Using intervention mapping to develop a community garden program at the women's home

This culminating experience was a practice based intervention conducted by an organization, utilizing an intervention mapping approach for the program planning. It took place summer 2010 through spring 2011 and included incorporating a community garden into the Gusto wellness program at The Women's Home. This organization offers long-term residential care, and therapeutic services. Literature relating to community gardens and nutrition behavior change was reviewed. Short-term objectives included: 1) Conducting a needs assessment using focus groups, 2) Designing gardening program components based on intervention mapping guidelines, 3) Constructing a garden bed at Midtown Community Garden for use of The Women's Home, 4) Planning and implementing gardening education, and 5) Assessing feasibility of the garden program. The target population included 24 residents living at the residential dormitory of The Women's Home at the time of this project. The major variables are intervention mapping constructs including: 1) Needs assessment, 2) Preparing matrices of change objectives, 3) Selecting theory-informed intervention methods and practical strategies, 4) Producing program components and materials, 5) Planning program adoption, implementation, and sustainability, and 6) Planning for evaluation. The specific focus was lack of access to fresh fruits and vegetables (FV) for this population. Focus group responses revealed interest in community garden participation. Matrices of change were developed for lack of FV access based on performance objectives for behavioral and environmental factors and related determinants and theory. Methods and strategies were developed to implement a community garden and encourage participation. Program components included initiating a garden club, networking activities, creating gardening curriculum, and participating at Midtown Community Garden. Adoption and implementation performance objectives were outlined, and many were carried out. Evaluation questions were designed and outcomes of the garden project were discussed. ^ Outcomes of the project included exposure of garden topics and activities for The Women's Home residents, focus group responses revealing an interest in gardening among this population, gardening program components designed based on intervention mapping steps, and a constructed garden bed that was used for planting vegetables and flowers through fall 2010. Limited resources and budget along with a lack of a residential coordinator at The Women's Home were the main limiting factors for this project. Future garden projects can be developed using the intervention mapping process.^

Adherence to HIV /AIDS therapies among low -literacy populations: The ALP project

Adherence to HIV/AIDS therapies has been an important health problem since the early 1980s when AZT was first prescribed as a therapy for HIV/AIDS. It became particularly important between 1995 and 1997 with the advent of protease inhibitors (Chesney, Ickovics, Hecht, Sikipa, & Rabkin J., 1999) and became even more significant as persons with HIV/AIDS began to develop resistance to medications. Low-literacy populations have poorer health (Brez & Taylor, 1997) and higher AIDS rates (Simon, Hu, Diaz, & Kerndt, 1995), than their higher literacy counterparts due to delayed treatment (Baker, Parker, Williams, Clark, & Nurss, 1997), shame of literacy skills (Parikh, 1996), and poor access to care (Williams, et al., 1995). Poorer health and higher AIDS rates can also be attributed to poor patient-provider relationships (Crespo-Fierro, 1997; Eldred, Wu, Chaisson, & Moore, 1998) to a poorer understanding of medical protocols (Murphy, 1997), and inadequate patient education (Ungvarski, 1997; Davis, Michielutte, Askov, Williams, & Weiss, 1998, Doak, Doak, & Root, 1996). ^ The ALP intervention was developed for HIV positive low-literacy populations of African American women in Houston, Texas. The intervention was based on a needs assessment, using the PRECEDE model, an innovative process referred to as Intervention Mapping, and validated using formative evaluation methods with 54 individuals. The needs assessment resulted in a list of behavioral, environmental, predisposing, enabling, and reinforcing determinants of adherence. The Intervention Mapping framework was used to refine these determinants and develop a list of objectives describing what must be learned or changed to for the target population to adhere to HIV/AIDS therapies. Methods and strategies, were developed using theoretical constructs from the Health Belief Model (Rosenstock, 1974) and Social Cognitive Theory (Bandura, 1986). These theories, empirical evidence, and information from the target population indicated that perceived susceptibility, perceived severity, outcome expectations, and self-efficacy were important and changeable determinants of adherence to HIV/AIDS therapies for this population. ^ These components were brought together in the form of a theory-based color cartoon book and 10-minute cassette tape. The book was developed for people with 2.9 years of U.S. education as measured with the Flesch-Kincaid Grade Level method and the script was recorded onto a cassette tape to make it suitable for populations with even lower-literacy skills. A formative evaluation was conducted to ensure that the content and structure were accurate, clear, realistic, readable, appropriate, and likely to be used as intended. ^

Gender-preferential intergenerational patterns in primary education attainment : a quantitative analysis of a case of rural Mindanao, the Philippines

The Philippines has achieved a relatively high standard of education. Previous researches, most of which deal with Luzon Island, have indicated that rural poverty alleviation began partly due to the increased investment in education. However, the suburban areas beyond Luzon Island have rarely been studied. This study examines a case from rural Mindanao, and investigates the determinants and factors associated with children's education, with a special focus on delays in schooling, which may be a cause of dropout and holdover incidences, as well as exploring gender-specific differential patterns. The result shows that after controlling other socioeconomic attributes, (1) delays in schooling, as well as years completed, are more favorable for girls than boys; (2) the level of maternal education is equally associated with the child(ren)’s education level regardless of their gender; and (3) paternal education is preferentially and favorably influential to the same-gender child(ren), i.e., son(s). To reduce the boy-unfriendly gender bias in primary education, this study suggests two future tasks, i.e., providing boy-specific interventions to enhance the magnitude of the father-son educational virtuous circle, and comparing the magnitude of gender-equal maternal education influence and boy-preferential paternal education influence to specify which effect is larger.

Peptide analogs to pathogenic epitopes of the human acetylcholine receptor alpha subunit as potential modulators of myasthenia gravis.

Myasthenia gravis is an autoimmune disease in which T cells specific to epitopes of the autoantigen, the human acetylcholine receptor, play a role. We identified two peptides, p195-212 and p259-271, from the alpha subunit of the receptor, which bound to major histocompatibility complex (MHC) class II molecules on antigen-presenting cells (APCs) from peripheral blood lymphocytes of myasthenia gravis patients and stimulated lymphocytes of >80% of the patients. We have prepared analogs of these myasthenogenic peptides and tested their ability to bind to MHC class II determinants and to interfere specifically with T-cell stimulation. We first determined relative binding efficiency of the myasthenogenic peptides and their analogs to APCs of patients. We found that single substituted analogs of p195-212 (Ala-207) and p259-271 (Lys-262) could bind to human MHC molecules on APCs as efficiently as the original peptides. Moreover, dual analogs containing the two single substituted analogs in one stretch (either sequentially, Ala-207/Lys-262, or reciprocally, Lys-262/Ala-207) could also bind to APCs of patients, including those that failed to bind one of the single substituted analogs. The single substituted analogs significantly inhibited T-cell stimulation induced by their respective myasthenogenic peptides in >95% of the patients. The dual analogs were capable of inhibiting stimulation induced by either of the peptides: They inhibited the response to p195-212 and p259-271 in >95% and >90% of the patients, respectively. Thus, the dual analogs are good candidates for inhibition of T-cell responses of myasthenia gravis patients and might have therapeutic potential.

Ligand-induced endocytosis of epidermal growth factor receptors that are defective in binding adaptor proteins.

Ligand-activated epidermal growth factor receptors (EGFRs) associate with coated pit adaptor proteins (AP2) in vivo, implying a mechanism for receptor retention in coated pits during internalization. Using an in vitro binding assay, we localized the adaptor binding determinant to residues 970-991 of EGFRs and confirmed specificity by competition with a synthetic peptide corresponding to this sequence. A mutant EGFR lacking this AP2 binding determinant did not associate with AP2 in vivo but demonstrated internalization and down-regulation kinetics indistinguishable from its wild-type counterpart. Immunocytochemistry confirmed ligand-induced internalization of the mutant EGFR. These data suggest that endocytic determinants are distinct from AP2 binding determinants and that processes other than association with AP2 regulate endocytosis of EGFRs.

Notas para una historia de la desnutrición en la Iberoamérica del siglo XX

El trabajo analiza los principales determinantes y las características de la desnutrición en América Latina durante la segunda mitad del siglo XX. En primer lugar, se explican las bases del problema moderno del hambre y la desnutrición, tanto en su dimensión fisiológica como social, al destacarse su condición de calamidad social y de expresión biológica del subdesarrollo y de las desigualdades sociales. En segundo lugar, a partir de testimonios contemporáneos, se exponen las principales características de la desnutrición que ha afectado a la población iberoamericana, y las causas que la explican. Por último, a modo de conclusión, se subrayan las consecuencias negativas de no haber aprovechado la oportunidad que conllevaba el reto de superar los factores condicionantes de la malnutrición por defecto, y haber finalizado el siglo XX con un panorama epidemiológico nutricional donde los problemas del hambre y la desnutrición conviven con fenómenos como los de la obesidad de la pobreza.

A memetic algorithm for the delineation of local labour markets

Given a territory composed of basic geographical units, the delineation of local labour market areas (LLMAs) can be seen as a problem in which those units are grouped subject to multiple constraints. In previous research, standard genetic algorithms were not able to find valid solutions, and a specific evolutionary algorithm was developed. The inclusion of multiple ad hoc operators allowed the algorithm to find better solutions than those of a widely-used greedy method. However, the percentage of invalid solutions was still very high. In this paper we improve that evolutionary algorithm through the inclusion of (i) a reparation process, that allows every invalid individual to fulfil the constraints and contribute to the evolution, and (ii) a hillclimbing optimisation procedure for each generated individual by means of an appropriate reassignment of some of its constituent units. We compare the results of both techniques against the previous results and a greedy method.

Competencias y contenidos comunes de salud pública del Grado en Medicina en las universidades españolas

Objetivo: Consensuar las competencias profesionales de salud pública que deben adquirir los estudiantes en el Grado en Medicina y los contenidos fundamentales que debe incluir la materia de salud pública según el criterio de un grupo de docentes de salud pública del Grado en Medicina de distintas universidades españolas. Métodos: Se organizó una 2 ª Reunión del Foro de Profesorado Universitario de Salud Pública en la Universidad Rey Juan Carlos (Madrid, 11-12 de diciembre de 2014), en la que participaron 24 docentes de 19 universidades españolas con Grado en Medicina que fueron distribuidos en tres grupos durante tres sesiones de trabajo. En la primera sesión, se identificaron y clasificaron las competencias propias del Grado; en la segunda, se propusieron contenidos de salud pública para las competencias identificadas; en la tercera, se organizaron los contenidos en bloques temáticos. Los resultados se discutieron hasta alcanzar acuerdos, en distintas sesiones plenarias. Resultados: El mayor número de competencias identificadas corresponde a actividades de las funciones «Valorar las necesidades de salud de la población» y «Desarrollar políticas de salud». El programa final incluye contenidos básicos organizados en cinco bloques: Concepto de salud, salud pública y sus condicionantes; Epidemiología e investigación en salud; Condicionantes y problemas de salud; Estrategias, intervenciones y políticas; y Sistemas de salud, gestión clínica y sanitaria. Conclusiones: Las competencias y los contenidos comunes consensuados en este Foro constituyen una base para actualizar y mejorar la formación en salud pública de los futuros profesionales de la medicina.

Inequality in the Southern Mediterranean: A survey of selected countries. MEDPRO Technical Report No. 23/December 2012

This paper addresses the issues of current levels of inequality: their trends, determinants and future scenarios, demonstrating that welfare levels are measured by per capita consumption. Location, educational attainment and employment status have been identified as the key factors affecting levels of welfare and its distribution. A benefit incidence analysis was performed to investigate benefits of different deciles of per capita expenditure from education and health services. The inequality patterns in countries under investigation present significant variations; countries such as Turkey, Morocco and Tunisia show relatively high inequality while others, such as Egypt or Syria, show moderate to low inequality. Inequality in human development was addressed using the inequality-adjusted human development index (IHDI), introduced by Global HDR 2010. The average loss in the HDI due to inequality in all Arab countries under investigation is about 20%. Two reference scenarios (optimistic and pessimistic) were used to project future paths up to 2020 and 2030. The impact of positive growth is increasing inequality and a shrinking middle class. Results show that the rich benefit most from this growth path. The opposite trend is observed for the pessimistic scenario.

The Portuguese National Programme for the Promotion of Healthy Eating: 2012–2015

This paper describes the first 4-year period (2012–2015) of implementation of the Portuguese National Programme for the Promotion of Healthy Eating (PNPAS). PNPAS was approved in 2012 and emerged as a preventive programme for noncommunicable diseases, aiming to improve the nutritional status of the population; it represents the first national strategy in Portugal for the promotion of healthy eating. To accomplish its mission, and taking into account its overall principles, PNPAS has five main goals: (i) to increase knowledge about the food intake of the Portuguese population and about its determinants and consequences; (ii) to modify the availability of certain foods (high in sugar, salt and fat), in schools, workplaces and public spaces; (iii) to inform and empower the population for the purchase, preparation and storage of healthy food, especially the most vulnerable groups; (iv) to identify and promote crosssectoral actions that encourage the consumption of foods of good nutritional quality in an articulate and integrated way with other sectors, namely agriculture, sport, environment, education, social security and local authorities; and (v) to improve the qualifications and conduct of the different professionals who, owing to their roles, may influence nutritional knowledge, attitudes and behaviours. The design of PNPAS followed the latest strategic lines suggested by WHO and the European Commission, proposing a crosssectoral mix of interventions to ensure physical and economic access to healthy eating by creating healthy environments and empowering individuals and communities. Several actions were implemented at different levels during the first 4-year period of implementation of PNPAS; two were especially relevant. The first concerned the empowerment of citizens regarding healthy eating, where the most important aspect was introduction of a digital strategy through development of a website and a blog dedicated to healthy eating. The second concerned the development of documents for health care and other professionals, including several guidelines in new areas, such as anthropometric measures and intervention in preobesity. Process and output indicators were defined to monitor and evaluate the programme. Among those considered as output indicators were the evaluation of childhood obesity, salt consumption and intake of breakfast by school-aged children.

Calculus, with analytic geometry.

Includes index.

The innovation decision:an economic analysis

Studies of the determinants and effects of innovation commonly make an assumption about the way in which firms make the decision to innovate, but rarely test this assumption. Using a panel of Irish manufacturing firms we test the performance of two alternative models of the innovation decision, and find that a two-stage model (the firm decides whether to innovate, then whether to perform product only, process only or both) outperforms a one-stage, simultaneous model. We also find that external knowledge sourcing affects the innovation decision and the type of innovation undertaken in a way not previously recognised in the literature. © 2007 Elsevier Ltd. All rights reserved.

Understanding marketing department's influence within the firm

Increasing debate centers on the decreasing influence of the marketing department within firms. This study investigates such influence and assesses its determinants and consequences. The results show that the accountability and innovativeness of the marketing department represent the two major drivers of its influence. However, the results do not indicate that the customer-connecting role of the marketing department increases its influence, though this role is important for shaping the firm's market orientation. A marketing department's influence is related positively to market orientation, which in turn is related positively to firm performance. This study also suggests a dual relationship between the marketing department's influence and market orientation. A key implication of this study is that marketers should become more accountable and innovative to gain more influence.

Getting marketing back in the boardroom:understanding the drivers of marketing's influence within the firm

As many strategically important aspects of marketing are addressed by other functions in the organization, the decreased influence of the marketing department within companies is a topic of growing debate. In this study, the authors investigate this diminished influence and assess its determinants and consequences. They interviewed 25 marketing and finance executives from leading Dutch firms. They also conducted a large-scale Internet-based survey of several hundred marketing, finance, and general managers. Their results show that accountability and the innovativeness of the marketing department are the major drivers of the marketing department’s influence. They also demonstrate that a firm’s short-term orientation is negatively related to the influence of the marketing department. Marketing influence is positively related to market orientation, which is positively related to firm performance. Their results do not support prior findings of a direct positive link between marketing influence and firm performance, which might suggest that there is no need for a strong marketing department. The study suggests that an influential marketing department is relevant primarily when the firm is not market oriented. When firms are market oriented, a less influential marketing department does not lower their performance. Hence, it appears that they can choose to have an influential or noninfluential marketing department without any repercussions for their performance. Marketing activities could move to other functions. The authors suggest that marketing departments should aim to retain their influence. Dispersing marketing decision making among many functions can cause a lack of coordination; customers also lose their advocate within the firm. How can marketing departments regain their influence? The authors suggest two general solutions. First, marketing departments should become more accountable by linking marketing actions and policies with financial results. Marketers should become capable in analytics and finance. Second, they should become more innovative by increasing their share in new product or service concepts. They can do so by using their knowledge of the market and customers to contribute to new product or service development.