Local to global policy as a catalyst for change: key messages

Feeding and nourishing a growing and changing global population in the face of rising numbers of chronically hungry people, slow progress on malnutrition, environmental degradation, systemic inequality, and the dire projections of climate change, demands a transformation in global food systems. Policy change at multiple levels is critical for catalysing an inclusive and sustainable transformation in food systems; global and regional policy are transformative only insofar as they are translated into ambitious national action with adequate support, including both public and private investment. Three areas of policy change show potential to be catalytic: 1) reducing emissions and increasing resilience, 2) tackling food loss and waste, and 3) shifting diets to promote nutrition and sustainability. Trade-offs mean a multi-sectoral approach to policymaking is needed, while inequalities in food systems necessitate transparent, inclusive processes and results. Gender inequality, in particular, must be addressed. Transformation demands participation and action from all actors

Stakeholder Perspectives about Developing and Implementing an Online Alternative to Out-of-School Suspension for First Time Substance Use Policy Violators

The purpose of this study was to explore statewide stakeholder perspectives about developing and implementing an online alternative to suspension (ATS) program in the Northwestern United States for youth who have violated school substance use policies. Out-of-school suspension has been linked to negative outcomes and alternatives to keep youth in school are desperately needed. Qualitative description methodology with content analysis was used to analyze data gathered from 201 stakeholders (principals & vice principals). Three themes were identified that described stakeholders’ perspectives about the development and implementation of an online ATS program: 1) the program must be impactful, 2) have a high degree of usability, and 3) additional support may be necessary. Themes identified can guide the development and implementation of an online ATS program. In collaboration with stakeholders, the initiation of an online ATS program could reduce out of school suspensions for middle and high school age youth

Reevaluating the value of Primary Care using Design Thinking

Primary care is at a critical crossroads. Our current delivery systems are unsustainable and lack the resiliency to survive in new environments where total cost of care, patient experience, and patient centered outcomes are the primary determinants of success. In order for primary care to remain relevant and viable, new solutions must be created that are practical and transformative, attract and retain new patients and provide high value, high satisfaction services that meet their consumer needs. Primary care has to especially think about how we can demonstrate our value in coordinating care, especially in managing populations of patients and subpopulations with multiple chronic conditions. Our cost of care must come down and our quality must remain high in order for us to be able to deliver affordable care in future reimbursement realities. However, we cannot solve this problem with the same thinking that got us into this predicament in the first place. Primary care providers have traditionally seen their value in maintaining a longitudinal provider-patient relationship. Research and experience have demonstrated that, when fully realized, this relationship decreases total healthcare expenditures with improved quality outcomes. However, regulatory and payment changes that started about a decade ago are now gaining momentum and will have significant impact on the ability of primary care providers to maintain this same depth of relationships with all of their patients. More people will now have access to health insurance and because of this there will be increasing demand on a shrinking pool of primary care providers. One option would be to simply continue as we always have and try to maintain relationships with more and more patients. Widely cited research shows that to accomplish all the necessary preventive services for the current average panel size would take 27 hours a day. And yet, because the work necessary to keep people healthy isn’t valued enough to be reimbursed properly, primary care practices have become places where acute illnesses are treated while long term health goals are pushed aside to maintain higher and higher volumes and productivity. Another option would be to look around us at the dedicated nursing and support staff in our clinics and tap into their vastly underutilized skills and knowledge to distribute the work of maintaining relationships and caring for more and more patients

Choosing a cut-off on the severity of dependence scale for ecstasy use

Despite controversy about the potential for the development of dependence in relation to ecstasy [1], some people do experience problems with ecstasy use, and full case reports of dependence have been identified [2]. The Severity of Dependence Scale (SDS) is a brief, five-item screening instrument that has demonstrated validity in identifying cases of DSM cannabis, amphetamine, cocaine and benzodiazepine dependence. This study aimed to determine a cut-off score on the SDS that could provide a useful indication of individuals that are potentially ecstasy dependent according to DSM criteria

Methodological considerations when translating "burnout"

No study has systematically examined how researchers address cross-cultural adaptation of burnout. We conducted an integrative review to examine how researchers had adapted the instruments to the different contexts. We reviewed the Content Validity Indexing scores for the Maslach Burnout Inventory-Human Services Survey from the 12-country comparative nursing workforce study, RN4CAST. In the integrative review, multiple issues related to translation were found in existing studies. In the cross-cultural instrument analysis, 7 out of 22 items on the instrument received an extremely low kappa score. Investigators may need to employ more rigorous cross-cultural adaptation methods when attempting to measure burnout

Living in Your Letters: Assessing Congruence Between Espoused and Enacted Values of One Fraternity/Sorority Community

Fraternity and sorority members have long been charged with fulfilling the espoused values of their organizations. Although several studies have explored the gap between the actions and values of undergraduate fraternal members and their institutions, few have examined the degree to which the publicly stated values of fraternal organizations are enacted by members. Using qualitative methodology, researchers compared the creeds and mission statements of undergraduate fraternal organizations to member actions observed on the campus transit system. Results indicated that while there is some congruence between organizational and institutional values and member actions, there are also areas of disconnect for members related to their values

Photonic Quantum Logic with Narrowband Light from Single Atoms

Increasing control of single photons enables new applications of photonic quantum-enhanced technology and further experimental exploration of fundamental quantum phenomena. Here, we demonstrate quantum logic using narrow linewidth photons that are produced under nearly perfect quantum control from a single ^87Rb atom strongly coupled to a high-finesse cavity. We use a controlled- NOT gate integrated into a photonic chip to entangle these photons, and we observe non-classical correlations between events separated by periods exceeding the travel time across the chip by three orders of magnitude. This enables quantum technology that will use the properties of both narrowband single photon sources and integrated quantum photonics, such as networked quantum computing, narrow linewidth quantum enhanced sensing and atomic memories.Comment: 5 pates, 3 figure