The Mana Kai Framework: a degrowth lens

The Mana Kai Framework is a set of values, goals and objectives to improve the food provisioning system in Aotearoa New Zealand, developed through a round of nationwide consultations, with the ultimate purpose of informing a national food strategy. This article builds upon Mana Kai, finding that the consultation process assumed only a growth economy in future; a second round of consultation using a degrowth lens, it is argued, would produce a valuable alternative framework. This could prove fruitful towards the stated Mana Kai aspiration to ignite a social movement to drive significant systemic change, and could, alongside the existing framework, inform a national food strategy that is ready for growth and degrowth futures, both of which are plausible, thereby ensuring a more resilient food system in Aotearoa New Zealand

The Future of Energy Regulation and Policy Development: A Summary Paper

In September 2013, The School of Public Policy at the University of Calgary hosted 19 speakers and 55 delegates in Calgary for a full-day symposium entitled “The Future of Energy Regulation and Policy Development: Conflict, Compromise or Cooperation?” Participants included current and past regulatory officials at the federal and provincial or state levels in both Canada and the United States, academics, lawyers active in regulatory matters, and representatives from industry and non-governmental organizations. Symposium chair Michal Moore (Area Director, Energy and Environmental Policy at The School of Public Policy) challenged participants to imagine what the “next regulatory world” would look like and what we want the regulator of the future to look like, and to consider the future success of energy regulation. The discussion on the role and the future of the energy regulator was wide-ranging and thought-provoking. This paper summarizes the discussion and main themes; policy-related implications and observations arising from the symposium are presented in the conclusion

2491: Parental concerns about child participation in s reflect a need to move beyond traditional notions of trust and race

OBJECTIVES/SPECIFIC AIMS: The objective of this study was to identify factors influencing parental willingness of adolescent participation in clinical trials. METHODS/STUDY POPULATION: We applied community engaged research principles to conduct a theory-based, cross-sectional study of parental willingness. Parents (N=307) were given a survey from November 2014 to April 2015. Factors influencing parental willingness were identified using binary logistic regression. SPSS version 22.0 was used to perform analyses, and

Accuracy of a Web-based System for Monitoring Chronic Wounds

This study evaluated the accuracy of a store-and-forward telemedicine system for assessing the status of chronic wounds, including those surgically repaired. Digital photos and other patient and wound data were collected by a nurse using a laptop and transmitted via the Internet to a database, which organized and posted the data onto a web page for access by the telemedicine physician. Two Veterans' Affairs (VA) medical centers and two specialties (plastic surgery, physical medicine and rehabilitation) participated in the study. Study patients included inpatients and outpatients with pressure ulcers of stage II, III, or IV, plus outpatients with diabetic foot ulcers or venous stasis ulcers. All patients were assessed both in-person (the "gold standard") and with the telemedicine system using yes/no responses and a 5-point scale, respectively, on four diagnostic questions concerning wound healing and infection, based on AHCPR guidelines. A total of 70 patients were enrolled, with data collected on 430 visits: up to 6 visits per wound. Percentage agreement for all visits ranged from 67.1 for "not healing" to 88.8 for "cellulitis present." Sensitivity ranged from 0.32 for cellulitis to 0.63 for necrosis; and specificity ranged from 0.80 for necrosis to 0.91 for cellulitis. Although agreement of the telemedicine system was not high, it was not significantly less than interphysician agreement on in-person assessments. A relatively inexpensive store-and-forward telemedicine system for monitoring the status of chronic wounds has the potential to improve access to specialty care for patients who are not currently receiving routine monitoring by specialized nurses or physicians.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/63181/1/153056203766437471.pd

CORRELATION BETWEEN IMPAIRMENT AND MOTOR PERFORMANCE DURING REACHING TASKS IN SUBJECTS WITH SPASTIC HEMIPARESIS

Objective: The main purposes of this study were to examine, in subjects with chronic hemiparesis following a stroke: (i) the correlations between tests of muscle tone, stiffness, spasticity, paresis and co-contraction, and (ii) the correlations of these tests and measurements of impairment to upper extremity motor performance. Design: Prospective, cross-sectional, correlation matrix using sample of convenience. Subjects: Thirteen subjects with chronic hemiparesis secondary to a cerebrovascular accident (stroke) were tested. Methods: Subjects were assessed using the Fugl-Meyer Upper Extremity Motor Assessment, modified Ashworth scale, deep tendon reflexes, and muscle characteristics that included quantification of muscle stiffness, paresis and co-contraction during a voluntary reaching task and during passive movements. Surface electromyographic and myotonometric muscle stiffness data were obtained during movement trials. Results: Biceps and triceps brachii muscle paresis and excess biceps brachii co-contraction during voluntary reaching had the highest correlations to decreased motor performance. Muscle tone measurements did not have significant correlations to upper extremity performance. Conclusion: Paresis of elbow flexors and extensors and excess co-contraction of the biceps brachii during voluntary reaching appear to be most predictive of upper extremity motor performance. Results are discussed in relation to the specific challenges these findings pose for spastic paresis clinical management

PAI-1 is a Critical Upstream Regulator of the TGF-β1/EGF-Induced Invasive Phenotype in Mutant p53 Human Cutaneous Squamous Cell Carcinoma

The emergence of highly aggressive subtypes of human cutaneous squamous cell carcinoma (SCC) often reflects increased autocrine/paracrine TGF-β synthesis and epidermal growth factor receptor (EGFR) amplification. Cooperative TGF-β/EGFR signaling promotes cell migration and induces expression of both proteases and protease inhibitors that regulate stromal remodeling resulting in acquisition of an invasive phenotype. TGF-β1+EGF stimulation increases the production of several matrix metalloproteinases (MMPs) in human SCC. Among the most prominent is MMP-10 which is known to be elevated in SCC in situ. Activation of stromal plasminogen appears to be critical in triggering downstream MMP activity. Paradoxically, PAI-1, the major physiological inhibitor of plasmin generation, is also up-regulated under these conditions and is an early event in progression of incipient epidermal SCC. A model is proposed in which TGF-β1+EGF-dependent MMP-10 elevation directs focalized matrix remodeling events that promote epithelial cell plasticity and tissue invasion. Increased PAI-1 expression serves to temporally and spatially modulate plasmin-initiated pericellular proteolysis, further facilitating epithelial invasive potential. Defining the complex signaling mechanisms that maintain this elegant balance is critical to developing potential therapeutics for the treatment of human cutaneous malignancies

Epidemiological trends and future care needs for pelvic floor disorders

We sought to provide a review of the recent literature regarding the prevalence and epidemiological trends in pelvic floor disorders (PFDs) including pelvic organ prolapse (POP), urinary incontinence (UI) and fecal incontinence (FI). We also examined the current trends in surgical treatment for these disorders and discuss future care needs

Civic Engagement in Adolescents: Engendering Civic Awareness Through a University Youth Program

A weeklong residential Youth Leadership Institute Project was conducted at USC Upstate to promote essential skills deemed necessary for future civic engagement and political identity. The program and curriculum followed a framework that suggests that underlying civic skills are necessary to foster civic engagement among youth. Building on this theory, this reported study illustrates that civic engagement requires a developmental and educational process. Adolescence is a primary time for identity exploration and formation, which makes this stage an optimal time to engender civic awareness. A diverse group of 49 youth ranging in age from 14 to 17 participated. Results from the project demonstrate that when evaluating the significance and success of youth civic engagement programs, an account must be made for both the developmental and educational capacities. In pursuing projects such as ours on university campuses and beyond, psychologists and political scientists should work together to measure their outcomes in terms of these variables

Managing suicidal ideation in a breast cancer cohort seeking reconstructive surgery

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/135255/1/pon4017_am.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/135255/2/pon4017.pd

Formative Research to Design a Culturally-appropriate Cancer Clinical Trial Education Program to Increase Participation of African American and Latino Communities

Background: Addressing knowledge deficiencies about cancer clinical trials and biospecimen donation can potentially improve participation among racial and ethnic minorities. This paper describes the formative research process used to design a culturally-appropriate cancer clinical trials education program for African American and Latino communities. We characterized community member feedback and its integration into the program. Methods: We incorporated three engagement approaches into the formative research process to iteratively develop the program: including community-based organization (CBO) leaders as research team members, conducting focus groups and cognitive interviews with community members as reviewers/consultants, and interacting with two community advisory groups. An iterative-deductive approach was used to analyze focus group data. Qualitative data from advisory groups and community members were compiled and used to finalize the program. Results: Focus group themes were: 1) Community Perspectives on Overall Presentation; 2) Community Opinions and Questions on the Content of the Presentation; 3) Culturally Specific Issues to Participation in Cancer Clinical Trials; 4) Barriers to Clinical Trial Participation; and 5) Perspectives of Community Health Educators. Feedback was documented during reviews by scientific experts and community members with suggestions to ensure cultural appropriateness using peripheral, evidential, linguistic, sociocultural strategies, and constituent-involving. The final program consisted of two versions (English and Spanish) of a culturally-appropriate slide presentation with speaker notes and videos representing community member and researcher testimonials. Conclusions: Incorporating multiple community engagement approaches into formative research processes can facilitate the inclusion of multiple community perspectives and enhance the cultural-appropriateness of the programs designed to promote cancer clinical trial participation among African Americans and Latinos