Creating Health Membership in a Health Commons

Persons living in the margins may be separated or isolated because of poverty, disability, gender, and ethnicity. Isolation, along with exposure to at-risk environments and barriers to accessing health care, contributes to adverse health outcomes. Nurses must be open to learning essential transcultural skills to work with persons living in the margins to provide culturally appropriate care that addresses health inequities. Students in a Doctor of Nursing Practice program at Augsburg University developed an innovative approach to care for people living in the margins. The Health Commons, a nursing-led drop-in center in Rochester, MN, and grounded in Newman\u27s (1999) Health is Expanding Consciousness Nursing Theory, is a safe space for people experiencing marginalization to develop relationships. The Rochester Health Commons (RHC) provides a place for guests experiencing resource insecurity to meet with nurses, receive basic personal care supplies, and discuss identified health concerns. The RHC engages with the community using transcultural nursing skills, creating nurse and citizen agency, and builds relationships by creating an environment of belonging and fostering health membership. Tracking the number of guests visiting the RHC helped gauge the success of the RHC. An increase in the number of returning guests was a positive measurable outcome because it reflects the connections and trust developing within the RHC. In the RHC nurses actively advocate for social justice and join guests on their healthcare journey through accompaniment. The RHC fosters a sense of belonging within a community and promotes health outcomes that negate ill effects of inequities and isolationism

Framing liberalism

Self identification as liberal has declined quite notably in the United States since the mid 1960s. Part of the explanation of this decline is a growing association of the connotation of liberalism along the lines of race, protest, counter culture, and the like. I investigate the portions of this group association thesis which are possible to observe in the ANES feeling thermometer data and observe clear evidence of growing group association with the term. That raised the question of where the group association arises. I hypothesize media framing as the cause and observe it by word counts, which I take as proxies for frames. I observe fairly strong associations between presumed cause, media frames, and effect, change in perceptions of liberals.Master of Art

Evaluation of the nutrition screening tool for childhood cancer (SCAN)

Background & aims: Malnutrition is a serious concern for children with cancer and nutrition screening may offer a simple alternative to nutrition assessment for identifying children with cancer who are at risk of malnutrition. The present paper aimed to evaluate the nutrition screening tool for childhood cancer (SCAN). Methods: SCAN was developed after an extensive review of currently available tools and published screening recommendation, consideration of pediatric oncology nutrition guidelines, piloting questions, and consulting with members of International Pediatric Oncology Nutrition Group. In Study 1, the accuracy and validity of SCAN against pediatric subjective global nutrition assessment (pediatric SGNA) was determined. In Study 2, subjects were classified as 'at risk of malnutrition' and 'not at risk of malnutrition' according to SCAN and measures of height, weight, body mass index (BMI) and body composition were compared between the groups. Results: The validation of SCAN against pediatric SGNA showed SCAN had 'excellent' accuracy (0.90, 95% CI 0.78-1.00; p < 0.001), 100% sensitivity, 39% specificity, 56% positive predictive value and 100% negative predictive value. When subjects in Study 2 were classified into 'at risk of malnutrition' and 'not at risk of malnutrition' according to SCAN, the 'at risk of malnutrition' group had significantly lower values for weight Z score (p = 0.001), BMI Z score (p = 0.001) and fat mass index (FMI) (p = 0.04), than the 'not at risk of malnutrition' group. Conclusions: This study shows that SCAN is a simple, quick and valid tool which can be used to identify children with cancer who are at risk of malnutrition

Cosmological Evolution of Supergiant Star-Forming Clouds

In an exploration of the birthplaces of globular clusters, we present a careful examination of the formation of self-gravitating gas clouds within assembling dark matter haloes in a hierarchical cosmological model. Our high-resolution smoothed particle hydrodynamical simulations are designed to determine whether or not hypothesized supergiant molecular clouds (SGMCs) form and, if they do, to determine their physical properties and mass spectra. It was suggested in earlier work that clouds with a median mass of several 10^8 M_sun are expected to assemble during the formation of a galaxy, and that globular clusters form within these SGMCs. Our simulations show that clouds with the predicted properties are indeed produced as smaller clouds collide and agglomerate within the merging dark matter haloes of our cosmological model. We find that the mass spectrum of these clouds obeys the same power-law form observed for globular clusters, molecular clouds, and their internal clumps in galaxies, and predicted for the supergiant clouds in which globular clusters may form. We follow the evolution and physical properties of gas clouds within small dark matter haloes up to z = 1, after which prolific star formation is expected to occur. Finally, we discuss how our results may lead to more physically motivated "rules" for star formation in cosmological simulations of galaxy formation.Comment: Accepted to The Astrophysical Journal; 17 pages, 8 figure

Thermoregulation of \u3ci\u3eEscherichia coil pap\u3c/i\u3e Transcription: H-NS is a Temperature-Dependent DNA Methylation Blocking Factor

The expression of Pap pili that facilitate the attach- ment of Escherichia coli to uroepithelial cells is shut off outside the host at temperatures below 268C. Ribo- nuclease protection analysis showed that this thermo- regulatory response was rapid as evidenced by the absence of papBA transcripts, coding for Pap pilin, after only one generation of growth at 238C. The his- tone-like nucleoid structuring protein H-NS and DNA sequences within papB were required for thermoregu- lation, but the PapB and PapI regulatory proteins were not. In vivo analysis of pap DNA methylation patterns indicated that H-NS or a factor regulated by H-NS bound within the pap regulatory region at 238C but not at 378C, as evidenced by H-NS-dependent inhibi- tion of methylation of the pap GATC sites designated GATC-I and GATC-II. These GATC sites lie upstream of the papBAp promoter and have been shown pre- viously to play a role in controlling Pap pili expression by regulating the binding of Lrp, a global regulator that is essential for activating papBAp transcription. Competitive electrophoretic mobility shift analysis showed that H-NS bound specifically to a pap DNA fragment containing the GATC-I and GATC-II sites. Moreover, H-NS blocked methylation of these pap GATC sites in vitro : H-NS blocked pap GATC methyla- tion at 1.4 mM but was unable to do so at higher con- centrations at which non-specific binding occurred. Thus, non-specific binding of H-NS to pap DNA was not sufficient to inhibit methylation of the pap GATC sites. These results suggest that the ability of H-NS to act as a methylation blocking factor is dependent upon the formation of a specific complex of H-NS with pap regulatory DNA. We hypothesize that a func- tion of H-NS such as oligomerization was altered at 238C, which enabled H-NS to repress pap gene expres- sion through the formation of a specific nucleoprotein complex

Opinions and practices of healthcare professionals on assessment of disease associated malnutrition in children: results from an international survey

Background &amp; aims: Lack of consensus on clinical indicators for the assessment of pediatric disease associated malnutrition (DAM) may explain its under-recognition in clinical practice. This study surveyed the opinions of health professionals (HP) on clinical indicators of DAM and barriers impeding routine nutritional screening in children. Methods: Web-based questionnaire survey (April 2013–August 2015) in Australia, Belgium, Israel, Spain, The Netherlands, Turkey and UK. Results: There were 937 questionnaires returned via local professional associations, of which 693 respondents fulfilled the inclusion criteria and were included in the final analysis; 315 pediatric gastroenterologists and 378 pediatric dieticians. The most important clinical indicators of DAM were ongoing weight loss (80.4%), increased energy/nutrient losses (73.0%), suboptimal energy/macronutrient intake (68.6%), a high nutritional risk condition (67.2%) and increased energy/nutrient requirements (66.2%). These findings were consistent across countries and professions. The most common approach to screen for DAM was assessment of weight changes (85%), followed by the usage of growth charts (77–80%). Common perceived barriers for routine nutritional screening/assessment were low staff awareness (47.5%), no local policy or guidelines (33.4%) and lack of time to screen (33.4%). Conclusions: HP who routinely assess and treat children with DAM identified ongoing weight loss, increased losses, increased requirements, low intake and high nutritional risk conditions as the most important clinical indicators of DAM. These clinical indicators should now serve as a basis to form clinical-based criteria for the identification of DAM in routine clinical practice. Low awareness, lack of guidelines or local policy and lack of resources were the most important barriers of routine screening

The validity of simple methods to detect poor nutritional status in paediatric oncology patients

Poor nutritional status is a major concern for children being treated for an oncology condition. It is vital for optimal prognosis that nutritional concerns are recognised and treated promptly. The majority of oncology treatment centres only use simple methods to screen for poor nutritional status; however, it is unknown whether these simple methods accurately recognise poor nutritional status. We aimed to determine whether commonly used simple nutritional assessment variables could accurately identify poor nutritional status in children being treated for oncological conditions. This cross-sectional study measured height, weight, mid-upper arm circumference, triceps skinfold, albumin levels and body cell mass in forty children being treated for an oncological condition. To determine whether commonly used nutritional variables were suitable determinants, the variables were compared against the reference measure of body cell mass index (BCMI) Z-scores. Using the BCMI Z-score cut-off of − 1·65, 48 % of the study population were considered poorly nourished. Correlational analysis showed that there was no significant biological relationship between the BCMI Z-score and the simple parameters. When divided into two groups based on the nutritional status indicated by the BCMI Z-score, the independent t tests between the well-nourished and malnourished groups demonstrated that there was a significant difference in the BMI Z-score (P = 0·01) between the groups. No simple nutritional measures were found to accurately identify poor nutritional status in children being treated for oncological conditions