The Community Health and Social Medicine Incubator: a service-learning framework for medical student-led projects.

The Community Health and Social Medicine (CHASM) Incubator is a social impact venture that gives medical and other health care students the opportunity to develop initiatives that sustainably promote health equity for, and in partnership with, community partners and historically marginalized communities. Students learn how to develop projects with project management curricula, are paired with community health mentors, and are given seed micro-financing. As the first community health incubator driven by medical students, CHASM provides a framework for students interested in implementing sustainable solutions to local health disparities which extends the service-learning opportunities offered in existing curricula.

L'incubateur CHASM (Community Health and Social Medicine) est une initiative visant à créer un impact social en donnant aux étudiants en médecine et des autres sciences de la santé la possibilité de développer des initiatives durables en collaboration avec des partenaires communautaires et des communautés historiquement marginalisées. CHASM met en valeur l'équité en matière de santé. Les étudiants apprennent à élaborer des projets via un cursus de gestion de projet, sont jumelés à des mentors en santé communautaire et bénéficient de micro-financement de départ. Ce premier incubateur de santé communautaire mené par des étudiants en médecine fournit un cadre aux étudiants qui souhaitent mettre en œuvre des solutions durables aux inégalités en matière de santé. Il élargit également les possibilités d'apprentissage par le service offertes dans les cursus existants.

Challenges newly-arrived migrant women in Montreal face when needing maternity care: Health care professionals' perspectives.

BACKGROUND: People who leave their country of origin, or the country of habitual residence, to establish themselves permanently in another country are usually referred to as migrants. Over half of all births in Montreal, Canada are to migrant women. To understand healthcare professionals' attitudes towards migrants that could influence their delivery of care, our objective was to explore their perspectives of challenges newly-arrived migrant women from non-Western countries face when needing maternity care. METHOD: In this qualitative multiple case study, we conducted face-to-face interviews with 63 health care professionals from four teaching hospitals in Montreal, known for providing maternity care to a high volume of migrant women. Interviews were transcribed and thematically analysed. RESULTS: Physicians, nurses, social workers, and therapists participated; 90% were female; and 17% were themselves migrants from non-Western countries. According to participants, newly-arrived migrant women face challenges at two levels: (a) direct care (e.g., understanding Canadian health care professionals' expectations, communicating effectively with health care professionals), and (b) organizational (e.g., access to appropriate health care). Challenges women face are strongly influenced by the migrant woman's background as well as social position (e.g., general education, health literacy, socio-cultural integration) and by how health care professionals balance women's needs with perceived requirement to adhere to standard procedures and regulations. CONCLUSIONS: Health care professionals across institutions agreed that maternity care-related challenges faced by newly-arrived migrant women often are complex in that they are simultaneously driven by conflicting values: those based on migrant women's sociocultural backgrounds versus those related to the implementation of Canadian guidelines for maternity care in which consideration of migrant women's particular needs are not priority.

Global and public health core competencies for nursing education: A systematic review of essential competencies.

OBJECTIVES: Nurses are learning and practicing in an increasingly global world. Both nursing schools and nursing students are seeking guidance as they integrate global health into their learning and teaching. This systematic review is intended to identify the most common global and public health core competencies found in the literature and better inform schools of nursing wishing to include global health content in their curricula. DESIGN: Systematic review. DATA SOURCES: An online search of CINAHL and Medline databases, as well as, inclusion of pertinent gray literature was conducted for articles published before 2013. REVIEW METHODS: Relevant literature for global health (GH) and public and community health (PH/CH) competencies was reviewed to determine recommendations of both competencies using a combination of search terms. Studies must have addressed competencies as defined in the literature and must have been pertinent to GH or PH/CH. The databases were systematically searched and after reading the full content of the included studies, key concepts were extracted and synthesized. RESULTS AND CONCLUSION: Twenty-five studies were identified and resulted in a list of 14 global health core competencies. These competencies are applicable to a variety of health disciplines, but particularly can inform the efforts of nursing schools to integrate global health concepts into their curricula.

Transforming a small midwestern city for physical activity: from the sidewalks up.

BACKGROUND: Jackson, Michigan (population 36,000) started active living interventions to help solve residents' low physical activity levels. Jackson's experience can serve as a case study for beginning similar efforts in smaller communities. METHODS: In 2003, Jackson began a 3-prong community intervention utilizing the 5P model to increase safe physical activity opportunities and encourage walking and biking for short trips. The focus included work on projects at 1) elementary schools, 2) worksites, and 3) city-wide networks. RESULTS: Evaluation results show changes in attitudes toward active transportation (8% increase in children who thought walking to school was "safer" postintervention), intentions to try active transportation (43% of Smart Commute Day participants "would" smart commute more often postevent), and increased physical activity (the percentage of students walking to school more than doubled at 3 of 4 intervention schools). In addition, a community level observational study was conducted at 10 locations in the city in 2005 and 2006. The number of people seen using active transportation increased from 1,028 in 2005 to 1,853 people in 2006 (a 63% increase). CONCLUSIONS: Local community-driven projects to increase walking and biking can be effective by utilizing a variety of interventions, from the individual to the policy level.

Role for BRG1 in cell cycle control and tumor suppression.

Human BRG1, a subunit of the Swi/Snf chromatin remodeling apparatus, has been implicated in regulation of cellular proliferation and is a candidate tumor suppressor. Reintroduction of BRG1 into a breast tumor cell line, ALAB, carrying a defined mutation in the BRG1 gene, induced growth arrest. Gene expression data revealed that the arrest may in part be accounted for by down-regulation of select E2F target genes such as cyclin E, but more dramatically, by up-regulation of mRNAs for the cyclin-dependent kinase inhibitors p21 and p15. Protein levels of both p15 and p21 were induced, and p21 protein was recruited to a complex with cyclin-dependent kinase, CDK2, to inhibit its activity. BRG1 can associate with the p21 promoter in a p53-independent manner, suggesting that the induction of p21 by BRG1 may be direct. Further, using microarray and real-time PCR analysis we identified several novel BRG1-regulated genes. Our work provides further evidence for a role for BRG1 in the regulation of several genes involved in key steps in tumorigenesis and has revealed a potential mechanism for BRG1-induced growth arrest.