Using architecture and urban design in creating an integrated learning environment

Thesis (M.S.)--Massachusetts Institute of Technology, Dept. of Architecture, 1997.Includes bibliographical references (p. 70-71).This thesis tests the assertion that the design of the physical environment plays a role in the effective integration of school and community. The design of most existing urban schools fails to recognize the integral role communities play in their children's education. Most schools are insular, turning their back physically and programmatically on the adjacent neighborhood. The identities of the community and its children are seemingly negated. Almost unintentionally, the design of such institutions mirrors the dislocation of the urban poor from mainstream society. To be effective, the formal (school) and informal (family and community life) components of a child's education must act symbiotically. Continuity among the educational systems of many inner-city children, however is often foiled by the socioeconomic and cultural differences between parents and teachers, administrators and community members. The disparities between school and community are further complicated in the condition of extreme urban poverty. Schools, often run by middle class outsiders, stand as physical manifestations of a system ill-equipped to recognize and facilitate the unique needs of urban communities and their children. The complete educational system, therefore, falls victim to stereotypes and a lack of understanding between educators and the community. At present, educational reform efforts are directed toward establishing meaningful communication between these diverse, and often adversarial, components of a child's education. Programmatic initiatives alone, however, will not be enough. While successful as social programs, these strategies fail to address the influence of the physical environment. This thesis explores the role urban design and architecture can play in redefining the interaction among schools, families and communities th rough the redesign of the destitute West Baltimore community of Poppleton. The (public) school becomes the new neighborhood center. This learning center should not only meet the traditional educational needs of children, but also serve as a vehicle for the physical and programmatic reintegration of family and community members into the pedagogical process.by Stephanie C. Farrell.M.S

Short-Term Overfeeding Increases Circulating Adiponectin Independent of Obesity Status

Background: Adiponectin is an adipose tissue derived hormone which strengthens insulin sensitivity. However, there is little data available regarding the influence of a positive energy challenge (PEC) on circulating adiponectin and the role of obesity status on this response. Objective: The purpose of this study was to investigate how circulating adiponectin will respond to a short-term PEC and whether or not this response will differ among normal-weight(NW), overweight(OW) and obese(OB). Design: We examined adiponectin among 64 young men (19-29 yr) before and after a 7-day overfeeding (70% above normal energy requirements). The relationship between adiponectin and obesity related phenotypes including; weight, percent body fat (%BF), percent trunk fat (%TF), percent android fat (%AF), body mass index (BMI), total cholesterol, HDLc, LDLc, glucose, insulin, homeostatic model assessment insulin resistance (HOMA-IR) and b-cell function (HOMA-b) were analyzed before and after overfeeding. Results: Analysis of variance (ANOVA) and partial correlations were used to compute the effect of overfeeding on adiponectin and its association with adiposity measurements, respectively. Circulating Adiponectin levels significantly increased after the 7-day overfeeding in all three adiposity groups. Moreover, adiponectin at baseline was not significantly different among NW, OW and OB subjects defined by either %BF or BMI. Baseline adiponectin was negatively correlated with weight and BMI for the entire cohort and %TF, glucose, insulin and HOMA-IR in OB. However, after controlling for insulin resistance the correlation of adiponectin with weight, BMI and %TF were nullified. Conclusion: Our study provides evidence that the protective response of adiponectin is preserved during a PEC regardless of adiposity. Baseline adiponectin level is not directly associated with obesity status and weight gain in response to shortterm overfeeding. However, the significant increase of adiponectin in response to overfeeding indicates the physiological potential for adiponectin to attenuate insulin resistance during the development of obesity

The Association Between an Addictive Tendency Toward Food and Metabolic Characteristics in the General Newfoundland Population

Background: Our previous study of 29 obese food addiction (FA) patients found that FA is associated with lipid profiles and hormones which may be a factor in cardiovascular disease (CVD) and insulin resistance (IR). However, there is currently no data available regarding the relationship between FA symptoms and metabolic characteristics of CVD and IR in the general population. We designed this study to investigate the correlation between FA symptoms with lipid profiles and IR in men and women of the general Newfoundland population. Methods: 710 individuals (435 women and 275 men) recruited from the general Newfoundland population were used in analysis. FA symptoms were evaluated using the Yale Food Addiction Scale (YFAS). Glucose, insulin, HDL, LDL, total cholesterol and triglycerides levels were measured. IR was evaluated using the homeostatic model of assessment (HOMA). Participants were grouped by sex and menopausal status. Age, physical activity, calories and total % body fat were controlled. Results: Partial correlation analysis revealed that in men, YFAS symptom counts were significantly correlated with HOMA-b (r = 0.196, p = 0.021), triglycerides (r = 0.140, p = 0.025) and inversely correlated with HDL (r = −0.133, p = 0.033). After separating by menopausal status, pre-menopausal women exhibited no correlations and post-menopausal women had a significantcorrelation with triglycerides (r = 0.198, p = 0.016). Conclusion: FA is significantly correlated with several markers of metabolic disturbance in men and to a lesser extent, post-menopausal women, in the general population. Further research is required to explain sex specific associations and elucidate any potentially causal mechanisms behind this correlation

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Cardiovascular and neuropsychiatric risks of varenicline:a retrospective cohort study

Background: Varenicline is an effective pharmacotherapy to aid smoking cessation. However, its use is limited by continuing concerns about possible associated risks of serious adverse cardiovascular and neuropsychiatric events. The aim of this study was to investigate whether use of varenicline is associated with such events. Methods: In this retrospective cohort study, we used data from patients included in the validated QResearch database, which holds data from 753 National Health Service general practices across England. We identified patients aged 18-100 years (registered for longer than 12 months before data extraction) who received a prescription of nicotine replacement treatment (NRT; reference group), bupropion, or varenicline. We excluded patients if they had used one of the drugs during the 12 months before the start date of the study, had received a prescription of a combination of these drugs during the follow-up period, or were temporary residents. We followed patients up for 6 months to compare incident cardiovascular (ischaemic heart disease, cerebral infarction, heart failure, peripheral vascular disease, and cardiac arrhythmia) and neuropsychiatric (depression and self-harm) events using Cox proportional hazards models, adjusted for potential confounders (primary outcomes). Findings: We identified 164 766 patients who received a prescription (106 759 for nicotine replacement treatment; 6557 for bupropion; 51 450 for varenicline) between Jan 1, 2007, and June 30, 2012. Neither bupropion nor varenicline showed an increased risk of any cardiovascular or neuropsychiatric event compared with NRT (all hazard ratios [HRs] less than 1. Varenicline was associated with a significantly reduced risk of ischaemic heart disease (HR 0·80 [95%CI 0·72-0·87]), cerebral infarction (0·62 [0·52-0·73]), heart failure (0·61 [0·45-0·83]), arrhythmia (0·73 [0·60-0·88]), depression (0·66 [0·63-0·69]), and self-harm (0·56 [0·46-0·68]). Interpretation: Varenicline does not seem to be associated with an increased risk of documented cardiovascular events, depression, or self-harm when compared with NRT. Adverse events that do not come to attention of general practitioners cannot be excluded. These findings suggest an opportunity for physicians to prescribe varenicline more broadly, even for patients with comorbidities, thereby helping more smokers to quit successfully than do at present. Funding: Egton Medical Information Systems, University of Nottingham, Ministry of Innovation, Science and Research of the German Federal State of North Rhine-Westphalia, Cancer Research UK, Medical Research Council, Commonwealth Fund

The twilight of the Liberal Social Contract? On the Reception of Rawlsian Political Liberalism

This chapter discusses the Rawlsian project of public reason, or public justification-based 'political' liberalism, and its reception. After a brief philosophical rather than philological reconstruction of the project, the chapter revolves around a distinction between idealist and realist responses to it. Focusing on political liberalism’s critical reception illuminates an overarching question: was Rawls’s revival of a contractualist approach to liberal legitimacy a fruitful move for liberalism and/or the social contract tradition? The last section contains a largely negative answer to that question. Nonetheless the chapter's conclusion shows that the research programme of political liberalism provided and continues to provide illuminating insights into the limitations of liberal contractualism, especially under conditions of persistent and radical diversity. The programme is, however, less receptive to challenges to do with the relative decline of the power of modern states

Constitutivism

A brief explanation and overview of constitutivism

High fat diet induces dysregulation of hepatic oxygen gradients and mitochondrial function in vivo

NAFLD (non-alcoholic fatty liver disease), associated with obesity and the cardiometabolic syndrome, is an important medical problem affecting up to 20% of western populations. Evidence indicates that mitochondrial dysfunction plays a critical role in NAFLD initiation and progression to the more serious condition of NASH (non-alcoholic steatohepatitis). Herein we hypothesize that mitochondrial defects induced by exposure to a HFD (high fat diet) contribute to a hypoxic state in liver and this is associated with increased protein modification by RNS (reactive nitrogen species). To test this concept, C57BL/6 mice were pair-fed a control diet and HFD containing 35% and 71% total calories (1 cal≈4.184 J) from fat respectively, for 8 or 16 weeks and liver hypoxia, mitochondrial bioenergetics, NO (nitric oxide)-dependent control of respiration, and 3-NT (3-nitrotyrosine), a marker of protein modification by RNS, were examined. Feeding a HFD for 16 weeks induced NASH-like pathology accompanied by elevated triacylglycerols, increased CYP2E1 (cytochrome P450 2E1) and iNOS (inducible nitric oxide synthase) protein, and significantly enhanced hypoxia in the pericentral region of the liver. Mitochondria from the HFD group showed increased sensitivity to NO-dependent inhibition of respiration compared with controls. In addition, accumulation of 3-NT paralleled the hypoxia gradient in vivo and 3-NT levels were increased in mitochondrial proteins. Liver mitochondria from mice fed the HFD for 16 weeks exhibited depressed state 3 respiration, uncoupled respiration, cytochrome c oxidase activity, and mitochondrial membrane potential. These findings indicate that chronic exposure to a HFD negatively affects the bioenergetics of liver mitochondria and this probably contributes to hypoxic stress and deleterious NO-dependent modification of mitochondrial proteins

Relative sea-level change in northeastern Florida (USA) during the last ~8.0 ka

An existing database of relative sea-level (RSL) reconstructions from the U.S. Atlantic coast lacked valid sea-level index points from Georgia and Florida. This region lies on the edge of the collapsing forebulge of the former Laurentide Ice Sheet making it an important location for understanding glacio-isostatic adjustment and the history of ice-sheet melt. To address the paucity of data, we reconstruct RSL in northeastern Florida (St. Marys) over the last ∼8.0 ka from samples of basal salt-marsh sediment that minimize the influence of compaction. The analogy between modern salt-marsh foraminifera and their fossil counterparts preserved in the sedimentary record was used to estimate paleomarsh surface elevation. Sample ages were determined by radiocarbon dating of identifiable and in-situ plant macrofossils. This approach yielded 25 new sea-level index points that constrain a ∼5.7 m rise in RSL during the last ∼8.0 ka. The record shows that no highstand in sea level occurred in this region over the period of the reconstruction. We compared the new reconstruction to Earth-ice models ICE 6G-C VM5a and ICE 6G-C VM6. There is good fit in the later part of the Holocene with VM5a and for a brief time in the earlier Holocene with VM6. However, there are discrepancies in model-reconstruction fit in the early to mid Holocene in northeastern Florida and elsewhere along the Atlantic coast at locations with early Holocene RSL reconstructions. The most pronounced feature of the new reconstruction is a slow down in the rate of RSL rise from approximately 5.0 to 3.0 ka. This trend may reflect a significant contribution from local-scale processes such as tidal-range change and/or change in base flow of the St. Marys River in response to paleoclimate changes. However, the spatial expression (local vs. regional) of this slow down is undetermined and corroborative records are needed to establish its geographical extent

A proposed systems approach to the evaluation of integrated palliative care

<p>Abstract</p> <p>Background</p> <p>There is increasing global interest in regional palliative care networks (PCN) to integrate care, creating systems that are more cost-effective and responsive in multi-agency settings. Networks are particularly relevant where different professional skill sets are required to serve the broad spectrum of end-of-life needs. We propose a comprehensive framework for evaluating PCNs, focusing on the nature and extent of inter-professional collaboration, community readiness, and client-centred care.</p> <p>Methods</p> <p>In the absence of an overarching structure for examining PCNs, a framework was developed based on previous models of health system evaluation, explicit theory, and the research literature relevant to PCN functioning. This research evidence was used to substantiate the choice of model factors.</p> <p>Results</p> <p>The proposed framework takes a systems approach with system structure, process of care, and patient outcomes levels of consideration. Each factor represented makes an independent contribution to the description and assessment of the network.</p> <p>Conclusions</p> <p>Realizing palliative patients' needs for complex packages of treatment and social support, in a seamless, cost-effective manner, are major drivers of the impetus for network-integrated care. The framework proposed is a first step to guide evaluation to inform the development of appropriate strategies to further promote collaboration within the PCN and, ultimately, optimal palliative care that meets patients' needs and expectations.</p