Environmental Communication Pedagogy for Sustainability: Developing Core Capacities to Engage with Complex Problems

Pedagogy informed by environmental communication can enhance collaboration within and outside the classroom. Through our collaborative, sustainability-focused work within the United States and internationally, we identified core capacities that prepare people to work together to form inclusive organizations and identify and respond to pressing socioecological problems.We describe six activities we have used in adult learner classrooms, on interdisciplinary and transdisciplinary research teams, and with organizational, governmental, and business partners to improve collaborations for sustainability-related problem solving. We conclude with a reflection on opportunities for situated assessment practices

Realist synthesis : illustrating the method for implementation research

BackgroundRealist synthesis is an increasingly popular approach to the review and synthesis of evidence, which focuses on understanding the mechanisms by which an intervention works (or not). There are few published examples of realist synthesis. This paper therefore fills a gap by describing, in detail, the process used for a realist review and synthesis to answer the question \u27what interventions and strategies are effective in enabling evidence-informed healthcare?\u27 The strengths and challenges of conducting realist review are also considered. MethodsThe realist approach involves identifying underlying causal mechanisms and exploring how they work under what conditions. The stages of this review included: defining the scope of the review (concept mining and framework formulation); searching for and scrutinising the evidence; extracting and synthesising the evidence; and developing the narrative, including hypotheses. ResultsBased on key terms and concepts related to various interventions to promote evidenceinformed healthcare, we developed an outcome-focused theoretical framework. Questions were tailored for each of four theory/intervention areas within the theoretical framework and were used to guide development of a review and data extraction process. The search for literature within our first theory area, change agency, was executed and the screening procedure resulted in inclusion of 52 papers. Using the questions relevant to this theory area, data were extracted by one reviewer and validated by a second reviewer. Synthesis involved organisation of extracted data into evidence tables, theming and formulation of chains of inference, linking between the chains of inference, and hypothesis formulation. The narrative was developed around the hypotheses generated within the change agency theory area. ConclusionsRealist synthesis lends itself to the review of complex interventions because it accounts for context as well as outcomes in the process of systematically and transparently synthesising relevant literature. While realist synthesis demands flexible thinking and the ability to deal with complexity, the rewards include the potential for more pragmatic conclusions than alternative approaches to systematic reviewing. A separate publication will report the findings of the review. <br /

Utility of routine data sources for feedback on the quality of cancer care: an assessment based on clinical practice guidelines

Background Not all cancer patients receive state-of-the-art care and providing regular feedback to clinicians might reduce this problem. The purpose of this study was to assess the utility of various data sources in providing feedback on the quality of cancer care. Methods Published clinical practice guidelines were used to obtain a list of processes-of-care of interest to clinicians. These were assigned to one of four data categories according to their availability and the marginal cost of using them for feedback. Results Only 8 (3%) of 243 processes-of-care could be measured using population-based registry or administrative inpatient data (lowest cost). A further 119 (49%) could be measured using a core clinical registry, which contains information on important prognostic factors (e.g., clinical stage, physiological reserve, hormone-receptor status). Another 88 (36%) required an expanded clinical registry or medical record review; mainly because they concerned long-term management of disease progression (recurrences and metastases) and 28 (11.5%) required patient interview or audio-taping of consultations because they involved information sharing between clinician and patient. Conclusion The advantages of population-based cancer registries and administrative inpatient data are wide coverage and low cost. The disadvantage is that they currently contain information on only a few processes-of-care. In most jurisdictions, clinical cancer registries, which can be used to report on many more processes-of-care, do not cover smaller hospitals. If we are to provide feedback about all patients, not just those in larger academic hospitals with the most developed data systems, then we need to develop sustainable population-based data systems that capture information on prognostic factors at the time of initial diagnosis and information on management of disease progression

Protocol for a randomized controlled trial of a specialized health coaching intervention to prevent excessive gestational weight gain and postpartum weight retention in women: the HIPP study

BackgroundPregnancy is a time of significant physiological and physical change for women. In particular, it is a time at which many women are at risk of gaining excessive weight. We describe the rationale and methods of the Health in Pregnancy and Post-birth (HIPP) Study, a study which aims primarily to determine the effectiveness of a specialized health coaching (HC) intervention during pregnancy, compared to education alone, in preventing excessive gestational weight gain and postpartum weight retention 12 months post birth. A secondary aim of this study is to evaluate the mechanisms by which our HC intervention impacts on weight management both during pregnancy and post birth.Methods/DesignThe randomized controlled trial will be conducted with 220 women who have a BMI &gt; 18.5 (American IOM cut-off for normal weight), are 18 years of age or older, English speaking, no history of disordered eating or diabetes and are less than 18 weeks gestation at recruitment. Women will be randomly allocated to either a specialized HC intervention group or an Education Alone group. Our specialized HC intervention has two components: (1) one-on-one sessions with a Health Coach, and (2) two by two hour educational group sessions led by a Health Coach. Women in the Education Alone group will receive two by two hour educational group sessions with no HC components. Body Mass Index, waist circumference, and psychological factors including motivation, readiness to change, symptoms of depression and anxiety, and body dissatisfaction will be assessed at baseline (14-16 weeks gestation), and again at follow-up: 32 weeks gestation, 6 weeks, 6 months and 12 months postpartum.DiscussionOur study responds to the urgent need to design effective interventions in pregnancy to prevent excessive gestational weight gain and postpartum weight retention. Our pregnancy HC intervention is novel and innovative and has been designed to be easily adopted by health professionals who work with pregnant women, such as obstetricians, midwives, allied health professionals and health psychologists. <br /

Dead men tell no tales: Speaking, Death and Poetic Authority in Propertius Book IV

 Propertius begins his fourth book of poetry by claiming that he is a changed man. No more for him the pining after his domina, but instead he now styles himself as the ‘Roman Callimachus’, who is writing poetry in the service of his country (Roma, fave, tibi surgit opus IV.1.67). The fourth book of Propertius is notable for the cast of characters to whom the poet gives voice, and after a preliminary survey, the reader would be forgiven for thinking that Propertius was overtly obsessed with bringing the dead to life, particularly dead women. This study explores the way in which these internal female narrators, including Arethusa, Cynthia, Acanthis and Cornelia, should be understood as mounting a narrative challenge to the wider context of Propertian poetics,  using the performative acts of both writing and speech to claim their own authority. This represents a contrast not only with the wider historical and social reality of the poems, but the dead women of Propertius also become provocative through the poet’s intertextual references to his great rival in aetiological poetry, Virgil

Characters and characterisation in the epic cycle

The aim of this thesis is to use the various characters who play a part in the Epic Cycle as a tool with which to understand more about the Cycle and the pre-Homeric oral tradition. In Part 1, I use characters as a way to approach the different sources of information we have for the Epic Cycle, namely the Bibliotheca of Apollodorus and the various fragments from later writers and scholiasts. I take the view that these sources are, on the whole, less valuable than Proclus’ epitomes. By looking at the characters unique to these accounts, I assess the value and utility of Apollodorus and the fragments for our knowledge of the Epic Cycle. Nevertheless, the thesis also raises questions about the status of Proclus’ epitomes and the extent to which they give us access to the ‘authentic’ Epic Cycle. Part 2 is dedicated to the individual characters who play a part in the narrative of Proclus’ epitomes. Using a mixture of methodological tools from the camps of both Neoanalysis and Oral Theory, I attempt to trace out a full account of how these different characters were depicted in the tradition of the Trojan War. By using the information given by both Proclus, the fragments, and the Homeric poems, the aim is to build as full a picture as possible of the position and characterisation of these characters in the pre-Homeric oral tradition of the Trojan War. The individuals discussed are both major (Achilles, Diomedes, Odysseus, and the Trojan Princes) and minor (Protesilaus, Philoctetes, Polypoites, Leonteus, and Palamedes)

Hospital morbidity data for determining spread of disease at diagnosis for colorectal cancer: a validation study

Aims: There is currently no routine collection of cancer stages in population-based data in Australia. This study evaluates the accuracy of International classification of diseases (ICD) codes for secondary neoplasms recorded in hospital morbidity data to assign spread of disease at diagnosis for colorectal cancer. Methods: The reference (gold) standard was the Australian clinicopathological stage (ACPS) documented by a treating colorectal surgeon and derived from histopathology and clinical findings. To allow comparison with stages derived from the hospital morbidity data (HMD), ACPS was mapped to the spread of disease (local, regional and distant). Sensitivity, specificity and positive-predictive values were calculated to compare the accuracy of stage derived from HMD. Results: Data from both the reference standard and HMD were available for 499 patients. HMD slightly overestimated patients with local disease (62.3 vs 56.9%). There was a corresponding underestimation of regional and distant spread of disease. While sensitivity for regional and distant disease was moderate (66.4 and 71.4%, respectively), specificity was high (92.7 and 96.6%, respectively). Conclusion: ICD codes for secondary neoplasms in HMD are limited in their utility for determining the spread of disease for colorectal cancer. Clinicians need to ensure that clinical coders are provided with enough information to accurately code for spread of disease. We recommend reporting histopathology in a synoptic format which includes background information on the presence or absence of distant metastasis and the tumor node metastasis stage