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Robèrt Forgot Goulet: Augmenting TNS with the Capabilities Approach to Support the Social Dimensions of Sustainability

Description

While the definition of sustainability remains open for all to contribute to and participate in, there do seem to be some notions it has come to embody that should not be neglected as the definition coalesces. Among these are the

While the definition of sustainability remains open for all to contribute to and participate in, there do seem to be some notions it has come to embody that should not be neglected as the definition coalesces. Among these are the ethical and social dimensions of sustainability. Whether or not it is appropriate, required, or even desirable, concepts like social equity, human rights, ethical sharing of commons, etc. have increasingly come under the umbrella of the sustainability discourse. Even if “sustainability” as a bare word doesn’t imply those things, the concept of sustainable development certainly has taken on those dimensions. That sustainability might be redefined or re-scoped to be a purely environmental or a rigidly scientific endeavor, is not an immediate concern of this paper, though if that were to occur (whether for the sake of simplicity or pragmatics), it should be done explicitly so the ethical sub-discourse can be maintained (indeed, sustained) by some other movement.

This paper proposes a mechanism by which such a migration in terms can be prevented. First, in reviewing the work of Denis Goulet, it shows the solid basis for including an ethical aspect in the sustainability discourse. Second, it points out that Karl-Henrik Robèrt’s highly-lauded and broadly-employed sustainability framework, The Natural Step, is deficient in this area. This deficiency provides the impetus for, finally, proposing a mechanism by which The Natural Step can be extended to include the important social and ethical dimensions of sustainability. This mechanism is based on the capabilities approaches that, in many respects, evolved out of Goulet’s early work. Augmented accordingly, TNS can continue to be used without fear of overlooking the social and ethical aspects of the sustainability discourse.

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Depression Screening and Breastfeeding Support in a Community Breastfeeding Clinic

Description

Purpose: Implementation of a postpartum depression (PPD) screening while using evidence-based interventions to improve depressive symptoms, enhance breastfeeding (BF) self-efficacy, and strengthen the mother-infant dyad (MID).

Background and Significance: PPD is highly prevalent among women living in the United States and

Purpose: Implementation of a postpartum depression (PPD) screening while using evidence-based interventions to improve depressive symptoms, enhance breastfeeding (BF) self-efficacy, and strengthen the mother-infant dyad (MID).

Background and Significance: PPD is highly prevalent among women living in the United States and threatens the physical and psychological health of MIDs. Many of these women go undiagnosed and without treatment, further worsening symptoms and outcomes. This has inspired world healthcare leaders and organizations to address maternal mental health among postpartum women.

Methods: A 12-week evidenced-based project consisted of two-sets of participants including mothers and staff. A comprehensive maternal support program guided by an informational pamphlet (IP) and implementation of PPD screening using the Edinburgh Postnatal Depression Scale served as the two-part intervention for this project. Goals were to decrease PPD, enhance BF satisfaction, and strengthen the MID. Comprehensive maternal support encompasses interventions proven to meet the project goals and includes tailored BF education and care to maternal needs, social support by peer/family involvement, skin-to-skin contact during BF, emotion-regulation strategies, and availability of community resources.

Outcomes: The BSES-SF scores did result in statistical significance based on an alpha value of 0.10, t(3) = -2.98, p = .059, proving a positive effect was seen in breastfeeding self-efficacy post intervention. The results did not show statistical significance (t(3) = 0.60, p = .591) in regard to pre and post-depression scores. However, the mean pre-score (M =3.50, SD 3.11) did decrease post-intervention (M =2.75, SD 1.26) and exemplifies clinical significance.

Conclusion: The outcomes of this Quality-Improvement project showed improved scores for depression and BF self-efficacy post-intervention. This demonstrates the value in screening for PPD using a validated screening tool and instituting comprehensive maternal support guided by evidence-based practice in a community setting.

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Date Created
2020-04-25

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Screening for Posttraumatic Stress Disorder in Behavioral Health

Description

Background: Non-Veteran Affair (VA) mental health care facilities are admitting increased numbers of military affiliated members due to recent changes, allowing veterans to outsource healthcare at civilian treatment centers. The VA reports less than 9 million veterans enrolled in VA

Background: Non-Veteran Affair (VA) mental health care facilities are admitting increased numbers of military affiliated members due to recent changes, allowing veterans to outsource healthcare at civilian treatment centers. The VA reports less than 9 million veterans enrolled in VA services, leaving over 50% seeking treatment from civilian providers. Given the high prevalence of Posttraumatic Stress Disorder (PTSD) in the military population, it is imperative to implement a valid and reliable screening tool at primary care facilities to ensure timely and accurate diagnosis and treatment.

Method: This project aimed to provide an evidence-based education for intake nurses to understand prevalence of PTSD and to use a screening tool Primary Care PTSD for DSM-5 (PC-PTSD-5) in a non-VA behavioral health facility.

Setting: The project site was a civilian behavioral health facility located in West Phoenix Metropolitan area. The behavioral health facility serves mental health and substance abuse needs. Project implementation focused on the intake department.

Measures: Sociodemographic data, PTSD diagnosis criteria, prevalence and PC-PTDSD-5 screening tool knowledge collected from pre and posttest evaluation. Patients’ charts for those admitted 6-week before and 6-week after the education to calculate numbers of screening tools completed by nurses at intake assessment.

Data analysis: Descriptive statistics was used to describe the sample and key measures; the Wilcoxon Signed Rank Test was used to examine differences between pre-test and post-test scores. Cohen’s effect size was used to estimate clinical significance.

Results: A total of 23 intake nurses (87.0% female, 65.2% 20-39 years old, 52.2% Caucasian, 95.6% reported having 0-10 years of experience, 56.5% completed Associate’s degree) received the education. For PTSD-related knowledge, the pre-test score (Mdn = 6.00) was significantly lower than the post-test score (Mdn = 10.00; Z= -4.23, p < .001), suggesting an increase of PTSD knowledge among nurses after the education. Regarding the diagnosis, the percentage of patients who were diagnosed with PTSD increased from (0.02% to 20% after the education).

Discussion: An evidence-based education aimed at enhancing intake nurses’ knowledge, confidence and skills implementing a brief and no-cost PTSD screening tool showed positive results, including an increase of PTSD diagnosis. The implementation of this screening tool in a civilian primary mental health care facility was feasible and helped patients connect to PTSD treatment in a timely fashion. Continued use of paper version of screening tool will be maintained at facility as an intermediary solution until final approval through parent company is received to implement into electronic medical records.

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Date Created
2020-05-06

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Increasing Cervical Cancer Screening in a Federally Qualified Health Center

Description

Routine cervical cancer screening has significantly decreased the mortality rate of cervical cancer. Today, cervical cancer predominantly affects those who are rarely or never screened. Government programs are in place to provide cervical cancer screening at little to no cost,

Routine cervical cancer screening has significantly decreased the mortality rate of cervical cancer. Today, cervical cancer predominantly affects those who are rarely or never screened. Government programs are in place to provide cervical cancer screening at little to no cost, yet screening rates remain suboptimal.

This project evaluated an evidence-based intervention to increase cervical cancer screening among underserved women in a federally qualified health center (FQHC). Female patients ages 21 to 65 years without history of hysterectomy (n=1,710) were sent reminders to their phones through the electronic health record (EHR). The message included educational material about the screening process and an announcement regarding government aid for free or reduced cost screening.

The number of patients who made an appointment after receiving the message was assessed two months later. In total, 156 responses were collected, and 28 patients made an appointment for screening. The most frequently observed category of Ethnicity was Hispanic/Latina (n = 24, 86%). The most frequently observed category of Insurance was Title X (n = 13, 46%). The observations for Age had an average of 41.04 (SD = 9.93). Using an EHR communication function to send motivational reminders has shown some promise for increasing cervical cancer screening, thereby reducing cervical cancer mortality among the underserved.

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Date Created
2020-04-18

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A Gap Analysis of Syphilis Screening During Pregnancy by Prenatal Care Clinicians

Description

Congenital syphilis (CS) is increasing at an alarming rate in Arizona. The state health department has recommended increased screening to include the third trimester, but providers in individual counties are not following the recommendation. A literature search and appraisal showed

Congenital syphilis (CS) is increasing at an alarming rate in Arizona. The state health department has recommended increased screening to include the third trimester, but providers in individual counties are not following the recommendation. A literature search and appraisal showed increased screening reduces the incidence of CS and presented interventions to increase screening rates. Furthermore, the literature suggests provider education increases screening rates. However, before education could be completed an understanding of providers current knowledge, attitudes, and practice was needed. Using this information, a gap analysis that was completed in an Arizona county (“the County”) of syphilis screening during pregnancy by prenatal care clinicians will be presented guided by the Knowledge-Attitude-Practice (KAP) Model and the ACE Star Model of Knowledge Transformation.

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Date Created
2020-04-24

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Access to Healthcare Among Those Experiencing Homelessness: A Depression Screening Project

Description

Homeless individuals encounter barriers such as lack of health insurance, increased cost of care and unavailability of resources. They have increased risk of comorbid physical disease and poor mental health. Depression is a prevalent mental health disorder in the US

Homeless individuals encounter barriers such as lack of health insurance, increased cost of care and unavailability of resources. They have increased risk of comorbid physical disease and poor mental health. Depression is a prevalent mental health disorder in the US linked to increased risk of mortality. Literature suggests depression screening can identify high-risk individuals with using the patient health questionnaire (PHQ-9).

The objective of this project is to determine if screening identifies depression in the homeless and how it impacts healthcare access. Setting is a local organization in Phoenix offering shelter to homeless individuals. An evidence-based project was implemented over two months in 2019 using convenience sampling. Intervention included depression screening using the PHQ-9, referring to primary care and tracking appointment times. IRB approval obtained from Arizona State University, privacy discussed, and consent obtained prior to data collection. Participants were assigned a random number to protect privacy.

A chart audit tool was used to obtain sociodemographics and insurance status. Descriptive statistics used and analyzed using Intellectus. Sample size was (n = 18), age (M = 35) most were White-non-Hispanic, 44% had a high school diploma and 78% were insured. Mean score was 7.72, three were previously diagnosed and not referred. Three were referred with a turnaround appointment time of one, two and seven days respectively. No significant correlation found between age and depression severity. A significant correlation found between previous diagnosis and depression severity. Attention to PHQ-9 varied among providers and not always addressed. Future projects should focus on improving collaboration between this facility and providers, increasing screening and ensuring adequate follow up and treatment.

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Date Created
2020-05-04

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Blockchain: An Assessment of its Potential and Challenges in Addressing Sustainability Issues

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Blockchain, the technology behind the worldwide-known cryptocurrency Bitcoin, offers a new set of potential advantages and opportunities that various industries and institutions could use to enhance their processes. Although most research and development on blockchain has focused on applications for

Blockchain, the technology behind the worldwide-known cryptocurrency Bitcoin, offers a new set of potential advantages and opportunities that various industries and institutions could use to enhance their processes. Although most research and development on blockchain has focused on applications for cryptocurrencies and the finance industry, relatively few analyses and assessments have been conducted on how it could provide tools to address social and environmental issues. This research, using interviews, literature review and examples of blockchain applications, explores how this technology can be employed to address sustainability issues under the framework of three UN Sustainable Development Goals: 2. Zero Hunger, 7. Affordable and Clean Energy, and 14. Life Below Water. The analysis shows that blockchain has the potential to support solutions to sustainability problems that need efficient traceability, trust, a unique ID, transparency, or a highly secure payment system. However, the technology should not be mistaken for a panacea for addressing sustainability issues in its current state because it is not yet mature and has not been sufficiently tested. Expansion of blockchain as an effective tool for helping solve sustainability challenges will require a greater understanding of the governance of blockchain, its scalability and its potential unintended consequences for the technology to become properly integrated into the decision-making progress.

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2019-04-17

Biochar Briquettes: Alternative to Firewood and Charcoal Fuel

Description

Domestic energy is an important component of our day to day lives and is something we cannot live without. Imagine how life would be without a means to cook our food, to warm our house, life would be unbearable. As

Domestic energy is an important component of our day to day lives and is something we cannot live without. Imagine how life would be without a means to cook our food, to warm our house, life would be unbearable. As we enjoy these comforts rarely do we stop to think what the opportunity cost is. For those using renewable sources, it is not a big issue, but for those who rely on wood fuel, they have to strike a delicate balance between need for fuel and the need to conserve the greatest support systems of their livelihoods, the forests. The main source of energy for households in many developing countries is biomass, mainly from forests and woodlands. The continued use of firewood and charcoal fuel puts a strain on forests, resulting in adverse effects on the environment such as prolonged droughts, loss of biodiversity, dwindling water resources, changing weather patterns among other sustainability challenges. An alternative to firewood to charcoal lies in biochar briquettes. This paper discusses the role of biochar briquettes in mitigating climate change and serves as a step by step guide on how biochar briquettes may be produced.

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2018

The Sustainability Fair: Building a Grassroots Movement Around Community

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People everywhere should be doing everything they can to be more sustainable so that climate change can begin to be mitigated. We are already feeling the negative effects of climate change, and they are thoroughly documented. Despite this people are

People everywhere should be doing everything they can to be more sustainable so that climate change can begin to be mitigated. We are already feeling the negative effects of climate change, and they are thoroughly documented. Despite this people are not changing to be more sustainable fast enough. Many either reject the idea of climate change, do not know what they could do, or are unaware of how climate change affects them. Sustainability also impacts more than just climate change. Living more sustainably can have positive impacts economically as well as positive impacts on human health. In a world that is so connected and with such a wealth of information, we can no longer afford to have communities in the dark. Leaders need to rise on a community level to make a difference. Leadership is an aspect of an organization or a project that can elevate it to new heights. A leader is not everything, but the difference a good leader makes is universal. In this paper I will teach you about organizing a sustainability fair that educates and engages marginalized communities that typically are not included in the conversation on how to save our world.

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2018-11-10

Moving Sustainability Forward: A Game-based Approach For Building Confidence In Municipal Administration

Description

Cities with a car-oriented mobility system are significant consumers of energy and require drastic transformations in their structure and function to minimize their harmful impacts on environment and people and to achieve sustainability goals. To promote such sustainable transformations, municipal

Cities with a car-oriented mobility system are significant consumers of energy and require drastic transformations in their structure and function to minimize their harmful impacts on environment and people and to achieve sustainability goals. To promote such sustainable transformations, municipal administrators need to act as change-agents. Because municipal governments are often not agile organizations, they tend toward incrementalism even in the pursuit of transformational goals. Therefore, there is a need in municipal governments to build individual transformative capacity so that municipal administrators can design, test, and implement plans, projects, and policies that are capable of transforming cities toward sustainability. This research presents a game-based workshop, “Stadt-liche Ziele” (AudaCity), that uses a backcasting approach to make municipal administrators build a sustainability strategy. I conducted a pilot study to test the effects of the game on municipal administrators’ confidence in their own ability and power to implement sustainability actions, a key determinant of transformative capacity. Five municipal administrators from Lüneburg, Germany, working on mobility issues, participated in a three-hour-workshop playing the game. Interviews and questionnaires were used before and after the workshop and participants’ contributions during the event were recorded to explore collective changes in confidence. Results indicate that the game increased participant confidence by rewarding collective success, breaking down an ambitious goal into achievable tasks, and acknowledging how administrators’ current actions already contribute to the goal.

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2018-06-28