Health promotion in emergency care: rationale, strategies and activities.

The concept of health promotion emerged in the 1970s, prompting global health leaders to adopt a perspective on maintaining and improving the population's health that accounts for the underlying causes of ill-health and mortality. Health is affected by social, economic and environmental factors, which explains why there are health inequalities within and between countries. Health services have been partly reoriented to focus on promoting health as well as treating ill-health, but health promotion is still misunderstood, including in the nursing profession. Health promotion is often viewed as being concerned with addressing patients' lifestyle behaviours, but this is only one aspect of a much broader framework of health promotion strategies. This article introduces the concept of health promotion, explains its relevance to nurses working in the emergency department (ED), and identifies activities ED nurses can undertake to promote the health of patients, staff and the wider community. It also explains how ED nurses can play a role in health activism to better understand the social determinants of health and address health inequalities. [Abstract copyright: © 2021 RCN Publishing Company Ltd. All rights reserved. Not to be copied, transmitted or recorded in any way, in whole or part, without prior permission of the publishers.

Elemental farmer and the subversion of the agrarian grid

Thesis (M. Arch.)--Massachusetts Institute of Technology, Dept. of Architecture, 2009.This electronic version was submitted by the student author. The certified thesis is available in the Institute Archives and Special Collections.Includes bibliographical references (p. 139-140).America's Heartland is nearing a state of cardiac arrest. The practice of Industrial agriculture has caused the Central Plains to fail not only environmentally, but socially and economically as well. The problem is not an intrinsically architectural one; but can design, through its practice of rethinking relationships, provide a solution? This thesis is situated on the boundary between Jeffersonian ideals and those of Sustainability. It proposes a linear architecture of synthesis. The final design is a farming infrastructure with the sole purpose of harvesting 'atmospheric crops' such as wind energy, fog, dew and precipitation. Furthermore, new type of farmer is introduced: the Elemental Farmer. His products are precious commodities, and his territory is not bounded by The Grid.by Adele D. Phillips.M.Arch

‘Care-less whispers’ in the academy during COVID-19: A feminist collaborative autoethnography

This collaborative autoethnography (Bochner and Ellis, 2016) has created a space for three women academics from working-class heritage, navigating the liminal and temporal space of the COVID-19 pandemic within a post-1992 Higher Education Institution, to explore the social relations of one Higher Education Institution and confront their lived experiences. The stories shared in this paper are analysed through a ‘care-less’ (Rogers, 2017) lens, which asks the academy to recognise and confront the duplicity and self-glorification of policy and practice, that might be viewed as acts of normalising and supporting care-less cultures and behaviours. The paper raises questions about social justice, diversity and inclusion, the intersectionality of class and gender, and the inequity of the lived experiences from those who sit on the margins. The paper is the first collaborative writing project from a newly formed staff network of academics who come from working-class backgrounds, and we are intentional in our commitment to support each other as new researchers, giving agency in support of the other to find their voice

Embodied Discourses of Literacy in the Lives of Two Preservice Teachers

This study examines the emerging teacher literacy identities of Ian and A.J., two preservice teachers in a graduate teacher education program in the United States. Using a poststructural feminisms theoretical framework, the study illustrates the embodiment of literacy pedagogy discourses in relation to the literacy courses’ discourse of comprehensive literacy and the literacy biographical discourses of Ian and A.J. The results of this study indicate the need to deconstruct how the discourse of comprehensive literacy limits how we, as literacy teacher educators, position, hear and respond to our preservice teachers and suggests the need for differentiation in our teacher education literacy courses

A Novel Mechanism for CTCF in the Epigenetic Regulation of Bax in Breast Cancer Cells

Wepreviously reported the association of elevated levels of themultifunctional transcription factor, CCCTC binding factor (CTCF), in breast cancer cells with the specific anti-apoptotic function of CTCF. To understand the molecularmechanisms of this phenomenon, we investigated regulation of the human Bax gene by CTCF in breast and non-breast cells. Two CTCF binding sites (CTSs) within the Bax promoter were identified. In all cells, breast and non-breast, active histone modifications were present at these CTSs, DNA harboring this region was unmethylated, and levels of Bax mRNA and protein were similar. Nevertheless, up-regulation of Bax mRNA and protein and apoptotic cell deathwere observed only in breast cancer cells depleted of CTCF.We proposed that increased CTCF binding to the Bax promoter in breast cancer cells, by comparison with non-breast cells, may be mechanistically linked to the specific apoptotic phenotype in CTCF-depleted breast cancer cells. In this study, we show that CTCF binding was enriched at the Bax CTSs in breast cancer cells and tumors; in contrast, binding of other transcription factors (SP1,WT1, EGR1, and c-Myc) was generally increased in non- breast cells and normal breast tissues. Our findings suggest a novel mechanism for CTCF in the epigenetic regulation of Bax in breast cancer cells, whereby elevated levels of CTCF support preferential binding of CTCF to the Bax CTSs. In this context, CTCF functions as a transcriptional repressor counteracting influences of positive regulatory factors; depletion of breast cancer cells from CTCF therefore results in the activation of Bax and apoptosis. © 2013 Neoplasia Press, Inc

The Big Yes and the Little No

Program for the sixth annual RISD Cabaret held in the cellar at the top of the Waterman Building. Design and layout by Nonie Close.https://digitalcommons.risd.edu/liberalarts_cabaret_programs/1005/thumbnail.jp

Factor structure and factorial invariance of the strengths and difficulties questionnaire among children of prisoners and their parents

Parental imprisonment has been linked to a variety of adverse psychological outcomes for children and adolescents. The Strengths and Difficulties Questionnaire (SDQ) has been widely used to assess behavioural and emotional difficulties among 7-17 year olds in the general population and more recently has been utilised among samples of children of prisoners. Previous research has variously tested traditional one-, three- and five- factor solutions to the SDQ, and more recently one bifactor solution has been examined. Based on a sample of children of prisoners (N = 724) and their non-imprisoned parent or caregiver (N = 658), the aim of the present study was to simultaneously compare nine alternative factor structures, including previously tested models and alternative bifactor solutions. Tests of factorial invariance and composite reliability were also performed. The five-factor model was found to provide the best fit for the data. Tests of factorial invariance revealed that the five-factor model provided an equally acceptable, but not identical fit, among boys and girls. Composite reliability scores were low for the Conduct Problems and Peer Problems subscales. The utility of the SDQ in measuring psychological functioning in response to parental imprisonment is discussed

The Active Brains Digital Intervention to Reduce Cognitive Decline in Older Adults: Protocol for a Feasibility Randomized Controlled Trial.

BACKGROUND: Increasing physical activity, improving diet, and performing brain training exercises are associated with reduced cognitive decline in older adults. OBJECTIVE: In this paper, we describe a feasibility trial of the Active Brains intervention, a web-based digital intervention developed to support older adults to make these 3 healthy behavior changes associated with improved cognitive health. The Active Brains trial is a randomized feasibility trial that will test how accessible, acceptable, and feasible the Active Brains intervention is and the effectiveness of the study procedures that we intend to use in the larger, main trial. METHODS: In the randomized controlled trial (RCT), we use a parallel design. We will be conducting the intervention with 2 populations recruited through GP practices (family practices) in England from 2018 to 2019: older adults with signs of cognitive decline and older adults without any cognitive decline. Trial participants were randomly allocated to 1 of 3 study groups: usual care, the Active Brains intervention, or the Active Brains website plus brief support from a trained coach (over the phone or by email). The main outcomes are performance on cognitive tasks, quality of life (using EuroQol-5D 5 level), Instrumental Activities of Daily Living, and diagnoses of dementia. Secondary outcomes (including depression, enablement, and health care costs) and process measures (including qualitative interviews with participants and supporters) will also be collected. The trial has been approved by the National Health Service Research Ethics Committee (reference 17/SC/0463). RESULTS: Results will be published in peer-reviewed journals, presented at conferences, and shared at public engagement events. Data collection was completed in May 2020, and the results will be reported in 2021. CONCLUSIONS: The findings of this study will help us to identify and make important changes to the website, the support received, or the study procedures before we progress to our main randomized phase III trial. TRIAL REGISTRATION: International Standard Randomized Controlled Trial Number 23758980; http://www.isrctn.com/ISRCTN23758980. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/18929

Mental disorders as risk factors: assessing the evidence for the Global Burden of Disease Study

Background: Mental disorders are associated with a considerable burden of disease as well as being risk factors for other health outcomes. The new Global Burden of Disease (GBD) Study will make estimates for both the disability and mortality directly associated with mental disorders, as well as the burden attributable to other health outcomes. Herein we discuss the process by which health outcomes in which mental disorders are risk factors are selected for inclusion in the GBD Study. We make suggestions for future research to strengthen the body of evidence for mental disorders as risk factors

Extending an evidence hierarchy to include topics other than treatment: revising the Australian 'levels of evidence'

Background: In 1999 a four-level hierarchy of evidence was promoted by the National Health and Medical Research Council in Australia. The primary purpose of this hierarchy was to assist with clinical practice guideline development, although it was co-opted for use in systematic literature reviews and health technology assessments. In this hierarchy interventional study designs were ranked according to the likelihood that bias had been eliminated and thus it was not ideal to assess studies that addressed other types of clinical questions. This paper reports on the revision and extension of this evidence hierarchy to enable broader use within existing evidence assessment systems. Methods: A working party identified and assessed empirical evidence, and used a commissioned review of existing evidence assessment schema, to support decision-making regarding revision of the hierarchy. The aim was to retain the existing evidence levels I-IV but increase their relevance for assessing the quality of individual diagnostic accuracy, prognostic, aetiologic and screening studies. Comprehensive public consultation was undertaken and the revised hierarchy was piloted by individual health technology assessment agencies and clinical practice guideline developers. After two and a half years, the hierarchy was again revised and commenced a further 18 month pilot period. Results: A suitable framework was identified upon which to model the revision. Consistency was maintained in the hierarchy of "levels of evidence" across all types of clinical questions; empirical evidence was used to support the relationship between study design and ranking in the hierarchy wherever possible; and systematic reviews of lower level studies were themselves ascribed a ranking. The impact of ethics on the hierarchy of study designs was acknowledged in the framework, along with a consideration of how harms should be assessed. Conclusion: The revised evidence hierarchy is now widely used and provides a common standard against which to initially judge the likelihood of bias in individual studies evaluating interventional, diagnostic accuracy, prognostic, aetiologic or screening topics. Detailed quality appraisal of these individual studies, as well as grading of the body of evidence to answer each clinical, research or policy question, can then be undertaken as required.Tracy Merlin, Adele Weston and Rebecca Toohe