International Environmental Agreements on Climate Change

This paper analyzes International Environmental Agreements (IEAs) as tools to fight the threat climate change poses on the environment and sustainable development. The paper reviews the literature that provides a theoretical foundation for the IEAs. Particularly, the issues such as the greenhouse gas emissions levels, investments in green technology, the duration of agreements, and the process of negotiation that goes behind these agreements are reviewed. Past agreements (such as the Kyoto Protocol, Copenhagen Accord, and Paris Agreement) are studied to determine their effectiveness and potential problematic aspects related to the contracts

Delivering Patient Centred Care; Advanced Communication Skills Teaching

No abstract available

Incorporating a Sense of Community in a Group Exercise Intervention Facilitates Adherence

Participant attrition is detrimental for exercise intervention studies, particularly if dropout is not random. Community engagement has helped facilitate participant adherence, which is particularly applicable for group exercise programs. Developing a sense of community (SOC) helps participants feel that they belong and provides ongoing social support. This paper reports on strategies used during an 11-week high intensity functional training (HIFT) intervention with exceptionally high adherence (96.7%) that involved 30 participants (57% women, age 36.7 ± 4.5 years). Participants recorded their heart rate variability using a smartphone app daily throughout the study, completed three different weeks of fitness assessments, and attended six weeks of five days/week HIFT group exercise sessions led by a certified coach. Coaches used strategies to facilitate group interactions and individual feedback and engagement. Participants completed a follow-up survey that included 14 items from the SOC in sport scale (SCS), eight questions about group dynamics, and three open-ended study feedback questions that were coded using the SOC categories. All SCS items were highly rated (mean range = 4.51-4.93/5) as were the group dynamics items (mean range = 4.30-4.85/5). Common interests were the most mentioned SOC category in open-ended responses, and while the participants reported really enjoying the study, they provided constructive feedback for improving future studies. Using specific strategies to facilitate a SOC in exercise intervention research (e.g., group exercise, social media connections, and facilitating participant interactions) are recommended for both researchers and practitioners to avoid attrition and encourage adherence, particularly for programs with high daily participant burden

Job design and employee engagement

Engage for Success White Paper no. 2014-0

IMPROVING ACCESS TO FRESH PRODUCE FOR PREDOMINANTLY NON-HISPANIC BLACK NEIGHBORHOODS IN DURHAM COUNTY, NC THROUGH THE MOBILE FARMER’S MARKET COLLABORATIVE PROGRAM

The infrastructure of a community’s physical surroundings and environment dictate their access to fresh, healthy foods. Compared to the North Carolina average of 24%, more than 30% of Durham County residents are burdened by poor grocery store access (Food Security and Nutrition, n.d.). This disparity is reflected in the higher rates of food insecurity and diet-modifiable chronic disease among racial and ethnic minority groups (Durham County, 2021; Osei & Gaillard, 2017). This proposal aims to increase access to fresh produce for residents of primarily non-Hispanic Black neighborhoods through the creation and maintenance of a Mobile Farmer’s Market Collaborative, rotating weekly between predominantly non-Hispanic Black neighborhoods, churches, hospitals, and other community locations. The cost of produce available through the Collaborative will be subsidized to address the financial barriers of healthy eating, and cooking demonstrations in conjunction with nutrition education will be provided to foster long-term health maintenance for beneficiaries. Keywords: Social determinant of health, neighborhood, food access, nutrition education, Durham County, North CarolinaMaster of Public Healt

Pedagogic development of a gamified approach to enhancing engagement in interprofessional education

Inter-professional education (IPE) is an integral part of learning for undergraduate healthcare students. From the evidence in the literature about the benefits of linked learning, collaboration between the health professions early in student development can lead to improved patient outcomes. This article reflects on the adoption at Keele University in the United Kingdom (UK), of a novel approach to introducing inter-professional education – with the intention of increasing interest in undergraduate health students across the Health faculty. A card-based scenario game (a ‘Braincept’ game) in the style of a pub quiz introduced elements of gamification, in order to engage students and increase their awareness of various healthcare professionals’ roles and interactions. This article assesses the impact of using gamification elements and outlines pedagogic principles underpinning development of this novel intervention

Development of an evidence-based mHealth weight management program using a formative research process

BACKGROUND: There is a critical need for weight management programs that are effective, cost efficient, accessible, and acceptable to adults from diverse ethnic and socioeconomic backgrounds. mHealth (delivered via mobile phone and Internet) weight management programs have potential to address this need. To maximize the success and cost-effectiveness of such an mHealth approach it is vital to develop program content based on effective behavior change techniques, proven weight management programs, and closely aligned with participants’ needs. OBJECTIVE: This study aims to develop an evidence-based mHealth weight management program (Horizon) using formative research and a structured content development process. METHODS: The Horizon mHealth weight management program involved the modification of the group-based UK Weight Action Program (WAP) for delivery via short message service (SMS) and the Internet. We used an iterative development process with mixed methods entailing two phases: (1) expert input on evidence of effective programs and behavior change theory; and (2) target population input via focus group (n=20 participants), one-on-one phone interviews (n=5), and a quantitative online survey (n=120). RESULTS: Expert review determined that core components of a successful program should include: (1) self-monitoring of behavior; (2) prompting intention formation; (3) promoting specific goal setting; (4) providing feedback on performance; and (5) promoting review of behavioral goals. Subsequent target group input confirmed that participants liked the concept of an mHealth weight management program and expressed preferences for the program to be personalized, with immediate (prompt) and informative text messages, practical and localized physical activity and dietary information, culturally appropriate language and messages, offer social support (group activities or blogs) and weight tracking functions. Most target users expressed a preference for at least one text message per day. We present the prototype mHealth weight management program (Horizon) that aligns with those inputs. CONCLUSIONS: The Horizon prototype described in this paper could be used as a basis for other mHealth weight management programs. The next priority will be to further develop the program and conduct a full randomized controlled trial of effectiveness

High prevalence of HPV in non-cervical sites of women with abnormal cervical cytology.

BACKGROUND: Human papillomaviruses (HPV) are causally associated with ano-genital and a subset of head and neck cancers. Rising incidence of HPV+ anal cancers and head and neck cancers have now been demonstrated in the developed world over the last decade. The majority of published data on HPV prevalence at the anal and oro-pharyngeal sites are from studies of higher-risk populations. There is a paucity of data on the prevalence of HPV at non-cervical sites in lower risk, non-HIV+ women and this study was designed to provide initial pilot data on a population of women recalled for colposcopy as part of the UK cervical screening programme. METHODS: 100 non-HIV+ women with abnormal cervical cytology, attending clinic for colposcopic examination were recruited. Swabs from the oro-pharyngeal, anal and cervical sites were taken and DNA extracted. HPV detection and genotyping were performed using a standardised, commercially available PCR-line blot assay, which is used to genotype 37 HPV subtypes known to infect the ano-genital and oro-pharyngeal areas. Strict sampling and laboratory precautions were taken to prevent cross-contamination. RESULTS: There was a very high prevalence of HPV infection at all three sites: 96.0%, 91.4% and 92.4% at the cervix, anus and oro-pharynx, respectively. Multiple HPV subtype infections were dominant at all 3 mucosal sites. At least one or more HR genotype was present at both the cervix/anus in 39/52 (75.0%) patients; both the cervix/oro-pharynx in 48/56 (85.7%) patients; and both the anus/oro-pharynx in 39/52 (75.0%) patients. HPV 16 infection was highly dominant across all mucosal sites, with over a 2-fold increase over the next most prevalent subtype (HPV 31). CONCLUSIONS: Women with abnormal smears have widespread infection with high-risk HPV at the cervical, anal and oro-pharyngeal mucosal sites and may represent a higher risk population for HPV disease in the future.RIGHTS : This article is licensed under the BioMed Central licence at http://www.biomedcentral.com/about/license which is similar to the 'Creative Commons Attribution Licence'. In brief you may : copy, distribute, and display the work; make derivative works; or make commercial use of the work - under the following conditions: the original author must be given credit; for any reuse or distribution, it must be made clear to others what the license terms of this work are

The MATISSE study: a randomised trial of group art therapy for people with schizophrenia.

RIGHTS : This article is licensed under the BioMed Central licence at http://www.biomedcentral.com/about/license which is similar to the 'Creative Commons Attribution Licence'. In brief you may : copy, distribute, and display the work; make derivative works; or make commercial use of the work - under the following conditions: the original author must be given credit; for any reuse or distribution, it must be made clear to others what the license terms of this work are.BACKGROUND: Art Therapy has been promoted as a means of helping people who may find it difficult to express themselves verbally engage in psychological treatment. Group Art Therapy has been widely used as an adjunctive treatment for people with schizophrenia but there have been few attempts to examine its effects and cost effectiveness has not been examined. The MATISSE study aims to evaluate the clinical and cost effectiveness of group Art Therapy for people with schizophrenia. METHOD/DESIGN: The MATISSE study is a three-arm, parallel group, pragmatic, randomised, controlled trial of referral to group Art Therapy plus standard care, referral to an attention control 'activity' group plus standard care, or standard care alone. Study participants were recruited from inpatient and community-based mental health and social care services at four centres in England and Northern Ireland. Participants were aged over 18 years with a clinical diagnosis of schizophrenia, confirmed by an examination of case notes using operationalised criteria. Participants were then randomised via an independent and remote telephone randomisation service using permuted stacked blocks, stratified by site. Art Therapy and activity groups were made available to participants once a week for up to 12 months. Outcome measures were assessed by researchers masked to allocation status at 12 and 24 months after randomisation. Participants and care givers were aware which arm of the trial participants were allocated to. The primary outcomes for the study are global functioning (measured using the Global Assessment of Functioning scale) and mental health symptoms (measured using the Positive and Negative Syndrome Scale) assessed at 24 months. Secondary outcomes were assessed at 12 and 24 months and comprise levels of group attendance, social function, satisfaction with care, mental wellbeing, and costs. DISCUSSION: We believe that this is the first large scale pragmatic trial of Art Therapy for people with schizophrenia. TRIAL REGISTRATION: Current Controlled Trials ISRCTN46150447.Published versio