231 research outputs found

    Developing an Indigenous Measure of Overall Health and Well-Being: the Wicozani Instrument

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    A Native community developed the Wicozani Instrument, a 9-item self-report measure, to assess overall health and well-being from an Indigenous epistemology. The Wicozani Instrument measures mental, physical, and spiritual health and their importance to an individual\u27s quality of life. The instrument’s validity and reliability was examined through two studies. Study 1 utilized standardized measures from Native (i.e., Awareness of Connectedness Scale) and Western (i.e., Psychological Sense of School Membership and Suicide Ideation Questionnaire) epistemologies with Native and non-Native youth. Study 2 utilized a community created measure (i.e., Indigenous Healing Strategies Scale) with Dakota women. Results suggest the Wicozani Instrument is valid and reliable. The development of an Indigenous measure of overall health and well-being addresses Western atomistic frameworks, which often perpetuate the perception of Native identity as a risk factor for poor health, and works to disrupt the Cycle of Native Health Disparities

    Maine Tidal Power Initiative: Environmental Impact Protocols for Tidal Power

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    As a result of ongoing climate change, the pressure for the development of new sources of renewable energy has increased. It is extremely likely that climate change is caused by anthropogenic activities. Thus even if dramatic gains are made in energy efficiency; the addition of novel renewable energy sources is critical to reducing fossil fuel emissions. Even current goals for a reduction in the growth of greenhouse gas emissions mean that all possible low-carbon or non-carbon emitting energy sources be considered. In the marine environment, energy in tidal currents, waves, and thermal structure may be extracted to produce electricity. These energy sources are a critical element in the overall renewable portfolio since, unlike wind and solar energy, both marine thermal and tidal energy are reliable additions to the overall electrical grid. In the case of tidal energy, the contribution of periodic but reliable sources of renewable energy becomes increasingly critical as wind and solar penetration in the grid increase. In a high renewable energy penetration grid, a resource like tidal energy does not provide the same base load capacity as, for example, a nuclear power plant. However, tidal energy can have the effect of reducing the size of either storage or peaking capacity that is required for grid stability by providing power for recovery of dispatchable loads. However, as an immature technology, significant questions remain regarding basic questions like the scale of the potential resource, the impact on sediment transport, the effects on fish populations and communities, and the ability to design a system which is acceptable by the people in the associated communities. The objectives of the funded project were to examine tidal power development in Maine from all perspectives: engineering, resource assessment, biological effects, and social dimensions. Resource and environmental research focused on data collection for the Cobscook Bay/Western Passage, possibly the most viable commercial tidal energy site in the US, tidal power sites along with initial evaluation of the suitability of the approach for at least two other tidal development sites in Maine. Concomitantly, alternative energy research is used as a basis of education for a number of graduate and undergraduate students at the University of Maine and Maine Maritime Academy. The Maine Tidal Power Initiative has developed resource and environmental assessment protocols in conjunction with the deployment of a specific marine hydrokinetic device. The protocols are transferrable throughout Maine and the US to evaluate tidal energy resources and better understand the potential impact of this development on the environment. Again, site-specific social science and environmental research focused on the Cobscook Bay/Western Passage area near Eastport Maine. The protocols and methods developed at these sites have also been used to perform initial scoping reviews of locations in Castine Harbor and Wiscasset, Maine that represent a more modest and more typical small scale energy resource. Specific barrier issues which have been addressed for the industry are technologies and protocols for measuring and modeling tidal flows, responses of fishes to those flows, and people interacting in these environments. Measuring tidal flows is critical to the key economic driver for this industry, the size of the potential resource. The second barrier issue is the need for methods for measuring the impact of marine hydrokinetic (MHK) devices on fish. Acoustic methods have been used with ground truth validation from trawls. The protocols developed in this project have already had a significant impact on the approach that has been taken at other sites. Finally the assessment of the human community response to these technologies and impact on community cohesion and participation is perhaps the largest single barrier to the acceptance of the projects. This work also has the potential to be replicated at other sites, although in both the case of the environmental effects and the social response to these projects, details of the species impacted and the economic and social environment are the ultimate determinants of impact and acceptance. The technology focus for most of this work has been the cross-flow turbine developed by Ocean Renewable Power Company. Testing in the University of Maine tow tank has allowed a large design space to be explored for the optimization of the commercial turbine design. The design code developed for the project was validated using this data set. Both the design code and the data will be placed in a public repository. The most important outcome of the turbine design portion of the work is some general design parameters that can be used to assist in the site assessment and for benchmarking of proprietary designs. The design as well as the data is available for resource assessment and design comparisons. The appeal of this turbine design is that the potential exists for a low solidity turbine with lower tip speed ratios, which will have good performance. The low solidity and tip speed ratio is likely to reduce the risk of fish impacts and thus reduce environmental impact and community resistance to these technologies. The need for low carbon energy sources is undeniable. Resistance to large-scale renewable energy development also continues to increase. The overall approach to this project, where the design of the system considers environmental impacts and social acceptance from the initial engineering design stages and continues with an adaptive management scheme, is the only option for addressing energy needs at the scale required

    Influence of Role Models and Hospital Design on the Hand Hygiene of Health-Care Workers

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    We assessed the effect of medical staff role models and the number of health-care worker sinks on hand-hygiene compliance before and after construction of a new hospital designed for increased access to handwashing sinks. We observed health-care worker hand hygiene in four nursing units that provided similar patient care in both the old and new hospitals: medical and surgical intensive care, hematology/oncology, and solid organ transplant units. Of 721 hand-hygiene opportunities, 304 (42%) were observed in the old hospital and 417 (58%) in the new hospital. Hand-hygiene compliance was significantly better in the old hospital (161/304; 53%) compared to the new hospital (97/417; 23.3%) (p<0.001). Health-care workers in a room with a senior (e.g., higher ranking) medical staff person or peer who did not wash hands were significantly less likely to wash their own hands (odds ratio 0.2; confidence interval 0.1 to 0.5); p<0.001). Our results suggest that health-care worker hand-hygiene compliance is influenced significantly by the behavior of other health-care workers. An increased number of hand-washing sinks, as a sole measure, did not increase hand-hygiene compliance

    Déclaration sur l’approche par l’archéologie sociale du changement climatique

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    Manifiesto sobre Arqueología Social del Cambio Climático aprobado en la Cumbre SACC celebrada en Kiel. Aprobado y firmado el 6 de septiembre de 2021.[ES] El SACC es un grupo independiente, constituido en Kiel, de investigadores e investigadoras que trabajan sobre cambio climático. El objetivo de SACC es reunir científicos y científicas internacionales y representantes de importantes organizaciones internacionales de las áreas de arqueología, paleoecología y gestión del patrimonio para con el fin de discutir y evaluar la contribución de la investigación arqueológica y paleo-ecológica para comprender la interrelación entre el cambio social, el cultural, el ecológico y el climático. Pretendemos resaltar cómo la arqueología, a través del estudio de la conducta adaptativa en el pasado, es capaz de reforzar tanto la resiliencia socio-ecológica de nuestras sociedades, como su capacidad adaptativa ante el actual cambio climático. Además, pretendemos contribuir a la comprensión del impacto del cambio climático en los yacimientos y sitios arqueológicos y patrimoniales, así como en los paisajes culturales, los museos, las colecciones y archivos patrimoniales. SACC celebrará cumbres cada dos años y emitirá una declaración o manifiesto al término de cada una de ellas. S ACC está organizada por un comité interino presidido por las personas convocantes del SACC 1.[EN] SACC is an independent group of researchers working on climate change in the past constituted in Kiel. The aim of SACC is to bring together international scientists and representatives of important international organisations in the fields of archaeology, paleoecology and heritage management to discuss and evaluate the contribution of archaeological and paleo-ecological research to understand the link between social, cultural, ecological and climatic change; and to highlight how archaeology, through the study of past adaptive behaviour, is able to enhance socio-ecological resilience of societies as well as their adaptive capacity to current climate change; furthermore, to contribute to the understanding of the impact of climate change on archaeological and heritage sites as well as on cultural landscapes, museums, collections, and archives. SACC will hold its summit every second year with a declaration at the end of each summit. SACC is organized by a steering committee chaired by the SACC 1 organisers.[FR] Le SACC est un groupe indépendant de chercheurs travaillant sur le changement climatique dans le passé, qui s’est formé à Kiel. L’objectif du S ACC est de réunir des scientifiques internationaux et des représentants d’organisations internationales importantes dans les domaines de l’archéologie, de la paléoécologie et de la gestion du patrimoine. Il a pour objectif de discuter et d’évaluer la contribution de la recherche archéologique et paléo-écologique à la compréhension du lien entre les changements sociaux, culturels, écologiques et climatiques et de souligner comment l’archéologie, par l’étude du comportement adaptatif du passé, est capable d’améliorer la résilience socioécologique des sociétés ainsi que leur capacité d’adaptation au changement climatique actuel. En outre, il contribue à la compréhension de l’impact du changement climatique sur les sites archéologiques et patrimoniaux ainsi que sur les paysages culturels, les musées, les collections et les archives. Le SACC tiendra son conseil tous les deux ans avec une déclaration à la fin de chaque conseil. Il est organisé par un comité de pilotage présidé par les organisateurs de SACC 1.Peer reviewe

    Societal-level versus individual-level predictions of ethical behavior: a 48-society study of collectivism and individualism

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    Is the societal-level of analysis sufficient today to understand the values of those in the global workforce? Or are individual-level analyses more appropriate for assessing the influence of values on ethical behaviors across country workforces? Using multi-level analyses for a 48-society sample, we test the utility of both the societal-level and individual-level dimensions of collectivism and individualism values for predicting ethical behaviors of business professionals. Our values-based behavioral analysis indicates that values at the individual-level make a more significant contribution to explaining variance in ethical behaviors than do values at the societal-level. Implicitly, our findings question the soundness of using societal-level values measures. Implications for international business research are discussed

    Assessing positive mental health in people with chronic physical health problems: correlations with socio-demographic variables and physical health status

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    Background: A holistic perspective on health implies giving careful consideration to the relationship between physical and mental health. In this regard the present study sought to determine the level of Positive Mental Health (PMH) among people with chronic physical health problems, and to examine the relationship between the observed levels of PMH and both physical health status and socio-demographic variables. Methods: The study was based on the Multifactor Model of Positive Mental Health (Lluch, 1999), which comprises six factors: Personal Satisfaction (F1), Prosocial Attitude (F2), Self-control (F3), Autonomy (F4), Problem-solving and Self-actualization (F5), and Interpersonal Relationship Skills (F6). The sample comprised 259 adults with chronic physical health problems who were recruited through a primary care center in the province of Barcelona (Spain). Positive mental health was assessed by means of the Positive Mental Health Questionnaire (Lluch, 1999). Results: Levels of PMH differed, either on the global scale or on specific factors, in relation to the following variables: age: global PMH scores decreased with age (r=-0.129; p=0.038); b) gender: men scored higher on F1 (t=2.203; p=0.028) and F4 (t=3.182; p=0.002), while women scored higher on F2 (t -3.086; p=0.002) and F6 (t=-2.744; p=0.007); c) number of health conditions: the fewer the number of health problems the higher the PMH score on F5 (r=-0.146; p=0.019); d) daily medication: polymedication patients had lower PMH scores, both globally and on various factors; e) use of analgesics: occasional use of painkillers was associated with higher PMH scores on F1 (t=-2.811; p=0.006). There were no significant differences in global PMH scores according to the type of chronic health condition. The only significant difference in the analysis by factors was that patients with hypertension obtained lower PMH scores on the factor Autonomy (t=2.165; p=0.032). Conclusions: Most people with chronic physical health problems have medium or high levels of PMH. The variables that adversely affect PMH are old age, polypharmacy and frequent consumption of analgesics. The type of health problem does not influence the levels of PMH. Much more extensive studies with samples without chronic pathology are now required in order to be able to draw more robust conclusions

    Habitat and Scale Shape the Demographic Fate of the Keystone Sea Urchin Paracentrotus lividus in Mediterranean Macrophyte Communities

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    Demographic processes exert different degrees of control as individuals grow, and in species that span several habitats and spatial scales, this can influence our ability to predict their population at a particular life-history stage given the previous life stage. In particular, when keystone species are involved, this relative coupling between demographic stages can have significant implications for the functioning of ecosystems. We examined benthic and pelagic abundances of the sea urchin Paracentrotus lividus in order to: 1) understand the main life-history bottlenecks by observing the degree of coupling between demographic stages; and 2) explore the processes driving these linkages. P. lividus is the dominant invertebrate herbivore in the Mediterranean Sea, and has been repeatedly observed to overgraze shallow beds of the seagrass Posidonia oceanica and rocky macroalgal communities. We used a hierarchical sampling design at different spatial scales (100 s, 10 s and <1 km) and habitats (seagrass and rocky macroalgae) to describe the spatial patterns in the abundance of different demographic stages (larvae, settlers, recruits and adults). Our results indicate that large-scale factors (potentially currents, nutrients, temperature, etc.) determine larval availability and settlement in the pelagic stages of urchin life history. In rocky macroalgal habitats, benthic processes (like predation) acting at large or medium scales drive adult abundances. In contrast, adult numbers in seagrass meadows are most likely influenced by factors like local migration (from adjoining rocky habitats) functioning at much smaller scales. The complexity of spatial and habitat-dependent processes shaping urchin populations demands a multiplicity of approaches when addressing habitat conservation actions, yet such actions are currently mostly aimed at managing predation processes and fish numbers. We argue that a more holistic ecosystem management also needs to incorporate the landscape and habitat-quality level processes (eutrophication, fragmentation, etc.) that together regulate the populations of this keystone herbivore

    Effect of sitagliptin on cardiovascular outcomes in type 2 diabetes

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    BACKGROUND: Data are lacking on the long-term effect on cardiovascular events of adding sitagliptin, a dipeptidyl peptidase 4 inhibitor, to usual care in patients with type 2 diabetes and cardiovascular disease. METHODS: In this randomized, double-blind study, we assigned 14,671 patients to add either sitagliptin or placebo to their existing therapy. Open-label use of antihyperglycemic therapy was encouraged as required, aimed at reaching individually appropriate glycemic targets in all patients. To determine whether sitagliptin was noninferior to placebo, we used a relative risk of 1.3 as the marginal upper boundary. The primary cardiovascular outcome was a composite of cardiovascular death, nonfatal myocardial infarction, nonfatal stroke, or hospitalization for unstable angina. RESULTS: During a median follow-up of 3.0 years, there was a small difference in glycated hemoglobin levels (least-squares mean difference for sitagliptin vs. placebo, -0.29 percentage points; 95% confidence interval [CI], -0.32 to -0.27). Overall, the primary outcome occurred in 839 patients in the sitagliptin group (11.4%; 4.06 per 100 person-years) and 851 patients in the placebo group (11.6%; 4.17 per 100 person-years). Sitagliptin was noninferior to placebo for the primary composite cardiovascular outcome (hazard ratio, 0.98; 95% CI, 0.88 to 1.09; P<0.001). Rates of hospitalization for heart failure did not differ between the two groups (hazard ratio, 1.00; 95% CI, 0.83 to 1.20; P = 0.98). There were no significant between-group differences in rates of acute pancreatitis (P = 0.07) or pancreatic cancer (P = 0.32). CONCLUSIONS: Among patients with type 2 diabetes and established cardiovascular disease, adding sitagliptin to usual care did not appear to increase the risk of major adverse cardiovascular events, hospitalization for heart failure, or other adverse events
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