Using a Model to Design Activity-Based Educational Experiences to Improve Cultural Competency among Graduate Students

To improve the cultural competency of 34 students participating in graduate nutrition counseling classes, the Campinha-Bacote Model of Cultural Competence in the Delivery of Health Care Services was used to design, implement, and evaluate counseling classes. Each assignment and activity addressed one or more of the five constructs of the model, i.e., knowledge, skill, desire, encounters, and awareness. A repeated measure ANOVA evaluated pre- and post-test cultural competence scores (Inventory for Assessing the Process of Cultural Competence among Healthcare Professionals). The overall cultural competence score significantly improved (p \u3c 0.001) from “culturally aware” (68.7 at pre-test) to “culturally competent” (78.7 at post-test). Students significantly improved (p \u3c 0.001) in four constructs of the model including awareness, knowledge, skill, and encounter. Factor analysis indicated that course activities accounted for 83.2% and course assignments accounted for 74.6% of the total variance of cultural competence. An activity-based counseling course encouraging self-evaluation and reflection and addressing Model constructs significantly improved the cultural competence of students. As class activities and assignments aligned well with the Campinha-Bacote Model constructs, the findings of this study can help guide health educators to design effective cultural competence training and education programs

Investigating obesity risk-reduction behaviours and psychosocial factors in Chinese Americans

AIM: The purpose of this research was to examine the attitudes, beliefs, and behaviors related to obesity risk reduction in Chinese Americans. METHODS: A questionnaire was administered to a convenience sample of 300 US-born and foreign-born Chinese Americans residing in the New York metropolitan area, ranging from 18 to 40 years of age. Obesity risk reduction behaviors and psychosocial variables derived from the Theory of Planned Behaviour and Health Belief Model were measured. Acculturation was assessed using a modified Suinn-Lew Asian Self-Identity Acculturation Scale. Frequency distributions were delineated and stepwise regression analyses were analyzed for different acculturation groups. RESULTS: 65% of the respondents were female and the mean age of the sample was 26 years. Respondents indicated the most commonly practiced behavior to be eating home-cooked meals instead of restaurant-prepared foods. Perceived barriers to adopting obesity risk-reduction behaviors included the convenience of consuming fast foods, cost, lack of time to prepare home-cooked meals, and the physical environment of unhealthy foods. In predicting intention to perform obesity risk-reduction behaviors, the attitude was significant for \u27Western-identified\u27 individuals. In \u27Asian-identified\u27 individuals, perceived behavioral control, self-efficacy and perceived benefits were salient. CONCLUSIONS: Nutrition educators working with Chinese Americans need to address self-efficacy in preparing plant-based, home-cooked meals and making healthy choices at fast-food restaurants with portion control. Concrete and perceived barriers such as lack of time and convenience need to be addressed in nutrition education interventions. Educators need to identify new channels and media outlets to disseminate practical, easy-to-implement behaviors for obesity risk reduction that are socially acceptable

Examination of Obesity Risk-Reduction Behaviors in Chinese Americans

The purpose of this survey research was to examine the psychosocial characteristics of obesity risk-reduction behaviors in Chinese Americans. Obesity risk-reduction behaviors and psychosocial variables derived from the Theory of Planned Behavior and the Health Belief Model were measured. A questionnaire was administered to a convenience sample of 300 young adult Chinese Americans residing in the New York metropolitan area. Results suggest that when communicating messages to low adopters of health behaviors, promoting positive attitudes and social influences for healthful eating should be emphasized. High behavior adopters may benefit from strategies to maintain self-efficacy to enact health-related behaviors conducive to obesity prevention

Fossil ginkgophyte seedlings from the Triassic of France resemble modern Ginkgo biloba.

Fossil evidence of ginkgophyte ontogeny is exceedingly rare. Early development in the extant Ginkgo biloba is characterized by a series of distinct ontogenetic stages. Fossils providing insights into the early ontogeny of ancient ginkgophytes may be significant in assessing the degree of relatedness between fossil ginkgophytes and G. biloba

Fossil ginkgophyte seedlings from the Triassic of France resemble modern Ginkgo biloba.

Fossil evidence of ginkgophyte ontogeny is exceedingly rare. Early development in the extant Ginkgo biloba is characterized by a series of distinct ontogenetic stages. Fossils providing insights into the early ontogeny of ancient ginkgophytes may be significant in assessing the degree of relatedness between fossil ginkgophytes and G. biloba

Managing small natural features: A synthesis of economic issues and emergent opportunities

Small natural features (SNFs), landscape elements that influence species persistence and ecological functioning on a much larger scale than one would expect from their size, can also offer a greater rate of return on conservation investment compared to that of larger natural features or more broad-based conservation. However, their size and perceived lack of significance also makes them more vulnerable to threats and destruction. We examine the management of SNFs and conservation of the associated ecosystem services they generate from an economics perspective. Using the economic concept of market failure, we identify three key themes that explain prevailing threats to SNFs and characterize impediments to and opportunities for SNF management: (1) the degree to which benefits derived from the feature spillover, beyond the feature itself (spatially and temporally); (2) the availability and quality of information about the feature and those who most directly influence its management; and (3) the existence and enforcement of property rights and legal standing of the feature. We argue that the efficacy of alternative SNF management approaches is highly case dependent and relies on four key components: (1) the specific ecosystem services of interest; (2) the amount of redundancy of the SNF on the landscape and the level of connectivity required by the SNF in order to provide ecosystem services; (3) the particular market failures that need correcting and their scope and extent; and (4) the magnitude and distribution of management costs

Using landscape metrics to characterize towns along an urban-rural gradient

Context: Urban-rural gradients are useful tools when examining the influence of human disturbances on ecological, social and coupled systems, yet the most commonly used gradient definitions are based on single broad measures such as housing density or percent forest cover that fail to capture landscape patterns important for conservation. Objectives: We present an approach to defining urban–rural gradients that integrates multiple landscape pattern metrics related to ecosystem processes important for natural resources and wildlife sustainability. Methods: We develop a set of land cover composition and configuration metrics and then use them as inputs to a cluster analysis process that, in addition to grouping towns with similar attributes, identifies exemplar towns for each group. We compare the outcome of the cluster-based urban-rural gradient typology to outcomes for four commonly-used rule-based typologies and discuss implications for resource management and conservation. Results: The resulting cluster-based typology defines five town types (urban, suburban, exurban, rural, and agricultural) and notably identifies a bifurcation along the gradient distinguishing among rural forested and agricultural towns. Landscape patterns (e.g., core and islet forests) influence where individual towns fall along the gradient. Designations of town type differ substantially among the five different typologies, particularly along the middle of the gradient. Conclusions: Understanding where a town occurs along the urban-rural gradient could aid local decision-makers in prioritizing and balancing between development and conservation scenarios. Variations in outcomes among the different urban-rural gradient typologies raise concerns that broad-measure classifications do not adequately account for important landscape patterns. We suggest future urban-rural gradient studies utilize more robust classification approaches

Discontinuation of reflex testing of stool samples for vancomycin-resistant enterococci resulted in increased prevalence

Discontinuation of reflex testing stool submitted for Clostridium difficile testing for vancomycin-resistant enterococci (VRE) led to an increase of patients with healthcare-associated VRE bacteremia and bacteriuria (2.1 versus 3.6 per 10,000 patient days; p<0.01 ). Cost-benefit analysis showed reflex screening and isolation of VRE reduced hospital costs