County Smoke-Free Laws and Asthma Discharges: Evidence from 17 US States

Although approximately 82 percent of the US population was covered by some form of law that restricted smoking in public establishments as of 2014, most research examining the relationship between smoke-free laws and health has been focused at the state level. Purpose. To examine the effect of county workplace smoke-free laws over and above the effect of other (restaurant or bar) smoke-free laws on adult asthma. Methods. The study estimated the effect of rates of adult asthma discharges before and after the implementation of county nonhospitality workplace smoke-free laws and county restaurant and bar smoke-free laws. Data were from2002 to 2009, and all analyses were performed in 2011 through 2013. Results. A statistically significant relationship (−5.43, �� \u3c .05) was found between county restaurant or bar smoke-free laws and reductions in working age adult asthma discharges. There was no statistically significant effect of nonhospitality workplace smoke-free laws over and above the effect of county restaurant or bar laws. Conclusions.This study suggests that further gains in preventable asthma-related hospitalizations in the US are more likely to be made by focusing on smoke-free laws in bars or restaurants rather than in nonhospitality workplaces

Actividades deportivas en el medio natural: su representación en libros de texto de Educación Física en Primaria

The objective of this research is to analyze the sport activities carried out in the natural environment represented in the textbooks of Physical Education (PE) in Primary Education (EP), published according to Organic Law of Education 2/2006, of May 3rd, (LOE). 4339 images have been analyzed, from 44 different textbooks, belonging to eight Spanish publishers. The SAIMEF (Physical Analysis Images Analysis System) tool, elaborated ad hoc, was used to analyze the content of the images. The pilot test, panel of experts and triangulation with several observers were some of the scientific criteria that endorsed this tool. The results show that the presence of images related to sport activities in the natural environment continues to be very scarce in PE textbooks. The editorial Teide represents in greater proportion this type of activities compared to the rest of publishers. In the third cycle appears a greater number of images, predominating drawings over pictures. The most represented sport activity is the orientation, with a 25.6%, included within the multidisciplinary sports, prevailing the terrestrial environment. The representation of sports in the natural environment varies according to the analyzed publishers. Thus, in Anaya and Bruño predominates the orientation, in Edelvives, Paidotribo and Serbal predominates the ski, and in the publishers Santillana and Teide prevails the escalation. It is necessary to reflect on the low representation of these activities in EF textbooks

Enhancing food security in an era of global climate change

The goal of the workshop was to build a more strategic and integrated perspective on the threats and opportunities latent in the food / climate issue, and to discuss the hard challenges of moving forward toward common goals in a private, off-the-record setting. An executive session convened by the John F. Kennedy School of Government at Harvard University and the Venice International University on June 6-9, 2010 attracted more than 25 of the world’s leading experts from the fields of policy, science, and business to San Servolo Island for an intensive three day session (see text for a list of the participants). The discussions were off-the-record, with each participant present in his or her own capacity, rather than representing an organization. The session was one in a series on Grand Challenges of the Sustainability Transition organized by the Sustainability Science Program at Harvard University with the generous support of the Italy’s Ministry for Environment, Land and Sea. This particular session was held in cooperation with the new Mega Program on Climate Change, Agriculture and Food Security being developed by the Consultative Group on International Agricultural Research (CGIAR) and the Earth System Science Partnership. This summary report of the session is our synthesis of the main points and arguments that emerged from the discussions. It does not represent a consensus document, since no effort was made at the Session to arrive at a single consensus view. Rather, we report here on what we heard to be the major themes discussed at the session. Any errors or misrepresentations remain solely our responsibility

Palliative care needs in patients hospitalized with heart failure (PCHF) study: rationale and design

Abstract Aims The primary aim of this study is to provide data to inform the design of a randomized controlled clinical trial (RCT) of a palliative care (PC) intervention in heart failure (HF). We will identify an appropriate study population with a high prevalence of PC needs defined using quantifiable measures. We will also identify which components a specific and targeted PC intervention in HF should include and attempt to define the most relevant trial outcomes. Methods An unselected, prospective, near-consecutive, cohort of patients admitted to hospital with acute decompensated HF will be enrolled over a 2-year period. All potential participants will be screened using B-type natriuretic peptide and echocardiography, and all those enrolled will be extensively characterized in terms of their HF status, comorbidity, and PC needs. Quantitative assessment of PC needs will include evaluation of general and disease-specific quality of life, mood, symptom burden, caregiver burden, and end of life care. Inpatient assessments will be performed and after discharge outpatient assessments will be carried out every 4 months for up to 2.5 years. Participants will be followed up for a minimum of 1 year for hospital admissions, and place and cause of death. Methods for identifying patients with HF with PC needs will be evaluated, and estimates of healthcare utilisation performed. Conclusion By assessing the prevalence of these needs, describing how these needs change over time, and evaluating how best PC needs can be identified, we will provide the foundation for designing an RCT of a PC intervention in HF

A qualitative study of health promotion in academy schools in England

BackgroundSchools are an important setting for health promotion. In England, around one third of publicly funded schools have become independent of local authorities since 2000 and are now academies, run by an academy trust. The aim of this research was to examine attitudes towards health promotion held by academy trust leaders and senior staff. The research questions were: 1. How do academy trusts in England perceive their role in health promotion amongst students? 2. How are decisions around health promotion made in academy trusts? 3. What factors inhibit and encourage health promotion in academy schools? 4. How might public health academics and practitioners best engage with academy schools to facilitate health promotion activity and research?MethodsQualitative study utilising semi-structured interviews. Twenty five academy and school leaders were purposively sampled to achieve variation in trust size and type. In addition, five respondents were recruited from public and third-sector agencies seeking to work with or influence academy trusts around health promotion. Framework analysis was used to determine emergent themes and identify relationships between themes and respondent type. Early findings were triangulated at a stakeholder event with 40 delegates from academia, local authority public health teams, and third sector organisations.ResultsThere is wide variation amongst senior academy and trust leaders in how they perceive the role of academies in promoting health and wellbeing amongst students. There is also variability in whether academy trusts responsible for more than one school adopt a centralised strategy to health promotion or allow individual schools autonomy. This was dependent on the trust leaders’ attitude and interest in health promotion rather than any perceived external accountability. Identified barriers to health promotion include financial constraints, a narrow focus on educational outcomes and school performance, and limited understanding about effective health interventions.ConclusionIn the current absence of national policy or guidance around health promotion in schools, health has variable status in academies in England. There is a need to better engage all academy trusts in health promotion and support them to implement a strategic approach to health promotion

CCAFS Gender Strategy

This Gender Strategy is intended to strengthen CCAFS’ development impact through the integration of gender issues into research in keeping with commitments in the CGIAR Strategy and Results Framework to ensure that rural women benefit from its contribution to poverty reduction, enhanced environmental resilience, improved food security, human health and nutrition. CCAFS plans to situate its gender strategy within a broader strategy addressing social inclusion for different social groups while bearing in mind that women are central to agriculture in developing countries. This Strategy was prepared following CGIAR Guidelines for CRP Gender Strategy1 that focus on showing how the CRP will address issues of gender in its research (as distinct from gender in the workplace which will be handled separately). Accordingly, the document is organized into seven sections that together provide an explanation of how the CRP will address gender issues relevant to its research outputs, activities and outcomes and against which the CRP will report in future, as part of the CGIAR annual monitoring process

A Retrospective Study of the Relationship Between Back Pain and Unilateral Knee Osteoarthritis in Candidates for Total Knee Arthroplasty

The purpose of this study was to determine the presence and temporal relationship between back pain and knee osteoarthritis (OA). All subjects were candidates for unilateral total knee arthroplasty (TKA) to relieve knee pain related to OA, and information regarding the prevalence of back pain was collected via questionnaires. A total of 42 subjects with unilateral knee OA responded to the questionnaires, and 74% of subjects reported chronic back pain, which first occurred approximately 10 years before their becoming candidates for TKA. All but 1 subject reported the onset of back pain prior to TKA candidacy, and less than 15% of subjects felt that their worst back pain occurred after the onset of knee OA. The results of this study are a first step toward quantifying the temporal relationship between back pain and unilateral knee OA, and future studies will look to assess potential risk factors for knee OA such as strength, biomechanical, and anatomical asymmetry