1,459 research outputs found

    The role of urban municipal governments in reducing health inequities: A meta-narrative mapping analysis

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    <p>Abstract</p> <p>Background</p> <p>The 1986 Ottawa Charter for Health Promotion coincided with a preponderance of research, worldwide, on the social determinants of health and health inequities. Despite the establishment of a 'health inequities knowledge base', the precise roles for municipal governments in reducing health inequities at the local level remain poorly defined. The objective of this study was to monitor thematic trends in this knowledge base over time, and to track scholarly prescriptions for municipal government intervention on local health inequities.</p> <p>Methods</p> <p>Using meta-narrative mapping, four bodies of scholarly literature - 'health promotion', 'Healthy Cities', 'population health' and 'urban health' - that have made substantial contributions to the health inequities knowledge base were analyzed over the 1986-2006 timeframe. Article abstracts were retrieved from the four literature bodies using three electronic databases (PubMed, Sociological Abstracts, Web of Science), and coded for bibliographic characteristics, article themes and determinants of health profiles, and prescriptions for municipal government interventions on health inequities.</p> <p>Results</p> <p>1004 journal abstracts pertaining to health inequities were analyzed. The overall quantity of abstracts increased considerably over the 20 year timeframe, and emerged primarily from the 'health promotion' and 'population health' literatures. 'Healthy lifestyles' and 'healthcare' were the most commonly emphasized themes in the abstracts. Only 17% of the abstracts articulated prescriptions for municipal government interventions on local health inequities. Such interventions included public health campaigns, partnering with other governments and non-governmental organizations for health interventions, and delivering effectively on existing responsibilities to improve health outcomes and reduce inequities. Abstracts originating from Europe, and from the 'Healthy Cities' and 'urban health' literatures, were most vocal regarding potential avenues for municipal government involvement on health inequities.</p> <p>Conclusions</p> <p>This study has demonstrated a pervasiveness of 'behavioural' and 'biomedical' perspectives, and a lack of consideration afforded to the roles and responsibilities of municipal governments, among the health inequities scholarly community. Thus, despite considerable research activity over the past two decades, the 'health inequities knowledge base' inadequately reflects the complex aetiology of, and solutions to, population health inequities.</p

    Mapping the interaction of B cell Leukemia 3 (BCL-3) and nuclear factor κB (NF-κB) p50 identifies a BCL-3-mimetic anti-inflammatory peptide

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    The NF-κB transcriptional response is tightly regulated by a number of processes including the phosphorylation, ubiquitination, and subsequent proteasomal degradation of NF-κB subunits. The IκB family protein BCL-3 stabilizes a NF-κB p50 homodimer·DNA complex through inhibition of p50 ubiquitination. This complex inhibits the binding of the transcriptionally active NF-κB subunits p65 and c-Rel on the promoters of NF-κB target genes and functions to suppress inflammatory gene expression. We have previously shown that the direct interaction between p50 and BCL-3 is required for BCL-3-mediated inhibition of pro-inflammatory gene expression. In this study we have used immobilized peptide array technology to define regions of BCl-3 that mediate interaction with p50 homodimers. Our data show that BCL-3 makes extensive contacts with p50 homodimers and in particular with ankyrin repeats (ANK) 1, 6, and 7, and the N-terminal region of Bcl-3. Using these data we have designed a BCL-3 mimetic peptide based on a region of the ANK1 of BCL-3 that interacts with p50 and shares low sequence similarity with other IκB proteins. When fused to a cargo carrying peptide sequence this BCL-3-derived peptide, but not a mutated peptide, inhibited Toll-like receptor-induced cytokine expression in vitro. The BCL-3 mimetic peptide was also effective in preventing inflammation in vivo in the carrageenan-induced paw edema mouse model. This study demonstrates that therapeutic strategies aimed at mimicking the functional activity of BCL-3 may be effective in the treatment of inflammatory disease

    A study of the services, materials and policies provided for homeschooling families by New Jersey public libraries

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    The purpose of this study was to determine if homeschoolers were being adequately served by the county public library systems of New Jersey. This was done by identifying and tabulating the materials, services, and policies available to homeschooling families served by twenty county library systems of New Jersey. The Website and online catalog of each system was searched using checklists developed by the researcher. A questionnaire developed by the researcher was completed by a representative of eighteen of the selected libraries. Most of the libraries surveyed had services and policies that were available to the general public rather than specifically for homeschoolers. The numbers of homeschooling materials varied, as did the percentage of titles available that were published since 2000. In conclusion, while three New Jersey county library systems offered many of the services, materials, and policies requested by homeschoolers, the remaining seventeen New Jersey county public library systems were in need of various improvements

    Out of the Shadows: A Young Woman\u27s Journey from Hiding to Celebrating her Identity

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    In April 2019 the UK government reported that little progress had been made to remedy social outcomes inequality between Roma and the wider population, recommending further recognition of Roma, for example in census data, to enable identification of Roma, their needs, and how to meet those needs. In this article we present an account of one Roma woman’s journey from hiding her identity to celebrating it. We expose five critical incidents that challenge and mould her sense of identity and career aspiration, with insights into her hopes and dreams as she reflects upon the barriers she faces and attempts to overcome. The narrative enhances understanding of the intersection of experience and ethnic identity formation, Marcella’s (pseudonym) case study emerges verbatim through quotes; we do not alter or correct her English. In our exploration, we follow the six classical steps recommended in case study analysis (Yin, 2009) and ground some of the key analytical concepts in Goffman’s theories of stigma (1963) and theatrical performances in everyday life. We conclude by identifying key parallels in her experience, relevant regardless of socioeconomic status to further debate on the nature of internalised shame, stigma, and class

    Presentation and Treatment Outcomes of Liberian Children Age 5 Years and Under Diagnosed With Severe Malaria

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    Malaria is endemic in Liberia with a prevalence rate of up to 60% in some regions, and it has been a major cause of death in children under 5 years of age. Prior to the recent Ebola epidemic, we undertook a prospective, hospital-based pilot study at the National Referral Hospital in Monrovia, to characterize the presentation, accuracy of diagnosis, and treatment outcomes of children presenting for treatment of malaria. From June 2013 to May 2014, we recruited children 5 years and under who presented to the JFK Medical Center with suspected malaria. We collected both clinical and laboratory data on admission and on discharge. We enrolled 477 patients with an average age of 1.6 years. Demographic factors associated with testing negative for malaria included regular bed net use and prior treatment for malaria. The most common presenting symptoms of severe malaria in this population were headache and seizures. Of 246 patients admitted and treated for severe malaria, 33% tested negative by rapid diagnostic test and blood smear for malaria. The case fatality rate was higher for the patients who tested negative for malaria (4.9%) versus those who tested positive (0.6%). Three children who tested negative for malaria showed evidence of undiagnosed Salmonella typhi infection. These results suggest that malaria may be overdiagnosed and that the diagnoses of other infectious diseases, which present in a similar fashion, may be neglected. These findings underscore the need to develop rapid diagnostic tests to screen for alternative causes of febrile illness

    Exploring Women’s Education and Employment Opportunities in India, Syria, and the Philippines

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    The implementation of the United Nations’ Sustainable Development Goals in 2015 marked a new chapter in global development and laid the foundations for addressing inequalities that hinder holistic progress. However, gender gaps pose a significant threat to achieving these goals. Project DREAM (Developing Resilience, Education, Aspiration, and Motivation) sought to explore women’s sense of aspiration, achievement, and lived experience in India, Syria, and the Philippines, as well as develop pilot interventions to address gender disparities. Semi-structured interviews with 69 young women from India, Syria, and the Philippines informed the development of three interventions, namely an aspiration and job skills workshop series in the Philippines, Motivational Interviewing training in Syria and the Philippines, and a social media presence and launch event worldwide. This paper presents the findings of this international project, identifying four key parallels underpinning women’s lived experience: poverty, incomplete education, tradition, and patriarchy. Pre-existing gender inequalities, aggravated by the widespread health, economic, and social disruption caused by the COVID-19 pandemic, must be urgently addressed to ensure that no one is left behind on the road to achieving the Sustainable Development Goals by 2030
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