Epistemic Wrong in The Handmaid\u27s Tale: A Literary Approach to Gendered Disinformation

This paper applies epistemological and literary paradigms of false and misleading information to Margaret Atwood’s novel The Handmaid\u27s Tale to argue that both systems and individuals perpetuate the false and misleading categories of information that result in depriving women of bodily autonomy. Analysis of the novel reveals how class divisions work to obstruct effective mobilization of the revolutionary movement. Specific moments in the plot and characterization reveal how individuals\u27 warped perceptions of reality translate into behavior that reinforces the patriarchal regime. Finally, this literary and epistemological analysis attempts to bring literary and philosophical frameworks to bear on definitions within the field of Disinformation Studies.https://orb.binghamton.edu/research_days_posters_2023/1142/thumbnail.jp

Restraint Free in 2023

This EBP project evaluated if in hospitalized adult patients on Sands 800 does the use of a restraint management bundle decrease the use of restraints during the inpatient admission compared to current restraint practices. In the SICU, restraint usage is an initial response instead of last intervention. This culture of care concerns nurses and providers. It was hypothesized that decrease restraint usage and time in restraints will allow the patient to remain safer by evaluating usage of restraint alternatives, cost savings, patient mobility, and clinical staff understanding of appropriate restraint usage. The SICU was educated on the least restrictive device, which in this project was soft mitts. In-services and poster included the restraint wheel that provided alternatives to restraints. The team prioritized peer support and chart review. Restrained patients were reported to leadership daily with a focus on restraint use greater than 72 hours. Twice-daily audits verified orders and nursing documentation then were reported at shift change. The RGH results showed 636 orders for non-violent restraint orders across 17 units with 96.7 average restraint time in hours June 1, 2023 to June 11, 2023. SICU restraint use decreased since the implementation of restraint education and restraint alternative wheel. Prior to implementation, 38 total patients restrained in March decreased to 28 restrained in August 2023. From the results, the hypotheses was supported. An increased availability of alternatives and types of alternatives as well as education for staff members would continue the culture change.https://scholar.rochesterregional.org/nursingresearchday_2023/1011/thumbnail.jp

Effects of ATP7A overexpression in mice on copper transport and metabolism in lactation and gestation

Placentae and mammary epithelial cells are unusual in robustly expressing two copper "pumps", ATP7A and B, raising the question of their individual roles in these tissues in pregnancy and lactation. Confocal microscopic evidence locates ATP7A to the fetal side of syncytiotrophoblasts, suggesting a role in pumping Cu towards the fetus; and to the basolateral (blood) side of lactating mammary epithelial cells, suggesting a role in recycling Cu to the blood. We tested these concepts in wild-type C57BL6 mice and their transgenic counterparts that expressed hATP7A at levels 10-20× those of endogenous mAtp7a. In lactation, overexpression of ATP7A reduced the Cu concentrations of the mammary gland and milk ~50%. Rates of transfer of tracer (64)Cu to the suckling pups were similarly reduced over 30-48 h, as was the total Cu in 10-day -old pups. During the early and middle periods of gestation, the transgenic litters had higher Cu concentrations than the wild-type, placental Cu showing the reverse trend; but this difference was lost by the first postnatal day. The transgenic mice expressed ATP7A in some hepatocytes, so we investigated the possibility that metalation of ceruloplasmin (Cp) might be enhanced. Rates of (64)Cu incorporation into Cp, oxidase activity, and ratios of holo to apoceruloplasmin were unchanged. We conclude that in the lactating mammary gland, the role of ATP7A is to return Cu to the blood, while in the placenta it mediates Cu delivery to the fetus and is the rate-limiting step for fetal Cu nutrition during most of gestation in mice

Priorities and challenges for health leadership and workforce management globally: a rapid review

Abstract Background Health systems are complex and continually changing across a variety of contexts and health service levels. The capacities needed by health managers and leaders to respond to current and emerging issues are not yet well understood. Studies to date have been country-specific and have not integrated different international and multi-level insights. This review examines the current and emerging challenges for health leadership and workforce management in diverse contexts and health systems at three structural levels, from the overarching macro (international, national) context to the meso context of organisations through to the micro context of individual healthcare managers. Methods A rapid review of evidence was undertaken using a systematic search of a selected segment of the diverse literature related to health leadership and management. A range of text words, synonyms and subject headings were developed for the major concepts of global health, health service management and health leadership. An explorative review of three electronic databases (MEDLINE®, Pubmed and Scopus) was undertaken to identify the key publication outlets for relevant content between January 2010 to July 2018. A search strategy was then applied to the key journals identified, in addition to hand searching the journals and reference list of relevant papers identified. Inclusion criteria were independently applied to potentially relevant articles by three reviewers. Data were subject to a narrative synthesis to highlight key concepts identified. Results Sixty-three articles were included. A set of consistent challenges and emerging trends within healthcare sectors internationally for health leadership and management were represented at the three structural levels. At the macro level these included societal, demographic, historical and cultural factors; at the meso level, human resource management challenges, changing structures and performance measures and intensified management; and at the micro level shifting roles and expectations in the workplace for health care managers. Conclusion Contemporary challenges and emerging needs of the global health management workforce orient around efficiency-saving, change and human resource management. The role of health managers is evolving and expanding to meet these new priorities. Ensuring contemporary health leaders and managers have the capabilities to respond to the current landscape is critical

Maternal mortality in Sierra Leone: from civil war to Ebola and the sustainable development goals

More than 1 year has passed since Sierra Leone marked the end of the largest Ebola virus epidemic ever recorded. However, maternal mortality remains a major challenge. The country’s maternal mortality ratio (MMR) is the highest in the world, estimated by the UN Maternal Mortality Estimation Inter-Agency Group to be 1360 [80% uncertainty interval (UI), 999–1980] deaths per 100,000 live births (WHO et al. 2015). This is higher than what the Demographic and Health Survey reports (1165 per 100,000 live births), given incomplete civil registration and vital statistics (CRVS) (Statistics Sierra Leone and ICF International 2014). In contrast, the Millennium Development Goal (MDG) 5A target the country needed to achieve by 2015 was 450 maternal deaths per 100,000 live births

Development and Validation of a Parental Health-Related Empowerment Scale with Low Income Parents

Objectives: Consistent with empowerment theory, parental empowerment acts as a mechanism of change in family-based interventions to support child health. Yet, there are no comprehensive, validated measures of parental health-related empowerment to test this important perspective. Informed by empowerment theory and in the context of a community-based obesity intervention, we developed a self-report measure of parental health-related empowerment and tested its preliminary validity with low-income parents. Methods: The Parental Empowerment through Awareness, Relationships, and Resources (PEARR) is a 21-item scale designed to measure three subdimensions of empowerment including resource empowerment, critical awareness, and relational empowerment. In the fall of 2017 or the fall of 2018, low-income parents (n = 770, 88% mothers) from 16 Head Start programs in Greater Boston completed the PEARR. The resulting data were randomly split into two equal samples with complete data. The factorial structure of the PEARR was tested in the first half of the sample using principal component analysis (PCA) and exploratory factor analysis (EFA) and subsequently confirmed with the second half of the sample using confirmatory factor analysis (CFA). Internal consistency coefficients were calculated for the final subscales. Results: Results from the PCA and EFA analyses identified three component factors (eigenvalues = 8.25, 2.75, 2.12) with all items loading significantly onto the hypothesized subdimension (β > 0.59 and p < 0.01). The three-factor model was subsequently confirmed with the second half of the sample using CFA (β > 0.54 and p < 0.01). Fit indices met minimum criteria (Comparative Fit Index = 0.95, Root Mean Square Error of Approximation = 0.05 (0.05, 0.06), Standardized Root-Mean-Square Residual = 0.05). Subscales demonstrated strong internal consistency (α= 0.83–0.90). Conclusions: Results support initial validity of a brief survey measuring parental empowerment for child health among Head Start parents. The PEARR can be utilized to measure changes in parental empowerment through interventions targeting empowerment as a mechanism of change

Human Foxp3-negative follicular regulatory T cells control IgE responses

Antibody responses to most infectious and food protein antigens depend on help to B cells from specialised T follicular helper (Tfh) cells. A subset of Foxp3+ regulatory T cells (Tregs) has been described in mice, with a prominent role in repressing germinal center reactions that are critical for memory B cell formation and long-lived antibody responses. These specialised Tregs co-opt the Bcl-6-dependent Tfh differentiation pathway in order to access the B cell-rich follicles and have therefore been designated as T follicular regulatory (Tfr) cells

Communities for Healthy Living (CHL) A Community-based Intervention to Prevent Obesity in Low-Income Preschool Children: Process Evaluation Protocol

Abstract Background Process evaluation can illuminate barriers and facilitators to intervention implementation as well as the drivers of intervention outcomes. However, few obesity intervention studies have documented process evaluation methods and results. Community-based participatory research (CBPR) requires that process evaluation methods be developed to (a) prioritize community members’ power to adapt the program to local needs over strict adherence to intervention protocols, (b) share process evaluation data with implementers to maximize benefit to participants, and (c) ensure partner organizations are not overburdened. Co-designed with low-income parents using CBPR, Communities for Healthy Living (CHL) is a family-centered intervention implemented within Head Start to prevent childhood obesity and promote family well-being. We are currently undertaking a randomized controlled trial to test the effectiveness of CHL in 23 Head Start centers in the greater Boston area. In this protocol paper, we outline an embedded process evaluation designed to monitor intervention adherence and adaptation, support ongoing quality improvement, and examine contextual factors that may moderate intervention implementation and/or effectiveness. Methods This mixed methods process evaluation was developed using the Pérez et al. framework for evaluating adaptive interventions and is reported following guidelines outlined by Grant et al. Trained research assistants will conduct structured observations of intervention sessions. Intervention facilitators and recipients, along with Head Start staff, will complete surveys and semi-structured interviews. De-identified data for all eligible children and families will be extracted from Head Start administrative records. Qualitative data will be analyzed thematically. Quantitative and qualitative data will be integrated using triangulation methods to assess intervention adherence, monitor adaptations, and identify moderators of intervention implementation and effectiveness. Discussion A diverse set of quantitative and qualitative data sources are employed to fully characterize CHL implementation. Simultaneously, CHL’s process evaluation will provide a case study on strategies to address the challenges of process evaluation for CBPR interventions. Results from this process evaluation will help to explain variation in intervention implementation and outcomes across Head Start programs, support CHL sustainability and future scale-up, and provide guidance for future complex interventions developed using CBPR. Trial registration ClinicalTrials.gov, NCT03334669 . Registered on October 10, 201