Linking the Child Care and Health Care Systems: A Consideration of Options

Funded by a grant from the Robert Wood Johnson Foundation, this report examines strategies for linking the health and child care systems in an effort to improve poor children's health. Studies show that poor, African American and Latino children have less access to health care and worse health outcomes than middle-class or non-Hispanic white children. With this reality in mind, the authors present five key strategies, identifying for each: the resources necessary for implementation, the strategy's potential to improve children's health, and the primary strengths and disadvantages -- including each strategy's promise for reaching the most vulnerable children. Drawing on interviews with experts in policy, health and child care, the report provides funders and policymakers with a framework for thinking about future interventions

Impact of Warrior Poses on Quadricep Muscle Activation

Yoga is an alternative form of exercise that improves health and fitness through the integration of the mind, body, and spirit. The purpose of this study was to compare the impact of three warrior poses on quadricep muscle activity. The null hypothesis stated that no significant differences would be found in quadriceps muscle activation between Warrior poses I, II, and IV. Six college-aged females (average age of 20.67 ± 0.62) with at least two years of experience participated in the study. Surface electromyography (sEMG) was recorded during maximum voluntary isometric contractions (MVICs) of the right and left vastus medialis (VM), and vastus lateralis (VL) to analyze muscle activity. Participants performed the selected poses and held each pose for ten seconds and performed each pose three times. A 60-second break was given between each pose. Results are currently being analyzed for statistical significance. ANOVA repeated tests are currently being conducted to compare quadriceps muscle activation between the selected Warrior poses: I, II, and IV

The knowledge, the will and the power : a plan of action to meet the HIV prevention needs of Africans living in England

The Knowledge, The Will and The Power is a statement of what we, the NAHIP Partners, plan to do to prevent HIV transmissions occurring during sexual activity among the diverse population of Africans living in England (Chapter 1). We describe the size and context of Africans living in England (Chapter 2), the size of the HIV epidemic and the number of new infections occurring (Chapter 3), as well as the behaviours and facilitators of new infections (Chapter 4). We then articulate how the NAHIP partners intend to influence future behaviours (Chapter 5). The final three chapters describe what is required in order to meet the HIV prevention needs of individual African people (Chapter 6), of NAHIP partner organisations (Chapter 7) and of those undertaking decisions related to policy, planning and research (Chapter 8)

Assuming Personal Responsibility for Improving the Environment: Moving Toward a New Environmental Norm

There is general agreement that we are nearing the end of achieving major gains in pollution abatement from traditional sources, that a significant portion of the remaining environmental problems facing this country is caused by individual behavior, and that efforts to control that behavior have either failed or not even been made. The phenomenon of individuals as irresponsible environmental actors seems counterintuitive when polls show that people consistently rate protecting the environment among their highest priorities, contribute to environmental causes, and are willing to pay more to protect environmental resources. This article is the author\u27s second effort at understanding why people who consider themselves to be “environmentalists” or support environmental causes behave in environmentally destructive ways, and what, if anything, can be done to change that behavior. The first article endorsed expansion of the abstract environmental protection norm to include individual environmental responsibility and concluded that doing this is the most promising approach to overcoming barriers to behavioral change. That article also identified environmental groups as the most effective “norm entrepreneurs” that can bring about widespread change in personal environmental conduct through carefully tailored information campaigns. This article expands on the earlier article’s discussion of the role norms play in influencing personal behavior and why changing them is a critical part of any campaign to make individuals more environmentally responsible. The best way to change norms is through education, as the first article acknowledged, but supplemental measures may be necessary. This article identifies what those additional measures might be and assesses their effectiveness. A third article will explore how republican theory supports the critical role that education performs in altering public behavior through changing norms. All three articles rest on the premise that the global climate change crisis has created circumstances in which norm change can take place, namely the occurrence of a second environmental republican moment, in which people are open to being educated about their civic responsibilities, including those pertaining to the environment. To develop these ideas, section II provides background information about individual contributions to environmental problems. Section III discusses various barriers to changing personal environmental behavior, such as the role federal laws play in perpetuating the myth that only industry is responsible for environmental harm. That section also explores certain cognitive heuristics that influence how people process information and personal barriers to changing behavior such as habits, inconvenience, cost, unavailability of alternatives, and self-interest. The role of norms in influencing behavior and how norms are formed and changed are examined in section IV. Next, section V investigates how a new norm of environmental responsibility might arise and displace competing norms. However, that section recognizes that the development of a new norm may not be an easy task because of some of the same barriers identified in section III. In section VI, acknowledging that neither norms nor the happenstance of an environmental republican moment will inexorably lead to changes in personal behavior, various norm and behavior-changing tools, such as public education, shaming and other sanctions, and market-based incentives are identified. Section VI examines the inherent strengths and weaknesses of these tools, as well as particular problems with their application to individual behavior. Section VII concludes that no single approach will work, but a combination of any or all of the above, depending on the source and nature of the problem, is called for. However, any combination of tools must include public education if a permanent new environmental norm is to emerge and change individual behavior in the long term

Extracorporeal Cardiopulmonary Resuscitation

Extracorporeal cardiopulmonary resuscitation (ECPR) is a method of resuscitation in which venoarterial (VA) extracorporeal membrane oxygenation(ECMO) is initiated during refractory cardiac arrest. ECPR promises to enhance outcomes after cardiac arrest by minimizing neurological deficits, stabilizing the patient for early reperfusion and hypothermia, and serving as a bridge to treatment or transplant. ECPR must be initiated according to structured guidelines and protocols, which are based on the patient’s age, comorbidities, code status, neurological baseline, no flow time, and low flow time. If a patient achieves return of spontaneous circulation on ECMO, the patient will receive post cardiac arrest care which includes but is not limited to therapeutic hypothermia, early reperfusion, intra-aortic balloon pump insertion, tight glycemic control, and low ventilation. While ECPR has been shown to improve outcomes, multiple complications including bleeding, infection, renal failure, limb ischemia, and stroke can result from the treatment. Nurses play a key role in monitoring these critical patients and achieving therapeutic outcomes. As ECPR is expensive, carries high risk of complications, and can not always be performed under informed consent, thus there are ethical implications. A review of the literature indicates that low flow time, age, percutaneous intervention, and sustained ventricular fibrillation are independent factors that directly impact patient outcomes. With advances in ECPR and its use in the clinical setting, it is evident that randomized control trials and uniform ECPR protocols and guidelines are essential to improve evidence base practice and patient outcomes