Tomando en Cuenta lo Importante: Investigación Vecinal para la Salud y Justicia Económica y Ambiental en Richmond, North Richmond, y San Pablo

108 p. Libro electrónicoEl Proyecto de Indicadores del Oeste del Condado fue lanzado en 2006 para descubrir las respuestas de la comunidad a esta pregunta y trabajar con residentes y organizaciones locales para fortalecer el poder para alcanzar esta visión. Su punto principal: una comunidad saludable requiere justicia ambiental y económica. Con justicia ambiental, los residentes de Richmond, North Richmond, y San Pablo viven en una comunidad saludable y segura sin importar su raza, nacionalidad o situación económica. Justicia económica asegura que cada habitante tiene acceso a un medio de subsistencia significativo y que cada vecindario cuenta con los recursos necesarios para que ellos mismos puedan desarrollarse. Subyacente a todo el proyecto está la idea de que la investigación controlada y dirigida por los habitantes del vecindario puede ayudar a construir movimientos poderosos para un cambio social. El poder unificador de la investigación participativa sobre preocupaciones del vecindario construye conexiones y tiene éxito en temas como buenos trabajos, calidad del aire, oportunidades para jóvenes, condiciones del parque, alumbrado público, y calidad de las viviendas, y tiene poder para ayudar a unificar diversas comunidades

The relationship of individual comorbid chronic conditions to diabetes care quality.

ObjectiveMultimorbidity affects 26 million persons with diabetes, and care for comorbid chronic conditions may impact diabetes care quality. The aim of this study was to determine which chronic conditions were related to lack of achievement or achievement of diabetes care quality goals to determine potential targets for future interventions.Research design and methodsThis is an exploratory retrospective analysis of electronic health record data for 23 430 adults, aged 18-75, with diabetes who were seen at seven Midwestern US health systems. The main outcome measures were achievement of six diabetes quality metrics in the reporting year, 2011 (glycated haemoglobin (HbA1c) control and testing, low-density lipoprotein control and testing, blood pressure control, kidney testing). Explanatory variables were 62 chronic condition indicators. Analyses were adjusted for baseline patient sociodemographic and healthcare utilization factors.ResultsThe 62 chronic conditions varied in their relationships to diabetes care goal achievement for specific care goals. Congestive heart failure was related to lack of achievement of cholesterol management goals. Obesity was related to lack of HbA1c and BP control. Mental health conditions were related to both lack of achievement and achievement of different care goals. Three conditions were related to lack of cholesterol testing, including congestive heart failure and substance-use disorders. Of 17 conditions related to achieving control goals, 16 were related to achieving HbA1c control. One-half of the comorbid conditions did not predict diabetes care quality.ConclusionsFuture interventions could target patients at risk for not achieving diabetes care for specific care goals based on their individual comorbidities

Time Management Strategies for Research Productivity

Researchers function in a complex environment and carry multiple role responsibilities. This environment is prone to various distractions that can derail productivity and decrease efficiency. Effective time management allows researchers to maintain focus on their work, contributing to research productivity. Thus, improving time management skills is essential to developing and sustaining a successful program of research. This article presents time management strategies addressing behaviors surrounding time assessment, planning, and monitoring. Herein, the Western Journal of Nursing Research editorial board recommends strategies to enhance time management, including setting realistic goals, prioritizing, and optimizing planning. Involving a team, problem-solving barriers, and early management of potential distractions can facilitate maintaining focus on a research program. Continually evaluating the effectiveness of time management strategies allows researchers to identify areas of improvement and recognize progress

Statoconia Formation in Molluscan Statocysts

The gravity sensors of all molluscs phylogenetically below the cephalopods are spherical organs called statocysts. The wall of the sphere contains mechanosensory cells whose sensory cilia project into the lumen of the cyst. The lumen is filled with fluid and dense stones , the statoconia or statoliths, which sink under the influence of gravity to load, and stimulate, those receptor cells which are at the bottom. The statuconia of Aplysia californica are shown to be calcified about a lamellar arrangement of membranes. Similar lamellar membrane arrangements are seen within the receptor cells, and their possible role in the formation of the statoconia is discussed. SEM of unfixed statoconia reveals plate-like crystallization on their surface. Elemental analysis shows a relatively high Sr content, which is of interest, since others have recently reported that Sr is required in the culture medium of several laboratory-reared molluscs in order for the statoconia to develop

NMFS / Interagency Working Group Evaluation of CITES Criteria and Guidelines.

EXECUTIVE SUMMARY: At present, the Convention on International Trade in Endangered Species of Wild Fauna and Flora (CITES) criteria used to assess whether a population qualifies for inclusion in the CITES Appendices relate to (A) size of the population, (B) area of distribution of the population, and (C) declines in the size of the population. Numeric guidelines are provided as indicators of a small population (less than 5,000 individuals), a small subpopulation (less than 500 individuals), a restricted area of distribution for a population (less than 10,000 km2), a restricted area of distribution for a subpopula-tion (less than 500 km2), a high rate of decline (a decrease of 50% or more in total within 5 years or two generations whichever is longer or, for a small wild population, a decline of 20% or more in total within ten years or three generations whichever is longer), large fluctuations (population size or area of distribution varies widely, rapidly and frequently, with a variation greater than one order of magnitude), and a short-term fluctuation (one of two years or less). The Working Group discussed several broad issues of relevance to the CITES criteria and guidelines. These included the importance of the historical extent of decline versus the recent rate of decline; the utility and validity of incorporating relative population productivity into decline criteria; the utility of absolute numbers for defining small populations or small areas; the appropriateness of generation times as time frames for examining declines; the importance of the magnitude and frequency of fluctuations as factors affecting risk of extinction; and the overall utility of numeric thresh-olds or guidelines

A comparison of the travel cost and contingent valuation methods of recreation valuation at Cullaby Lake County Park

While there are many people who feel it is impossible to place a monetary value on a recreation resource, economists argue that not only is it possible to do so but also necessary because so many recreation sites are publicly provided. There have been various methods used to value non-market goods such as a recreation resource, but the methods being used today are still in a changing process. The objective of this thesis is to use and compare two of the most popular means of valuing a recreation site. The two methods are the contingent valuation method (direct questioning of willingness to pay) and the travel cost method. The site to be valued is Cullaby Lake County Park near Astoria, Oregon. Contingent valuation attempts to discover people's willingness to pay for use of the recreation site by "selling" annual passes for use of the site. Through summation of all individual's willingness to pay, a value for the recreation site is calculated. The travel cost method estimates a demand curve by asking users about their travel expenditures and assuming that people would react to an on-site price increase in the same manner as they would to an increase in travel expenditures. The demand curve estimated in this thesis divides users into distance zones and uses zone averages for all the variables. The dependent variable is visits per thousand population for each zone. The independent variables are travel costs (as a price proxy), income, and one-way distance traveled to the site (to represent travel time). The estimate of site value is derived through integration of the consumers' surplus area underneath the demand curve and above the price line. Value estimates derived by the two models show a wide divergence. The travel cost estimate is seven times larger than the contingent valuation estimate. Part of the reason for this discrepancy lies in the fact that the methods were estimating values for two different goods. A benefit estimate of a watershed development project on Cullaby Lake was desired. The contingent valuation method is flexible enough to allow estimation of the benefits attributable to only the improvements made on a natural lake. However, the travel cost model does not have this flexibility and will give a value for the lake as well as for the project improvements. While this thesis does not prove that one method is superior to the other, it may be an important contribution to the literature. Which model (if either) should be chosen to estimate recreation benefits may depend on exactly what it is that one is attempting to value

Obesity and the food environment: income and ethnicity differences among people with diabetes: the Diabetes Study of Northern California (DISTANCE).

ObjectiveIt is unknown whether any association between neighborhood food environment and obesity varies according to individual income and/or race/ethnicity. The objectives of this study were to test whether there was an association between food environments and obesity among adults with diabetes and whether this relationship differed according to individual income or race/ethnicity.Research design and methodsSubjects (n = 16,057) were participants in the Diabetes Study of Northern California survey. Kernel density estimation was used to create a food environment score for each individual's residence address that reflected the mix of healthful and unhealthful food vendors nearby. Logistic regression models estimated the association between the modeled food environment and obesity, controlling for confounders, and testing for interactions between food environment and race/ethnicity and income.ResultsThe authors found that more healthful food environments were associated with lower obesity in the highest income groups (incomes 301-600% and >600% of U.S. poverty line) among whites, Latinos, and Asians. The association was negative, but smaller and not statistically significant, among high-income blacks. On the contrary, a more healthful food environment was associated with higher obesity among participants in the lowest-income group (<100% poverty threshold), which was statistically significant for black participants in this income category.ConclusionsThese findings suggest that the availability of healthful food environments may have different health implications when financial resources are severely constrained

Strategies for a Successful PhD Program: Words of Wisdom From the \u3cem\u3eWJNR\u3c/em\u3e Editorial Board

Nursing doctoral programs prepare students for research-focused careers within academic settings. The purpose of this Editorial Board Special Article is to provide PhD students and advisors with suggestions for making the most of their doctoral experience. Editorial Board members provide their individual insights on the skills and attributes students must acquire during the course of their doctoral education in order to succeed. The authors provide practical tips and advice on how to excel in a PhD program, including how to select an advisor and a dissertation committee, the importance of attending conferences to increase visibility and develop a network of colleagues, presenting and publishing research while still a student, and balancing work and personal life. Students who take full advantage of the opportunities available to them during the course of their doctoral programs will graduate well prepared to take on the multiple responsibilities of research, teaching, and leadership

Normalizing Rejection

Getting turned down for grant funding or having a manuscript rejected is an uncomfortable but not unusual occurrence during the course of a nurse researcher’s professional life. Rejection can evoke an emotional response akin to the grieving process that can slow or even undermine productivity. Only by “normalizing” rejection, that is, by accepting it as an integral part of the scientific process, can researchers more quickly overcome negative emotions and instead use rejection to refine and advance their scientific programs. This article provides practical advice for coming to emotional terms with rejection and delineates methods for working constructively to address reviewer comments

Diabetes Pharmacotherapies and Bladder Cancer: A Medicare Epidemiologic Study

Objective: Patients with type II diabetes have an increased risk of bladder cancer and are commonly treated with thiazolidinediones and angiotensin receptor blockers (ARBs), which have been linked to cancer risk. We explored the relationship between use of one or both of these medication types and incident bladder cancer among diabetic patients (diabetics) enrolled in Medicare. Research Design and Methods: We constructed both a prevalent and incident retrospective cohort of pharmacologically treated prevalent diabetics enrolled in a Medicare fee-for-service plan using inpatient, outpatient (2003–2011) and prescription (2006–2011) administrative data. The association of incident bladder cancer with exposure to pioglitazone, rosiglitazone and ARBs was studied using muitivariable Cox’s hazard models with time-dependent covariates in each of the two cohorts. Results: We identified 1,161,443 prevalent and 320,090 incident pharmacologically treated diabetics, among whom 4433 and 1159, respectively, developed incident bladder cancers. In the prevalent cohort mean age was 75.1 years, mean follow-up time was 38.0 months, 20.2% filled a prescription for pioglitazone during follow-up, 10.4% received rosiglitazone, 31.6% received an ARB and 8.0% received combined therapy with pioglitazone + ARB. We found a positive association between bladder cancer and duration of pioglitazone use in the prevalent cohort (P for trend = 0.008), with ≥24 months of pioglitazone exposure corresponding to a 16% (95% confidence interval 0–35%) increase in the incidence of bladder cancer compared to no use. There was a positive association between bladder cancer and rosiglitazone use for \u3c24 months in the prevalent cohort, but no association with ARB use. There were no significant associations in the incident cohort. Conclusions: We found that the incidence of bladder cancer increased with duration of pioglitazone use in a prevalent cohort of diabetics aged 65+ years residing in the USA, but not an incident cohort