Assessing the "Livability" of Cities & Towns in Central North Carolina for Older Adults: Implementing the "TJCOG Livability Self-Assessment" Pilot Study

The demographic changes in aging are occurring both nationally and globally. The dramatic increase in the older adult population raises a critical issue demanding immediate attention: how will we support and care for this growing population of older adults? In 2014, the Triangle J Council of Governments (TJCOG), located in Durham, North Carolina, developed the electronic "TJCOG Livability Self-Assessment for Municipalities" and an accompanying Toolkit as a way to help the cities and town in their region prepare for the long-term needs of their aging community members. It was based on the Stanford Center for Longevity’s report: “Livable Community Indicators for Sustainable Aging in Place.” The report presented a framework for how livable community characteristics influence aging in place, including measurable indicators on housing, transportation, safety, health care, supportive services, retail, social integration, and community participation. In order to provide information on the usability and effectiveness of the Livability Self-Assessment and Toolkit, and to prepare for broader implementation of these resources, a pilot-study was conducted with five cities and towns from the Triangle J Region. Key informants were self-selected by each of the municipalities, including city or town planners or other government representatives. Participants were interviewed following completion of the electronic Assessment and six months later. The analysis of the interviews and Assessment results provided specific recommendations for enhancing the Livability Self-Assessment and accompanying Toolkit and insights into the facilitators and challenges for using the findings of the Assessment to promote community dialogue and collective planning for the rising older adult population. The results of the study conclude the TJCOG Livability Self-Assessment for Municipaities is a useable and potentially effective electronic tool to assist communities in examining their livability, identifying areas of strength and improvement. An eight step plan for change is offered on how to approach sustainable and long-lasting change. While the Assessment was developed for the cities and towns within the Triangle J Region, the possibilities for broad-based pubic health impact extend beyond the region, with state, national and international opportunities.Doctor of Public Healt

Enacting a Constellation of Logics: How Transferred Practices Are Recontextualized in a Global Organization

We explore how new practices are transferred across locations in a global organization. The company we studied strove to infuse more user-centered innovation and quicker, more agile delivery of software into their development teams. The practices for doing so were crafted in the United States and then transferred to China and India. Over a period of 20 months, we observed how three practices were transferred to and enacted at each location. Our findings suggest a constellation of logics, which varied by site and by practice, molded the particular recontextualizations at each site. We contribute to a deeper understanding of how employees experience and respond to the transfer of practices from abroad by proposing that a constellation of logics guides recontextualization of meaning as well as action. Our empirical work and analysis also raises numerous questions about the effects of the recontextualizations on performance, what makes a particular logic or constellation of logics salient for a particular practice at a particular time, the stability and malleability of these logics, and what happens in global collaborations when different logics are invoked at different locations

The senior citizen population of Cary : Wake County, North Carolina : a community diagnosis including secondary and qualitative data collection

The community diagnosis presented in this document is the result of a two-semester academic requirement of first-year Master’s students enrolled in the Health Behavior and Health Education Department at the School of Public Health at the University of North Carolina at Chapel Hill. Students in this program conduct a community diagnosis in order to learn to assess and comprehend the needs and resources of a particular community. It is a team effort, allowing small groups of students to work together to understand the many factors that directly or indirectly affect the overall health and quality of life of that community and its residents. This community diagnosis focused on identifying the needs and interests of the senior citizen population of Cary, North Carolina. Particular emphasis was placed on the strengths and limitations of the community and the potential for resolution of those concerns that are most important. In general, the process involved gathering information from written documents, personal interviews, and community dialogue. The findings of this process are presented as clearly and completely as possible in the following pages. Included are sections about Cary’s history, geography, political system, and demographics, as well as an overview of indicators of economic, education and health status of residents. In addition, seven major topics identified by community members -- town growth, transportation, housing, health issues, social isolation, a proposed new senior center, and perceptions of seniors -- are discussed in detail. In the final conclusions section, the major findings from the various parts of the community diagnosis are examined in order to assess general community competence and present some implications for the future. The authors of this document endeavored to examine the quality of life of the senior residents of the town of Cary throughout the process described above. During the community diagnosis the team gained an understanding and appreciation of the diversity of experiences and opinions of the seniors of Cary, the variety of resources currently available, and the potential for community members to address key concerns. Throughout the document, great care was taken to ensure objective interpretation of all subject matter, opinions, and concerns as they were presented. Although this process began as part of an academic requirement, it is hoped that the community as a whole benefited from the experience and that this document might be considered a catalyst for continued collective action on the part of Cary senior residents.Master of Public Healt

Towards a Data Sharing Culture: Recommendations for Leadership from Academic Health Centers

Rebecca Crowley and colleagues propose that academic health centers can and should lead the transition towards a culture of biomedical data sharing

word~river literary review (2009)

wordriver is a literary journal dedicated to the poetry, short fiction and creative nonfiction of adjuncts and part-time instructors teaching in our universities, colleges, and community colleges. Our premier issue was published in Spring 2009. We are always looking for work that demonstrates the creativity and craft of adjunct/part-time instructors in English and other disciplines. We reserve first publication rights and onetime anthology publication rights for all work published. We define adjunct instructors as anyone teaching part-time or full-time under a semester or yearly contract, nationwide and in any discipline. Graduate students teaching under part-time contracts during the summer or who have used up their teaching assistant time and are teaching with adjunct contracts for the remainder of their graduate program also are eligible.https://digitalscholarship.unlv.edu/word_river/1002/thumbnail.jp

Biogenesis of Influenza A Virus Hemagglutinin Cross-Protective Stem Epitopes

Antigenic variation in the globular domain of influenza A virus (IAV) hemagglutinin (HA) precludes effective immunity to this major human pathogen. Although the HA stem is highly conserved between influenza virus strains, HA stem-reactive antibodies (StRAbs) were long considered biologically inert. It is now clear, however, that StRAbs reduce viral replication in animal models and protect against pathogenicity and death, supporting the potential of HA stem-based immunogens as drift-resistant vaccines. Optimally designing StRAb-inducing immunogens and understanding StRAb effector functions require thorough comprehension of HA stem structure and antigenicity. Here, we study the biogenesis of HA stem epitopes recognized in cells infected with various drifted IAV H1N1 strains using mouse and human StRAbs. Using a novel immunofluorescence (IF)-based assay, we find that human StRAbs bind monomeric HA in the endoplasmic reticulum (ER) and trimerized HA in the Golgi complex (GC) with similar high avidity, potentially good news for producing effective monomeric HA stem immunogens. Though HA stem epitopes are nestled among several N-linked oligosaccharides, glycosylation is not required for full antigenicity. Rather, as N-linked glycans increase in size during intracellular transport of HA through the GC, StRAb binding becomes temperature-sensitive, binding poorly to HA at 4°C and well at 37°C. A de novo designed, 65-residue protein binds the mature HA stem independently of temperature, consistent with a lack of N-linked oligosaccharide steric hindrance due to its small size. Likewise, StRAbs bind recombinant HA carrying simple N-linked glycans in a temperature-independent manner. Chemical cross-linking experiments show that N-linked oligosaccharides likely influence StRAb binding by direct local effects rather than by globally modifying the conformational flexibility of HA. Our findings indicate that StRAb binding to HA is precarious, raising the possibility that sufficient immune pressure on the HA stem region could select for viral escape mutants with increased steric hindrance from N-linked glycans.</p

Core Outcome Set-STAndardised Protocol items: the COS-STAP statement

Background: Several hundred core outcome set (COS) projects have been systematically identified to date which, if adopted, ensure that researchers measure and report those outcomes that are most likely to be relevant to users of their research. The uptake of a COS by COS users will depend in part on the transparency and robustness of the methods used in the COS development study, which would be increased by the use of a standardised protocol. This article describes the development of the COS-STAP (Core Outcome Set-STAndardised Protocol Items) Statement for the content of a COS development study protocol. Methods: The COS-STAP Statement was developed following the Enhancing the Quality and Transparency Of Health Research (EQUATOR) Network’s methodological framework for guideline development. This included an initial item generation stage, a two-round Delphi survey involving more than 150 participants representing three stakeholder groups (COS developers, journal editors and patient and public involvement researchers interested in COS development), followed by a consensus meeting with eight voting participants. Results: The COS-STAP Statement consists of a checklist of 13 items considered essential documentation in a protocol, outlining the scope of the COS, stakeholder involvement, COS development plans and consensus processes. Conclusions: Journal editors and peer reviewers can use the guidance to assess the completeness of a COS development study protocol submitted for publication. By providing guidance for key content, the COS-STAP Statement will enhance the drafting of high-quality protocols and determine how the COS development study will be carried out

Patient-, organization-, and system-level barriers and facilitators to preventive oral health care:A convergent mixed-methods study in primary dental care

Background: Dental caries is the most common chronic disease of adult and childhood, a largely preventable yet widespread, costly public health problem. This study identified patient-, organization-, and system-level factors influencing routine delivery of recommended care for prevention and management of caries in primary dental care. Methods: A convergent mixed-methods design assessed six guidance-recommended behaviours to prevent and manage caries (recording risk, risk-based recall intervals, applying fluoride varnish, placing preventive fissure sealants, demonstrating oral health maintenance, taking dental x-rays). A diagnostic questionnaire assessing current practice, beliefs, and practice characteristics was sent to a random sample of 651 dentists in National Health Service (NHS) Scotland. Eight in-depth case studies comprising observation of routine dental visits and dental team member interviews were conducted. Patient feedback was collected from adult patients with recent checkups at case study practices. Key informant interviews were conducted with decision makers in policy, funding, education, and regulation. The Theoretical Domains Framework within the Behaviour Change Wheel was used to identify and describe patient-, organization-, and system-level barriers and facilitators to care. Findings were merged into a matrix describing theoretical domains salient to each behaviour. The matrix and Behaviour Change Wheel were used to prioritize behaviours for change and plan relevant intervention strategies. Results: Theoretical domains associated with best practice were identified from the questionnaire (N-196), case studies (N = 8 practices, 29 interviews), and patient feedback (N = 19). Using the study matrix, key stakeholders identified priority behaviours (use of preventive fissure sealants among 6–12-year-olds) and strategies (audit and feedback, patient informational campaign) to improve guidance implementation. Proposed strategies were assessed as appropriate for immediate implementation and suitable for development with remaining behaviours. Conclusions: Specific, theoretically based, testable interventions to improve caries prevention and management were coproduced by patient-, practice-, and policy-level stakeholders. Findings emphasize duality of behavioural determinants as barriers and facilitators, patient influence on preventive care delivery, and benefits of integrating multi-level interests when planning interventions in a dynamic, resource-constrained environment. Interventions identified in this study are actively being used to support ongoing implementation initiatives including guidance, professional development, and oral health promotion

mTORC2 Regulates Amino Acid Metabolism in Cancer by Phosphorylation of the Cystine-Glutamate Antiporter xCT

Mutations in cancer reprogram amino acid metabolism to drive tumor growth, but the molecular mechanisms are not well understood. Using an unbiased proteomic screen, we identified mTORC2 as a critical regulator of amino acid metabolism in cancer via phosphorylation of the cystine-glutamate antiporter xCT. mTORC2 phosphorylates serine 26 at the cytosolic N terminus of xCT, inhibiting its activity. Genetic inhibition of mTORC2, or pharmacologic inhibition&nbsp;of the mammalian target of rapamycin (mTOR) kinase, promotes glutamate secretion, cystine uptake, and incorporation into glutathione, linking growth factor receptor signaling with amino acid uptake and utilization. These results identify an unanticipated mechanism regulating amino acid metabolism in cancer, enabling tumor cells to adapt to changing environmental conditions