Associations between air pollution and cardio-respiratory physiological measures in older adults exercising outdoors.

We examined whether exercising indoors vs. outdoors reduced the cardio-respiratory effects of outdoor air pollution. Adults ≥55 were randomly assigned to exercise indoors when the Air Quality Health Index was ≥5 and outdoors on other days (intervention group, n = 37), or outdoors everyday (control group, n = 35). Both groups completed cardio-respiratory measurements before and after exercise for up to 10 weeks. Data were analyzed using linear mixed effect regression models. In the control group, an interquartile range increase in fine particulate matter (PM2.5) was associated with increases of 1.4% in heart rate (standard error (SE) = 0.7%) and 5.6% (SE = 2.6%) in malondialdehyde, and decreases of 5.6% (SE = 2.5%) to 16.5% (SE = 7.5%) in heart rate variability measures. While the hypothesized benefit of indoor vs. outdoor exercise could not be demonstrated due to an insufficient number of intervention days (n = 2), the study provides evidence of short-term effects of air pollution in older adults. ISRCTN #26552763.

Science for Policy: A Case Study of Scientific Polarization, Values, and the Framing of Risk and Uncertainty.

It is well documented that more research can lead to hardened positions, particularly when dealing with complex, controversial, and value-laden issues. This study is an attempt to unveil underlying values in a contemporary debate, where both sides use scientific evidence to support their argument. We analyze the problem framing, vocabulary, interpretation of evidence, and policy recommendations, with particular attention to the framing of nature and technology. We find clear differences between the two arguments. One side stress that there is no evidence that the present approach is causing harm to humans or the environment, does not ruminate on uncertainties to that end, references nature's ability to handle the problem, and indicates distrust in technological solutions. In contrast, the other side focuses on uncertainties, particularly the lack of knowledge about potential environmental effects and signals trust in technological development and human intervention as the solution. Our study suggests that the two sides' diverging interpretations are tied to their perception of nature: vulnerable to human activities versus robust and able to handle human impacts. The two sides also seem to hold diverging views of technology, but there are indications that this might be rooted in their perception of governance and economy rather than about technology per se. We conclude that there is a need to further investigate how scientific arguments are related to worldviews, to see how (if at all) worldview typologies can help us to understand how value-based judgments are embedded in science advice, and the impact these have on policy preferences.

Interfering with therapeutic tranquility: Debates surrounding biosolid waste processing in rural Ontario.

Uncertainty surrounding potential health effects of techno-industrial facilities continues to result in heightened debate about what are the best and safest options for future generations in rural places regarded by residents for their therapeutic tranquility. This research examines how a proposed biosolid processing facility in rural Ontario producing agricultural fertilizer from primarily urban sewage has in some residents elicited particularly strong concerns about potential health impacts, which are accompanied by perceptions that the tranquil and pastoral nature of their landscape is being altered. However, fueling community conflict between friends and relatives is the contested nature of the landscape's restorative qualities and the facility's disruption of this tranquil place.

'Stepping in' or 'stepping back': how first year nursing students begin to learn about person-centred care.

BACKGROUND: The concept of person-centred care has gained international recognition over the last decade and forms one of the key concepts of our Nursing Quality Improvement Curricular Framework. OBJECTIVES: This study aimed to investigate nursing students' learning about person-centred care during the first-year of their programme. METHODS: Qualitative thematic analysis of a section of placement learning documents from two consecutive cohorts of students from all fields of nursing (n=405), supplemented by three focus group discussions. RESULTS: Two conceptual categories of student approaches to learning emerged. Firstly, 'stepping back', or learning from a distance about how nurses provide care, often through reading case notes and care plans; second, 'stepping in', learning about the patient as a person by direct interaction with service users. Evidence of reflection on the patient's experience of care was limited. These results have resonance with existing pedagogical theories around preferences for active or passive styles of learning. The potential for clinical mentors to build student confidence and encourage direct engagement with patients was highlighted. CONCLUSIONS: Students are aware of the concepts, principles and professional values of person-centred care from early in their programme; however, the majority tend to be preoccupied by learning about what nurses 'do', rather than 'how patients experience care'. Development towards a more person-centred approach may require targeted support from mentors to help students gain confidence and begin reflecting on how patients experience care.