Your search

As the population of Aotearoa/New Zealand heads towards one-in-four being aged over 65-years-and-over by 2040, it is anticipated that family members will play an increasingly important role in caring for older relatives with chronic and age-related health issues. Multi-generational, and in particular three-generational living arrangements, combined with family care of older relatives are a growing trend; a trend already even evident among Māori communities. This paper reports on a study that explored the care experiences and expectations of 14 past and current Māori carers (aged 23 to 72-years) of older relatives. Interviews were audio-recorded, transcribed verbatim, and coded independently. The initial thematic analysis revealed nine themes and participants were invited to feedback on the summary in person or in writing. The feedback resulted in the original themes being collapsed into four (with subthemes): “Care is Normal”; “Collective Coordination of Care”; “Insider-Carer—Outsider Perspectives on Caring”; and “Societal Influences on Family Care/Carers”. Firstly, these themes highlight how Māori cultural norms infuse direct care, support, and coordination roles within family care of the older family member. Secondly, they reveal the challenges for family carers in talking about their work with others, especially (thirdly) in the face of negative attitudes towards care and carers of an older family member within wider society. These findings have implications for cultural and wider socio-political influences in socialising different groups to carer role expectations. If society is to better prepare future caregivers for their role, ongoing research is needed with the various cultural groups in Aotearoa/New Zealand.

1 2 1 1 2 1/15 Purpose: Inclusive recreation practices are one of the most recognized means of providing recreational sport opportunities for youth with disabilities. Municipal recreation departments are responsible for ensuring opportunities to partake in youth sport programs. This study evaluates the extent to which recreation departments are providing inclusive recreational sport opportunities to individuals with disabilities. Methods: This study employed a cross-sectional design mail survey to gather data from recreation directors across New England. The two dependent variables for this study are provision of inclusive services and perceived challenges to providing those services. The independent variables include director recreation/sport education, years as a director, and community size. Analysis included univariate, bivariate, and ANOVA for the quantitative data. Qualitative data were reviewed for commonalities. Results: There were 136 respondents for a response rate of 34.8%. Most (85%) directors noted their agency provided some inclusive recreation. Areas of success included accessible facilities and accommodations/modifications. Areas of needed improvement included staff training and providing transportation for individuals with disabilities. The only significant factor was years as a Director (F=4.315; p=0.016). The multiple comparison test found statistical significance between those with the fewest years of experience (x=22.14) and highest experience (x=19.57). The top challenges in providing inclusive recreational sport was additional expense, and the lack of training for the provision of these services. Conclusions: Without director support, inclusive recreation can be difficult to achieve. Director support, including making inclusion an agency priority, reflecting inclusion in the agency's mission, and hiring practices was imperative to facilitating an inclusive recreation environment and program. Financial concerns and need for staff training are the biggest obstacles to providing inclusive recreational sport programming. Applications in Sport: Training of recreation and youth sport staff members, including those that aspire to be directors, can have a great impact on opening opportunities for inclusive recreational sports. University academic recreation and sport management programs need to embed the principles and practices of inclusion into their curriculum. In-service training can be an important tool to increase inclusion offerings to the community, increasing the amount of staff members who can facilitate increased opportunities for inclusive recreational sport.

There are emerging concerns about the preparedness of rural communities in the United States in the face of the 2019 novel coronavirus (called SARS-CoV-2, causing the disease COVID-19) considering the existing disparities across the social determinants of health between rural and urban Americans. Taking into account the current exponential rate of spread of the coronavirus, this article critically examines the risk facing the 60 million Americans living in rural areas, discusses possible solutions pertaining to rural COVID-19 prevention, and examines measures to consider to prepare for this epidemic before it reaches rural areas.

Breast cancer patients undergoing radiotherapy often experience severe levels of anxiety and depression within the African context. There is a gap in the research literature from Africa, particularly Ghana, with few studies focusing on depression among patients undergoing radiation treatment. The purpose of the study was to find various interventions for depression and anxiety among breast cancer patients in Ghana. A mixed method study examined breast cancer patients undergoing radiotherapy and their responses through a concurrent triangulation involving an interview with selected professional and a detailed patient survey. In all, 100 patients between the ages of 20-89 completed a questionnaire and individual interviews were held with 6 professionals with a minimum of 5 years of work experience. Themes were generated through open coding of the interview data, while multiple regression was performed to determine the relationship between depression and anxiety with the independent variables. In all, 89% had no family history of breast cancer, and the majority (55%) had the disease duration of one to three years. Almost 95% of patients with breast cancer had anxiety and depression in different categories. This included hair loss, discolored finger nails, cost of treatment, and fear of the unknown. Age and monthly income of patients were statistically significant in predicting the anxiety and depression among the patients. Coping mechanisms are essential for all patients undergoing treatment. This study’s implications will lead to positive change when all stakeholders assist in implementing measures to promote coping strategies for breast cancer patients in Ghana.

Recreational boating is increasing in popularity worldwide, prompting challenges concerning pollution management, aquatic ecosystem preservation, and waterway access. Electric boating technology may provide a sustainable alternative to gasoline-powered boats, helping to address these challenges. In this study, the environmental and health impacts associated with using electric service vessels in the recreational boating industry were assessed. The focus was on pump-out boats, which enable the sanitary management of human waste generated onboard recreational vessels, as a tractable model of the whole recreational boating service sector. To query stakeholder attitudes about changing to electric technology, surveys were distributed to a nationwide network of pump-out boat service providers. A wide range of attitudes exists among this group towards the adoption of electric technology, and financial concerns dominate the anticipated barriers to electric technology adoption. A life-cycle assessment of electric and gasoline-powered pump-out boats revealed that electric boats have lower lifetime greenhouse gas emissions than do gasoline-powered equivalents, especially when electric boats are charged using renewable resources. Our study demonstrates that already-existing electric technology is a sustainable alternative to gasoline combustion in the boating service sector, and identifies the key challenges remaining for the widespread adoption of electric service boats.

Objective: Increasing BMI, overweight, and obesity are urgent and grave problems in the US. The goal of this study is to begin to understand trends in overweight and obesity among undergraduate students in the U.S. to assist in informing public health education and health promotion practices. Methods: Data on self-reported weight and height were collected in 2012, 2014, and 2016 from randomly selected college students who were enrolled in a public university in Northeast US. Spearman's Rank Order Test was used to evaluate trends within specific demographic categories. Results: BMI increased for almost all studentsfrom 2012-2016. Groups with significant increases in BMI included: males, females, sophomores, and seniors. Conclusions: Results suggest the need for interventions to reduce increases in overweight and obesity that are experienced during college years. College is a critical transitional time when students adopt health behaviors that they continue into adulthood. Increasing BMI in college students indicates a need for additional research to understand the factors that contribute to the increasing trend of overweight and obesity in this population. College is an optimal setting for implementation of effective interventions that can help prevent BMI increases in this population and establish healthy behaviors for the future. Keywords: Overweight, Obesity, College Students, BMI, Spearman’s Rank, Interventions

The pandemic of respiratory disease spreading from person-to-person, named “coronavirus disease 2019” (abbreviated “COVID-19”), presents a public health emergency of international concern. This pandemic is occurring during renewed attention to the persistent issue of police brutality against Blacks in the United States. Protests have ensued to highlight perceived and observed injustice against minorities, particularly Black people. Concerns arise that these protests may complicate efforts to adhere to social distancing and increase risks of COVID-19 exposure among Black persons, who are already disproportionality affected by COVID-19 outcomes due to systemic barriers within the healthcare system and society. This article discusses police brutality against Blacks in the United States and subsequent protests, considerations for social distancing and racial disparities in health during COVID-19, and the need for policies to ensure fair and equitable enforcement of social distancing mandates. We also discuss the need for policies to improve access to COVID-19 testing, diagnosis, and management among underserved and minority communities. © 2020 Taylor & Francis Group, LLC.

Founded in 1950, the Society for Public Health Education (SOPHE) provides leadership to the health education profession and promotes the health of all people through six strategic commitments: developing and promoting standards for professional preparation and credentialing of community and school health educators; stimulating research on the theory, practice, and teaching of health education; supporting elimination of health disparities and the achievement of health equity; providing continuing education of the health education workforce; advocating for policy and legislation affecting public health and health promotion; and supporting a network of local chapters. This article describes how SOPHE has pursued these strategic commitments during the past 70 years and discusses challenges that will influence the future of SOPHE and the contours of the research and practice agendas of the field going forward. © 2020 Society for Public Health Education.

BACKGROUND: Naloxone is an opioid antagonist that can reverse an opioid overdose. Increased opioid-related mortality rates led to greater distribution of naloxone without a prescription and administration of naloxone by laypersons. This study fills a gap in knowledge of naloxone experiences among active users of opioids living in suburban communities. PURPOSE: The purpose of this article is to provide nurse practitioners with an in-depth understanding of current naloxone use practices among people who experience overdose events. The specific aims are to compare access to naloxone in diverse suburban towns, to examine administration differences across settings, and to understand perspectives on naloxone experiences from people who are actively using opioids. METHODOLOGICAL ORIENTATION: The data for this analysis were drawn from an ethnographic study in the suburban towns around Atlanta, Georgia; Boston, Massachusetts; and New Haven, Connecticut. Short surveys and in-depth interviews were collected. Inductive methods were used to compare data across settings. SAMPLE: The sample of 106 included 48% female, 62% White, 24% African American/Black, 13% more than one race, and 21% Hispanic/Latinx. The mean age was 41.35 years. CONCLUSIONS: Differences between study settings in access to naloxone, administration frequency, and delivery systems were found. Findings suggest more education and training is needed in overdose prevention and harm reduction intervention. Studies on delivery systems need to address the increase in fentanyl-related overdoses. IMPLICATIONS FOR PRACTICE: Nurse practitioners can help to target distribution of naloxone in local communities, facilitate collaboration with harm reduction services, and provide evidence-based education and training to laypersons. Copyright © 2020 American Association of Nurse Practitioners.

Background: Non-motor symptoms (NMS) are common in Parkinson's disease (PD), but their relationships to nigrostriatal degeneration remain largely unexplored. Methods: We evaluated 18 NMS scores covering 5 major domains in relation to concurrent and future dopamine transporter (DAT) imaging in 344 PD patients from the Parkinson's Progression and Markers Initiative (PPMI). We standardized NMS assessments into z-scores for side-by-side comparisons. Patients underwent sequential DaTSCAN imaging at enrollment and at months 12, 24, and 48. Specific binding ratios (SBR) were calculated using the occipital lobe reference region. We evaluated the association of striatal DAT binding at the four time points with each baseline NMS using mixed-effects regression models. Results: Multiple baseline NMS were significantly associated with DAT binding at baseline and at follow-up scans. REM sleep behavior disorder (RBD) symptoms showed the strongest association – mean striatal SBR declined with increasing RBD symptom z-score (average of time-point-specific slopes per unit change in z-score: βAVG = −0.083, SE = 0.017; p < 0.0001). In addition, striatal DAT binding was linearly associated with increasing baseline z-scores: positively for the memory (βAVG=0.055, SE = 0.022; p = 0.01) and visuospatial (βAVG=0.044, SE = 0.020; p = 0.03) cognitive domains, and negatively for total anxiety (βAVG= −0.059, SE = 0.018; p = 0.001). Striatal DAT binding showed curvilinear associations with odor identification, verbal discrimination recognition, and autonomic dysfunction z-scores (p = 0.001, p = 0.0009, and p = 0.0002, respectively). Other NMS were not associated with DAT binding. Conclusions: Multiple NMS, RBD symptoms in particular, are associated with nigrostriatal dopaminergic changes in early PD. © 2020 Elsevier Ltd

Health education and promotion researchers and practitioners are committed to eliminating health disparities, and the Society for Public Health Education (SOPHE) has continuously supported this effort through its journals, professional development, annual conferences, and advocacy. The COVID-19 pandemic elucidated inequities directly caused by racism and other social determinants of health. In order to achieve health equity, we need to become antiracist in our research, practice, and advocacy work by standing united against racist policies and practices. I invite us all to heed the call to action on these five points: place racism on the agenda, practice cultural humility, claim your privilege and eliminate microaggressions, utilize strategies that promote inclusion and equity, and embrace your inner leader and activist. Just as SOPHE as an organization pivoted its annual conference from on ground to virtual in March 2020, so can we be innovative and brave as professionals to face the hard work and dedication needed to become antiracist., (C)2020Sage Publications

Objective: To examine health behaviors associated with overweight/obesity by race/ethnicity at a diverse urban college. Participants: 270 undergraduates (77.0% female; 26.7% non-Hispanic white) and median body mass index (BMI) of 23.1 kg/m2. Methods: A questionnaire about health-related behaviors as part of the “Get Fruved” project was used to measure health behaviors (sugar sweetened beverage (SSB), fruit and vegetable consumption, physical activity, stress, and sleep) by race/ethnicity. Multivariable logistic regression was used to assess the adjusted odds of engaging in positive health-related behaviors. Results: Non-Hispanic black and Hispanic students were 64% and 59% less likely to consume lower amounts of SSB. Hispanic students were 83% and 81% less likely to meet vegetable and fruit recommendations. Non-Hispanic black and other (including biracial) had reduced odds of meeting vegetable recommendations (AOR = 0.18 and 0.28). Conclusions: Disparities in SSB, fruit, and vegetable consumption represent potential intervention targets to improve health behaviors among racial/ethnic minorities. © 2020 Taylor & Francis Group, LLC.

Research has shown that service-learning can increase student-learning outcomes across various disciplines. Service-learning opportunities have been steadily increasing in college settings, especially in health-related fields. This evaluation of an undergraduate public health course at a mid-size, public university in New England sought to understand the impact of service-learning on material retention, internships, and post-graduation public health careers. A 25-item questionnaire was emailed to students who took the course between the Fall 2010 and Spring 2016 semesters with 75 completed (33.3% completion rate). More than half of the respondents noted that their participation in a service-learning project positively affected their internship experience, their first post-graduation job, and their overall career, while also helping them retain the course material after graduation. Open-ended responses provided insight to the qualitative responses. Respondents noted that in addition to having the understanding and ability to put on programs in their community, they also had more confidence in their abilities. The opportunity to practice public speaking skills as well as work collaboratively in group settings, were both noted as essential skills needed to succeed in the public health workforce. It was concluded the project had a positive impact on student's learning and retention in planning, implementing, and evaluating an actual health promotion program as well as how they were able to use those skills in their careers., (C)2021Sage Publications

The purpose of this study was to gain an understanding of the ambiguities and uncertainties experienced by a diverse group of African-American caregivers. The study applied Schlossberg's transition theory (TT) and Mishel’s revised uncertainty theory to narratives of self-identified African-American caregivers who provided care at least 5 h a week. The men (6) and women (8) were mostly unmarried, mostly caring for a parent or grandparent. The caregivers’ average age was 52 (SD = 19; ages ranged from 24 to 82 years); and the care recipients’ average age was 84 (SD = 9). Six care recipients had dementia and the remainder had multiple disease diagnoses. Narratives were obtained by in-depth interviews or focus group discussions. These were audio-recorded, transcribed verbatim professionally and analyzed independently by trained coders. Schlossberg’s TT contextualized whereas Mishel’s RUIT illuminated the characteristics of the transition, its associated uncertainty, and their relationship to the development of caregiver stress. Situational factors such as difficulties with illness symptoms of the care recipient, conflict between previous experience and current expectations and the adjustments to the new caregiving role, burdened younger caregivers more than older caregivers. Self-factors related to lack of knowledge about the illness and feelings of lack of control. Social support was predominantly provided by family members, and its absence resulted in conflict among siblings and caregiver stress. The most common coping strategies include religiosity, expectations of reciprocity, and coming to terms with the uncertainty. Understanding the feelings, perceptions and needs of caregivers in transition is tantamount to providing nursing care.