Development of Evaluation and Capacity Building Plans for the Chapel Hill-Carrboro City Schools' Local Wellness Policy

Research shows that students who eat a healthy diet and regularly engage in physical activity show improved behavior and academic performance in schools. However, many children in North Carolina, and across the nation, are not healthy: rates of childhood obesity and overweight are high and continue to rise. Schools provide a unique opportunity for interventions to improve healthy eating and physical activity, and there is ample evidence to show that school-based interventions are effective in improving students' health. For this reason, in 2004, Congress mandated that all schools participating in the National School Lunch Program must develop and implement a Local Wellness Policy (LWP), as well as a plan to evaluate the policy. Our Capstone team worked with Chapel Hill-Carrboro City Schools (CHCCS) to design an evaluation plan to measure implementation of their LWP and a capacity building plan to increase CHCCS' ability to successfully implement the policy. First, we conducted a literature review to learn more about LWPs and their implementation across the country. Next, we created a process evaluation plan and a survey tool to collect information from stakeholders to measure LWP implementation annually. Throughout the project, we attended monthly meetings of the Healthy Schools Advisory Council (HSAC) to interact with stakeholders and update them on our progress. We assisted school nurses at three schools in applying for national awards to recognize their wellness efforts. Lastly, we created a capacity building plan to help the district improve its ability to fully and consistently implement the LWP. These Capstone deliverables expand CHCCS' capacity to evaluate the implementation of its LWP and use the results to make improvements, thus making progress toward the ultimate goal of improving student and staff health. As a result of this project, the Capstone team gained knowledge and experience in designing evaluations and writing clearly for a wide audience. By disseminating our deliverables through CHCCS and online in the form of a public Drop Box folder, the team added to the field of resources on LWP implementation, evaluation, and capacity-building, allowing future projects to use our deliverables to inform their own work.Master of Public Healt

Sticky Stories: Joe Orton, Queer History, Queer Dramaturgy

This paper investigates the resonances of Orton’s work for contemporary queer audiences. By presenting potential reasons for the rise and fall in popularity and visibility of Orton’s work for queer and gay audiences through the 1980s and 1990s, this paper looks to the queer context in which Joe Orton’s work developed in order to explore the queer social history into which it fits.  This sense of queer history is linked to contemporary notions of queer theorising about temporalities and queer dramaturgy, which offers potentially novel ways of engaging with Orton’s work queerly without twisting it to fit a ‘neat’ reading, in part because such readings tend to ‘smooth out’ the more difficult elements of the work.  In particular, the paper explores the theatrical form of farce, often articulated as conservative, in relation to queer positions, which are quite the opposite.  In so doing, the paper, by way of queer temporalities and work on queer dramaturgies, sketches out a reading strategy that does not ignore Orton’s more difficult or stickier elements, in particular his treatment of women and race

613 cases of splenic rupture without risk factors or previously diagnosed disease: a systematic review

Background Rupture of the spleen in the absence of trauma or previously diagnosed disease is largely ignored in the emergency literature and is often not documented as such in journals from other fields. We have conducted a systematic review of the literature to highlight the surprisingly frequent occurrence of this phenomenon and to document the diversity of diseases that can present in this fashion. Methods Systematic review of English and French language publications catalogued in Pubmed, Embase and CINAHL between 1950 and 2011. Results We found 613 cases of splenic rupture meeting the criteria above, 327 of which occurred as the presenting complaint of an underlying disease and 112 of which occurred following a medical procedure. Rupture appeared to occur spontaneously in histologically normal (but not necessarily normal size) spleens in 35 cases and after minor trauma in 23 cases. Medications were implicated in 47 cases, a splenic or adjacent anatomical abnormality in 31 cases and pregnancy or its complications in 38 cases. The most common associated diseases were infectious (n = 143), haematologic (n = 84) and non-haematologic neoplasms (n = 48). Amyloidosis (n = 24), internal trauma such as cough or vomiting (n = 17) and rheumatologic diseases (n = 10) are less frequently reported. Colonoscopy (n = 87) was the procedure reported most frequently as a cause of rupture. The anatomic abnormalities associated with rupture include splenic cysts (n = 6), infarction (n = 6) and hamartomata (n = 5). Medications associated with rupture include anticoagulants (n = 21), thrombolytics (n = 13) and recombinant G-CSF (n = 10). Other causes or associations reported very infrequently include other endoscopy, pulmonary, cardiac or abdominal surgery, hysterectomy, peliosis, empyema, remote pancreato-renal transplant, thrombosed splenic vein, hemangiomata, pancreatic pseudocysts, splenic artery aneurysm, cholesterol embolism, splenic granuloma, congenital diaphragmatic hernia, rib exostosis, pancreatitis, Gaucher's disease, Wilson's disease, pheochromocytoma, afibrinogenemia and ruptured ectopic pregnancy. Conclusions Emergency physicians should be attuned to the fact that rupture of the spleen can occur in the absence of major trauma or previously diagnosed splenic disease. The occurrence of such a rupture is likely to be the manifesting complaint of an underlying disease. Furthermore, colonoscopy should be more widely documented as a cause of splenic rupture