Community Partner Mobilization Strategies and Practices Employed by Public Health Professionals in Ontario’s Public Health Units to Prevent Falls among Community-dwelling Older Adults

The prevention of falls among older adults remains a significant and complex problem that cannot be solved without community collaboration, partnership, support, and expertise. Ontario’s Public Health Units (PHU) have a key responsibility in preventing falls by mobilizing with the community. While PHU’s do already work with community partners, little is known about what community partner mobilization strategies and practices are being employed by PHU professionals to prevent falls among community-dwelling older adults, whether these efforts are productive, which community partners they are working with, who best to work with, and what might be done to strengthen future practices. This qualitative study explored and described the mobilization strategies and practices employed by public health professionals in Ontario’s PHUs in working with their community partners to prevent falls among community-dwelling older adults (65 years of age and older). Although fall prevention among community-dwelling older adults is an important public health issue and is part of a broader range of interventions by PHUs and partners pertaining to injury prevention, the primary focus of this research is on community mobilization. A purposeful sample of five PHU professionals tasked with preventing falls among community-dwelling older adults, six community partners, and two future potential partners provided rich data through in-depth, semi-structured interviews. Interview questions explored the individuals’ knowledge, engagement processes, performance, benefits and challenges of community partner mobilization, and public health professionals’ views on capacity building and policy development. Analysis of the data, guided by grounded theory methods, generated multiple themes related to each topic. Regardless of geographic location, population served, organizational and funding structure, all interviewed PHU professionals reported mobilizing with community partners. Community partners and future potential partners primarily represented not-for profit organizations, offering a range of services to older adults, although none were falls specific. The majority of participants had heard of the term community mobilization and defined it in terms of several major themes including engaging in action, gathering community support and involvement, establishing community togetherness and partnership, and change. Reducing and preventing falls and having seniors’ age in a much healthier way was described as a frequently shared mobilization goal or value among PHU professionals and their partners. However, descriptions of the purposes, community partner mobilization processes, and activities engaged in and the order in which these occurred varied among participants and research sites. Common themes describing activities engaged in included initiation, research and data collection, bringing people together, partnership organization, planning, implementation, and evaluating and reviewing work. Other themes related to roles, strategy performance, benefits, challenges, and views about capacity building were also found. The findings of this study are discussed considering existing models of community mobilization used in public health practice in other jurisdictions and presents a practical community partner mobilization framework for future application. It advances knowledge by providing evidence of current mobilization practices to prevent falls and a conceptual approach to engage community partners for falls prevention among community-dwelling older adults

Kinderherzanästhesie in Deutschland : Ergebnisse einer webbasierten Umfrage

Einleitung: Die Anästhesie hat einen gleichwertigen Stellenwert in der chirurgischen Versorgung von Kinderherzen neben Kinderherzchirurgie, Kinderkardiologie und spezieller kinderkardiochirurgischer Intensivmedizin nach dem Verständnis einiger Experten, so auch dem Kinderherzchirurgen Prof. Dr. med. Gerhard Ziemer vom Medical Center der University of Chicago. Methode: Bei der vorliegenden Arbeit handelt es sich um die quantitative Auswertung eines Online-Fragebogens, der von ausgewählten Anästhesist*innen deutscher Kinderherzzentren beantwortet wurde. Ergebnisse: Es zeigt sich deutlich die Heterogenität der deutschen Kinderherzzentren quer durch die Themenkomplexe Institutsorganisation, Teamzusammenstellung, Einarbeitung, allgemeines und spezielles Anästhesiemanagement. Im Themenbereich Institutsorganisation zeigt sich, operative Spektren und Fallzahlen in den jeweiligen Kliniken könnten größer kaum sein. Es gibt in nahezu allen Kliniken Kernteams von Anästhesist*innen, die mit der perioperativen Betreuung der Patienten betraut sind, deren Erfahrungsschatz und Routine sich aber deutlich unterscheiden. Ebenso lassen die unterschiedlichen Einschätzungen zur notwendigen Einarbeitung der eingesetzten Anästhesist*innen Rückschlüsse auf große Unterschiede der jeweils gelebten Praxis vermuten. Deutliche Unterschiede zeigen sich ebenso im allgemeinen und speziellen Anästhesiemanagement. Ein weitgehend einheitliches Vorgehen besteht beispielsweise in den Bereichen des perioperativen Monitorings, der Prämedikation, der Punktionsorte für Gefäßzugänge oder der perioperativen Beatmungsformen ohne CPB. Bundesweit wird bei Narkoseeinleitung und Narkoseführung unterschiedlich vorgegangen. Große Unterschiede gibt es ebenfalls beim Einsatz inotropisch wirksamer Substanzen, der Beatmungsstrategie während des CPB oder dem Vorgehen und Monitoring bei speziellen Eingriffen wie zum Beispiel Operationen am Aortenbogen. Schlussfolgerung: In nahezu allen Bereichen fehlen evidenzbasierte Studien. Diese sollten zeitnah durchgeführt werden, um die bestmögliche anästhesiologische Versorgung der uns anvertrauten herzkranken Kinder zu gewährleisten. Langfristig sollte es das Ziel der DGAI sein, Empfehlungen oder sogar Leitlinien für die Kinderherzanästhesie zu veröffentlichen, um bundesweit einen einheitlichen Versorgungsstandard zu erreichen

An Examination of Planned Quit Attempts among Ontario Smokers and Its Impact on Abstinence

Background: Planning has long been assumed to be an important element of any successful quit smoking strategy. However, recent research findings indicate that unplanned, or spontaneous quit attempts, may lead to more successful and longer cessation periods than planned attempts. This calls into question continued advice to plan and the validity of planning based behaviour change theories. Objectives: To: 1) assess the prevalence of planning; 2) identify the attributes of planners; 3) examine the association of planning and intentions to quit; 4) examine the association of planning and use of quit aids; and 5) examine the impact of planning on smoking cessation outcomes. Methods: Data from the longitudinal Ontario Tobacco Survey (OTS) were examined. Analyses consisted of 418 smokers who made a planned or unplanned quit attempt between their waves 4 and 5 survey response. Descriptive, bivariate, and multivariate analyses were conducted using specialized survey analysis procedures to account for the complex sampling and design features of the OTS. Multiple Imputation (MI) was used to fill in missing data to reduce bias. Results: The prevalence of planning among Ontario smokers who made a quit attempt in the past six months was 70%. Regression models indicated that women, smokers who felt that it would be “very hard to quit”, and those with intentions to quit in the next 6 months had higher odds of making a planned quit attempt. Individuals who made a planned quit attempt had increased odds for using a quit aid compared to those making unplanned attempts. Univariate regression models indicated that planned attempts did not result in higher odds ratios for being abstinent for at least one week and at least one month. Conclusions: The present results suggest that a majority of smokers who made a quit attempt did so with a plan. Planned quit attempts had higher odds use of any quit aid compared with unplanned attempts. Planning was not found to increase the odds of being abstinent compared to unplanned attempts. Although more research is needed, the current study contributes to the dialogue of planning and smoking cessation

Zwischen Wandel und Stabilität: Die Rolle von Regionalen Bildungsbüros beim Abbau von Bildungsungleichheit

Chancenungleichheit in Deutschland manifest sich beim Übergang von der Grundschule zu den weiterführenden Schulformen. Viele Projekte im Rahmen des Reformprogramms kommunale Bildungslandschaften bzw. Bildungsregionen setzen hier an. Ein Übergangsmanagement durch die kommunale Schulverwaltung etwa soll die Zusammenarbeit zwischen Grund- und weiterführenden Schulen unterstützen. Ob die relevanten Akteure, wie Regionale Bildungsbüros, dabei tatsächlich Bildungsungleichheiten adressieren und Reformprozesse anstoßen (können), ist nur wenig erforscht. Die Arbeit greift dieses Desiderat auf und geht folgender übergreifenden Fragestellung nach: Welchen Beitrag haben Regionale Bildungsbüros an einer chancengerechte(re)n Übergangsgestaltung? Die Arbeitshypothese greift auf das Konzept der Pfadabhängigkeit zurück und nimmt an, dass unterschiedliche institutionelle Zwänge, denen Regionale Bildungsbüros ausgesetzt sind, eher ein "weiter wie bisher", anstatt tiefgreifende Wandlungsprozesse begünstigen. Um diese These zu überprüfen, wurden die Übergangsgestaltung von acht Regionalen Bildungsbüros aus der Metropolregion Rhein-Ruhr im Rahmen des Projektes "Schulen im Team - Übergänge gemeinsam gestalten" untersucht. Ein Mixed-Methods Forschungsdesign kam dabei zum Einsatz. So wurde eine Analyse der amtlichen Statistik zu den strukturellen Problemlagen der Projektkommunen beim Übergang durchgeführt. Eine Sozialraumanalyse beleuchtet die sozio-ökonomische Lage der am Projekt (nicht) teilnehmenden Schulen. Projektdokumente, lokale Zeitungsartikel sowie Interviews der Mitarbeiterinnen und Mitarbeiter der Regionalen Bildungsbüros wurden inhaltsanalytisch ausgewertet. Im Fokus standen die Problemwahrnehmung, die Projektziele sowie die Strategien der Regionalen Bildungsbüros bei der Auswahl und Unterstützung von Projektschulen und -netzwerken. Übergreifend zeigt sich mit Blick auf die untersuchten Projektkommunen, dass von einem kommunalen Übergangsmanagement wichtige Impulse für mehr Chancengerechtigkeit beim Übergang ausgehen können. Die Arbeit zeigt allerdings auch, dass die Regionalen Bildungsbüros widersprüchliche Erwartungshaltungen bei der Übergangsgestaltung in Einklang bringen mussten. Es kommt eher zu einem inkrementellen statt einem abrupten Wandel. Die Arbeit verdeutlicht, dass regionale Reformprojekte sowie Forschungsarbeiten institutionelle Ausgangslagen kritisch(er) reflektieren müssen, wollen sie einen Wandel initiieren und Wandlungsprozesse analytisch greifbar machen.Inequality of opportunities in Germany manifests itselfs in the transition from primary to secondary school. Many projects within the framework of area-based educational initiatives consider this as an entry point for reforms. Managing bodies for school transitions of Local Educational Authorities, for instance, support cooperation between primary and secondary schools. Little research has been conducted, however, to determine whether the relevant actors, such as Local Education Offices, actually address educational inequalities and (can) initiate reform processes. This paper addresses this research gap analyzing the following overarching question: To what extent are Local Education Offices contributing to a transition system that improves equity? Based on the concept of path dependency the working hypothesis is that different institutional constraints, that Local Education Offices are exposed to, tend to favour a "business as usual" scenario rather than far-reaching processes of change. In order to examine this hypothesis, the transition management of eight Local Education Offices in the metropolitan area of Rhine-Ruhr was analysed. This was done in the context of a network project called “Schools in a Team”. The paper follows a mixed-methods design that takes an analysis of official statistics on relevant structural problems faced by project municipalities in the school transitions as a starting point. A social space analysis illuminates the socio-economic situation of the schools participating (and not participating) in the project. Project documents as well as local newspapers and interviews with the staff of the Local Education Offices were evaluated using content analysis. The focus was on the perception of the problem, the project objectives and the strategies of the Local Education Offices in selecting and supporting project schools and networks. With regard to the project municipalities studied, it is evident that municipal transition management can provide important impulses for more equity in school transitions. However, the study also shows that the Local Education Offices have had to reconcile contradictory expectations in shaping transition processes. The result is an incremental rather than an abrupt change. The study makes it clear that both regional reform projects and research must critically reflect on institutional starting points if they are to initiate change and make change processes analytically tangible

Die Schulaufsicht als vernachlässigte Akteurin der Schulreform: Eine Sammelbesprechung

Sammelbesprechung zu: 1) Klein, Esther Dominique, & Bremm, Nina (Hrsg.): Unterstützung - Kooperation - Kontrolle: zum Verhältnis von Schulaufsicht und Schulleitung in der Schulentwicklung. Wiesbaden: Springer 2020. 2) Huber, Stephan Gerhard, Arnz, Siegfried, & Klieme, Torsten (Hrsg.): Schulaufsicht im Wandel - Rollen und Aufgaben neu denken. Stuttgart: Raabe 2020

Motivation among reluctant readers: Capturing the goal setting experience in the 'Reading Rocks' program

This study explored goal setting among children with reading disabilities. Of particular focus was the goal setting experience of participants in a literacy-based program, titled “Reading Rocks”. Reading Rocks, offered by the Learning Disabilities Association of Niagara Region (LDANR), supports children with reading disabilities to become more confident readers. The program aims to strengthen literacy skills among vulnerable readers. Another essential component of the program targets children’s reading motivation through goal setting, a recognized strategy for increasing motivation. I outline the importance of reading, followed by exploring children’s reluctance to read. Goal setting is examined as an opportunity to increase motivation among reluctant readers. My research included a qualitative case study of one child-tutor pair in the program. I utilized a think-aloud protocol, a photo elicitation interview, and researcher observations to collect my data. Lastly, I triangulated the data to analyze how children in Reading Rocks experience goal setting

Determining the Impacts of the Sunshine Foundation\u27s Dream-Like Experiences for Children with Severe Physical Disabilities

The Sunshine Foundation is a charity dedicated to providing dream-like experiences to children and families with severe physical disabilities with the hopes to foster optimism, independence and hope, and improve mental health. However, they lack empirical evidence to illustrate the positive long-term impacts that their wishes provide. Thus, our main goal was to generate quantifiable data to highlight the positive impacts of the program, in order to improve donor interest, raise awareness, and ultimately be able to reach more children nation-wide. We intended to do this through a literature review and present concrete statistical findings through a multi-media deliverable in the form of an infographic. The Sunshine Foundation conducts pre- and post-assessment surveys for their participating children and guardians. They provided the results of these surveys in the form of raw ordinal data, and we performed statistical analysis to detect significant changes in the responses. The results were analyzed using the Wilcoxon signed-rank test to determine if the dream-like experience elicited a significant change (α=0.05). We represented our findings in the form of pie charts and incorporated them into the infographic. In addition to the graphs, we added several relevant statistics and quotes that would appeal to potential donors and emphasize the significance and impact of Sunshine\u27s work. The literature review included information regarding three different topics that would provide evidence supporting the long-term impact of Sunshine. The topics addressed were the association between severe physical disabilities and increased risk of mental health issues, the efficacy of pre-existing wish-granting programs, and alternative psychosocial interventions for children with severe disabilitie

Kommunikationsempfehlungen zur Verbesserung des Verhaltens bei der Verwendung von PoC Antigen-Schnelltests und Selbsttests

Die breitere Anwendung von Antigentests zum Auffinden einer akuten Infektion mit SARS-CoV-2 beinhaltet Chancen, aber auch Risiken und Limitationen. Die Tests können als einer von mehreren Bausteinen zur Pandemiekontrolle beitragen, indem sie die Erkennung von Infektionen und somit die Unterbrechung von Infektionsketten ermöglichen - insbesondere durch wiederholte, engmaschige Testungen derselben Personen. Der Beitrag fasst die wichtigsten Aspekte zusammen und gibt evidenzbasierte Tipps zur Kommunikation rund um die PoC Antigen-Schnelltests und Selbsttests

Recent Contributions of Air- and Biomarkers to the Control of Secondhand Smoke (SHS): A Review

Since the publication of the US Surgeon General Reports in 1996 and 2006 and the report of the California Environmental Protection Agency in 1999, many reports have appeared on the contribution of air and biomarkers to different facets of the secondhand smoke (SHS) issue, which are the targets of this review. These recent studies have allowed earlier epidemiological surveys to be biologically validated, and their plausibility demonstrated, quantified the levels of exposure to SHS before the bans in various environments, showed the deficiencies of mechanical control methods and of partial bans and the frequently correct implementation of the efficient total bans. More stringent regulation remains necessary in the public domain (workplaces, hospitality venues, transport sector, etc.) in many countries. Personal voluntary protection efforts against SHS are also needed in the private domain (homes, private cars). The effects of SHS on the cardiovascular, respiratory and neuropsychic systems, on pregnancy and fertility, on cancers and on SHS genotoxicity are confirmed through experimental human studies and through the relationship between markers and prevalence of disease or of markers of disease risk