"Blaming the Flowers for Wilting": Idealized Aging in a Health Charity Video.

Amid growing concern about the graying population, an emerging theme in public health discourse is that of "successful aging." In this article, we use a governmentality lens to analyze a Canadian health promotion video, titled "Make Health Last: What Will Your Last 10 Years Look Like?" and viewers' responses to its message. The video presents starkly different scenarios of the last decade of life, conveying a neo-liberal rationality in which health in old age is positioned as a matter of individual choice. Our analysis suggests that while viewers generally support the video's message of personal responsibility for health, some are uneasy about implied claims that age-related illness can be prevented by choosing to be healthy. We argue that the video's simplistic messaging about health in later life raises disturbing questions about health promotion campaigns that deny the "normal" aging body and blame the elderly for "deciding" not to remain youthful and healthy.

Reconsidering healthcare evidence as dynamic and distributed: the role of information and cognition.

AIM: The basic thrust of evidence-based healthcare is that current best evidence should be used explicitly and judiciously for diagnosis, management, and other activities in healthcare settings. For this to be possible, researchers, practitioners, and other stakeholders must have a clear and accurate conceptualization of what constitutes 'evidence' in healthcare environments, and the manner in which it is used in decision-making and other activities. Currently, the dominant conceptualization of evidence is that of a body of information that can be retrieved by stakeholders for use in healthcare practice. The aim of this article is to critically examine the concept of evidence, particularly in light of recent models of human cognition and information use in decision-making and other cognitive activities. METHODS: In this theoretical article, we employ both analytical and synthetic methods to critically examine the concepts under investigation. Key concepts, such as evidence and information, and the essential relationships between them are analyzed from the vantage point of cognitive science, information science, and other relevant disciplines to explicate a conceptualization of evidence that moves past static and objectivist accounts. RESULTS: We demonstrate that evidence is fundamentally information that takes various forms-i.e., artifacts, mental structures, or communication processes. Specific forms and manifestations of evidence can thus be described in the context of information use in dynamic information environments. Furthermore, evidence-based healthcare activities are shown to be fundamentally cognitive in nature. For any given evidence-based healthcare activity, its quality and outcome can be understood in the context of how different sources of evidence are coordinated within a distributed cognitive system. In this sense, evidence based health care activity becomes more a matter of understanding the movement of information and knowledge within a distributed and dynamic cognitive system than mere access to or translation of a ready-at-hand resource. CONCLUSIONS: The conceptualization of evidence presented in this article has a number of implications for evidence-based healthcare-in terms of where attention is focused, the direction of future research efforts, how evidence generation, use, and practice are conceptualized and discussed, and how healthcare technologies are designed and evaluated. Furthermore, the conceptualization presented in this article has implications for the manner in which evidence 'hierarchies' are developed. Such hierarchies do not provide a complete picture of evidence and the way it is used in healthcare activities. Understanding the dynamic nature of evidence and its role in distributed cognitive activities may lead to more robust and multi-faceted taxonomies, frameworks, and hierarchies related to evidence-based healthcare.

Strategies to promote uptake and use of intimate partner violence and child maltreatment knowledge: an integrative review.

BACKGROUND: Intimate partner violence (IPV) and child maltreatment (CM) are major social and public health problems. Knowledge translation (KT) of best available research evidence has been suggested as a strategy to improve the care of those exposed to violence, however research on how best to promote the uptake and use of IPV and CM evidence for policy and practice is limited. Our research asked: 1) What is the extent of IPV/CM-specific KT research? 2) What KT strategies effectively translate IPV/CM knowledge? and 3) What are the barriers and facilitators relevant to translating IPV/CM-specific knowledge? METHODS: We conducted an integrative review to summarize and synthesize the available evidence regarding IPV/CM-specific KT research. We employed multiple search methods, including database searches of Embase, CINAHL, ERIC, PsycInfo, Sociological Abstracts, and Medline (through April, 2013). Eligibility and quality assessments for each article were conducted by at least two team members. Included articles were analyzed quantitatively using descriptive statistics and qualitatively using descriptive content analysis. RESULTS: Of 1230 identified articles, 62 were included in the review, including 5 review articles. KT strategies were generally successful at improving various knowledge/attitude and behavioural/behavioural intention outcomes, but the heterogeneity among KT strategies, recipients, study designs and measured outcomes made it difficult to draw specific conclusions. Four key themes were identified: existing measurement tools and promising/effective KT strategies are underused, KT efforts are rarely linked to health-related outcomes for those exposed to violence, there is a lack of evidence regarding the long-term effectiveness of KT interventions, and authors' inferences about barriers, facilitators, and effective/ineffective KT strategies are often not supported by data. The emotional and sometimes contested nature of the knowledge appears to be an important barrier unique to IPV/CM KT. CONCLUSIONS: To direct future KT in this area, we present a guiding framework that highlights the need for implementers to use/adapt promising KT strategies that carefully consider contextual factors, including the fact that content in IPV/CM may be more difficult to engage with than other health topics. The framework also provides guidance regarding use of measurement tools and designs to more effectively evaluate and report on KT efforts.