Promoting resilience and well-being for indigenous adolescents in Canada: connecting to the good life through an outdoor adventure leadership experience

Background: Promoting mental health for Indigenous youth in Canada is a well-documented priority. Indigenous approaches to health promotion share similarities with the holistic process in outdoor adventure and experiential education contexts. The purpose of this study was to develop, implement, and evaluate an Outdoor Adventure Leadership Experience (OALE) for Indigenous adolescents from one First Nations community in Northeastern Ontario, Canada. Methods: Principles of community-based participatory research were used to guide this mixed method study that included three phases. Phase 1 involved the development of a culturally relevant OALE intervention. The intervention was available to adolescents, aged 12-18 years, living in Wikwemikong Unceded Indian Reserve. Phase 2 consisted of a quantitative evaluation of the effectiveness of the OALE, based on participant self-report. It focused primarily on assessing resilience using the 14-Item Resilience Scale (RS-14). Using an ethnographic approach, Phase 3 comprised a qualitative evaluation of the ways in which the OALE promoted resilience and well-being. Results: Phase 1 occurred over a period of 10 months (September 2008 to June 2009), and it resulted in the development of an intentionally designed 10-day OALE program. The program was implemented in the summer of 2009 and 2010 with 73 adolescent participants, aged 12-18 years. Results from Phase 2 revealed that there was a 3.40 point increase in mean resilience for the adolescent participants at one month post-OALE compared to one day pre-OALE (n=46, p=.011), but the improvement was not sustained one year later. Phase 3 results revealed that the OALE facilitated the development of resilience and well-being by helping the adolescents connect to Anishinaabe Bimaadziwin, an Ojibway concept that can be translated as the Good iv Life. Connecting involved an external experiential process of connecting with various aspects of creation and an internal reflective process of connecting within to different aspects of self. Conclusion: The OALE appears to be a program that helped the adolescents: (1) become more resilient in the short-term, and (2) become more aware of Anishinaabe Bimaadziwin (the Good Life) by providing opportunities for connecting with creation and self through a variety of experiences and reflections that were unique for each youth.Doctor of Philosophy (PhD) in Rural and Northern Healt

GPNN: Power Studies and Applications of a Neural Network Method for Detecting Gene-Gene Interactions in Studies of Human Disease

The identification and characterization of genes that influence the risk of common, complex multifactorial disease primarily through interactions with other genes and environmental factors remains a statistical and computational challenge in genetic epidemiology. We have previously introduced a genetic programming optimized neural network (GPNN) as a method for optimizing the architecture of a neural network to improve the identification of gene combinations associated with disease risk. The goal of this study was to evaluate the power of GPNN for identifying high-order gene-gene interactions. We were also interested in applying GPNN to a real data analysis in Parkinson\u27s disease

Reflexivity Through a Yoga Class Experience: Preparing for My Health Promotion Without Borders Excursion to Mongolia

In this paper, I (S. L. Deibert) share my story of discovering the relationship between reflexivity, autoethnography, and yoga through a meaningful experience. Yoga has been an important influence on my physical and mental well-being for over a decade, but I did not consider its implications in my academic life until I was asked to write a reflexive assignment for a course. The task was exploring who I am in connection to my master’s thesis project; the challenge was finding a starting point for my reflexive journey of self-discovery. Frustrated by the latter, I turned to yoga for refuge; instead of escaping the assignment, I found that my quest for self-exploration was intertwined with my yoga practice. The purpose of this paper is to delve further into my experience with yoga as a medium for developing reflexivity. Using autoethnography, I share my journey of developing critical thinking through a narrative related to my yoga class experience. Linking my research to my yoga practice allowed me to better understand myself as a person and researcher, become mindful of how my own views shape my experiences, and develop a deeper level of critical reflection. Overall, this work demonstrates the experience of a connection between yoga, reflexivity, and autoethnography, and adds to the sparse literature exploring the intersection of these three

Neuromuscular responses to mild-muscle damaging eccentric exercise in a low glycogen state.

The aim of this study was to examine the effect of low muscle glycogen on the neuromuscular responses to maximal eccentric contractions. Fourteen healthy men (22±3years) performed single-leg cycling (20min at ∼75% maximal oxygen uptake (V̇O2 max); eight 90 s sprints at a 1:1 work-to-rest ratio (5% decrements from 90% to 55% V̇O2 max until exhaustion) the evening before 100 eccentric (1.57rads(-1)) with reduced (RED) and normal glycogen (NORM). Neuromuscular responses were measured during and up to 48h after with maximal voluntary and involuntary (twitch, 20Hz and 50Hz) isometric contractions. During eccentric contractions, peak torque decreased (RED: -16.1±2.5%; NORM: -6.2±5.1%) and EMG frequency increased according to muscle length. EMG activity decreased for RED only. After eccentric contractions, maximal isometric force was reduced up to 24h for NORM (-13.5±5.8%) and 48h for RED (-7.4±10.9%). Twelve hours after eccentric contractions, twitch force and the 20:50Hz ratio were decreased for RED but not for NORM. Immediate involuntary with prolonged voluntary force loss suggests that reduced glycogen is associated with increased susceptibility to mild muscle-damaging eccentric exercise with contributions of peripheral and central mechanisms to be different during recovery

Healthcare students’ perceptions about their role, confidence and competence to deliver brief public health interventions and advice

Background Public health improvement has long been an important focus for the United Kingdom Department of Health. The Allied Health Professions (AHP) Federation has 84,000 members, such a large number of AHP professionals should play a role in public health initiatives, but it is not clear if they or the AHP students who will be the future healthcare workforce feel themselves equipped to do so. Our aim was to understand the perceptions of AHP students about their role in delivering public health advice. Methods AHP students were recruited in one teaching university from different departments. Participants were final year AHP students who had completed all clinical placements related to their course. All students were emailed an invitation to participate, and those interested were asked to contact the researchers to participate in one of several focus groups. Data were recorded, transcribed, and analysed using framework analysis by two independent researchers. Results Nineteen students were recruited and participated in four focus groups. The main themes produced by the data analysis were: understanding of public health issues, perceptions of their role in this, challenges and opportunities to develop a public health role, and preparation for a public health role. Conclusions AHP students felt that they had a role in public health advice-giving, but barriers to providing this advice included their own lack of confidence and knowledge, time, and the environment of the clinical placement. They considered that there should be more teaching on public health issues, and that these should feature in both the curriculum and on clinical placement

Developing Dementia-Friendly Tourism Destinations: An Exploratory Analysis

Dementia is emerging as a global issue. Increases in life expectancy create an older population structure with accompanying health needs but also high lifestyle expectations. For example existing generations have come to expect to be able to participate in leisure and tourism activities in later life, which can be constrained by the onset of dementia. Leading healthy lifestyles and engaging in tourism activities are viewed as fundamental to remaining active and contributing to slowing the progress of dementia. This study is the first to examine the challenges and implications of the growing scale of dementia and the business opportunities this may create for destinations wishing to achieve dementia-friendly status. The paper reports results from an initial scoping study with tourism businesses in a coastal resort in the United Kingdom with such ambitions to assess the nature of the issues that arose from a series of face-to-face interviews

Operational Implementation of the Healthy Communities Study How Communities Shape Children’s Health

The Healthy Communities Study (HCS) is examining how characteristics of community programs and policies targeting childhood obesity are related to childhood diet, physical activity, and obesity outcomes. The study involves selected districts and public schools in 130 communities; families recruited through schools; and data collected at the community, school, household, and child levels. Data collection took place in two waves—Wave 1 in Spring 2012 and Wave 2 from 2013 to 2015—with analysis to be completed by August 2016. This paper describes operational elements of the HCS, including recruitment activities, field operations, training of data collectors, human subjects protection, and quality assurance and quality control procedures. Experienced trainers oversaw and conducted all training, including training of: (1) district and school recruitment staff; (2) telephone interviewers for household screening and recruitment; (3) field data collectors for conducting household data collection; and (4) community liaisons for conducting key informant interviews, document abstraction, and community observations. The study team developed quality assurance and quality control procedures that were implemented for all aspects of the study. Planning and operationalizing a study of this complexity and magnitude, with multiple functional teams, required frequent communication and strong collaboration among all study partners to ensure timely and effective decision making

Murray Valley encephalitis virus surveillance and control initiatives in Australia.

Mechanisms for monitoring Murray Valley encephalitis (MVE) virus activity include surveillance of human cases, surveillance for activity in sentinel animals, monitoring of mosquito vectors and monitoring of weather conditions. The monitoring of human cases is only one possible trigger for public health action and the additional surveillance systems are used in concert to signal the risk of human disease, often before the appearance of human cases. Mosquito vector surveillance includes mosquito trapping for speciation and enumeration of mosquitoes to monitor population sizes and relative composition. Virus isolation from mosquitoes can also be undertaken. Monitoring of weather conditions and vector surveillance determines whether there is a potential for MVE activity to occur. Virus isolation from trapped mosquitoes is necessary to define whether MVE is actually present, but is difficult to deliver in a timely fashion in some jurisdictions. Monitoring of sentinel animals indicates whether MVE transmission to vertebrates is actually occurring. Meteorological surveillance can assist in the prediction of potential MVE virus activity by signalling conditions that have been associated with outbreaks of Murray Valley encephalitis in humans in the past. Predictive models of MVE virus activity for south-eastern Australia have been developed, but due to the infrequency of outbreaks, are yet to be demonstrated as useful for the forecasting of major outbreaks. Surveillance mechanisms vary across the jurisdictions. Surveillance of human disease occurs in all States and Territories by reporting of cases to health authorities. Sentinel flocks of chickens are maintained in 4 jurisdictions (Western Australia, the Northern Territory, Victoria and New South Wales) with collaborations between Western Australia and the Northern Territory. Mosquito monitoring complements the surveillance of sentinel animals in these jurisdictions. In addition, other mosquito monitoring programs exist in other States (including South Australia and Queensland). Public health control measures may include advice to the general public and mosquito management programs to reduce the numbers of both mosquito larvae and adult vectors. Strategic plans for public health action in the event of MVE virus activity are currently developed or being developed in New South Wales, the Northern Territory, South Australia, Western Australia and Victoria. A southern tri-State agreement exists between health departments of New South Wales, Victoria and South Australia and the Commonwealth Department of Health and Aged Care. All partners have agreed to co-operate and provide assistance in predicting and combatting outbreaks of mosquito-borne disease in south-eastern Australia. The newly formed National Arbovirus Advisory Committee is a working party providing advice to the Communicable Diseases Network Australia on arbovirus surveillance and control. Recommendations for further enhancement of national surveillance for Murray Valley encephalitis are described

What is the 'problem' that outreach work seeks to address and how might it be tackled? Seeking theory in a primary health prevention programme

<b>Background</b> Preventive approaches to health are disproportionately accessed by the more affluent and recent health improvement policy advocates the use of targeted preventive primary care to reduce risk factors in poorer individuals and communities. Outreach has become part of the health service response. Outreach has a long history of engaging those who do not otherwise access services. It has, however, been described as eclectic in its purpose, clientele and mode of practice; its effectiveness is unproven. Using a primary prevention programme in the UK as a case, this paper addresses two research questions: what are the perceived problems of non-engagement that outreach aims to address; and, what specific mechanisms of outreach are hypothesised to tackle these.<p></p> <b>Methods</b> Drawing on a wider programme evaluation, the study undertook qualitative interviews with strategically selected health-care professionals. The analysis was thematically guided by the concept of 'candidacy' which theorises the dynamic process through which services and individuals negotiate appropriate service use.<p></p> <b>Results</b> The study identified seven types of engagement 'problem' and corresponding solutions. These 'problems' lie on a continuum of complexity in terms of the challenges they present to primary care. Reasons for non-engagement are congruent with the concept of 'candidacy' but point to ways in which it can be expanded.<p></p> <b>Conclusions</b> The paper draws conclusions about the role of outreach in contributing to the implementation of inequalities focused primary prevention and identifies further research needed in the theoretical development of both outreach as an approach and candidacy as a conceptual framework