Advancing urban health equity in the United States in an age of health care gentrifcation : a framework and research agenda

Altres ajuts: Juan de la Cierva (JC-2018- 035322-I)Background: Access to health care has traditionally been conceptualized as a function of patient socio-demographic characteristics (i.e., age, race/ethnicity, education, health insurance status, etc.) and/or the system itself (i.e., payment structures, facility locations, etc.). However, these frameworks typically do not take into account the broader,dynamic context in which individuals live and in which health care systems function. Purpose: The growth in market-driven health care in the U.S. alongside policies aimed at improving health care delivery and quality have spurred health system mergers and consolidations, a shift toward outpatient care, an increase in for-proft care, and the closure of less proftable facilities. These shifts in the type, location and delivery of health care services may provide increased access for some urban residents while excluding others, a phenomenon we term "health care gentrifcation." In this commentary, we frame access to health care in the United States in the context of neighborhood gentrifcation and a concurrent process of changes to the health care system itself. Conclusions: We describe the concept of health care gentrifcation, and the complex ways in which both neighborhood gentrifcation and health care gentrifcation may lead to inequitable access to health care. We then present a framework for understanding health care gentrifcation as a function of dynamic and multi-level systems, and propose ways to build on existing models of health care access and social determinants of health to more efectively measure and address this phenomenon. Finally, we describe potential strategies applied researchers might investigate that could prevent or remediate the efects of health care gentrifcation in the United States

Symphony Orchestra featuring Helen Kim and Allatoona High School Sinfonia Orchestra with Judith Cole

KSU School of Music presents Symphony Orchestra directed by Dr. Nathaniel F. Parker featuring Helen Kim along with Allatoona High School Sinfonia Orchestra.https://digitalcommons.kennesaw.edu/musicprograms/1835/thumbnail.jp

Interview with Helen Smith

An interview with Helen Sarah Atwater Smith regarding her experiences in a one-room school house.https://scholars.fhsu.edu/ors/1077/thumbnail.jp

The Evolution of Public Health Education and Training in the United Kingdom

The United Kingdom has a long and evolving history of public health education. From the initiation of formal standardised training for Medical Officers for Health in the early 1900s, to the current national public health training programme, public health education has adapted to the changing contexts of public health practice. Whilst the profession was originally only a medical specialty, subsequent re­­cognition of the skills and contribution of the wider public health workforce has led to changes in professional specialist training for public health, which is now open to non-medical applicants. This well-established professional training scheme allows the formal accreditation of competence in a broad range of public health skills. The academic component of public health training is provided by a rapidly growing number of postgraduate courses. Once confined to the UK’s first school of public health, the London School of Hygiene and Tropical Medicine and a handful of British Universities, the current 60 or so courses across the country are found in diverse university settings. Quality and standards in higher education are monitored by the Quality Assurance Agency for Higher Education but there are no other professional accreditation schemes for postgraduate courses in public health nationally. Public health education and training continues to face challenges in the UK, notably the current government plans for major restructuring of the National Health Service (NHS) which threatens the loss of traditional NHS training placements and has created uncertainty around how professional training might be structured in the future. Whilst the long established tradition of public health education and more recent adoption of competency-based approaches to training gives some flexibility to meet these challenges, insight and innovative responses are required to ensure that public health education and training are not destabilised by these challenges. Revisions of the curricula of postgraduate courses and the competencies required for professional accreditation along with provision of experience in the new locations where public health is to be practiced in the future will be key to ensuring that public health professionals are ready to tackle the key issues that confront them

Numerical Modeling of Flow Distribution in Micro-Fluidics Systems

This paper describes an application of a general purpose computer program, GFSSP (Generalized Fluid System Simulation Program) for calculating flow distribution in a network of micro-channels. GFSSP employs a finite volume formulation of mass and momentum conservation equations in a network consisting of nodes and branches. Mass conservation equation is solved for pressures at the nodes while the momentum conservation equation is solved at the branches to calculate flowrate. The system of equations describing the fluid network is solved by a numerical method that is a combination of the Newton-Raphson and successive substitution methods. The numerical results have been compared with test data and detailed CFD (computational Fluid Dynamics) calculations. The agreement between test data and predictions is satisfactory. The discrepancies between the predictions and test data can be attributed to the frictional correlation which does not include the effect of surface tension or electro-kinetic effect

Listening through seeing: Using design methods to learn about the health perceptions of Garden on the Go® customers

The goal of this project is to apply an innovative approach to gathering beliefs and attitudes of an inner city population in a more valid and reliable way than traditional data collection methods. This community based research study will focus on dietary risk factors for obesity, diabetes type 2, and cardiovascular disease in underserved communities. Our study assesses what health means to the underserved Garden on the Go® clients and how they define a healthy diet. Garden on the Go®, a signature obesity prevention effort, is Indiana University Health’s year-round mobile produce delivery program providing fresh, affordable produce to Marion County neighborhoods in need. We build upon previous research conducted with Garden on the Go® to enhance the effectiveness of this intervention and provide valuable information that other groups may use to improve the impact of their efforts in meeting the health needs of similar communities

The lived experience of diabetes: conceptualisation using a metaphor

Introduction: It is important for healthcare professionals to understand the reality of living with diabetes in order to better engage and enable people to self-manage. The purpose of this research was thus a preliminary exploration of the lived experience of diabetes. Method: This qualitative study involved seven people with a diagnosis of type 1, type 2 or pre-diabetes. Data was collected via semi-structured interviews and analysed using a phenomenological approach including the use of metaphor. Findings were shared with participants using a felted metaphor of charting a course of health and wellbeing through a choppy sea. Findings: Themes explored within the elements of the metaphor included the boat (self-identity, control, balance, compliance and empowerment, emotions), the sea (physical and social environment, lifestyle, life events), the course (information gathering, change, self-action) and the boatyard (relationships with healthcare providers). Conclusion: For those with type 1, type 2 and pre-diabetes, the elements of charting a course of health and wellbeing through a choppy sea are very much focused on the person in their own context, impacted by their environment, life stage, occupations and attitudes to diabetes self-management, all of which fall within the remit of occupational therapy

Conference on Binary Optics: An Opportunity for Technical Exchange

The papers herein were presented at the Conference on Binary Optics held in Huntsville, AL, February 23-25, 1993. The papers were presented according to subject as follows: modeling and design, fabrication, and applications. Invited papers and tutorial viewgraphs presented on these subjects are included

La musique comme cadre dans la mise en scène de Peter Brook

Dans la plupart des spectacles de Peter Brook, la musique de scène ne semble tenir qu’une place marginale de simple accompagnement. Mais en raison de son rôle conséquent dans leur genèse et dans leur construction, ainsi que dans leur réception par le spectateur, nous postulons qu’elle sert aussi subtilement de cadre aux spectacles et à l’ensemble de la démarche théâtrale du metteur en scène. Si l’image des marges paraît effectivement significative pour évoquer l’aire d’influence de la musique..