Allotments and alternative food networks: the case of Plymouth, UK

Alternative food networks (AFNs) are the focus of an ‘explosive growth’ of research in Europe (Goodman 2004), and the term covers a wide range of activities, from food banks, community gardens, and farmers’ markets, to community supported or organic agriculture. However, there is an impasse in differing positions over whether AFNs represent an exclusionary place-based ‘quality turn’ (Ilbery and Kneafsey 2000), or whether they contribute to inclusive local communities, sustainability and food security (Tregear 2011, Kirwan and Maye 2013). This research aimed to clarify these debates, through exploration of UK allotments as a benchmark for AFNs, using the case of Plymouth, SW England. A political ecology perspective of social-ecological systems (Ostrom 2008) was used to investigate the activities, relations and governance involved in allotments and AFNs, organised through the concepts of multidimensional capital assets (Bebbington 1999). This research demonstrates how activities on allotments involve human, social, cultural, natural and political capital assets, encompassing both basic food security and a quality turn towards ‘good food’ (Sage 2003). Taking the long view, it is seen that the relative importance of the different asset dimensions are contingent on wider socio-political settings. Relations on allotments illustrate the building of social capital, which extends to wider communities of interest, practice and place (Harrington et al. 2008), and which involves values of social justice that can be explained as diverse or care economies (Gibson-Graham 2008, Dowler et al. 2010). However, the politics and governance of allotments are largely influenced by neoliberal policies that favour oligopolistic and transnational food systems and restrict urban land allocations for place-based food initiatives. Present-day urban population densities are at levels far higher than envisaged for the original garden cities. Nevertheless, alliances at neighbourhood, city, regional, national and transnational scales are coalescing around the values represented in the original setting up of the UK allotment system: of self-reliance, human-scale settlements and the restorative value of the natural environment. Any realization of the potential contribution of allotments and AFNs to the sustainability and resilience of food supplies for urban populations (Armitage et al. 2008, Folke et al. 2010) ultimately depends on multilevel responses to a large range of challenges. Finally, the thesis contends that, in the present day, evidence is building up around the potential of allotments and many other AFN activities, or place-based food systems, to meet multiple policy objectives through aligned values

Goal Development in Parents of Children with Epilepsy and Learning Disorders

poster abstractEpilepsy is the most common, chronic neurological condition in children, impacting 2.4 children per 1,000. Caregivers of children with epilepsy and learning disorders are affected by many confounding factors including complex drug regimens, navigating a complex healthcare system, the uncertainty of their child’s future and the challenge of creating an effective educational program in conjunction with their child’s school. Parents of children with epilepsy and learning disorders participated in the Creating Avenues for Parent Partnerships (CAPP) program. The original study was an experimental design in which parents were randomly placed in an intervention group or a wait list control group. Each group consisted of 25 parents, with a total of 50 parents participating in the pilot test of CAPP. One of the instruments that the parents completed throughout the duration of this interventional program was the Goal Attainment Scale (GAS). In the GAS, parents described their goals related to their child’s condition and care. Using a qualitative and systematic coding system the parent’s goals were categorized based on content and outcomes related to their child. The goals created by parents in this population subset fell into eight distinct categories. The categories discerned during analysis were future oriented, internal/perspective adjustment, interpersonal, maintaining normalcy, education/coordination with schools, interaction with health care professionals, physical fitness, and acknowledgement/fostering independence.. Based on analysis of the goals that parents created within the GAS, parents of children with epilepsy are particularly concerned with the security of their child’s future (both residentially and vocationally), educational advancement in partnership with schools, and improving health status through interaction with health care professionals. For the nurse interacting with patients and their caregiver in this specialized population it is critical to understand the goals that caregivers create in relation to the problems that they perceive as the most significant in their lives. Then the nurse will be able to enable caregivers to meet their goals and improve the health outcomes and overall quality of life in children with epilepsy and learning disorders

Sex and Gender in Medical Education, and proceedings from the 2015 Sex and Gender Education Summit

The Sex and Gender Medical Education Summit: a roadmap for curricular innovation was a collaborative initiative of the American Medical Women\u27s Association, Laura W. Bush Institute for Women’s Health, Mayo Clinic, and Society for Women\u27s Health Research (www.sgbmeducationsummit.com). It was held on October 18–19, 2015 to provide a unique venue for collaboration among nationally and internationally renowned experts in developing a roadmap for the incorporation of sex and gender based concepts into medical education curricula. The Summit engaged 148 in-person attendees for the 1 1/2-day program. Pre- and post-Summit surveys assessed the impact of the Summit, and workshop discussions provided a framework for informal consensus building. Sixty-one percent of attendees indicated that the Summit had increased their awareness of the importance of sex and gender specific medicine. Other comments indicate that the Summit had a significant impact for motivating a call to action among attendees and provided resources to initiate change in curricula within their home institutions. These educational efforts will help to ensure a sex and gender basis for delivery of health care in the future

Epilepsy self-management during a pandemic: Experiences of people with epilepsy

This article is made available for unrestricted research re-use and secondary analysis in any form or be any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.The purpose of this descriptive study was to, from the perspective of adult people with epilepsy (PWE) and caregivers of PWE, explore the effects of the current pandemic and resulting societal changes on epilepsy self-management. Ninety-four respondents completed a mixed-methods quantitative and qualitative survey focused on their epilepsy self-management experiences during the coronavirus disease-19 (COVID-19) pandemic. Respondents noted significant disruption in epilepsy self-management. Lack of ability to obtain medications or see epilepsy providers, as well as increased stress, social isolation, and changes in routine were all reported as troublesome, and more than one-third of the sample reported an increase in seizure frequency since the onset of the pandemic. Suggestions are given regarding how to support PWE during future COVID-19 outbreaks and to better prepare PWE and their caregivers for any life-altering events, such as a pandemic, with robust self-management skills that will allow them to maintain the highest level of function possible

Chronic Disease Self-Management: A Hybrid Concept Analysis

BACKGROUND: Chronic diseases require chronic disease self-management (CDSM). Existing CDSM interventions, while improving outcomes, often do not lead to long-lasting effects. To render existing and new CDSM interventions more effective, an exploration of the concept of CDSM from both the literature and patient perspectives is needed. The purpose of this study was to describe the current conceptualization of CDSM in the literature, identify potential inadequacies in this conceptualization based on a comparison of literature- and patient-based CDSM descriptions, and to offer a more comprehensive definition of CDSM. METHODS: A hybrid concept analysis was completed. DISCUSSION: In the literature, CDSM is defined as behaviors influenced by individual characteristics. Patients in the fieldwork phase discussed aspects of CDSM not well represented in the literature. CONCLUSIONS: CDSM is a complex process involving behaviors at multiple levels of a person's environment. Pilot work to develop and test CDSM interventions based on both individual and external characteristics is needed

Oncology Nurses’ Experiences with Prognosis Related Communication

poster abstractBackground: Oncology nurses have opportunities to engage in prognosis related communication with advanced cancer patients but often encounter barriers that impede patient prognosis understanding. Deficits in prognosis understanding have been associated with delays in transitions to end of life care, overly aggressive and potentially non-beneficial cancer treatments, and poor quality of life. Purpose: The purpose of this study was to describe nurses' experiences with prognosis related communication with advanced cancer patients. Methods: A framework of realism was used in this qualitative, descriptive design. A thematic analysis of audio-recorded interviews with oncology nurses (n=27) recruited from a Midwestern urban academic health center and 3 affiliated institutions was performed. Interviews were transcribed verbatim and accuracy checked. Data were coded by 3 experienced researchers. After coding, themes were identified, and a thematic map was developed. Methods to ensure trustworthiness of the findings were used. Results: Six themes were identified: Being in the middle, assessing the situation, barriers to prognosis communication, nurse actions, benefits of prognosis understanding, and negative outcomes. Nurses managed barriers through facilitation, collaboration, or independent actions to assist patients and/or families with prognosis understanding. Conclusions: Shortcomings in prognosis related communication with advanced cancer patients may contribute to negative outcomes for patients and nurses. Interventions to advance nurses’ abilities to facilitate and engage in prognosis communications are needed. Inter-professional communication skills education may also be beneficial

Characterizing Mathematics Graduate Student Teaching Assistants’ Opportunities to Learn from Teaching

Exemplary models to inform novice instruction and the development of graduate teaching assistants (TAs) exist. What is missing from the literature is the process of how graduate students in model professional development programs make sense of and enact the experiences offered. A first step to understanding TAs’ learning to teach is to characterize how and whether they link observations of student work to hypotheses about student thinking and then connect those hypotheses to future teaching actions. A reason to be interested in these connections is that their strength and coherence determine how well TAs can learn from experiences. We found TAs can connect observations and future teaching, but that the connections vary in quality. Our analysis suggests future revisions to TA development programs, which we discuss in the conclusion

Cutting Ties with Pro-Ana: A Narrative Inquiry Concerning the Experiences of Pro-Ana Disengagement from Six Former Site Users.

Websites advocating the benefits of eating disorders (“Pro-Ana”) tend to reinforce and maintain restrictive eating and purging behaviors. Yet remarkably, no study has explored individual accounts of disengagement from these sites and the associated meanings. Using narrative inquiry, this study sought to address this gap. From the interviews of six women, two overarching storylines emerged. The first closely tied disengagement to recovery with varying positions of personal agency claimed: this ranged from enforced and unwelcomed breaks that ignited change, to a personal choice that became viable through the development of alternative social and personal identities. A strong counternarrative to “disengagement as recovery” also emerged. Here, disengagement from Pro-Ana was storied alongside a need to retain an ED lifestyle. With “recovery” being just one reason for withdrawal from Pro-Ana sites, clinicians must remain curious about the meanings individuals ascribe to this act, without assuming it represents a step toward recovery.Peer reviewedFinal Accepted Versio

Blending Credit & Non-Credit Courses: Best Practices, Opportunities, Barriers

Community colleges offer an array of programs designed to help students meet different goals. Noncredit education provides training for students seeking targeted, often shorter, courses for personal and professional enrichment (Cohen, Brawer, & Kisker, 2014). Many community colleges are now increasingly emphasizing noncredit workforce education as they support regional workforce development efforts and strive to meet the needs of their local industry partners (Van Noy, Jacobs, Korey, Bailey, & Hughes, 2008). Despite the millions of students enrolled in these courses and their potential to generate revenue for the institutions delivering programs, Voorhees and Milam (2005) refer to noncredit community college education as the “hidden college” and existing research on noncredit offerings is limited. Blending community college credit and noncredit programs with thoughtful and intentional strategies will benefit the students and the institutions. Van Noy, Jacobs, Korey, Bailey, and Hughes (2008) made five recommendations for strengthening noncredit education based on their research. They included the need to expand state funding with clear goals, to increase coordination of credit and noncredit offerings, to promote articulation of noncredit courses into credit programs, to establish non-degree forms of validation for noncredit programs, and to capture more information regarding employment outcomes resulting from noncredit training. These recommendations provide the framework for an analysis of current VCCS programming