Clinical education reflective ecological model for health science majors

The clinical education is an integral part of the Health Science majors’ curriculum programs of the University of Aveiro’s School of Health (i.e., Nursing, Physical Therapy, Radiology, Radiotherapy and Speech-Language Pathology) and aims to develop clinical competences in order to generate excellent health care professionals. The organization was based on the Ecological Model of Clinical-Reflective Training, which was characterized by inter-institutional interaction and student’s reflection on actions on a professional setting. This study encompassed two moments of clinical internships in the Nursing, Physical Therapy, Radiology and Radiotherapy majors. The Clinical Internship I provided the 123 students with a global view of the health care professional activities. The Clinical Internship II, with 119 students, developed competences of each health professional. Questionnaires with categorical scales from 1 to 5 evaluated the organization and efficiency of the two internships. The results revealed averages over 3 in all items. In conclusion, the Ecological Model of Clinical-Reflective Training was well accepted by students and clinical supervisors. Applications in the health care area were demonstrated.

Using participatory action research in a community-based initiative addressing complex mental health needs

Objective: This paper describes the first phase of a larger project that utilizes participatory action research to examine complex mental health needs across an extensive group of stakeholders in the community. Method: Within an objective qualitative analysis of focus group discussions the social ecological model is utilized to explore how integrative activities can be informed, planned and implemented across multiple elements and levels of a system. Seventy-one primary care workers, managers, policy-makers, consumers and carers from across the southern metropolitan and Gippsland regions of Victoria, Australia took part in seven focus groups. All groups responded to an identical set of focusing questions. Results: Participants produced an explanatory model describing the service system, as it relates to people with complex needs, across the levels of social ecological analysis. Qualitative themes analysis identified four priority areas to be addressed in order to improve the system's capacity for working with complexity. These included: (i) system fragmentation; (ii) integrative case management practices; (iii) community attitudes; and (iv) money and resources. Conclusions: The emergent themes provide clues as to how complexity is constructed and interpreted across the system of involved agencies and interest groups. The implications these findings have for the development and evaluation of this community capacity-building project were examined from the perspective of constructing interventions that address both top-down and bottom-up processes.

Political Violence and Child Adjustment: Longitudinal Tests of Sectarian Antisocial Behavior, Family Conflict, and Insecurity as Explanatory Pathways

Understanding the impact of political violence on child maladjustment is a matter of international concern. Recent research has advanced a social ecological explanation for relations between political violence and child adjustment. However, conclusions are qualified by the lack of longitudinal tests. Toward examining pathways longitudinally, mothers and their adolescents (M = 12.33, SD = 1.78, at Time 1) from 2-parent families in Catholic and Protestant working class neighborhoods in Belfast, Northern Ireland, completed measures assessing multiple levels of a social ecological model. Utilizing autoregressive controls, a 3-wave longitudinal model test (T1, n = 299; T2, n = 248; T3, n = 197) supported a specific pathway linking sectarian community violence, family conflict, childrens insecurity about family relationships, and adjustment problems.

Longitudinal relations between sectarian and nonsectarian community violence and child adjustment in Northern Ireland

Although relations between political violence and child adjustment are well documented, longitudinal research is needed to adequately address the many questions remaining about the contexts and developmental trajectories underlying the effects on children in areas of political violence. The study examined the relations between sectarian and nonsectarian community violence and adolescent adjustment problems over 4 consecutive years. Participants included 999 mother-child dyads (482 boys, 517 girls), M ages = 12.18 (SD = 1.82), 13.24 (SD = 1.83), 13.61 (SD = 1.99), and 14.66 (SD = 1.96) years, respectively, living in socially deprived neighborhoods in Belfast, Northern Ireland, a context of historical and ongoing political violence. In examining trajectories of adjustment problems, including youth experience with both sectarian and nonsectarian antisocial behaviors, sectarian antisocial behavior significantly predicted more adjustment problems across the 4 years of the study. Experiencing sectarian antisocial behavior was related to increased adolescent adjustment problems, and this relationship was accentuated in neighborhoods characterized by higher crime rates. The discussion considers the implications for further validating the distinction between sectarian and nonsectarian violence, including consideration of neighborhood crime levels, from the child's perspective in a setting of political violence. Copyright © Cambridge University Press 2013.

Active living in municipal parks and recreation : a case study

If quality of life is an important recreation outcome, then municipal parks and recreation management's efforts have to change because:· Over one-third of all the little kids in schools will be diabetic in their lifetime if the trends we are looking at continue. The average loss of life is about 15 years, and there is an average reduction in quality oflife by about 20 years (Jackson, 2007). This thesis is about municipal parks and recreation, an agency that controls and limits physical activity opportunity. It is also about active living; from an ecological perspective, a multi-disciplinary approach to incorporate physical activity into more 111 people's daily lives. In particular, this thesis examines one case --'. the Donutville Case - . with the intent of providing an explanation of how municipal parks and recreation can advance its management efforts to improve health outcomes of people suffering from daily physical activity deficits. More specifically, how can the tension between external and internal environments to municipal parks and recreation be better balanced to affect the change needed? Given that changing the current social reality is through making decisions, decision-making functions connected with systems theory helps identify how recreation authorities can more effectively influence environmental physical activity determinants. , Sallis et al.' (2006) ·social ecological model provides the a priori focus on active living decision-making. An integrated analogous emerging logic model is developed and presented as an efficacious strategy for how municipal parks and recreation decisionmakers can affect change. Keywords: physical activity, benefits outcomes, healthy livable community, quality of life, systems thinking, social ecological model, deci~ion-making, logic modeling, municipal parks and recreation, active living.

Is a perceived supportive physical environment important for self-reported leisure time physical activity among socioeconomically disadvantaged women with poor psychosocial characteristics? An observational study

Background Over the past decade, studies and public health interventions that target the physical environment as an avenue for promoting physical activity have increased in number. While it appears that a supportive physical environment has a role to play in promoting physical activity, social-ecological models emphasise the importance of considering other multiple levels of influence on behaviour, including individual (e.g. self-efficacy, intentions, enjoyment) and social (e.g. social support, access to childcare) factors (psychosocial factors). However, not everyone has these physical activity-promoting psychosocial characteristics; it remains unclear what contribution the environment makes to physical activity among these groups. This study aimed to examine the association between the perceived physical environment and self-reported leisure-time physical activity (LTPA) among women living in socioeconomically disadvantaged areas demonstrating different psychosocial characteristics.

Methods In 2007–8, 3765 women (18–45 years) randomly selected from low socioeconomic areas in Victoria, Australia, self-reported LTPA, and individual, social and physical environmental factors hypothesised within a social-ecological framework to influence LTPA. Psychosocial and environment scores were created. Associations between environment scores and categories of LTPA (overall and stratified by thirds of perceived environment scores) were examined using generalised ordered logistic regression.

Results Women with medium and high perceived environment scores had 20-38% and 44-70% greater odds respectively of achieving higher levels of LTPA than women with low environment scores. When stratified by thirds of psychosocial factor scores, these associations were largely attenuated and mostly became non-significant. However, women with the lowest psychosocial scores but medium or high environment scores had 76% and 58% higher odds respectively of achieving ≥120 minutes/week (vs. <120 minutes/week) LTPA.

Conclusions Acknowledging the cross-sectional study design, the findings suggest that a physical environment perceived to be supportive of physical activity might help women with less favourable psychosocial characteristics achieve moderate amounts of LTPA (i.e. ≥120 minutes/week). This study provides further support for research and public health interventions to target perceptions of the physical environment as a key component of strategies to promote physical activity.

Iterative development of Stand Up Australia : a multi-component intervention to reduce workplace sitting

Sitting, particularly in prolonged, unbroken bouts, is widespread within the office workplace, yet few interventions have addressed this newly-identified health risk behaviour. This paper describes the iterative development process and resulting intervention procedures for the Stand Up Australia research program focusing on a multi-component workplace intervention to reduce sitting time. The development of Stand Up Australia followed three phases. 1) Conceptualisation: Stand Up Australia was based on social cognitive theory and social ecological model components. These were operationalised via a taxonomy of intervention strategies and designed to target multiple levels of influence including: organisational structures (e.g. via management consultation), the physical work environment (via provision of height-adjustable workstations), and individual employees (e.g. via face-to-face coaching). 2) Formative research: Intervention components were separately tested for their feasibility and acceptability. 3) Pilot studies: Stand Up Comcare tested the integrated intervention elements in a controlled pilot study examining efficacy, feasibility and acceptability. Stand Up UQ examined the additional value of the organisational- and individual-level components over height-adjustable workstations only in a three-arm controlled trial. In both pilot studies, office workers’ sitting time was measured objectively using activPAL3 devices and the intervention was refined based on qualitative feedback from managers and employees. Results and feedback from participants and managers involved in the intervention development phases suggest high efficacy, acceptance, and feasibility of all intervention components. The final version of the Stand Up Australia intervention includes strategies at the organisational (senior management consultation, representatives consultation workshop, team champions, staff information and brainstorming session with information booklet, and supportive emails from managers to staff), environmental (height-adjustable workstations), and individual level (face-to-face coaching session and telephone support). Stand Up Australia is currently being evaluated in the context of a cluster-randomised controlled trial at the Department of Human Services (DHS) in Melbourne, Australia. Stand Up Australia is an evidence-guided and systematically developed workplace intervention targeting reductions in office workers’ sitting time.

Barreras para la práctica de actividad física y deportiva en las personas adultas de la Comunidad de Madrid. Desarrollo y validación de un instrumento

El propósito de este estudio fue la construcción y validación de un instrumento de medición de barreras a la práctica de la actividad física y deportiva por parte de las personas adultas desde la teoría ecológico social y analizar la presencia de las diferentes barreras así como las innovaciones y alternativas de conciliación a las barreras relacionadas con el empleo, el cuidado de hijos e hijas y las tareas del hogar, identificando las posibles diferencias existentes en función del género y del tipo de demanda en la población adulta de la Comunidad de Madrid. Se ha realizado un estudio cuantitativo, descriptivo y transversal en una muestra representativa de la población residente en la Comunidad de Madrid entre 30 y 64 años. El tipo de muestreo fue probabilístico, de tipo polietápico según tamaño demográfico de municipio y género, con un margen de error del ± 5,27% y un intervalo de confianza del 95,5%. El tamaño de la muestra final fue de 360 personas (50,3% mujeres, 49,7% hombres), quienes completaron un cuestionario estructurado mediante entrevista personal cara a cara en su domicilio entre octubre y diciembre de 2011, que incluía una escala de barreras específica, así como sub-cuestionarios de innovaciones y alternativas de conciliación vinculados a los tres ítems relacionados con el empleo, cuidado de hijos e hijas y hogar de la escala de barreras. La escala de barreras fue completada por las personas practicantes de actividad física y deportiva que deseaban realizar otra actividad, es decir, por la Demanda Establecida, así como por las personas no practicantes pero deseosas de hacerlo o Demanda Latente, y las personas no practicantes no interesadas en practicar o Demanda Ausente (n=246). Las personas que alcanzaron elevadas puntuaciones en los tres ítems de la escala de barreras vinculados al empleo, cuidado de hijos e hijas y hogar, completaron sub-cuestionarios específicos de innovaciones y alternativas de conciliación vinculados a estas barreras. Para el estudio métrico de los ítems y la dimesionalidad de la escala de barreras se llevaron a cabo análisis descriptivos de los ítems, análisis correlacionales y análisis factoriales exploratorios (AFE). Como resultado se obtuvo una escala de barreras constituida por 13 ítems que explicaron el 59,1% de la variabilidad total de los datos, agrupados en cuatro dimensiones denominadas: Barreras Interpersonales (2 ítems), Barreras Individuales (4 ítems), Barreras Comunidad-Institucionales (4 ítems) y Barreras Obligaciones-Tiempo (3 ítems). Los datos de la escala de barreras y los sub-cuestionarios de innovaciones y alternativas de conciliación fueron analizados con el SPSS v. 18. Para la comparación de variables cuantitativas y ordinales se utilizaron ANOVAS de dos factores (género por tipo de demanda), el tamaño del efecto para esta prueba se cuantificó mediante eta cuadrado. Los resultados se expresaron como porcentajes para las variables nominales y como medias y desviaciones típicas para las variables ordinales y cuantitativas. El nivel de riesgo se fijó en 0,05. El instrumento presentó una fiabilidad aceptable (α=0,58) en consonancia con el modelo ecológico social presentando dimensiones que explicaron los niveles de influencia de las diferentes esferas. Los resultados obtenidos permitieron avalar tanto la adecuación de las propiedades psicométricas de los ítems, así como la validez y fiabilidad de la escala de barreras para la práctica de actividad física y deportiva. Los distintos análisis realizados han aportado evidencia de la validez de una estructura de cuatro dimensiones acorde a los planteamientos teóricos previos de los modelos ecológicos sociales. En la dimensión barreras Individuales se identificaron diferencias según el tipo de demanda (F2,237=40,28; p<0,001; η2=0,25) y el género (F1,237=8,72; p<0,01; η2=0,84). En la dimensión barreras Interpersonales se identificaron diferencias de género (F1,239 =14,9; p<0,01; η2=0,06) pero no entre demandas (F2,239=2,35; p>0,05; 1-β=0,47). En la dimensión Barreras Obligaciones-Tiempo se identificaron diferencias en función del tipo de demanda (F2,239=3,88; p<0,05; η2=0,03) sin presentar diferencias entre hombres y mujeres (F1,239=1,06; p>0,05; 1-β=0,18). Por último, en la dimensión Comunidad Institucionales, se identificaron diferencias en función del tipo de demanda (F2,240=5,69; p<0,01; η2=0,045) y no hubo diferencias en función del género (F1,240=0,65; p>0,05; 1-β=0,13). Las innovaciones y alternativas de conciliación relacionadas con el empleo más valoradas fueron la de flexibilidad en los horarios de trabajo y adecuación de horarios; las más valoradas relacionadas con la barrera cuidado de hijos fueron que en la instalación deportiva se ofertaran actividades físicas conjuntas, en las en las que pudiesen participar madres e hijos y que la instalación deportiva ofreciera, en el mismo horario, actividades para ellos y sus hijos, y, por último, las más valoradas en relación con las tareas del hogar, una mayor implicación de la pareja seguida por una mayor implicación de los hijos. ABSTRACT The objectives of this study were to build and validate an instrument to measure the barriers of adult people to the practice of sport and physical activities from the perspective of the social-ecological theory, analyse the presence of the different barriers, as well as the innovations and alternatives regarding conciliation with work and the care of children and home as barriers, identifying the possible differences that exist based on gender and the type of demand of the adult population within the Community of Madrid. For this, a quantitative, descriptive and transversal study was carried out on a representative sample of the resident population of the Community of Madrid, ages ranging from 30 to 64 years old. Given that is an infinite or very large population, and working with an interval of confidence of the 95,5%, and assuming in the population variance, the worst case of p equal to q, the margin of sampling error was ± 5,27. The sample consisted of 360 people (50,3% women, 49,7% men), who completed a questionnaire during face-to-face personal interviews between October and December 2011. The questionnaire included a scale of specific barriers, as well as sub-questionnaires on the innovations and alternatives linked to the three items regarding work, the care of children and home of the barriers scale. The barriers scale was completed by people who practice physical and sport activities and wanted to do other activities, i.e. by the Established Demand; by people who do not practice these activities but would like to do so, i.e. Latent Demand; and by people who do not practice these activities and have no desire to do so, i.e. Absent Demand (n=246). The people who peaked on the three items of the barriers scale regarding work, the care of children and home, then completed specific sub-questionnaires on the innovations and alternatives for conciliation related to these barriers. The metric study of the items and the dimensionality of the barriers scale was carried out through descriptive analyses of the items, as well as correlation analyses and exploratory factor analyses (EFA). This resulted in a barriers scale composed of 13 items that explained 59,1% of the total variability of the data, grouped in four dimensions as follows: Interpersonal Barriers (2 items), Individual Barriers (4 items), Community-Institutional Barriers (4 items) and Obligations-Time Barriers (3 items). The data obtained from the barriers scale and sub-questionnaires on the innovations and alternatives for conciliation were analyzed using software SPSS v. 18. Two-way ANOVA (gender by type of demand) was used for the comparison of quantitative and ordinal variables, and the effect size for this test was quantified with eta squared. The results were expressed as percentages for nominal variables, and as means and standard deviations for quantitative and ordinal variables. The level of risk was set at 0,05. The instrument showed an acceptable reliability (α=0,58) in line with the social-ecological model, providing dimensions that explained the influence levels of the different spheres. The results obtained establish both the adaptation of the psychometric properties of the items, and the validity and reliability of the barriers scale for the practice of physical and sport activities. The different analyses have supported the validity of a four-dimensional structure consistent with the previous theoretical approaches on the social-ecological models, while showing adequate statistical indices. The differences identified in the Individual Barriers dimension were based on the type of demand (F2,237=40,28; p<0,001; η2=0,25) and gender (F1,237=8,72; p<0,01; η2=0,84). The differences identified in the Interpersonal Barriers dimension were based on gender (F1,239 =14,9; p<0,01; η2=0,06) but not on demand (F2,239=2,35; p>0,05; 1-β=0,47). The differences identified for the Obligations-Time Barriers dimension were based on the type of demand (F2,239=3,88; p<0,05; η2=0,03) and did not show differences between men and women (F1,239=1,06; p>0,05; 1-β=0,18). Finally, the differences identified for the Community-Institutional Barriers dimension were based on the type of demand (F2,240=5,69; p<0,01; η2=0,045) and provided no differences based on gender (F1,240=0,65; p>,05; 1-β=0,13). The most valued innovations and alternatives for conciliation regarding work were the adaptation and flexibility of working hours and timetables; the most valued related to the care of children were the offer of joint activities for adults and children in sport centres, as well as separate activities within the same timetable; and, finally, the most valued regarding the home was a higher degree of participation and involvement on the part of the spouse or partner, followed by a higher degree of participation and involvement on the part of the children.

Feasibility of An Online Survey Examining the Physical Activity Patterns Among South Asian Adults Residing In the United States

Background: Physical inactivity is a major risk factor for cardiovascular disease and diabetes among South Asians (SAs) - Bangladeshi, Bhutanese, Indian, Maldivian, Nepali, Pakistani, and Sri Lankan. Methods: An online survey was used to determine the feasibility of examining physical activity (PA) levels of SAs living in the US. The Social Ecological Model was the theoretical basis for identifying individual-level, social environmental, and physical environmental factors that impact PA. Results: Ethnicity, intention, self-efficacy, and perceived health benefits of PA were significantly associated with being physically active. Facilitators to PA included achieving improved health; while barriers were lack of time to exercise, unfamiliarity with PA, and nonexistent gender-specific PA facilities. Conclusions: This study showed that online surveys can be a promising tool for data collection among SAs. Health promotion programs should include education on the benefits of PA, and provide culturally sensitive facilities that support PA, especially for SA women.

Adolescents' educational outcomes in a social ecology of parenting, family, and community risks in Northern Ireland

This study examines the influence of social ecological risks within the domains of parenting, family environment, and community in the prediction of educational outcomes for 770 adolescents (49% boys, 51% girls, M = 13.6 years, SD = 2.0) living in a setting of protracted political conflict, specifically working class areas of Belfast, Northern Ireland. Controlling for religious community, age, and gender, youths' lower academic achievement was associated with family environments characterized by high conflict and low cohesion. School behaviour problems were related to greater exposure to community violence, or sectarian and nonsectarian antisocial behaviour. Youths' expectations about educational attainment were undermined by conflict in the family environment and antisocial behaviour in the community, as well as parenting low in warmth and behavioural control. Findings underscore the importance of considering family and community contributions to youths' educational outcomes. Suggestions regarding targeted interventions toward promoting resilience are discussed, such as assessing both child and family functioning, developing multidimensional interventions for parents, and building community partnerships, among others.

Community response in disasters: an ecological learning framework

Natural disasters are frequently exacerbated by anthropogenic mechanisms and have social and political consequences for communities. The role of community learning in disasters is seen to be increasingly important. However, the ways in which such learning unfolds in a disaster can differ substantially from case to case. This article uses a comparative case study methodology to examine catastrophes and major disasters from five countries (Japan, New Zealand, UK, US and Germany) to consider how community learning and adaptation occurs. An ecological model of learning is considered, where community learning is of small loop (adaptive, incremental, experimental) type or large loop (paradigm changing) type. Using this model we consider that there are three types of community learning that occur in disasters (navigation, organisation, reframing). The type of community learning that actually develops in a disaster depends upon a range of social factors such as stress and trauma, civic innovation and coercion.

Coupling anchovy eggs and hydrodynamic model as an assessement tool for estuarine ecohydrological management

Nitrate and urban waste water directives have raised the need for a better understanding of coastal systems in European Union. The incorrect application of these directives can lead to important ecological or social penalties. In the paper this problem is addressed to Ria Formosa Coastal Lagoon. Ria Formosa hosts a Natural Park, important ports of the southern Portuguese coast and significant bivalve aquaculture activity. Four major urban waste water treatment plants discharging in the lagoon are considered in this study. Its treatment level must be selected, based on detailed information from a monitoring program and on a good knowledge of the processes determining the fate of the material discharged in the lagoon. In this paper the results of a monitoring program and simulations using a coupled hydrodynamic and water quality / ecological model, MOHID, are used to characterise the system and to understand the processes in Ria Formosa. It is shown that the water residence time in most of the lagoon is quite low, of the order of days, but it can be larger in the upper parts of the channels where land generated water is discharged. The main supply of nutrients to the lagoon comes from the open sea rather than from the urban discharges. For this reason the characteristics and behaviour of the general lagoon contrasts with the behaviour of the upper reaches of the channels where the influence of the waste water treatment plants are high. In this system the bottom mineralization was found to be an important mechanism, and the inclusion of that process in the model was essential to obtain good results.

An Investigation of the Role of Attention in the Cross-Race Effect: An Ecological Approach

The current set of studies was conducted to examine the cross-race effect (CRE), a phenomenon commonly found in the face perception literature. The CRE is evident when participants display better own-race face recognition accuracy than other-race recognition accuracy (e.g. Ackerman et al., 2006). Typically the cross-race effect is attributed to perceptual expertise, (i.e., other-race faces are processed less holistically; Michel, Rossion, Han, Chung & Caldara, 2006), and the social cognitive model (i.e., other-race faces are processed at the categorical level by virtue of being an out-group member; Hugenberg, Young, Bernstein, & Sacco, 2010). These effects may be mediated by differential attention. I investigated whether other-race faces are disregarded and, consequently, not remembered as accurately as own-race (in-group) faces. In Experiment 1, I examined how the magnitude of the CRE differed when participants learned individual faces sequentially versus when they learned multiple faces simultaneously in arrays comprising faces and objects. I also examined how the CRE differed when participants recognized individual faces presented sequentially versus in arrays of eight faces. Participants’ recognition accuracy was better for own-race faces than other-race faces regardless of familiarization method. However, the difference between own- and other-race accuracy was larger when faces were familiarized sequentially in comparison to familiarization with arrays. Participants’ response patterns during testing differed depending on the combination of familiarization and testing method. Participants had more false alarms for other-race faces than own-race faces if they learned faces sequentially (regardless of testing strategy); if participants learned faces in arrays, they had more false alarms for other-race faces than own-races faces if ii i they were tested with sequentially presented faces. These results are consistent with the perceptual expertise model in that participants were better able to use the full two seconds in the sequential task for own-race faces, but not for other-race faces. The purpose of Experiment 2 was to examine participants’ attentional allocation in complex scenes. Participants were shown scenes comprising people in real places, but the head stimuli used in Experiment 1 were superimposed onto the bodies in each scene. Using a Tobii eyetracker, participants’ looking time for both own- and other-race faces was evaluated to determine whether participants looked longer at own-race faces and whether individual differences in looking time correlated with individual differences in recognition accuracy. The results of this experiment demonstrated that although own-race faces were preferentially attended to in comparison to other-race faces, individual differences in looking time biases towards own-race faces did not correlate with individual differences in own-race recognition advantages. These results are also consistent with perceptual expertise, as it seems that the role of attentional biases towards own-race faces is independent of the cognitive processing that occurs for own-race faces. All together, these results have implications for face perception tasks that are performed in the lab, how accurate people may be when remembering faces in the real world, and the accuracy and patterns of errors in eyewitness testimony.