A National Dementia Care Pathway Explored

Background: A national, systematic diagnosis and care pathway has the potential to alleviate pressing challenges experienced by individuals with dementia, their carers, and healthcare providers. International exemplars were sought to compare/contrast dementia care with current practice in the United States (US). The 2013 New Zealand (NZ) Framework for Dementia Care was explored. The aim was to understand this systematic, primary care-led, home- and community-focused dementia management approach from the perspective of those delivering care. Providers in one US state were similarly studied. Method: Maximum variation purposive sampling was used in this qualitative descriptive study of 28 participants (18 New Zealand, 10 United States). Semi-structured interviews were used, with recruitment of participants continuing until data saturation was reached. Data were then explored for themes using qualitative content analysis. Results: National standards in NZ provide a progressive pathway grounded in early primary care diagnosis and adaptable teams that foster caregiver support to decrease their burden. The approach also ensures streamlined access to specialists. This is in contrast to the US, where a reactive rather than proactive approach requires providers to navigate unpredictability as they strive to weave together insufficient, inadequate, inconsistent, and inequitable resources to provide families with foundations for an uncertain future. Conclusion: Compared to the US where only 2.12% of the Medicare spend is on primary care, NZ has a strong primary care foundation. Exploring total cost care models, some states have the capacity to redesign primary care for dementia management within practice and community settings and should take action

Convergence of Indigenous Science and Western Science Impacts Student\u27s Interest in STEM and Identity as a Scientist

Within the context of North American Indigenous culture, certain Elders are respected gatekeepers to Indigenous science, also known as traditional knowledge. Yet, while North American born minorities such as Black Americans, Amerindians, and Latin Americans may hail from cultures with a similar appreciation of their own Indigenous science Elders, these minority groups are especially underrepresented in Western science, technology, engineering, and math (STEM)—both in academia and in the workforce. North American underrepresented minorities experience high attrition rates in academia generally, and in STEM specifically. Canada’s Truth and Reconciliation Commission makes a call to action to Indigenize education to benefit all students. Herein lies an opportunity to investigate the impact of Indigenization of a Western science biochemistry course to assess the impact upon university students, both minority (non-White) and non-minority (White) in Anglophone North America (Canada and USA). The aim of the study is to investigate the impact of an Indigenized Western science online course upon student interest in STEM, student perception of the relevance of Elder co-instructors, and student identity as a scientist. A pedagogical quasiexperiment was conducted at North American tribal colleges and mainstream research-intensive universities, regarding an online science course taught either with or without Elder co-educators alongside PhD STEM-trained instructors. Student perceptions of the value of Elder co-educators did not differ across groups and remained unchanged after course delivery. Findings also show that after taking the course co-taught by Indigenous science Elder co-educators, students have significantly greater interest in STEM than those students not exposed to Elders’ teachings. Non-White students reported significantly less self-identification as a scientist than did White students at pre-course, but reported similar identity as a scientist to White students post-course. We attribute these findings to the impact of culturally competent course content to minority students especially. This work establishes the relevance of using online technology to Indigenize a Western science course taught internationally, and suggests the need for more investigative work toward the convergence of Indigenous science and Western science in academia

Traditional Elders in Post-Secondary STEM Education

Native/Aboriginal students are underrepresented in Western science, technology, engineering, and mathematics (STEM), due in part to perceived cultural irrelevance. Yet many Native people continue to engage in Indigenous science, such as through traditional medicine and food systems. Recently it was shown that Aboriginal university students are significant users of natural health products (NHP) and learn about NHP from Elders. Thus, in post-secondary educational settings, the presence of Elders may positively impact Native students\u27 interest in science-related topics. At the First Nations University of Canada, partnering of STEM-trained faculty with Elders occurs in community-based research and education endeavours. This paper highlights these efforts, which include a traditional medicine room teaching laboratory. Medicine walks with Elders have been videotaped and used in live and online classes. Workshops have led to the development and publication of traditional foods and medicine booklets. A prairie medicine wheel garden on campus serves to reinforce Aboriginal values in the appreciation of native prairie plants. An evidence-based ethnomedicine course engages STEM-trained PhDs and Indigenous science Elders as co-educators in the online environment. In these applications, Elders share cultural knowledge to ensure relevance to Natives and to positively impact student interest in science. Future directions include a pedagogical experiment to determine the impact of Elders as educators upon post-secondary student interest in STEM. This ongoing work should facilitate a discourse regarding Aboriginal science education, and illuminates downstream policy implications regarding science literacy, Native retention in science, indigenous science, and the role of Elders in post-secondary STEM education

Inter-organizational governance and trilateral trust building: a case study of crowdsourcing-based open innovation in China

In a case study of a Chinese crowdsourcing intermediary, we explore the impact of inter-organizational governance on trilateral trust-building. We show that formal control and relational governance mechanisms are essential for swift and knowledge-based trust in R&D crowdsourcing. The case also indicates that Chinese businesses continue to use guanxi (informal personal connections) as a relational and contingent mechanism to maintain affect-based trust, but guanxi is shown to inhibit the growth of Internet-based crowdsourcing for open innovation in China

Strategies for enacting health policy codesign: a scoping review and direction for research

Abstract Background Strategies for supporting evidence-informed health policy are a recognized but understudied area of policy dissemination and implementation science. Codesign describes a set of strategies potentially well suited to address the complexity presented by policy formation and implementation. We examine the health policy literature describing the use of codesign in initiatives intended to combine diverse sources of knowledge and evidence in policymaking. Methods The search included PubMed, MEDLINE, PsychInfo, CINAHL, Web of Science, and Google Scholar in November 2022 and included papers published between 1996 and 2022. Terms included codesign, health, policy, and system terminology. Title and abstracts were reviewed in duplicate and included if efforts informed policy or system-level decision-making. Extracted data followed scoping review guidelines for location, evaluation method, health focus, codesign definition, description, level of health system user input, sectors involved, and reported benefits and challenges. Results From 550 titles, 23 citations describing 32 policy codesign studies were included from multiple continents (Australia/New Zealand, 32%; UK/Europe, 32%; South America, 14%; Africa, 9%; USA/Canada 23%). Document type was primarily case study (77%). The area of health focus was widely distributed. Policy type was more commonly little p policy (47%), followed by big p policy (25%), and service innovations that included policy-enabled funding (25%). Models and frameworks originated from formal design (e.g., human-centered or participatory design (44%), political science (38%), or health service research (16%). Reported outcomes included community mobilization (50%), policy feasibility (41%), improved multisector alignment (31%), and introduction of novel ideas and critical thinking (47%). Studies engaging policy users in full decision-making roles self-reported higher levels of community mobilization and community needs than other types of engagement. Discussion Policy codesign is theoretically promising and is gaining interest among diverse health sectors for addressing the complexity of policy formation and implementation. The maturity of the science is just emerging. We observed trends in the association of codesign strategies and outcomes that suggests a research agenda in this area could provide practical insights for tailoring policy codesign to respond to local contextual factors including values, needs, and resources

Developer/Adapter Method: A Community-Based Approach to Improve Health in Indigenous Communities

The purpose of this paper is to provide a narrative of our experience with community-driven change using our “Developer/Adapter” research method in Northern Ontario, Canada, so it can be explored in other First Nations contexts. The goal of our currently funded research is to identify community solutions and knowledge and implement community-developed interventions to better support older Indigenous persons, especially those in rural and remote communities, to “age in place” and remain independent in the community through timely access to relevant care. Our Developer/Adapter research method was developed in response to the community-identified need for self-determination to overcome the limitations of traditional Western approaches and effectively plan and execute change in Indigenous communities. Our approach commits to supporting a self- determining voice for Indigenous people and working collaboratively to develop wholistic care interventions. We believe this approach can generate compelling data for policy and practice change in both Canada and Australia

Biological restoration of major transportation facilities domestic demonstration and application project (DDAP): technology development at Sandia National Laboratories.

The Bio-Restoration of Major Transportation Facilities Domestic Demonstration and Application Program (DDAP) is a designed to accelerate the restoration of transportation nodes following an attack with a biological warfare agent. This report documents the technology development work done at SNL for this DDAP, which include development of the BROOM tool, an investigation of surface sample collection efficiency, and a flow cytometry study of chlorine dioxide effects on Bacillus anthracis spore viability