence; Assaults; Emergency department; Nighttime; Deprivation; Monitoring
15.  Facial Firework Injury: A Case Series 
Fireworks are used to celebrate a variety of religious, patriotic, and cultural holidays and events around the world. Fireworks are common in the United States, with the most popular holiday for their use being national Independence Day, also known as July Fourth. The use of fireworks within the context of celebrations and holidays presents the ideal environment for accidents that lead to severe and dangerous injuries. Injuries to the face from explosions present a challenging problem in terms of restoring ideal ocular, oral, and facial function. Despite the well documented prevalence of firework use and injury, there is a relatively large deficit in the literature in terms of firework injury that involves the face. We present a unique case series that includes 4 adult male patients all with severe firework injuries to the face that presented at an urban level 1 trauma center. These four patients had an average age of 26.7 years old and presented within 5 hours of each other starting on July Fourth. Two patients died from their injuries and two patients underwent reconstructive surgical management, one of which had two follow up surgeries. We explore in detail their presentation, management, and subsequent outcomes as an attempt to add to the very limited data in the field of facial firework blast injury. In addition, the coincidence of their presentation within the same 5 hours brings into question the availability of the fireworks involved, and the possibility of similar injuries related to this type of firework in the future.
doi:10.5811/westjem.2014.1.19857
PMCID: PMC4100840  PMID: 25035740
16.  Prevalance of ABO and Rhesus Blood Groups in Blood Donors: A Study from a Tertiary Care Teaching Hospital of Kumaon Region of Uttarakhand 
Backround: ABO and Rhesus (Rh) blood group antigens are hereditary characters and are useful in population genetic studies, in resolving medico-legal issues and more importantly for the immunologic safety of blood during transfusion.
Aims: This study is aimed to determine the distribution pattern of the ABO and Rh blood groups among blood donors in Kumaon region of Uttarakhand and compare it with other data from similar studies within the India and all over the world.
Design: It is a retrospective study carried out at blood bank of Shushila Tewari Hospital of Government Medical College, Haldwani from January 2012 to December 2013.
Materials and Methods: The study was conducted on 12,701 blood donors. ABO and Rh typing was done using slide agglutination method with antisera ABO and Rh (Tulip diagnostics ltd). Doubtful cases were confirmed by tube agglutination method and reverse grouping using known pooled A and B cells. The age group and sex of donors, frequency of ABO and Rh blood groups were reported in simple percentages.
Results: The predominant donors belonged to age group between 18-35years (84.28%). Male donors were more than female donors, ratio being 352:1. Replacement donors (99.71%) were much more than voluntary donors (0.91%). The most common blood group was B (32.07%) and least common being AB (10.53%). Blood group ‘O’ and ‘A’ had same frequency. The prevalence of Rhesus positive and negative distribution in the studied population was 94.49% and 5.51% respectively. Blood group frequency with respect to ABO and Rhesus positive was found to be shown by formula B> O>A >AB. The frequency for ABO and Rhesus negative was given by the formula B>A>O>AB.
Conclusion: Knowledge of frequencies of the different blood groups is very important for blood banks and transfusion service policies that could contribute significantly to the National Health System.
doi:10.7860/JCDR/2014/9794.5355
PMCID: PMC4316263  PMID: 25653957
ABO; Blood groups; Blood donors; Kumaon; Rhesus
17.  Celebrity Appeal: Reaching Women to Promote Colorectal Cancer Screening 
Journal of women's health (2002)  2014;24(3):169-173.
The Centers for Disease Control and Prevention’s Screen for Life: National Colorectal Cancer Action Campaign works with the Entertainment Industry Foundation’s National Colorectal Cancer Research Alliance to develop public service announcements (PSAs) featuring celebrities. Selection of Screen for Life celebrity spokespersons is based on a variety of factors, including their general appeal and personal connection to colorectal cancer. Screen for Life PSAs featuring celebrities have been disseminated exclusively through donated media placements and have been formatted for television, radio, print, and out-of-home displays such as dioramas in airports, other transit stations, and shopping malls. A 2012 national survey with women aged 50–75 years (n = 772) investigated reported exposure to Screen for Life PSAs featuring actor Terrence Howard. In total, 8.3% of women recalled exposure to the PSAs. Celebrity spokespersons can attract the attention of both target audiences and media gatekeepers who decide which PSAs will receive donated placements.
doi:10.1089/jwh.2014.5084
PMCID: PMC4387845  PMID: 25521047
18.  Effects of Infection by Belonolaimus longicaudatus on Rooting Dynamics among St. Augustinegrass and Bermudagrass Genotypes 
Journal of Nematology  2015;47(4):322-331.
Understanding rooting dynamics using the minirhizotron technique is useful for cultivar selection and to quantify nematode damage to roots. A 2-yr microplot study including five bermudagrass (‘Tifway’, Belonolaimus longicaudatus susceptible; two commercial cultivars [TifSport and Celebration] and two genotypes [‘BA132’ and ‘PI 291590’], which have been reported to be tolerant to B. longicaudatus) and two St. Augustinegrass (‘FX 313’, susceptible, and ‘Floratam’ that was reported as tolerant to B. longicaudatus) genotypes in a 5 x 2 and 2 x 2 factorial design with four replications, respectively, was initiated in 2012. Two treatments included were uninoculated and B. longicaudatus inoculated. In situ root images were captured each month using a minirhizotron camera system from April to September of 2013 and 2014. Mixed models analysis and comparison of least squares means indicated significant differences in root parameters studied across the genotypes and soil depths of both grass species. ‘Celebration’, ‘TifSport’ and ‘PI 291590’ bermudagrass, and ‘Floratam’ St. Augustinegrass had significantly different root parameters compared to the corresponding susceptible genotypes (P ≤ 0.05). Only ‘TifSport’ had no significant root loss when infested with B. longicaudatus compared to non-infested. ‘Celebration’ and ‘PI 291590’ had significant root loss but retained significantly greater root densities than ‘Tifway’ in B. longicaudatus-infested conditions (P ≤ 0.05). Root lengths were greater at the 0 to 5 cm depth followed by 5 to 10 and 10 to 15 cm of vertical soil depth for both grass species (P ≤ 0.05). ‘Celebration’, ‘TifSport’, and ‘PI 291590’ had better root vigor against B. longicaudatus compared to Tifway.
PMCID: PMC4755707  PMID: 26941461
Belonolaimus longicaudatus; bermudagrass; minirhizotron; rooting dynamics; St. Augustinegrass; sting nematode; turfgrass
19.  Do celebrity endorsements matter? Observational study of BRCA gene testing and mastectomy rates after Angelina Jolie’s New York Times editorial 
The BMJ  2016;355:i6357.
Objective To examine the effect on BRCA testing and mastectomy rates of a widely viewed 2013 New York Times editorial by public figure Angelina Jolie that endorsed BRCA testing and announced Jolie’s decision to undergo preventive mastectomy.
Design Observational study with difference-in-difference analysis.
Setting Commercially insured US population.
Participants Women aged 18-64 years with claims in the Truven MarketScan commercial claims database (n=9 532 836).
Main outcome measures Changes in BRCA testing rates in the 15 business days before versus after 14 May 2013 (editorial date) compared with the change in the same period in 2012; mastectomy rates in the months before and after publication, both overall and within 60 days of BRCA testing among women who were tested; national estimates of incremental tests and expenditures associated with Jolie’s article in the 15 days after publication.
Results Daily BRCA test rates increased immediately after the 2013 editorial, from 0.71 tests/100 000 women in the 15 business days before to 1.13 tests/100 000 women in the 15 business days after publication. In comparison, daily test rates were similar in the same period in 2012 (0.58/100 000 women in the 15 business days before 14 May versus 0.55/100 000 women in the 15 business days after), implying a difference-in-difference absolute daily increase of 0.45 tests/100 000 women or a 64% relative increase (P<0.001). The editorial was associated with an estimated increase of 4500 BRCA tests and $13.5m (£10.8m; €12.8) expenditure nationally among commercially insured adult women in those 15 days. Increased BRCA testing rates were sustained throughout 2013. Overall mastectomy rates remained unchanged in the months after publication, but 60 day mastectomy rates among women who had a BRCA test fell from 10% in the months before publication to 7% in the months after publication, suggesting that women who underwent tests as a result of to the editorial had a lower pre-test probability of having the BRCA mutation than women tested before the editorial.
Conclusions Celebrity endorsements can have a large and immediate effect on use of health services. Such announcements can be a low cost means of reaching a broad audience quickly, but they may not effectively target the subpopulations that are most at risk for the relevant underlying condition.
doi:10.1136/bmj.i6357
PMCID: PMC5156611  PMID: 27974323
20.  Safe male circumcision in Botswana: Tension between traditional practices and biomedical marketing 
Global Public Health  2015;10(5-6):739-756.
Botswana has been running Safe Male Circumcision (SMC) since 2009 and has not yet met its target. Donors like the US Centers for Disease Control and Prevention and Africa Comprehensive HIV/AIDS Partnership (funded by the Gates Foundation) in collaboration with Botswana's Ministry of Health have invested much to encourage HIV-negative men to circumcise. Demand creation strategies make use of media and celebrities. The objective of this paper is to explore responses to SMC in relation to circumcision as part of traditional initiation practices. More specifically, we present the views of two communities in Botswana on SMC consultation processes, implementation procedures and campaign strategies. The methods used include participant observation, in-depth interviews with key stakeholders (donors, implementers and Ministry officials), community leaders and men in the community. We observe that consultation with traditional leaders was done in a seemingly superficial, non-participatory manner. While SMC implementers reported pressure to deliver numbers to the World Health Organization, traditional leaders promoted circumcision through their routine traditional initiation ceremonies at breaks of two-year intervals. There were conflicting views on public SMC demand creation campaigns in relation to the traditional secrecy of circumcision. In conclusion, initial cooperation of local chiefs and elders turned into resistance.
doi:10.1080/17441692.2015.1028424
PMCID: PMC4487566  PMID: 25866013
voluntary medical male circumcision; traditional initiation; biomedical interventions; cultural practices
21.  Proposed legislative change mandating retrospective release of identifying information: consultation with donors and Government response 
STUDY QUESTION
How do gamete donors who presumed they could remain anonymous respond to proposed legislation to retrospectively remove anonymity?
SUMMARY ANSWER
A little more than half of the donors opposed the recommendation to introduce legislation to remove donor anonymity with retrospective effect.
WHAT IS KNOWN ALREADY
An increasing proportion of parents disclose their origins to their donor-conceived children and growing numbers of donor-conceived adults are aware of how they were conceived. Research indicates that access to information about the donor is important to donor-conceived people. However, worldwide most donor-conceived people are unable to find any identifying information about the donor because of the practice of anonymous gamete donation.
STUDY DESIGN, SIZE, DURATION
This study adopted a qualitative research model using semi-structured interviews with gamete donors that included open questions. Interviews with 42 volunteers were conducted between December 2012 and February 2013.
PARTICIPANTS/MATERIALS, SETTING, METHODS
Before 1998 gamete donors in Victoria, Australia, were able to remain anonymous. Pre-1998 donors were invited through an advertising campaign to be interviewed about their views on a recommendation that legislation mandating retrospective release of identifying information be introduced.
MAIN RESULTS AND THE ROLE OF CHANCE
Donors were almost evenly split between those who supported and those who rejected the recommendation to introduce legislation to remove donor anonymity with retrospective effect. About half of the donors who rejected the recommendation suggested the compromise of persuading donors voluntarily to release information (whether identifying or non-identifying) to donor-conceived people. These donors were themselves willing to supply information to their donor offspring. The findings of this study informed the Victorian Government's response to the proposed legislative change. While acknowledging donor-conceived people's right of access to information about their donors, the Government decided that identifying information should be released only with the consent of donors and that donors should be encouraged to allow themselves to be identifiable to their donor offspring.
LIMITATIONS, REASONS FOR CAUTION
There is no way of knowing whether participants were representative of all pre-1998 donors.
WIDER IMPLICATIONS OF THE FINDINGS
The balancing of donors' and donor-conceived people's rights requires utmost sensitivity. All over the world, increasing numbers of donor-conceived people are reaching adulthood; of those who are aware of their mode of conception, some are likely to have a strong wish to know the identity of their donors. Legislators and policy-makers in jurisdictions permitting anonymous gamete donations will need to respond when these desires are expressed, and may choose to be guided by the model of consultation described in this paper.
STUDY FUNDING/COMPETING INTERESTS
The study was funded by the Victorian Department of Health. The authors have no conflicts of interest to declare.
TRIAL REGISTRATION NUMBER
Not applicable.
doi:10.1093/humrep/det434
PMCID: PMC3896224  PMID: 24319103
donor conception; anonymity; disclosure; legislation; intermediary services
22.  Nucleic acid testing: Is it the only answer for safe Blood in India? 
Background:
With the implementation of NAT in countries around the world, there is a growing pressure on the transfusion services in India to adopt NAT testing. India has about 2545 licensed Blood Centres. The Transfusion Services in India are fragmented, poorly regulated and the quality standards are poorly implemented. Blood Centres are still dependent on replacement/family donors and in most places laboratory testing for Transfusion transmitted infections is not quality assured, laboratory equipment are not calibrated and maintained, and validation of results is not carried out. Against the current scenario introducing NAT for screening of blood donors in India would pose a challenge.
Aim:
To study the prudence of universal NAT testing in India.
Materials and Methods:
A retrospective study of 5 years from 2008-2012 was undertaken to study the true reactivity of donors using WHO strategy II and III and therefore the true seroprevalence of TTI infections in the donor populations.
Results:
The true reactivity of the donors was much less as compared to the initially reactive donors due to the use of a well designed testing algorithm. In addition having a total voluntary blood collection along with good pre-donation counseling program also reduces the transmission of infections.
Conclusions:
What India essentially needs to do is religiously implement the strategies outlined in the WHO Aide-memoire. The blood should be collected only from voluntary non remunerative and repeat donors, there should be stringent donor selection with pre-donation counseling instituted. Strict implementation of quality management system, development of well defined testing startegies and strong haemovigilance system could take us a step in the right direction.
doi:10.4103/0973-6247.175423
PMCID: PMC4782501  PMID: 27011677
NAT yield; window period; haemovigilance; algorithms
23.  The Lombardy Rare Donor Programme 
Blood Transfusion  2014;12(Suppl 1):s249-s255.
Background
In 2005, the government of Lombardy, an Italian region with an ethnically varied population of approximately 9.8 million inhabitants including 250,000 blood donors, founded the Lombardy Rare Donor Programme, a regional network of 15 blood transfusion departments coordinated by the Immunohaematology Reference Laboratory of the Ca’ Granda Ospedale Maggiore Policlinico in Milan. During 2005 to 2012, Lombardy funded LORD-P with 14.1 million euros.
Materials and methods
During 2005–2012 the Lombardy Rare Donor Programme members developed a registry of blood donors and a bank of red blood cell units with either rare blood group phenotypes or IgA deficiency. To do this, the Immunohaematology Reference Laboratory performed extensive serological and molecular red blood cell typing in 59,738 group O or A, Rh CCDee, ccdee, ccDEE, ccDee, K− or k− donors aged 18–55 with a record of two or more blood donations, including both Caucasians and ethnic minorities. In parallel, the Immunohaematology Reference Laboratory implemented a 24/7 service of consultation, testing and distribution of rare units for anticipated or emergent transfusion needs in patients developing complex red blood cell alloimmunisation and lacking local compatible red blood cell or showing IgA deficiency.
Results
Red blood cell typing identified 8,747, 538 and 33 donors rare for a combination of common antigens, negative for high-frequency antigens and with a rare Rh phenotype, respectively. In June 2012, the Lombardy Rare Donor Programme frozen inventory included 1,157 red blood cell units. From March 2010 to June 2012 one IgA-deficient donor was detected among 1,941 screened donors and IgA deficiency was confirmed in four previously identified donors. From 2005 to June 2012, the Immunohaematology Reference Laboratory provided 281 complex red blood cell alloimmunisation consultations and distributed 8,008 Lombardy Rare Donor Programme red blood cell units within and outside the region, which were transfused to 2,365 patients with no untoward effects.
Discussion
Lombardy Rare Donor Programme, which recently joined the ISBT Working Party on Rare Donors, contributed to increase blood transfusion safety and efficacy inside and outside Lombardy.
doi:10.2450/2013.0182-12
PMCID: PMC3934293  PMID: 23522888
red blood cell groups; rare blood donor; molecular biology; DNA array
24.  Biological, psychological and social processes that explain celebrities’ influence on patients’ health-related behaviors 
Background
Celebrities can have substantial influence as medical advisors. However, their impact on public health is equivocal: depending on the advice’s validity and applicability, celebrity engagements can benefit or hinder efforts to educate patients on evidence-based practices and improve their health literacy. This meta-narrative analysis synthesizes multiple disciplinary insights explaining the influence celebrities have on people’s health-related behaviors.
Methods
Systematic searches of electronic databases BusinessSource Complete, Communication & Mass Media Complete, Humanities Abstracts, ProQuest Political Science, PsycINFO, PubMed, and Sociology Abstracts were conducted. Retrieved articles were used to inform a conceptual analysis of the possible processes accounting for the substantial influence celebrities may have as medical advisors.
Results
Fourteen mechanisms of celebrity influence were identified. According to the economics literature, celebrities distinguish endorsed items from competitors and can catalyze herd behavior. Marketing studies tell us that celebrities’ characteristics are transferred to endorsed products, and that the most successful celebrity advisors are those viewed as credible, a perception they can create with their success. Neuroscience research supports these explanations, finding that celebrity endorsements activate brain regions involved in making positive associations, building trust and encoding memories. The psychology literature tells us that celebrity advice conditions people to react positively toward it. People are also inclined to follow celebrities if the advice matches their self-conceptions or if not following it would generate cognitive dissonance. Sociology explains how celebrities’ advice spreads through social networks, how their influence is a manifestation of people’s desire to acquire celebrities’ social capital, and how they affect the ways people acquire and interpret health information.
Conclusion
There are clear and deeply rooted biological, psychological and social processes that explain how celebrities influence people’s health behaviors. With a better understanding of this phenomenon, medical professionals can work to ensure that it is harnessed for good rather than abused for harm. Physicians can discuss with their patients the validity of celebrity advice and share more credible sources of health information. Public health practitioners can debunk celebrities offering unsubstantiated advice or receiving inappropriate financial compensation, and should collaborate with well-meaning celebrities, leveraging their influence to disseminate medical practices of demonstrated benefit.
Electronic supplementary material
The online version of this article (doi:10.1186/2049-3258-73-3) contains supplementary material, which is available to authorized users.
doi:10.1186/2049-3258-73-3
PMCID: PMC4429495  PMID: 25973193
Medical advice; Celebrities; Health literacy; Evidence-based medicine
25.  Diamond Light Source: status and perspectives 
Diamond Light Source, a third-generation synchrotron radiation (SR) facility in the UK, celebrated its 10th anniversary in 2012. A private limited company was set up in April 2002 to plan, construct and operate the new user-oriented SR facility, called in brief Diamond. It succeeded the Synchrotron Radiation Source in Daresbury, a second-generation synchrotron that opened in 1980 as the world's first dedicated X-ray-providing facility, closing finally in 2008, by which time Diamond's accelerators and first beamlines were operating and user experiments were under way. This theme issue of Philosophical Transactions of the Royal Society A gives some examples of the rich diversity of research done in the initial five years, with some glimpses of activity up to 2014. Speakers at the 10 year anniversary symposium were drawn from a small number of major thematic areas and each theme was elaborated by a few speakers whose contributions were placed into a broader context by a leading member of the UK academic community in the role of rapporteur. This introduction gives a summary of the design choices and strategic planning of Diamond as a coherent user facility, a snapshot of its present status and some consideration of future perspectives.
doi:10.1098/rsta.2013.0161
PMCID: PMC4308985  PMID: 25624517
Diamond Light Source; synchrotron radiation; X-ray physics

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