Addressing Challenges to the Reliable, Large-Scale Implementation of Effective School Health Education

The long-held priority of teaching young people the knowledge and skills needed for healthy living has recently been diminished in many preK-12 schools. Driven by federal and state priorities, laws, and policies associated with high-stakes testing, instruction in untested subjects has been reduced or eliminated in most schools in order to devote more attention to tested subjects, like reading, math, writing, and science. This article proposes a pathway to ensure that all children are able to learn what society knows about health. To that end, four challenges to the reliable, large-scale implementation of effective school health education are identified: (1) establishing school health education as an undeniable social and cultural priority through improved advocacy; (2) strengthening educational institutions’ capacities to reliably deliver large-scale, high-quality, school-based health education; (3) collaboratively coordinating efforts of health-promoting governmental and nongovernmental organizations that generate thought leadership for school health education; and (4) creating multidisciplinary research capacities for solving problems associated with the implementation of reliable, large-scale, effective school health education. By implementing specific strategies associated with each challenge, health educators can promote the social and system-level conditions required to support, elevate, and ensure delivery of effective health education to every student in every school every year

Attitudes of Graduating Health Practitioners Toward Older Persons in Ghana

Purpose: This study examined attitudes of graduating medical and nursing students toward older persons in Ghana. The association between the overall quality of students’ experiences with older persons and their attitudes was also examined to identify educational interventions to increase interest in geriatrics. Materials and Methods: A sample of 135 final year medical and nursing students from a public institution in Ghana participated in a cross-sectional study by completing a web-based self-administered questionnaire consisting of the 14-item University of California at Los Angeles Geriatric Attitudes (UCLA-GA) scale and demographic questions. Data analysis involved a two-sample t-test and a one-way ANOVA. Results: Overall, most participants (82.2%) held positive attitudes towards older persons. Medical students had significantly more positive attitudes toward older persons (3.50 ± 0.44) than nursing students (3.26 ± 0.38) (t [133] = 3.257, p = .001). The association between students’ attitudes and the quality of their experiences with older persons was significant (F [2, 132] = 7.062, p = .001). Students whose experiences with older persons were negative had the least positive attitudes. Conclusion: Considering the impact of previous experiences with older persons on medical and nursing students’ attitude in Ghana, training to increase interest in geriatrics should include positive clinical and community-based exposure

Mammography Social Support for Women Living in a Midwestern City: Toward Screening Promotion via Social Interactions

Notwithstanding recommendations and interventions, the percentage of 50 – 74-year-old U.S. women who reported having had a mammography in the past two years remained below target coverage. Social interactions may influence mammography rates. To measure characteristics of social interactions in a Midwestern city as they relate to social support for mammography received by women older than 40 years of age. A cross-sectional study was conducted in Bloomington, Indiana, sending mail surveys to 3,000 telephone directory addresses selected by simple random sampling. An anonymous, self-administered, closed-ended, questionnaire with eight checklist items (for demographics) and six multipart semantic differential scale items (for social support), derived from validated instruments, was used. Social support for mammography in women who had undergone regular screening was analyzed using chi-square test and logistic regression. Of 450 respondents with valid responses, 91% were white; 47% were older than 80; 92% had good health insurance coverage; and 82% had undergone regular mammography. Healthcare workers provided the highest support, followed by children, siblings, and relatives. Friends, neighbors, and co-workers were least supportive. In social interactions, emotional support was the most prominent, followed by informational, appraisal, and instrumental supports. Having higher income and being married were associated with receiving greater support. Although mammography provides limited benefits after age 74, women older than 80 years of age received the highest support. Identifying the structural and functional characteristics of social interactions is important for: 1) designing interventions that enhance social support, and 2) expanding breast cancer screening via personalized approaches using existing social interactions

Global Perspectives for Strengthening Health Education: A Mixed-Methods Study

This study aimed to identify the knowledge, experiences, and attitudes about current practices of health education (HE) among government-affiliated high-profile health administrators in developed and developing nations. Respondents (N = 21) were purposively selected based on their affiliation as a health administrator at the national level, with roles in high-profile decision-making for devising policies/programs and allocating funding or advocating strategies to advance HE. Information was gathered using a web-based cross-sectional survey in 5 languages, consisting of 14 closed-ended and 8 open-ended questions. A majority were males (70%) and spoke English (57%), 45% had postgraduate degrees, and 57% were from high-income countries. Participants recognized the importance of HE in their countries and estimated percentages of adults who received health information through various sources. Participants also rated population subgroups that benefit from HE. They highly rated these health issues for HE: control/prevention of communicable diseases, nutrition, physical activity, mental health, and tobacco and other drugs. Only 40% reported having enough resources and funding available for HE. For the qualitative questions, irrespective of being from developed or developing countries, most respondents identified the need for invigorating HE that could be categorized into seven key areas: HE program evaluation, actions to strengthen HE, organizations responsible for identifying HE priorities, job titles of health educators, how ministry collects information on HE needs, high priority health issues and ensuring equity, and ways nongovernmental organizations can strengthen HE. Findings were helpful to identify: high priority HE issues across countries; status of HE programs among government entities; status of funding for HE programs; and how countries can provide more effective program outcomes. Further studies with higher response rate are needed to address these specific issues

Untying the Gordian Knot: The Development of an Immunization Information Exchange

Legislative mandates require the sharing of immunization information among multiple stakeholders. This in turn requires the implementation of interoperable systems across various information systems. A key challenge to system interoperability is the need to integrate healthcare information and processes across different settings. This paper reports work in progress on the development of a student immunization Health Information Exchange (HIE). The system builds on a commercially available platform, appropriately modified on both front and backend, to meet the needs of school health professionals and other stakeholders involved in the production and maintenance of immunization information. We describe the situated change perspective as well as the iterative and incremental development process adopted for the project, and examine some of the lessons learned throughout

Measurement of inclusive D*+- and associated dijet cross sections in photoproduction at HERA

Inclusive photoproduction of D*+- mesons has been measured for photon-proton centre-of-mass energies in the range 130 < W < 280 GeV and a photon virtuality Q^2 < 1 GeV^2. The data sample used corresponds to an integrated luminosity of 37 pb^-1. Total and differential cross sections as functions of the D* transverse momentum and pseudorapidity are presented in restricted kinematical regions and the data are compared with next-to-leading order (NLO) perturbative QCD calculations using the "massive charm" and "massless charm" schemes. The measured cross sections are generally above the NLO calculations, in particular in the forward (proton) direction. The large data sample also allows the study of dijet production associated with charm. A significant resolved as well as a direct photon component contribute to the cross section. Leading order QCD Monte Carlo calculations indicate that the resolved contribution arises from a significant charm component in the photon. A massive charm NLO parton level calculation yields lower cross sections compared to the measured results in a kinematic region where the resolved photon contribution is significant.Comment: 32 pages including 6 figure

Measurement of Jet Shapes in Photoproduction at HERA

The shape of jets produced in quasi-real photon-proton collisions at centre-of-mass energies in the range $134-277$ GeV has been measured using the hadronic energy flow. The measurement was done with the ZEUS detector at HERA. Jets are identified using a cone algorithm in the $\eta - \phi$ plane with a cone radius of one unit. Measured jet shapes both in inclusive jet and dijet production with transverse energies $E^{jet}_T>14$ GeV are presented. The jet shape broadens as the jet pseudorapidity ($\eta^{jet}$) increases and narrows as $E^{jet}_T$ increases. In dijet photoproduction, the jet shapes have been measured separately for samples dominated by resolved and by direct processes. Leading-logarithm parton-shower Monte Carlo calculations of resolved and direct processes describe well the measured jet shapes except for the inclusive production of jets with high $\eta^{jet}$ and low $E^{jet}_T$. The observed broadening of the jet shape as $\eta^{jet}$ increases is consistent with the predicted increase in the fraction of final state gluon jets.Comment: 29 pages including 9 figure

Measurement of event shapes in deep inelastic scattering at HERA

Inclusive event-shape variables have been measured in the current region of the Breit frame for neutral current deep inelastic ep scattering using an integrated luminosity of 45.0 pb^-1 collected with the ZEUS detector at HERA. The variables studied included thrust, jet broadening and invariant jet mass. The kinematic range covered was 10 < Q^2 < 20,480 GeV^2 and 6.10^-4 < x < 0.6, where Q^2 is the virtuality of the exchanged boson and x is the Bjorken variable. The Q dependence of the shape variables has been used in conjunction with NLO perturbative calculations and the Dokshitzer-Webber non-perturbative corrections (`power corrections') to investigate the validity of this approach.Comment: 7+25 pages, 6 figure

Phosphorylation Alters the Interaction of the Arabidopsis Phosphotransfer Protein AHP1 with Its Sensor Kinase ETR1

The ethylene receptor ethylene response 1 (ETR1) and the Arabidopsis histidine-containing phosphotransfer protein 1 (AHP1) form a tight complex in vitro. According to our current model ETR1 and AHP1 together with a response regulator form a phosphorelay system controlling the gene expression response to the plant hormone ethylene, similar to the two-component signaling in bacteria. The model implies that ETR1 functions as a sensor kinase and is autophosphorylated in the absence of ethylene. The phosphoryl group is then transferred onto a histidine at the canonical phosphorylation site in AHP1. For phosphoryl group transfer both binding partners need to form a tight complex. After ethylene binding the receptor is switched to the non-phosphorylated state. This switch is accompanied by a conformational change that decreases the affinity to the phosphorylated AHP1. To test this model we used fluorescence polarization and examined how the phosphorylation status of the proteins affects formation of the suggested ETR1−AHP1 signaling complex. We have employed various mutants of ETR1 and AHP1 mimicking permanent phosphorylation or preventing phosphorylation, respectively. Our results show that phosphorylation plays an important role in complex formation as affinity is dramatically reduced when the signaling partners are either both in their non-phosphorylated form or both in their phosphorylated form. On the other hand, affinity is greatly enhanced when either protein is in the phosphorylated state and the corresponding partner in its non-phosphorylated form. Our results indicate that interaction of ETR1 and AHP1 requires that ETR1 is a dimer, as in its functional state as receptor in planta

Measurement of the Diffractive Cross Section in Deep Inelastic Scattering using ZEUS 1994 Data

The DIS diffractive cross section, $d\sigma^{diff}_{\gamma^* p \to XN}/dM_X$, has been measured in the mass range $M_X < 15$ GeV for $\gamma^*p$ c.m. energies $60 < W < 200$ GeV and photon virtualities $Q^2 = 7$ to 140 GeV$^2$. For fixed $Q^2$ and $M_X$, the diffractive cross section rises rapidly with $W$, $d\sigma^{diff}_{\gamma^*p \to XN}(M_X,W,Q^2)/dM_X \propto W^{a^{diff}}$ with $a^{diff} = 0.507 \pm 0.034 (stat)^{+0.155}_{-0.046}(syst)$ corresponding to a $t$-averaged pomeron trajectory of \bar{\alphapom} = 1.127 \pm 0.009 (stat)^{+0.039}_{-0.012} (syst) which is larger than \bar{\alphapom} observed in hadron-hadron scattering. The $W$ dependence of the diffractive cross section is found to be the same as that of the total cross section for scattering of virtual photons on protons. The data are consistent with the assumption that the diffractive structure function $F^{D(3)}_2$ factorizes according to \xpom F^{D(3)}_2 (\xpom,\beta,Q^2) = (x_0/ \xpom)^n F^{D(2)}_2(\beta,Q^2). They are also consistent with QCD based models which incorporate factorization breaking. The rise of \xpom F^{D(3)}_2 with decreasing \xpom and the weak dependence of $F^{D(2)}_2$ on $Q^2$ suggest a substantial contribution from partonic interactions