Building and Maintaining a Whole Community Initiative: Health Communication in Practice with Be Well Communities™.

The most effective health communication builds from evidence-based best practices and theory. In practice, health campaigns rely on considerations often under-discussed in health communication, such as consistent agency-style client service, image management, and community coalition-building. Health outcome progress often requires change at multiple levels, from individual cognition and behavior to policy creation. These multi-level needs further highlight the importance of effective practical health communication supporting a range of outcomes and building toward replication. This article covers the complexities of building and implementing a theory-informed health communication structure for a multifaceted, place-based cancer prevention initiative. Part of the overall process includes detailing the internal communications of a health communication group, interorganizational communication, engaging community partner support, the message creation process, and longitudinal efforts on program maintenance and assessment. Furthermore, this article seeks to offer an example of the client service role a health communication team can play to combine theory, empirical message development, and community goals in whole community efforts. Ultimately, the goal is to share experiences from seven years of program work to help guide future community-based efforts in other health contexts and foster progress in theoretical and practical understandings of health communication.

Modes and strategies for providing conventional mechanical ventilation in neonates.

Neonatal respiratory failure is a common and serious clinical problem which in a considerable proportion of infants requires invasive mechanical ventilation. The basic goal of mechanical ventilation is to restore lung function while limiting ventilator-induced lung injury, which is considered an important risk factor in the development of bronchopulmonary dysplasia (BPD). Over the last decades, new conventional mechanical ventilation (CMV) modalities have been introduced in clinical practice, aiming to assist clinicians in providing lung protective ventilation strategies. These modalities use more sophisticated techniques to improve patient-ventilator interaction and transfer control of ventilation from the operator to the patient. Knowledge on how these new modalities work and how they interact with lung physiology is essential for optimal and safe use. In this review, we will discuss some important basic lung physiological aspects for applying CMV, the basic principles of the old and new CMV modalities, and the evidence to support their use in daily clinical practice.

Assessment of environmental and occupational exposure to heavy metals in Taranto and other provinces of Southern Italy by means of scalp hair analysis.

The monitoring of heavy metals in industrialized areas to study their association with different occupational and environmental factors is carried out in different ways. In this study, scalp hair analysis was used for the assessment of exposure to these metals in the industrial city of Taranto, characterized by a severe environmental pollution. The highest median values were observed for aluminum, barium, cadmium, lead, mercury, and uranium. Moreover, in the industrial area of Taranto, high levels of barium, cadmium, lead, mercury, nickel, and silver were observed in comparison with other Apulia areas. The risk odds ratios (ORs) for observing values above the 50th percentile were elevated for mercury and fish consumption, uranium and milk consumption, lead and female sex, and aluminum and mineral water consumption. No significant increased risk was observed for occupational activities. In a dendrogram of a cluster analysis, three clusters were observed for the different areas of Taranto (Borgo, San Vito, and Statte). A scree plot and score variables plot underline the presence of two principal components: the first regarding antimony, lead, tin, aluminum and silver; the second regarding mercury and uranium. The observed clusters (Borgo, San Vito, and Statte) showed that lead, antimony, tin, aluminum, and silver were the main component. The highest values above the 50th percentile of these minerals, especially lead, were observed in the Borgo area. The observed metal concentration in the Borgo area is compatible with the presence in Taranto of a military dockyard and a reported increase of lung cancer risk among residents of that area.