Adults making meaning at Colonial Williamsburg: A descriptive study of planners\u27 intentions and audience members\u27 constructions of the 1996 History Forum

Forecasts reveal an increase in the percentage of mid to older adults in the U. S. and the need of educational programs for lifelong learners. In recognition of changing demographics, the American Association of Museums urged its member institutions to place a high priority on adult programs and research into learning. While museums have experienced changes in adapting to environmental conditions and more explicit educative mission, professionals have noticed the emergence of a meaning-making, constructivist paradigm.;Previously, no study dealt with the mental constructions adults have or form as they interface with a multi-faceted museum program such as the History Forum at Colonial Williamsburg. Using a conceptual framework based on Mezirow\u27s (1991) work, this study explored, described, documented, analyzed, and interpreted the meanings intended by program planners and constructed by audience members. Furthermore, it interpreted changes in meaning audience interviewees reported. The study was phenomenological in orientation and employed various qualitative methods, such as a questionnaire, multiple interviews, and an evaluation form.;Findings indicated that the planners wanted to provide diverse opinions so that the audience could increase their perspectives, form their own opinions, and become more intelligent contributors in dealing with modern-day problems. The audience interviewees spoke of similar program aims, but they also variously addressed finding little diversity of opinion, difficulty in expressing their opinions, and no way to take further action in their everyday lives based on what they had learned.;Whereas the content of the forum provoked participants\u27 thoughts about the program\u27s topic and an eighteenth-century way of thinking, it also raised concerns about race and gender and political and religious issues. Throughout the interviewees\u27 almost paradoxical statements about similarities and differences between now and then, a strong theme emerged--namely, that there has been very little change in the last 200 years. The findings also revealed some audience interviewees\u27 uncritical attitudes, the importance of visual materials, and the power of interpretive drama. Although inferences should not be made about other audiences, this study may be enlightening to all educators concerned with andragogical strategies and who wonder what meanings adults form from a particular program

Evidence for 24-hour posture management: A scoping review

© The Author(s) 2023. This is an open access article distributed under the Creative Commons Attribution License, to view a copy of the license, see: https://creativecommons.org/licenses/by/4.0/Introduction:: People with complex physical disabilities unable to change their position independently are at risk of developing postural deformities and secondary complications. 24-hour posture management is needed to protect body structure. With inconsistencies in current service provision, this research aimed to scope the evidence for a 24-hour posture management approach. Method:: A scoping review was conducted using four health and social science databases. Inclusion and exclusion criteria were applied; further papers were included through citation chaining. Results:: The evidence for 24-hour posture management was often low quality due to the complications of completing robust research studies in this complex specialty. However, many professionals in the field agree that a 24-hour approach to postural care is essential. Conclusion:: There is a need for clear national policy and guidance relating to postural care and scope for development of dedicated posture management services. Current NHS service provision is variable and inconsistent. Lack of postural care is a safeguarding and human rights issue. Specialist training and research in postural care within the Occupational Therapy profession is required to raise awareness of the role Occupational Therapists can play in preventing postural deformities and other secondary complications through providing good postural care.Peer reviewe

Electronic Health Records and Population Health Research

Adoption of electronic health records (EHRs) by clinical practices and hospitals in the US has increased substantially since 2009, and offers opportunities for population health researchers to access rich structured and unstructured clinical data on large, diverse, and geographically distributed populations. However, because EHRs are intended for clinical and administrative use, the data must be curated for effective use in research. We describe EHRs, examine their use in population health research, and compare the strengths and limitations of these applications to traditional epidemiologic methods. To date, EHR data have primarily been used to validate prior findings, to study specific diseases and population subgroups, to examine environmental and social factors and stigmatized conditions, to develop and implement predictive models, and to evaluate natural experiments. Although primary data collection may provide more reliable data and better population retention, EHR-based studies are less expensive and require less time to complete. In addition, large patient samples that can be readily identified from EHR data enable researchers to evaluate simultaneously multiple risk factors and/or outcomes while maintaining study power. In addition to current advantages, improved capture of social, behavioral, environmental, and genetic data, and use of natural language processing, clinical biobanks, and personal sensing via smartphone should further enable EHR researchers to understand complex diseases with multifactorial etiologies. Integrating emerging technologies with clinical care could lead to innovative approaches to precision public health, reduce health care spending on individuals, and directly improve population health

Race, Ethnicity, Income Concentration and 10-Year Change in Urban Greenness in the United States

Background: Cross-sectional studies suggest urban greenness is unequally distributed by neighborhood demographics. However, the extent to which inequalities in greenness have changed over time remains unknown. Methods: We estimated 2001 and 2011 greenness using Moderate-resolution Imaging Spectroradiometer (MODIS) satellite-derived normalized difference vegetative index (NDVI) in 59,483 urban census tracts in the contiguous U.S. We fit spatial error models to estimate the association between baseline census tract demographic composition in 2000 and (1) 2001 greenness and (2) change in greenness between 2001 and 2011. Results: In models adjusted for population density, climatic factors, housing tenure, and Index of Concentration at the Extremes for income (ICE), an SD increase in percent White residents (a 30% increase) in 2000 was associated with 0.021 (95% CI: 0.018, 0.023) higher 2001 NDVI. We observed a stepwise reduction in 2001 NDVI with increased concentration of poverty. Tracts with a higher proportion of Hispanic residents in 2000 lost a small, statistically significant amount of greenness between 2001 and 2011 while tracts with higher proportions of Whites experienced a small, statistically significant increase in greenness over the same period. Conclusions: Census tracts with a higher proportion of racial/ethnic minorities, compared to a higher proportion of White residents, had less greenness in 2001 and lost more greenness between 2001 and 2011. Policies are needed to increase greenness, a health-promoting neighborhood asset, in disadvantaged communities

Associations between historical residential redlining and current age-adjusted rates of emergency department visits due to asthma across eight cities in California: an ecological study.

BackgroundAsthma disproportionately affects communities of colour in the USA, but the underlying factors for this remain poorly understood. In this study, we assess the role of historical redlining as outlined in security maps created by the Home Owners' Loan Corporation (HOLC), the discriminatory practice of categorising neighbourhoods on the basis of perceived mortgage investment risk, on the burden of asthma in these neighbourhoods.MethodsWe did an ecological study of HOLC risk grades and asthma exacerbations in California using the security maps available for the following eight cities: Fresno, Los Angeles, Oakland, Sacramento, San Diego, San Jose, San Francisco, and Stockton. Each census tract was categorised into one of four risk levels (A, B, C, or D) on the basis of the location of population-weighted centroids on security maps, with the worst risk level (D) indicating historical redlining. We obtained census tract-level rates of emergency department visits due to asthma from CalEnviroScreen 3.0. We assessed the relationship between risk grade and log-transformed asthma visit rates between 2011 and 2013 using ordinary least squares regression. We included potential confounding variables from the 2010 Census and CalEnviroScreen 3.0: diesel exhaust particle emissions, PM2·5, and percent of the population living below 2 times the federal poverty level. We also built random intercept and slope models to assess city-level variation in the relationship between redlining and asthma.FindingsIn the 1431 census tracts assessed (64 [4·5%] grade A, 241 [16·8%] grade B, 719 [50·2%] grade C, and 407 [28·4%] grade D), the proportion of the population that was non-Hispanic black and Hispanic, the percentage of the population living in poverty, and diesel exhaust particle emissions all significantly increased as security map risk grade worsened (p<0·0001). The median age-adjusted rates of emergency department visits due to asthma were 2·4 times higher in census tracts that were previously redlined (median 63·5 [IQR 34·3] visits per 10 000 residents per year [2011-13]) than in tracts at the lowest risk level (26·5 [18·4]). In adjusted models, redlined census tracts were associated with a relative risk of 1·39 (95% CI 1·21-1·57) in rates of emergency department visits due to asthma compared with that of lowest-risk census tracts.InterpretationHistorically redlined census tracts have significantly higher rates of emergency department visits due to asthma, suggesting that this discriminatory practice might be contributing to racial and ethnic asthma health disparities.FundingNational Heart Lung Blood Institute

Measurement of a Model of Implementation for Health Care: Toward a Testable Theory

Greenhalgh et al. used a considerable evidence-base to develop a comprehensive model of implementation of innovations in healthcare organizations [1]. However, these authors did not fully operationalize their model, making it difficult to test formally. The present paper represents a first step in operationalizing Greenhalgh et al.\u27s model by providing background, rationale, working definitions, and measurement of key constructs.A systematic review of the literature was conducted for key words representing 53 separate sub-constructs from six of the model\u27s broad constructs. Using an iterative process, we reviewed existing measures and utilized or adapted items. Where no one measure was deemed appropriate, we developed other items to measure the constructs through consensus

Retirements of Coal and Oil Power Plants in California: Association With Reduced Preterm Birth Among Populations Nearby.

Coal and oil power plant retirements reduce air pollution nearby, but few studies have leveraged these natural experiments for public health research. We used California Department of Public Health birth records and US Energy Information Administration data from 2001-2011 to evaluate the relationship between the retirements of 8 coal and oil power plants and nearby preterm (gestational age of <37 weeks) birth. We conducted a difference-in-differences analysis using adjusted linear mixed models that included 57,005 births-6.3% of which were preterm-to compare the probability of preterm birth before and after power plant retirement among mothers residing within 0-5 km and 5-10 km of the 8 power plants. We found that power plant retirements were associated with a decrease in the proportion of preterm birth within 5 km (-0.019, 95% CI: -0.031, -0.008) and 5-10 km (-0.015, 95% CI: -0.024, -0.007), controlling for secular trends with mothers living 10-20 km away. For the 0-5-km area, this corresponds to a reduction in preterm birth from 7.0% to 5.1%. Subgroup analyses indicated a potentially larger association among non-Hispanic black and Asian mothers than among non-Hispanic white and Hispanic mothers and no differences in educational attainment. Future coal and oil power plant retirements may reduce preterm birth among nearby populations

Peduncle necking in Rosa hybrida induces stress-related transcription factors, upregulates galactose metabolism, and downregulates phenylpropanoid biosynthesis genes

Roses are highly valued as cut flowers worldwide but have limited vase life. Peduncle bending “bent neck” or “necking” is a major cause of reduced vase life, especially in some cultivars. Necking is thought to be caused by either an air embolism or accumulation of microorganisms at or within the stem end, blocking the xylem vessels and preventing water uptake. However, the underlying mechanisms of necking are poorly understood. Here, RNAseq analysis was applied to compare gene expression across three stages of peduncle necking (straight, 90°), in the necking-susceptible Rosa hybrida cultivar H30. Most gene expression change was later in bending and there was, overall, more downregulation than upregulation of gene expression during necking. Photosynthetic, starch, and lignin biosynthesis genes were all downregulated, while genes associated with galactose metabolism, producing raffinose and trehalose that are both related to osmoprotection, were upregulated. Genes associated with starch breakdown, autophagy, and senescence were also upregulated, as were most of the NAC and WRKY transcription factors, involved in stress and senescence regulation. Microscopy showed a cellular collapse in the peduncle. These data support a possible mechanism, whereby a reduction in water transport leads to a cellular collapse in the peduncle, accompanied by upregulation of senescence and drought responses

Oral microbiota of periodontal health and disease and their changes after nonsurgical periodontal therapy

This study examined the microbial diversity and community assembly of oral microbiota in periodontal health and disease and after nonsurgical periodontal treatment. The V4 region of 16S rRNA gene from DNA of 238 saliva and subgingival samples of 21 healthy and 48 diseased subjects was amplified and sequenced. Among 1979 OTUs identified, 28 were overabundant in diseased plaque. Six of these taxa were also overabundant in diseased saliva. Twelve OTUs were overabundant in healthy plaque. There was a trend for disease-associated taxa to decrease and health-associated taxa to increase after treatment with notable variations among individual sites. Network analysis revealed modularity of the microbial communities and identified several health- and disease-specific modules. Ecological drift was a major factor that governed community turnovers in both plaque and saliva. Dispersal limitation and homogeneous selection affected the community assembly in plaque, with the additional contribution of homogenizing dispersal for plaque within individuals. Homogeneous selection and dispersal limitation played important roles, respectively, in healthy saliva and diseased pre-treatment saliva between individuals. Our results revealed distinctions in both taxa and assembly processes of oral microbiota between periodontal health and disease. Furthermore, the community assembly analysis has identified potentially effective approaches for managing periodontitis

HTLV-III Serology in Hemophilia: Relationship with Immunologic Abnormalities

We investigated the relationship of the presence of antibodies to HTLV-III and immunologic abnormalities in patients with hemophilia. Serum antibodies to HTLV-III were analyzed by ELISA assay, immunoprecipitation of labeled cell extracts, and immunoprecipitation of purified HTLV-III p24. Thirty-four (61%) of the total group (n = 56) had antibody to HTLV-III; 34 (76%) of 45 patients given commercial factor VIII preparations were seropositive, compared with none of 11 patients treated exclusively with cryoprecipitate obtained from volunteer blood donors. Of patients who were seropositive for HTLV-III antibody, 94% had abnormal T4/T8 ratios, and 33% of those whose serum was antibody negative had abnormal T4/T8 ratios; five patients, each antibody positive, have lymphadenopathy syndrome. Sequential studies in a subset of patients indicate that there is a changing pattern of antibody production to HTLV-III antigens after seroconversion