Critical Education in Community Health Literacy for Brazilian Nurses: A Course Evaluation

This article presents an immediate evaluation of a professional development course in community health literacy for Brazilian nurses. An evaluation based on an applied thematic analysis of the accounts of 63 attendees in three Brazilian cities (January 2020) was guided by the following themes: (a) expansion of understanding about community health literacy as a pillar for planning and providing health care; (b) encouragement of innovation in research and/or practice; and (c) plans to incorporate the information shared in the course into professional projects. The evaluation disclosed the complexity of social contexts for health literacy, which is intertwined with ethnocultural diversity and deep socioeconomic disparities, such as restricted access to essential public health services for socially deprived and vulnerable individuals. Expanded understanding about community health literacy is a pillar for care planning and delivery, as well as innovation in research and practice projects. Participants’ evaluations revealed ideas to improve nurses’ practice in promoting community health literacy and empowerment, as well as quality of life and social well-being. Future knowledge dissemination may impact nurses’ clinical practice and management actions, bringing changes in various areas of practice to redesign more socially inclusive actions for clientele. Keywords: Community health literacy; extracurricular education; immediate evaluation; nursing; professional development course

Situating care in mainstream health economics: an ethical dilemma?

Standard health economics concentrates on the provision of care by medical professionals. Yet ‘care’ receives scant analysis; it is portrayed as a spillover effect or externality in the form of interdependent utility functions. In this context care can only be conceived as either acts of altruism or as social capital. Both conceptions are subject to considerable problems stemming from mainstream health economics’ reliance on a reductionist social model built around instrumental rationality and consequentialism. Subsequently, this implies a disregard for moral rules and duties and the compassionate aspects of behaviour. Care as an externality is a second-order concern relative to self-interested utility maximization, and is therefore crowded out by the parameters of the standard model. We outline an alternative relational approach to conceptualising care based on the social embeddedness of the individual that emphasises the ethical properties of care. The deontological dimension of care suggests that standard health economics is likely to undervalue the importance of care and caring in medicine

Organisational Legitimacy, Capacity and Capacity Development

The European Centre for Development Policy Management (ECDPM) has undertaken a study of capacity development, with a focus on organisational change and performance enhancement. Both individual organisations and networks of organisations have been studied with the aim of identifying important relationships among endogenous change factors (e.g. ownership, commitment and managerial style), key internal organisation variables (e.g. structures, procedures, staffing and management systems), performance and sustainability outcomes, and external environmental factors (e.g. policy frameworks, resource availability, politics, stakeholders, governance regimes, etc.).To date, the ECDPM study team has conducted 16 case studies (see Appendix). Among the findings that have emerged from several of the cases is the presence of an organisation's legitimacy as a factor contributing to successful capacity and performance. To delve in more detail into the concept of legitimacy, and to identify the implications for capacity building, ECDPM commissioned a working paper on the topic. This exploratory paper reviews the relevant literature and examines: differing definitions, types and sources of legitimacy; the links between legitimacy and organisational capacity, performance and sustainability; and management strategies for building and maintaining legitimacy. It discusses a selected set of the ECDPM cases in terms of the legitimacy concept

Carbon Free Boston: Social equity report 2019

OVERVIEW: In January 2019, the Boston Green Ribbon Commission released its Carbon Free Boston: Summary Report, identifying potential options for the City of Boston to meet its goal of becoming carbon neutral by 2050. The report found that reaching carbon neutrality by 2050 requires three mutually-reinforcing strategies in key sectors: 1) deepen energy efficiency while reducing energy demand, 2) electrify activity to the fullest practical extent, and 3) use fuels and electricity that are 100 percent free of greenhouse gases (GHGs). The Summary Report detailed the ways in which these technical strategies will transform Boston’s physical infrastructure, including its buildings, energy supply, transportation, and waste management systems. The Summary Report also highlighted that it is how these strategies are designed and implemented that matter most in ensuring an effective and equitable transition to carbon neutrality. Equity concerns exist for every option the City has to reduce GHG emissions. The services provided by each sector are not experienced equally across Boston’s communities. Low-income families and families of color are more likely to live in residences that are in poor physical condition, leading to high utility bills, unsafe and unhealthy indoor environments, and high GHG emissions.1 Those same families face greater exposure to harmful outdoor air pollution compared to others. The access and reliability of public transportation is disproportionately worse in neighborhoods with large populations of people of color, and large swaths of vulnerable neighborhoods, from East Boston to Mattapan, do not have ready access to the city’s bike network. Income inequality is a growing national issue and is particularly acute in Boston, which consistently ranks among the highest US cities in regards to income disparities. With the release of Imagine Boston 2030, Mayor Walsh committed to make Boston more equitable, affordable, connected, and resilient. The Summary Report outlined the broad strokes of how action to reach carbon neutrality intersects with equity. A just transition to carbon neutrality improves environmental quality for all Bostonians, prioritizes socially vulnerable populations, seeks to redress current and past injustice, and creates economic and social opportunities for all. This Carbon Free Boston: Social Equity Report provides a deeper equity context for Carbon Free Boston as a whole, and for each strategy area, by demonstrating how inequitable and unjust the playing field is for socially vulnerable Bostonians and why equity must be integrated into policy design and implementation. This report summarizes the current landscape of climate action work for each strategy area and evaluates how it currently impacts inequity. Finally, this report provides guidance to the City and partners on how to do better; it lays out the attributes of an equitable approach to carbon neutrality, framed around three guiding principles: 1) plan carefully to avoid unintended consequences, 2) be intentional in design through a clear equity lens, and 3) practice inclusivity from start to finish

A decision support tool for supporting individuals living with long-term conditions make informed choices: LTC-Choices tool for continuous healthcare

An increasing number of individuals are now living with some form of chronic, long-term condition (LTC). The holistic perspective of LTCs makes it important to acknowledge that priorities and decisions are in fluctuation over the course of an individual’s life. The landscape of digital healthcare is full of information systems that capture individuals’ health data, clinical guidelines and/or advice on health conditions, which taken together can help create a comprehensive overview of suitable lifestyle choices to optimise health and well-being. Despite this, there is no evidence of existing frameworks to support individuals living with LTCs from a continuum of care perspective. In this paper, we propose such a multidimensional model for a decision support tool – LTC-Choices. This tool was developed from existing work conducted by the authors around use of multicriteria to support health decisionmaking. We illustrate how LTC-Choices can be implemented using the example of individuals living post-stroke

Our door is always open : Aligning Literacy LearningPractices in Writing Programs and Residential LearningCommunities

Writing studies has considered college students\u27 literacy development as a chronological progression and as influenced by their off-campus connections to various cultural and professional communities. This project considers students\u27 literacy development across disciplines and university activity systems in which they\u27re simultaneously involved to look at the (missed) opportunities for fostering transfer across writing courses and residential learning communities as parallel—but rarely coordinated—high-impact practices. Rather than calling for the development of additional programs, I argue for building/strengthening connections between these existing programs by highlighting shared learning outcomes focused on literacy skills development and learning how to learn

What makes people bond?: A study on social interactions and common life points on Facebook

In this paper we aim at understanding if and how, by analysing people's profile and historical data (such as data available on Facebook profiles and interactions, or collected explicitly) we can motivate two persons to interact and eventually create long-term bonds. We do this by exploring the relationship between connectedness, social interactions and common life points on Facebook. The results are of particular importance for the development of technology that aims at reducing social isolation for people with less chances to interact, such as older adults

Social enterprise as a socially rational business

What is the goal of social enterprise policy? Is it the creation of a ‘not-for-profit’ or ‘more-than-profit’ business movement? In institutional policy circles, arguments are shaped by the desire to protect assets for the community, while entrepreneurial discourses favour a mixture of investment sources, surplus sharing and inclusive systems of governance. This article uses data from a critical ethnography to offer a third perspective. Human behaviour is a product of, and support system for, our socio-sexual choices. A grounded theory of social and economic capital is developed that integrates sexuality into organisation development. This constructs business organisations as complex centres of community-building replete with economic and social goals. By viewing corporate governance from this perspective social enterprise is reconceived as a business movement guided by social rationality with the long-term goal of distributing social and economic capital across stakeholder groups to satisfy individual and collective needs.</p

Interventions to increase physical activity in disadvantaged communities: A review of behavioural mechanisms. ESRI Working Paper No. 646 December 2019

Physical inactivity is now a significant driver of health and social inequalities among socioeconomically disadvantaged communities and poses a major challenge to policymakers, worldwide. Although a vast amount of research has focused on designing and evaluating interventions to increase physical activity, there remains little consensus on which interventions are likely to work. In this narrative review, we build on previous reviews by not only examining what interventions tend to work but by trying to understand why certain interventions tend to work, while others do not, through the lens of behavioural science. We present a behavioural framework through which the existing body of physical activity research could be viewed, in order to identify potentially effective mechanisms that would be likely to work in their intended domain. Our analysis finds that while there is evidence that the physical and educational environment matter for increasing levels of physical activity, interventions are more likely to be successful where they involve a social component. We conclude that a behaviourally informed physical activity intervention would thus employ a set of focused educational and socially-mediated behavioural mechanisms, within an appropriate physical environment

Overcoming barriers and increasing independence: service robots for elderly and disabled people

This paper discusses the potential for service robots to overcome barriers and increase independence of elderly and disabled people. It includes a brief overview of the existing uses of service robots by disabled and elderly people and advances in technology which will make new uses possible and provides suggestions for some of these new applications. The paper also considers the design and other conditions to be met for user acceptance. It also discusses the complementarity of assistive service robots and personal assistance and considers the types of applications and users for which service robots are and are not suitable