Apex, Wake County : an action-oriented community diagnosis including secondary data analysis and qualitative data collection

This document is a community diagnosis of the town of Apex. A field team of five graduate students from the UNC at Chapel Hill School of Public Health worked in Apex from September 2000 to May 2001 collecting data on the strengths and needs of the Apex community as perceived by service providers and by community members. This report includes an analysis of the team’s findings from secondary data as well as from interviews and focus groups held with community members and service providers who reside or work in Apex. In addition, the results are presented from a community meeting held by the field team in April 2001 for community members and service providers to discuss the major issues affecting Apex and collectively work on steps for future action. The purpose of this document is to synthesize our findings to present a critical analysis of the strengths, resources, challenges, and needs within the Apex community. It is our hope that the information presented will help the Apex community recognize and prioritize its response to conditions and situations that affect the general health, wellness, and quality of life for its residents. Growth is by far the biggest issue in Apex, as it has been with most of Wake County over the past decade. The focus previously had been on whether or not growth should continue, and now it has shifted to a focus on how to best handle the consequences of it. This enormous growth has created or exacerbated some important issues in the Apex community. The ones that stand out in the data and were most frequently mentioned by both community members and service providers are transportation, affordable housing, social and political community cohesion, youth and education, and services and access for low-income residents. Of these topics, service providers talked mostly about the availability of services for residents of Apex while community members focused mainly on community cohesion and youth issues. In the following report, we will discuss how the changes in Apex over the last 5-10 years have impacted the services available, the services needed, and the quality of life of Apex residents. Apex is a well-established, competent community, already actively working to improve the quality of life for its residents. However, this paper presents several suggestions for improvement based on our research and the discussion at the community meeting. The main recommendation for future action is increased collaboration between already existing community organizations (such as faith-based organizations) and community members and service providers. This collaboration is necessary to create and implement solutions for problems with transportation, housing, and access to services, which mostly affect lower-income residents of Apex. In addition, the community might want to consider ways in which youth can get involved in community service, as well as creating recreational activities for older teens.Master of Public Healt

Accelerating design and transforming baccalaureate nursing education to foster a culture of health

Healthcare reform and changing population health demographics call for a radical transformation in healthcare delivery and the education of healthcare providers. Nurses comprise the largest proportion of healthcare providers making it necessary to ensure that they are prepared to address the challenges that arise from the evolving healthcare delivery system. A key message of the Institute of Medicine’s The Future of Nursing: Leading Change, Advancing Health, is that nurses must lead healthcare change. To accomplish this, nurses must recognize their role in educating the new nursing workforce about creating a culture of health. Specifically, nurse educators must act as stewards for promoting health and wellness, and reducing health disparities and inequities. They must also recognize their role in forming partnerships with community organizations to improve primary care and population health by addressing social determinants of health. The purpose of this paper is to describe the structure for developing an innovative baccalaureate nursing curriculum and lessons learned that can inform the efforts of others interested in accelerating design of new curriculum

Accelerating Curriculum Design: A Love It, Don\u27t Leave It Approach to Creative Process and Idealized Design

Purpose and Background: The Institute of Medicine’s (IOM) report (2010) on the “Future of Nursing” emphasized the need for nurses to lead health care change. One of the key messages in this report is a call to action for nursing schools to re-envision nursing education that focuses on a population-based perspective and emerging roles for nurses across the care continuum. With an evolving focus on primary and community-based care rather than acute care, and recognition of the importance of coordinating care and managing transitions across providers and settings of care, registered nurses now and in the future will need to be prepared with a breadth of knowledge, skills, and competencies. In response, the Jefferson College of Nursing (JCN) embarked on the ambitious task of designing a new 21st century baccalaureate nursing curriculum over a 13-month period. Nursing curriculum design varies widely and can span the course of two to five years. To reduce the lengthy process and ensure faculty commitment, JCN leadership selected a core team of nine faculty members to navigate the full faculty through the design of the curriculum. Each team member was assigned three teaching credits for curriculum development and design. Although a 13-month turnaround time for curriculum design is unprecedented, what is most unique about JCN’s initiative is that it began with a charge of developing an idealized curriculum from a blank slate. To ensure that the curriculum reflected multiple perspectives, the team recruited six stakeholders including a nurse practice partner, health care consumer, community leader, alumnus, current student, and adjunct clinical faculty. Poster presented at: NLN Education Summit, 2015:Bridging Practice and Education, Las Vegas, Nevada, September 30, 2015-October 2, 2015.https://jdc.jefferson.edu/nursingposters/1009/thumbnail.jp

Duchamp's Erotic Stereoscopic Exercises

This article explores certain links between medicine and art, with regard to their use of stereoscopy. I highlight a work by the artist Marcel Duchamp (the ready-made Stéréoscopie a la Main) and stereoscopic cards used in ophthalmic medicine. Both instances involve the drawing of graphic marks over previously existing stereoscopic cards. This similarity between Stéréoscopie a la Main and stereoscopic cards is echoed in the form of "stereoscopic exercises." Stereoscopic exercises were prescribed by doctors to be performed with the stereoscope as early as 1864. Stereoscopic cards were widely diffused in the 19th century, often promoted as "stay-at-home travel." It was over such kinds of materials that both Marcel Duchamp and doctors of ophthalmic medicine drew their graphic marks. I explore Duchamp's Stéréoscopie a la Main as a hypothetical basis for stereoscopic exercises of different types, proposing that this rectified ready-made is the locus for erotic stereoscopic exercises.Este artigo busca explorar certos elos entre a medicina e a arte por meio da estereoscopia. Destaca-se uma obra do artista Marcel Duchamp (o ready-made Stéréoscopie a la Main) e cartões estereoscópicos usados na oftalmologia. As duas instâncias envolvem o desenho de marcas gráficas sobre cartões estereoscópicos pré-existentes. A similaridade entre Stéréoscopie a la Main e os ditos cartões ecoa também na forma dos exercícios estereoscópicos. O cartão estereoscópico foi amplamente difundido na segunda metade do séc. XIX, frequentemente na forma da "viagem sem sair de casa." Foi sobre esse tipo de material que tanto médicos quanto Marcel Duchamp desenharam suas marcas. Explora-se a obra Stéréoscopie a la Main como um sítio hipotético para uma espécie de exercício, propondo que tal ready-made retificado seja um lugar para exercícios estereoscópicos eróticos

Effects of antiplatelet therapy on stroke risk by brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases: subgroup analyses of the RESTART randomised, open-label trial

Background Findings from the RESTART trial suggest that starting antiplatelet therapy might reduce the risk of recurrent symptomatic intracerebral haemorrhage compared with avoiding antiplatelet therapy. Brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases (such as cerebral microbleeds) are associated with greater risks of recurrent intracerebral haemorrhage. We did subgroup analyses of the RESTART trial to explore whether these brain imaging features modify the effects of antiplatelet therapy

Girls and Boys Born before 28 Weeks Gestation: Risks of Cognitive, Behavioral, and Neurologic Outcomes at Age 10 Years

To compare the prevalence of cognitive, neurological, and behavioral outcomes at 10 years of age in 428 girls and 446 boys who were born extremely preterm (EP)

The Relationship of Maternal Prepregnancy Body Mass Index and Pregnancy Weight Gain to Neurocognitive Function at Age 10 Years among Children Born Extremely Preterm

OBJECTIVE: To assess the association between maternal prepregnancy body mass index and adequacy of pregnancy weight gain in relation to neurocognitive function in school-aged children born extremely preterm. STUDY DESIGN: Study participants were 535 ten-year-old children enrolled previously in the prospective multicenter Extremely Low Gestational Age Newborns cohort study who were products of singleton pregnancies. Soon after delivery, mothers provided information about prepregnancy weight. Prepregnancy body mass index and adequacy of weight gain were characterized based on this information. Children underwent a neurocognitive evaluation at 10 years of age. RESULTS: Maternal prepregnancy obesity was associated with increased odds of a lower score for Differential Ability Scales-II Verbal IQ, for Developmental Neuropsychological Assessment-II measures of processing speed and visual fine motor control, and for Wechsler Individual Achievement Test-III Spelling. Children born to mothers who gained an excessive amount of weight were at increased odds of a low score on the Oral and Written Language Scales Oral Expression assessment. Conversely, children whose mother did not gain an adequate amount of weight were at increased odds of a lower score on the Oral and Written Language Scales Oral Expression and Wechsler Individual Achievement Test-III Word Reading assessments. CONCLUSION: In this cohort of infants born extremely preterm, maternal obesity was associated with poorer performance on some assessments of neurocognitive function. Our findings are consistent with the observational and experimental literature and suggest that opportunities may exist to mitigate risk through education and behavioral intervention before pregnancy

Evolution and host-specific adaptation of <i>Pseudomonas aeruginosa</i>.

The major human bacterial pathogen Pseudomonas aeruginosa causes multidrug-resistant infections in people with underlying immunodeficiencies or structural lung diseases such as cystic fibrosis (CF). We show that a few environmental isolates, driven by horizontal gene acquisition, have become dominant epidemic clones that have sequentially emerged and spread through global transmission networks over the past 200 years. These clones demonstrate varying intrinsic propensities for infecting CF or non-CF individuals (linked to specific transcriptional changes enabling survival within macrophages); have undergone multiple rounds of convergent, host-specific adaptation; and have eventually lost their ability to transmit between different patient groups. Our findings thus explain the pathogenic evolution of P. aeruginosa and highlight the importance of global surveillance and cross-infection prevention in averting the emergence of future epidemic clones

A Giant Planet Candidate Transiting a White Dwarf

Astronomers have discovered thousands of planets outside the solar system, most of which orbit stars that will eventually evolve into red giants and then into white dwarfs. During the red giant phase, any close-orbiting planets will be engulfed by the star, but more distant planets can survive this phase and remain in orbit around the white dwarf. Some white dwarfs show evidence for rocky material floating in their atmospheres, in warm debris disks, or orbiting very closely, which has been interpreted as the debris of rocky planets that were scattered inward and tidally disrupted. Recently, the discovery of a gaseous debris disk with a composition similar to ice giant planets demonstrated that massive planets might also find their way into tight orbits around white dwarfs, but it is unclear whether the planets can survive the journey. So far, the detection of intact planets in close orbits around white dwarfs has remained elusive. Here, we report the discovery of a giant planet candidate transiting the white dwarf WD 1856+534 (TIC 267574918) every 1.4 days. The planet candidate is roughly the same size as Jupiter and is no more than 14 times as massive (with 95% confidence). Other cases of white dwarfs with close brown dwarf or stellar companions are explained as the consequence of common-envelope evolution, wherein the original orbit is enveloped during the red-giant phase and shrinks due to friction. In this case, though, the low mass and relatively long orbital period of the planet candidate make common-envelope evolution less likely. Instead, the WD 1856+534 system seems to demonstrate that giant planets can be scattered into tight orbits without being tidally disrupted, and motivates searches for smaller transiting planets around white dwarfs.Comment: 50 pages, 12 figures, 2 tables. Published in Nature on Sept. 17, 2020. The final authenticated version is available online at: https://www.nature.com/articles/s41586-020-2713-