Callahan, Rebecca M.; Shifrer, Dara
Purpose EL education policy has long directed schools to address English learner (EL) students’ linguistic and academic development, and must do so without furthering inequity or segregation (Lau, 1974; Castañeda, 1981). The recent ESSA (2015) reauthorization expresses a renewed focus on evidence of equity, effectiveness, and opportunity to learn. We propose that high school course taking patterns provide evidence of program effectiveness and equity in access. Research Design Using data from the nationally representative Educational Longitudinal Study of 2002 (ELS: 2002), we employ multinomial regression models to predict students’ likelihood of completing two types of high school coursework (basic graduation, college preparatory) by their linguistic status. Findings Despite considerable linguistic, sociodemographic, and academic controls, marked disparities in high school course taking patterns remain, with EL students experiencing significantly less academic exposure. Implications for Policy and Practice Building on McKenzie and Scheurich’s (2004) notion of an equity trap and evidence of a long-standing EL opportunity gap, we suggest that school leaders might use our findings and their own course taking patterns to prompt discussions about the causes and consequences of local EL placement processes. Such discussions have the potential to raise awareness about how educators and school leaders approach educational equity and access, key elements central to the spirit of EL education policy. PMID:27429476
Love, Susan M; Sanders, Matthew R; Metzler, Carol W; Prinz, Ronald J; Kast, Elizabeth Z
11 focus groups (N = 160) of high-risk parents in Los Angeles County were asked to assess the value of social media to deliver an evidence-based parenting program, Triple P-Positive Parenting Program, to reduce child maltreatment. For feasibility, (N = 238) parents were surveyed regarding their internet use. Parents responded enthusiastically to the online program, and expressed the importance of a sense of community and learning through the experiences of others. 78% of the young, high-poverty, minority parents used the internet. An online evidence-based parenting program delivered in social media could enhance accessibility and engagement of high-risk parents - a powerful tool to reduce child maltreatment.
Love, Susan M.; Sanders, Matthew R.; Metzler, Carol W.; Prinz, Ronald J.; Kast, Elizabeth Z.
11 focus groups (N = 160) of high-risk parents in Los Angeles County were asked to assess the value of social media to deliver an evidence-based parenting program, Triple P—Positive Parenting Program, to reduce child maltreatment. For feasibility, (N = 238) parents were surveyed regarding their internet use. Parents responded enthusiastically to the online program, and expressed the importance of a sense of community and learning through the experiences of others. 78% of the young, high-pover...
Hennig, Teresa; Hepworth, George; Yudovich, Dagi (Doug)
Authoritative and comprehensive coverage for building Access 2013 Solutions Access, the most popular database system in the world, just opened a new frontier in the Cloud. Access 2013 provides significant new features for building robust line-of-business solutions for web, client and integrated environments. This book was written by a team of Microsoft Access MVPs, with consulting and editing by Access experts, MVPs and members of the Microsoft Access team. It gives you the information and examples to expand your areas of expertise and immediately start to develop and upgrade projects. Exp
This document deals with the procurements planned for the construction of an Atomic Vapor Laser Isotope Separation (AVLIS) production plant. Several large-scale AVLIS facilities have already been built and tested; a full-scale engineering demonstration facility is currently under construction. The experience gained from these projects provides the procurement basis for the production plant construction and operation. In this document, the status of the AVLIS process procurement is presented from two viewpoints. The AVLIS Production Plant Work Breakdown Structure is referenced at the level of the items to be procured. The availability of suppliers for the items at this level is discussed. In addition, the work that will result from the AVLIS enrichment plant project is broken down by general procurement categories (construction, mechanical equipment, etc.) and the current AVLIS suppliers are listed according to these categories. A large number of companies in all categories are currently providing AVLIS equipment for the Full-Scale Demonstration Facility in Livermore, California. These companies form an existing and expanding supplier network for the AVLIS program. Finally, this document examines the relationship between the AVLIS construction project/operational facility and established commercial suppliers. The goal is to utilize existing industrial capability to meet the needs of the project in a competitive procurement situation. As a result, costs and procurement risks are both reduced because the products provided come from within the AVLIS suppliers' experience base. At the same time, suppliers can benefit by the potential to participate in AVLIS technology spin-off markets. 35 figures.
... Access Program; Final Rule #0;#0;Federal Register / Vol. 77 , No. 96 / Thursday, May 17, 2012 / Rules and... Market Access Program AGENCY: Foreign Agricultural Service and Commodity Credit Corporation, USDA. ACTION... Access Program (MAP) by updating and merging the application requirements and the activity plan...
... Corporation 7 CFR Part 1485 Market Access Program AGENCY: Foreign Agricultural Service and Commodity Credit... Trade Programs, Program Operations Division; or by phone: (202) 720- 4327; or by fax: (202) 720-9361; or... submitted later than 3 months after the end of a MAP Participant's program year. At any given time, total...
National Oceanic and Atmospheric Administration, Department of Commerce — This limited access system limits the number of charter vessels that may participate in the guided sport fishery for halibut in area 2C and 3A. NMFS issues a charter...
National Oceanic and Atmospheric Administration, Department of Commerce — ERDDAP (the Environmental Research Division's Data Access Program) is a data server that gives you a simple, consistent way to download subsets of scientific...
This dissertation illustrates how admission policies shape access to postsecondary education. Evidence comes from two sectors, each with a distinct type of admission system: highly selective institutions that practice holistic admission (chapters 2 and 3) and less selective public four-year colleges that use admission thresholds (chapter 4). The…
... COMMISSION Access Authorization Program for Nuclear Power Plants AGENCY: Nuclear Regulatory Commission... revision to Regulatory Guide 5.66, ``Access Authorization Program for Nuclear Power Plants.'' This guide... Authorization Requirements for Nuclear Power Plants,'' and 10 CFR part 26, ``Fitness for Duty Programs.'' The RG...
... COMMISSION Video Programming and Accessibility Advisory Committee; Announcement of Date of Next Meeting... meeting of the Video Programming Accessibility Advisory Committee (``Committee'' or ``VPAAC''). The... description, access to emergency programming, and access to user interfaces, menus, and programming guides...
Since the Transportation Equity Act for the 21st Century authorized the Access to Jobs program in June 1998, the Department of Transportation has made several important decisions about the program's...
Cwiak, Carol L
The number of emergency management higher education programs has grown dramatically since 1994 when the FEMA Higher Education Program was created to propagate and support such growth. Data collected annually since 2007 from emergency management higher education programs shows that these programs face some consistent challenges. These challenges were coupled with annual data on program access and support indicators via dimensional analysis to answer the questions: To what extent are the challenges linked to a lack of access or support? If there is linkage, what can be gleaned from these linkages that can help address the challenges through improving access and support? The analysis showed that lack of access to funding and resources, and lack of support from partner organizations, has an impact on emergency management higher education. Discussion of that impact is followed with detailed recommendations that are focused on strengthening both internal and external access and support relationships for emergency management higher education programs.
In policy discussions, it has frequently been claimed that migrants' remittances could function as a 'catalyst' for financial access among receiving households. This paper provides empirical evidence on this hypothesis from Mexico, a main receiver of remittances worldwide. Using the Mexican Family Life Survey panel (MxFLS) for 2002 and 2005, the results from the treatment-effect-model at household level show that a change in remittance status has an important impact on ownership of savings ac...
... Service 7 CFR Part 1735 RIN 0572-AC24 Expansion of 911 Access; Telecommunications Loan Program AGENCY... access and integrated emergency communications systems in rural areas for the Telecommunications Loan... Villano, Assistant Administrator, Telecommunications Program, USDA--Rural Utilities Service, 1400...
Lehner, William D
... Training Corps, and Officer Candidate School. Three areas are covered: historical patterns in officer accessions and historical changes in Navy pre-commissioning training and education philosophy and policy...
Dennis, Kristopher; Linden, Kelly; Balboni, Tracy; Chow, Edward
Palliating symptoms of advanced and metastatic cancers are one of the most common indications for radiation therapy (RT), and the demand for palliative RT is increasing. Dedicated rapid access palliative RT programs improve access to care, and can deliver RT in a more efficient and evidence-based manner than standard RT programs. In this narrative review, we discuss the role of palliative RT in comprehensive cancer care, and challenges that have faced patients trying to access it. We describe how rapid access programs developed to address these challenges and provide an overview of dedicated programs worldwide. Finally, we show how these programs can serve as models for multidisciplinary care and education, and sources of exciting research opportunities in clinical care and advanced technologies.
Albert, Dayna; Fortin, Rebecca; Herrera, Christine; Hanning, Rhona; Lessio, Anne; Rush, Brian
In public health and chronic disease prevention there is increasing priority for effective use of evidence in practice. In Ontario, Canada, despite various models being advanced, public health practitioners are seeking ways to identify and apply evidence in their work in practical and meaningful ways. In a companion article, “Strengthening Chronic Disease Prevention Programming: The Toward Evidence-Informed Practice (TEIP) Program Assessment Tool,” we describe use of a tool to assess and strengthen program planning and implementation processes using 19 criteria derived from best and promising practices literature. In this article, we describe use of a complementary Program Evidence Tool to identify, synthesize, and apply a range of evidence sources to strengthen the content of chronic disease prevention programming. The Program Evidence Tool adapts tools of evidence-based medicine to the unique contexts of community-based health promotion and chronic disease prevention. Knowledge management tools and a guided dialogue process known as an Evidence Forum enable community stakeholders to make appropriate use of evidence in diverse social, political, and structural contexts. Practical guidelines and worksheets direct users through 5 steps: 1) define an evidence question, 2) develop a search strategy, 3) collect and synthesize evidence, 4) interpret and adapt evidence, and 5) implement and evaluate. We describe the Program Evidence Tool’s benefits, strengths, challenges, and what was learned from its application in 4 Ontario public health departments. The Program Evidence Tool contributes to the development and understanding of the complex use of evidence in community-based chronic disease prevention. PMID:23721788
... challenging exclusive contracts involving cable-affiliated programming; and amendments to its rules to ensure that buying groups utilized by small and medium-sized multichannel video programming distributors..., identified by MB Docket No. 12-68, by any of the following methods: Federal Communications Commission's Web...
... programming beyond its October 5, 2012 expiration date. Instead of this prohibition, the Commission will address exclusive contracts involving satellite-delivered, cable-affiliated programming on a case-by-case...). Summary of the Report and Order and Order on Reconsideration I. Introduction 1. In this Report and Order...
Office of Postsecondary Education, US Department of Education, 2012
The Technological Innovation and Cooperation for Foreign Information Access (TICFIA) Program supports projects focused on developing innovative technologies for accessing, collecting, organizing, preserving, and disseminating information from foreign sources to address the U.S.' teaching and research needs in international education and foreign…
Full Text Available This paper presents an approach to automatically analyzing program spectra, an execution profile of program testing results for fault localization. Using a mathematical theory of evidence for uncertainty reasoning, the proposed approach estimates the likelihood of faulty locations based on evidence from program spectra. Our approach is theoretically grounded and can be computed online. Therefore, we can predict fault locations immediately after each test execution is completed. We evaluate the approach by comparing its performance with the top three performing fault localizers using a benchmark set of real-world programs. The results show that our approach is at least as effective as others with an average effectiveness (the reduction of the amount of code examined to locate a fault of 85.6% over 119 versions of the programs. We also study the quantity and quality impacts of program spectra on our approach where the quality refers to the spectra support in identifying that a certain unit is faulty. The results show that the effectiveness of our approach slightly improves with a larger number of failed runs but not with a larger number of passed runs. Program spectra with support quality increases from 1% to 100% improves the approach's effectiveness by 3.29%.
Supporting graduation programs through empirical evidence and leadership promotion. This project will support the scaling up of locally-tested interventions aimed at improving the livelihoods of women and youth in sub-Saharan Africa and Asia. It targets special interventions for people who have fallen through the cracks ...
Watt, D.; Verma, S; Flynn, L
OBJECTIVE: To review studies that have examined an association between wellness programs and improvements in quality of life and to assess the strength of the scientific evidence. DATA SOURCES: A MEDLINE search was constructed with the following medical subject headings: "psychoneuroimmunology," "chronic disease" and "health promotion," "chronic disease" and "health behaviour," "relaxation techniques," "music therapy," "laughter," "anger," "mediation" and "behavioural medicine." Searches usin...
Full Text Available A current limitation in embedded controller design and programming is the lack of database support in development tools such as Esterel Studio. This article proposes a way of integrating databases and Esterel by providing two application programming interfaces (APIs which enable the use of relational databases inside Esterel programs. As databases and Esterel programs are often executed on different machines, result sets returned as responses to database queries may be processed either locally and according to Esterel’s synchrony hypothesis, or remotely along several of Esterel’s execution cycles. These different scenarios are reflected in the design and usage rules of the two APIs presented in this article, which rely on Esterel’s facilities for extending the language by external data types, external functions, and procedures, as well as tasks. The APIs’ utility is demonstrated by means of a case study modelling an automated warehouse storage system, which is constructed using Lego Mindstorms robotics kits. The robot’s controller is programmed in Esterel in a way that takes dynamic ordering information and the warehouse’s floor layout into account, both of which are stored in a MySQL database.
Full Text Available Abstract A current limitation in embedded controller design and programming is the lack of database support in development tools such as Esterel Studio. This article proposes a way of integrating databases and Esterel by providing two application programming interfaces (APIs which enable the use of relational databases inside Esterel programs. As databases and Esterel programs are often executed on different machines, result sets returned as responses to database queries may be processed either locally and according to Esterel's synchrony hypothesis, or remotely along several of Esterel's execution cycles. These different scenarios are reflected in the design and usage rules of the two APIs presented in this article, which rely on Esterel's facilities for extending the language by external data types, external functions, and procedures, as well as tasks. The APIs' utility is demonstrated by means of a case study modelling an automated warehouse storage system, which is constructed using Lego Mindstorms robotics kits. The robot's controller is programmed in Esterel in a way that takes dynamic ordering information and the warehouse's floor layout into account, both of which are stored in a MySQL database.
Remote Memory Access (RMA) programming enables direct access to low-level hardware features to achieve high performance for distributed-memory programs. However, the design of RMA programming schemes focuses on the memory access and less on the synchronization. For example, in contemporary RMA programming systems, the widely used producer-consumer pattern can only be implemented inefficiently, incurring in an overhead of an additional round-trip message. We propose Notified Access, a scheme where the target process of an access can receive a completion notification. This scheme enables direct and efficient synchronization with a minimum number of messages. We implement our scheme in an open source MPI-3 RMA library and demonstrate lower overheads (two cache misses) than other point-to-point synchronization mechanisms for each notification. We also evaluate our implementation on three real-world benchmarks, a stencil computation, a tree computation, and a Colicky factorization implemented with tasks. Our scheme always performs better than traditional message passing and other existing RMA synchronization schemes, providing up to 50% speedup on small messages. Our analysis shows that Notified Access is a valuable primitive for any RMA system. Furthermore, we provide guidance for the design of low-level network interfaces to support Notified Access efficiently.
McClellan, Sean R; Snowden, Lonnie
This study examined the association between language access programming and quality of psychiatric care received by persons with limited English proficiency (LEP). In 1999, the California Department of Mental Health required county Medicaid agencies to implement a "threshold language access policy" to meet the state's Title VI obligations. This policy required Medi-Cal agencies to provide language access programming, including access to interpreters and translated written material, to speakers of languages other than English if the language was spoken by at least 3,000, or 5%, of the county's Medicaid population. Using a longitudinal study design with a nonequivalent control group, this study examined the quality of care provided to Spanish speakers with LEP and a severe mental illness before and after implementation of mandatory language access programming. Quality was measured by receipt of at least two follow-up medication visits within 90 days or three visits within 180 days of an initial medication visit over a period of 38 quarter-years. On average, only 40% of Spanish-speaking clients received at least three medication follow-up visits within 180 days. In multivariate analyses, language access programming was not associated with receipt of at least two medication follow-up visits within 90 days or at least three visits within 180 days. This study found no evidence that language access programming led to increased rates of follow-up medication visits for clients with LEP.
... Control Medicaid Eligibility Quality Control (meqc) Program § 431.818 Access to records: MEQC program. (a) The agency, upon written request, must mail to the HHS staff all records, including complete local... State has an alternate method of submitting these records that is approved by CMS or has received, on an...
... methods of achieving program accessibility include— (i) Using audio-visual materials and devices to depict... would result in a fundamental alteration in the nature of a program or activity or in undue financial... such alteration or burdens. The decision that compliance would result in such alteration or burdens...
... program accessibility include— (i) Using audio-visual materials and devices to depict those portions of an... action that it can demonstrate would result in a fundamental alteration in the nature of a program or... § 530.150(a) would result in such alteration or burdens. The decision that compliance would result in...
... of achieving program accessibility include— (i) Using audio-visual materials and devices to depict... action that it can demonstrate would result in a fundamental alteration in the nature of a program or... § 720.150(a) would result in such alteration or burdens. The decision that compliance would result in...
...), alternative methods of achieving program accessibility include— (i) Using audio-visual materials and devices... action that it can demonstrate would result in a fundamental alteration in the nature of a program or... § 1153.150(a) would result in such alteration or burdens. The decision that compliance would result in...
... methods of achieving program accessibility include— (i) Using audio-visual materials and devices to depict... can demonstrate would result in a fundamental alteration in the nature of a program or activity or in...) would result in such alteration or burdens. The decision that compliance would result in such alteration...
... program accessibility include— (i) Using audio-visual materials and devices to depict those portions of an... fundamental alteration in the nature of a program or activity or in undue financial and administrative burdens... has the burden of proving that compliance with § 2416.150(a) would result in such alteration or...
...), alternative methods of achieving program accessibility include— (i) Using audio-visual materials and devices... can demonstrate would result in a fundamental alteration in the nature of a program or activity or in...) would result in such alteration or burdens. The decision that compliance would result in such alteration...
... program accessibility include— (i) Using audio-visual materials and devices to depict those portions of an... result in a fundamental alteration in the nature of a program or activity or in undue financial and... agency has the burden of proving that compliance with § 1207.150(a) would result in such alteration or...
... of achieving program accessibility include— (i) Using audio-visual materials and devices to depict... action that it can demonstrate would result in a fundamental alteration in the nature of a program or... § 500.150(a) would result in such alteration or burdens. The decision that compliance would result in...
... methods of achieving program accessibility include— (i) Using audio-visual materials and devices to depict... demonstrate would result in a fundamental alteration in the nature of a program or activity or in undue... such alteration or burdens. The decision that compliance would result in such alteration or burdens...
... of achieving program accessibility include— (i) Using audio-visual materials and devices to depict... action that it can demonstrate would result in a fundamental alteration in the nature of a program or... § 507.150(a) would result in such alteration or burdens. The decision that compliance would result in...
... of achieving program accessibility include— (i) Using audio-visual materials and devices to depict... action that it can demonstrate would result in a fundamental alteration in the nature of a program or... § 1014.150(a) would result in such alteration or burdens. The decision that compliance would result in...
... of achieving program accessibility include— (i) Using audio-visual materials and devices to depict... action that it can demonstrate would result in a fundamental alteration in the nature of a program or... § 144.150(a) would result in such alteration or burdens. The decision that compliance would result in...
... COMMISSION 47 CFR Part 79 Accessibility of User Interfaces, and Video Programming Guides and Menus... authority for requiring MVPDs to ensure that video programming guides and menus that ] provide channel and... the instructions for submitting comments. Federal Communications Commission's Web site: http...
... COMMISSION Video Programming and Accessibility Advisory Committee; Announcement of Date of Next Meeting... meeting of the Video Programming Accessibility Advisory Committee (``Committee'' or ``VPAAC''). The..., and the delivery of video description, access to emergency programming, and the interoperability and...
... COMMISSION Video Programming and Emergency Access Advisory Committee; Announcement of Establishment and... Programming and Emergency Access Advisory Committee (``Committee'' or ``VPEAAC'') of the Federal... name to the Video Programming Accessibility Advisory Committee (``VPAAC''). The Commission further...
Watt, D; Verma, S; Flynn, L
To review studies that have examined an association between wellness programs and improvements in quality of life and to assess the strength of the scientific evidence. A MEDLINE search was constructed with the following medical subject headings: "psychoneuroimmunology," "chronic disease" and "health promotion," "chronic disease" and "health behaviour," "relaxation techniques," "music therapy," "laughter," "anger," "mediation" and "behavioural medicine." Searches using the text words "wellness" and "wellness program" were also carried out. References from the primary articles identified in the search and contemporary writing on wellness were also considered. Selection was limited to randomized controlled trials or prospective studies published in English that involved human subjects and that took place between 1980 and 1996. All studies with an intervention aimed at promoting wellness and measuring outcomes were included, except studies of patients with cancer and HIV and studies of health promotion programs in the workplace. Of the 1082 references initially identified, 11 met the criteria for inclusion in the critical appraisal. The following information was extracted from the 11 studies: characteristics of the study population, number of participants (and number followed to completion), length of follow-up, type of intervention, outcome measures and results. All 11 studies were assessed for the quality of their evidence. All studies reported some positive outcomes following the intervention in question, although many had limitations precluding applicability of the results to a wider population. Despite the suggested benefit associated with wellness programs, the evidence was inconclusive. Whether the composition of the target group or the type of intervention has a role in determining outcomes is unknown. Although trends suggest that wellness programs may be cost-effective, further research is needed for confirmation.
Khan, Aziz; Mathelier, Anthony
JASPAR is a widely used open-access database of curated, non-redundant transcription factor binding profiles. Currently, data from JASPAR can be retrieved as flat files or by using programming language-specific interfaces. Here, we present a programming language-independent application programming interface (API) to access JASPAR data using the Representational State Transfer (REST) architecture. The REST API enables programmatic access to JASPAR by most programming languages and returns data in eight widely used formats. Several endpoints are available to access the data and an endpoint is available to infer the TF binding profile(s) likely bound by a given DNA binding domain protein sequence. Additionally, it provides an interactive browsable interface for bioinformatics tool developers. This REST API is implemented in Python using the Django REST Framework. It is accessible at http://jaspar.genereg.net/api/ and the source code is freely available at https://bitbucket.org/CBGR/jaspar under GPL v3 license. email@example.com, firstname.lastname@example.org. Supplementary data are available at Bioinformatics online.
Holbein, M E Blair; Berglund, Jelena P; Weatherwax, Kevin; Gerber, David E; Adamo, Joan E
The Food and Drug Administration Expanded Access (EA) program and "Right-to-Try" legislation aim to provide seriously ill patients who have no other comparable treatment options to gain access to investigational drugs and biological agents. Physicians and institutions need to understand these programs to respond to questions and requests for access. FDA EA programs and state and federal legislative efforts to provide investigational products to patients by circumventing FDA regulations were summarized and compared. The FDA EA program includes Single Patient-Investigational New Drug (SP-IND), Emergency SP-IND, Intermediate Sized Population IND, and Treatment IND. Approval rates for all categories exceed 99%. Approval requires FDA and Institutional Review Board (IRB) approval, and cooperation of the pharmaceutical partner is essential. "Right-to-Try" legislation bypasses some of these steps, but provides no regulatory or safety oversight. The FDA EA program is a reasonable option for patients for whom all other therapeutic interventions have failed. The SP-IND not only provides patient access to new drugs, but also maintains a balance between immediacy and necessary patient protection. Rather than circumventing existing FDA regulations through proposed legislation, it seems more judicious to provide the knowledge and means to meet the EA requirements. © 2015 Wiley Periodicals, Inc.
Smith, Carol Lynn [Iowa State Univ., Ames, IA (United States)
One of the main purposes of a programming language is to provide a framework within which a user can convey the specification of a task to an information processing system. A model is proposed in which name accessing conventions can be analyzed and compared.
... 24 Housing and Urban Development 1 2010-04-01 2010-04-01 false Program accessibility: discrimination prohibited. 9.149 Section 9.149 Housing and Urban Development Office of the Secretary, Department of Housing and Urban Development ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF DISABILITY IN...
... FOUNDATION ON THE ARTS AND THE HUMANITIES INSTITUTE OF MUSEUM AND LIBRARY SERVICES ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE INSTITUTE OF MUSEUM AND... services to accessible buildings, assignment of aides to beneficiaries, home visits, delivery of services...
... Development (Continued) OFFICE OF ASSISTANT SECRETARY FOR PUBLIC AND INDIAN HOUSING, DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT COMMUNITY DEVELOPMENT BLOCK GRANTS FOR INDIAN TRIBES AND ALASKA NATIVE VILLAGES Grant... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false Public access to program records...
... accessibility include— (i) Using audio-visual materials and devices to depict those portions of an historic... result in a fundamental alteration in the nature of a program or activity or in undue financial and... agency has the burden of proving that compliance with § 711.150(a) would result in such alteration or...
... of achieving program accessibility include— (i) Using audio-visual materials and devices to depict...) Require the agency to take any action that it can demonstrate would result in a fundamental alteration in... proving that compliance with § 2104.150(a) would result in such alteration or burdens. The decision that...
... of achieving program accessibility include— (i) Using audio-visual materials and devices to depict...) Require the agency to take any action that it can demonstrate would result in a fundamental alteration in... proving that compliance with § 149.150(a) would result in such alteration or burdens. The decision that...
... accessibility include— (i) Using audio-visual materials and devices to depict those portions of an historic... result in a fundamental alteration in the nature of a program or activity or in undue financial and... agency has the burden of proving that compliance with § 1200.150(a) would result in such alteration or...
... accessibility include— (i) Using audio-visual materials and devices to depict those portions of an historic... demonstrate would result in a fundamental alteration in the nature of a program or activity or in undue... such alteration or burdens. The decision that compliance would result in such alteration or burdens...
... accessibility include— (i) Using audio-visual materials and devices to depict those portions of an historic... result in a fundamental alteration in the nature of a program or activity or in undue financial and... agency has the burden of proving that compliance with § 2301.150(a) would result in such alteration or...
... accessibility include— (i) Using audio-visual materials and devices to depict those portions of an historic... fundamental alteration in the nature of a program or activity or in undue financial and administrative burdens... has the burden of proving that compliance with § 1636.150(a) would result in such alteration or...
... (a)(3), alternative methods of achieving program accessibility include— (i) Using audio-visual...) Require the agency to take any action that it can demonstrate would result in a fundamental alteration in... proving that compliance with § 1313.150(a) would result in such alteration or burdens. The decision that...
Birkett, Nicholas; Nair, Rama; Murphy, Maureen; Roberge, Ginette; Lockett, Donna
This paper examines access to bathtub grab bars in privately and publicly owned apartment buildings and explores the profile of seniors who have access to bathtub grab bars. Results indicate that bathtub grab bars were significantly more prevalent in apartments that were publicly owned (91.3%) as compared to privately owned (37.8%) (p lesser than…
Abstract. Although both formal and informal financial institutions exist in developing economies, firms are often constrained by lack of access to financial services. ... Without improved and regular access to finance, grain traders and millers cannot make the necessary investment to provide effective marketing services for the ...
... COMMISSION Video Programming and Accessibility Advisory Committee; Announcement of Date of Next Meeting... meeting of the Video Programming Accessibility Advisory Committee (``Committee'' or ``VPAAC''). The meeting will address the provision of closed captioning of Internet programming previously captioned on...
Roque da Silva Araújo
Full Text Available ABSTRACT Objective: to verify causes of inactivity in the Home Delivery Medicament Program, as referred by users from a Primary Health Care Service in São Paulo, comparing them to the causes registered in the program and analyzing them in the theoretical model Concept of Access to Health. Methods: cross-sectional study, interviewing 111 inactive users; and documentary study in the program records. Results: half of the users did not know the condition of inactivity. Discrepancies were found between the user's and the program's information, observing different levels of agreement: Absence of physician and administrative staff member 0%; Transfer to other service 25%; Death 50%; Option to quit 50%; Address change 57% and Change in therapeutic schedule 80%. The users' feeling of accepting the program was observed. In the health access concept, inactivity can be explained in the information dimension, in the degree of asymmetry between the patient's and the health professional's knowledge, identified through the indicators: education, knowledge and information sources. Conclusions: due to the low education level, the user does not assimilate the information on the steps of the program flowchart, does not return for the assessment that guarantees its continuity. Consequently, (she stops receiving the medication and spends a long time without treatment, increasing the cardiovascular risk of hypertensive (92% of the sample, diabetic (44% and dyslipidemic patients (31%.
Juan G Victores
Full Text Available In this paper, we present an accessible interface in the context of our work on bringing advanced robotics closer to everyday domestic users. This interface allows inexperienced users to be capable of programming an assistive robotic arm to perform a specific desired task in a household environment. The programming process is performed through the developed Web Browsable interface, within which a Task Creator Wizard plays an essential role. The robot's open architecture enables flexible multi-modal interaction. In addition to the touch buttons provided by the Web Browsable interface when presented on a touch screen, voice commands and the use of the Wii RemoteTM controller for intuitive robotic movement have also been enabled. The Web Browsable interface has been designed to provide high accessibility while taking aesthetic details into account, in order to prevent distraction caused by boredom of the user.
Lashitew, Addisu A.
Lack of access to finance is argued to be one of the most binding constraints for firm growth. There is, however, limited empirical evidence on the relationship between access to finance and the cost of capital. This paper uses international manufacturing data to analyze the effect of access to
... Programming Distribution and Carriage AGENCY: Federal Communications Commission. ACTION: Final rule... carriage of video programming vendors by multichannel video programming distributors (program carriage... and Order, Leased Commercial Access; Development of Competition and Diversity in Video Programming...
Beck, T.H.L.; Hoseini, M.
This paper gauges the effect of financial deepening and bank outreach on informality using micro data from the Indian manufacturing sector and exploiting cross-industry variation in the need for external finance. We distinguish between two channels through which access to finance can reduce
Beck, T.H.L.; Hoseini, M.
This paper gauges the effect of financial deepening and bank outreach on informality using micro data from the Indian manufacturing sector and exploiting cross-industry variation in the need for external finance. We distinguish between two channels through which access to finance can reduce
Dickson, Anisah; Perry, Laura B.; Ledger, Susan
This study examines access to International Baccalaureate schools in Australia. It is important to examine whether, as a highly regarded form of rigorous academic education, IB programmes are available to a wide range of students. We examine the location of schools in Australia that offer one or more of the IB Primary Years Programme, Middle Years…
Karimi, Hossein; Ferreira, Fernanda
The amount of information attached to a noun phrase (henceforth, NP) has been shown to enhance accessibility and increase pronominal reference in language production. However, both the effect of information quantity on the comprehension of ambiguous pronouns and the time course of any informativity effect have been left unexplored. In two eyetracking experiments, we investigated how additional information on the part of NP referents influenced the resolution of following ambiguous pronouns. The results of the first experiment revealed an informativity effect, with more looks to the informationally richer referent than to the competitor. However, the effect of additional information emerged late in time when the referent was the object of the verb. The second experiment replicated the results of the first and also showed that, consistent with the online results, an ambiguous pronoun is interpreted as referring to the informationally richer NP in an offline, explicit pronoun resolution task. The results lend support to theories of language processing that assume that explicit information increases the accessibility of the associated concept, in contrast to approaches that assume that accessibility is associated with givenness.
... Access; Development of Competition and Diversity in Video Programming Distribution and Carriage; Revision... Video Programming Distribution and Carriage AGENCY: Federal Communications Commission. ACTION: Final... carriage of video programming vendors by multichannel video programming distributors (``MVPDs''), known as...
Sevre, E. O.; Lee, S.
The goal of this research is to develop an interface that will simplify user interaction with software for scientists. The motivating factor of the research is to develop tools that assist scientists with limited motor skills with the efficient generation and use of software tools. Reliance on computers and programming is increasing in the world of geology, and it is increasingly important for geologists and geophysicists to have the computational resources to use advanced software and edit programs for their research. I have developed a prototype of a program to help geophysicists write programs using a simple interface that requires only simple single-mouse-clicks to input code. It is my goal to minimize the amount of typing necessary to create simple programs and scripts to increase accessibility for people with disabilities limiting fine motor skills. This interface can be adapted for various programming and scripting languages. Using this interface will simplify development of code for C/C++, Java, and GMT, and can be expanded to support any other text based programming language. The interface is designed around the concept of maximizing the amount of code that can be written using a minimum number of clicks and typing. The screen is split into two sections: a list of click-commands is on the left hand side, and a text area is on the right hand side. When the user clicks on a command on the left hand side the applicable code is automatically inserted at the insertion point in the text area. Currently in the C/C++ interface, there are commands for common code segments that are often used, such as for loops, comments, print statements, and structured code creation. The primary goal is to provide an interface that will work across many devices for developing code. A simple prototype has been developed for the iPad. Due to the limited number of devices that an iOS application can be used with, the code has been re-written in Java to run on a wider range of devices
Mihalic, Sharon F; Elliott, Delbert S
There is a growing demand for evidence-based programs to promote healthy youth development, but this growth has been accompanied by confusion related to varying definitions of evidence-based and mixed messages regarding which programs can claim this designation. The registries that identify evidence-based programs, while intended to help users sift through the findings and claims regarding programs, has oftentimes led to more confusion with their differing standards and program ratings. The advantages of using evidence-based programs and the importance of adopting a high standard of evidence, especially when taking programs to scale,are described. One evidence-based registry is highlighted--Blueprints for Healthy Youth Development hosted at the University of Colorado Boulder. Unlike any previous initiative of its kind, Blueprints established unmatched standards for identifying evidence-based programs and has acted in a way similar to the FDA--evaluating evidence, data and research to determine which programs meet their high standard of proven efficacy. Published by Elsevier Ltd.
Racine, Elizabeth F; Delmelle, Eric; Major, Elizabeth; Solomon, Corliss A
The Supplemental Nutrition Assistance Program (SNAP) is the largest food assistance program in the United States. Participants receive electronic benefits that are redeemable at a variety of food stores. Previous research notes that low-income neighborhoods often lack supermarkets with high-quality, affordable food. The first aim of this study was to explore the number and spatial distribution of SNAP stores by type and to assess how SNAP benefit redemption is linked to store type in North Carolina in 2015. The second aim was to compare the demographics of populations living in areas with a high concentration of SNAP participants vs areas with a lower concentration of SNAP participants. The third aim was to test for disparities in the availability of and access to SNAP-authorized stores in areas with high vs low concentration of SNAP participants stratified by rural/urban status. US Department of Agriculture and US Census data were used to explore the spatial distribution of SNAP stores at the census block group level utilizing a Geographic Information System. The 9,556 North Carolina SNAP stores in 2015 categorized into full-variety and limited-variety stores. Proximity to limited-variety SNAP food stores and full-variety SNAP food stores within access range (1 mile in urban areas and 10 miles in rural areas). Wilcoxon rank sum and χ 2 tests are used to compare the distance to and concentration of SNAP stores by rurality and SNAP participant concentration at census block group scale. Among the SNAP stores in North Carolina, 83% are limited-variety stores and 17% are full-variety stores. There are disparities in the demographics of individuals living in census block groups with a high proportion of SNAP participants compared to census block groups with a lower proportion of SNAP participants. More households in higher SNAP participant census block groups were non-white, did not have a car, and had children compared to census block groups with lower SNAP
Leathers, Sonya J.; Strand, Tonya C.
Objective: This pilot study examined the effect of increasing field instructors access to information about evidence-based practices (EBPs) on their level of knowledge and attitudes about EBPs. Method: Eighteen field instructors received training and access to a library with extensive online journals. Half were randomly selected to also receive a…
In addition to building the capacity of BRAC's program managers to carry out rigorous impact evaluation of their key initiatives, this project will also promote the sharing of BRAC's lessons more broadly within the development research community to inform up-scaling and graduation programs in the region.
Balis, Laura E; Strayer, Thomas; Ramalingam, NithyaPriya; Wilson, Meghan; Harden, Samantha M
Open-access, community-based programs are recommended to assist older adults in meeting physical activity guidelines, but the characteristics, impact, and scalability of these programs is less understood. The Land-Grant University Cooperative Extension System, an organization providing education through county-based educators, functions as a delivery system for these programs. A systematic review was conducted to determine characteristics of effective older adult physical activity programs and the extent to which programs delivered in Extension employ these characteristics. A systematic review of peer-reviewed and grey literature was conducted from August 2016 to February 2017. The review was limited to open-access (available to all), community-based physical activity interventions for older adults (≥65 years of age). The peer-reviewed literature search was conducted in PubMed and EBSCOhost; the grey literature search for Extension interventions was conducted through Extension websites, Land-Grant Impacts, and the Journal of Extension. Sixteen peer-reviewed studies and 17 grey literature sources met inclusion criteria and were analyzed. Peer-reviewed and Extension programs were similar in their limited use of behavioral theories and group-based strategies. Compared to Extension programs, those in the peer-reviewed literature were more likely to use a combination of physical activity components and be delivered by trained professionals. The results indicate notable differences between peer-reviewed literature and Extension programs and present an opportunity for Extension programs to more effectively use evidence-based program characteristics, including behavioral theories and group dynamics, a combination of physical activity components, and educator/agent-trained delivery agents.
Bentin, S; Bargai, N; Katz, L
In Hebrew script, vowels are represented by small dots appended to the consonants. However, in print the dots are almost always omitted, and because a single consonant string may represent several different words (with different vowels), the reader can assign to it a unique meaning and pronunciation only in relation to the syntactic and semantic contexts. We investigated the role of phonemic mediation for lexical access when printed Hebrew words are presented in isolation. Two experiments manipulated phonemic ambiguity by comparing consonant strings that have only a single meaningful pronunciation with strings that have several meaningful pronunciations. Although naming was slower when several pronunciations were possible, these phonemically ambiguous strings were not recognized more slowly in a lexical-decision task. A third study, in which lexical decisions were made for consonant strings presented with the vowel dots, showed that nonword homographs were rejected more slowly than were nonword homophones. These results suggest that in Hebrew, orthographic codes play a more important role in the process of word recognition than do phonemic codes, especially in comparison with the roles played in other languages.
Martoccia, Maria [Decision Technology Centre, London (United Kingdom)
The sectors characterised by the use of transmission or transport networks as inputs of production (electricity, gas, telecommunications) have long been considered as natural monopolies. Thanks to the technological innovations which have modified the economics of production (as in electricity generation) or that have driven the development of high value added services (as in telecommunications), the boundaries of the old natural monopolies have been eroded by the presence of operators potentially able to compete in national and international markets. The objective is to delineate, by analysing the more significant theoretical contributions and some of the restructuring experiences of the sector in question, the possible regulatory solutions which, in the perspective of a `European market` for electricity, makes the management and the expansion of the transmission networks adequate for the `open access` of national electricity sectors. The analysis of some mature experiences, such as in Chile, Argentina, the UK and Norway, in the second section, will offer a useful support to this evaluation. The regulatory solution here adopted will be analysed, in particular, with reference to the two main problems outlined above: on the one hand, the problem of providing through prices the necessary information about the opportunities of using the transmission assets; and on the other hand, the problem of defining an efficient incentive mechanism for the behaviour of the monopolist (the owner of the transmission assets). Finally, by considering the limits found in the solutions explored in these models, we will try, in the third section, to delineate the evolution that the regulation of the analysed sectors could follow, in an attempt to make the optimal solution defined in the first section consistent with the imperfections of the real scenarios. (EHS)
Poliana Remundini de Lima
Full Text Available A cross-sectional study aimed to describe the access and integrality of attention to children before one year old, born between January of 2010 and December of 2012 in a Brazilian city, in a newborn attention program. From the 24.560 children, 55.0% were users of the Unified Health System (SUS; 10.1% children presented low weight at birth; 6,332 (46.9% children received BCG vaccine at the nursing consultation day; 13,590 (79.5% children had neonatal screening being less than seven days old; 17,035 (69.4% children were vaccinated for Hepatitis B at birth. Within SUS users, 68% of children went to nursing consultation at their first week of life and, 37.8% went to a medical consultation being 10 days old. The study presents information of care after birth at the primary healthcare as potential instrument to coordinate assistance to this clientele.
Jessica L. Buescher
Worldwide epidemiologic studies have repeatedly demonstrated an association between prenatal nutritional environment, birth weight and susceptibility to adult diseases including obesity, cardiovascular disease and type 2 diabetes. Despite advances in mammalian model systems, the molecular mechanisms underlying this phenomenon are unclear, but might involve programming mechanisms such as epigenetics. Here we describe a new system for evaluating metabolic programming mechanisms using a simple, genetically tractable Drosophila model. We examined the effect of maternal caloric excess on offspring and found that a high-sugar maternal diet alters body composition of larval offspring for at least two generations, augments an obese-like phenotype under suboptimal (high-calorie feeding conditions in adult offspring, and modifies expression of metabolic genes. Our data indicate that nutritional programming mechanisms could be highly conserved and support the use of Drosophila as a model for evaluating the underlying genetic and epigenetic contributions to this phenomenon.
Hebert, Kathy; Dias, Andre; Franco, Emiliana; Tamariz, Leonardo; Steen, Dylan; Arcement, Lee M
In order to provide efficient utilization of resources in an outpatient setting for acute exacerbation of heart failure (HF), the authors piloted an open-access outpatient intravenous (IV) diuretic program (IVDP) to evaluate utilization in an HF disease management program (HFDMP), patient characteristics for users of the program, and safety. An outpatient HFDMP at Jackson Memorial Hospital in Miami, Florida, enrolling 577 patients 18 years and older with an ejection fraction ≤40% was implemented. For symptoms or weight gain ≥5 pounds, patients were eligible to use an open-access IVDP during clinic hours. A total of 130 HFDM patients (22.5%) used the IVDP. IVDP users were more likely to be diabetic, with lower body mass indices than non-IVDP users. New York Heart Association class IV patients and previously hospitalized patients were more likely to use the IVDP. There were no documented adverse reactions for patients receiving treatment and no difference in mortality between groups. This open-access outpatient IVDP model for patients with HF was readily utilized by the HFDMP participants and appears safe for use in this population. This unique model may provide alternative access for acute HF treatment. Congest Heart Fail. © 2011 Wiley Periodicals, Inc.
Goddard, M; Smith, P
The pursuit of equity of access to health care is a central objective of many health care systems. This paper first sets out a general theoretical framework within which equity of access can be examined. It then applies the framework by examining the extent to which research evidence has been able to detect systematic inequities of access in UK, where equity of access has been a central focus in the National Health Service since its inception in 1948. Inequity between socio-economic groups is used as an illustrative example, and the extent of inequity of access experienced is explored in each of five service areas: general practitioner consultations; acute hospital care; mental health services; preventative medicine and health promotion; and long-term health care. The paper concludes that there appear to be important inequities in access to some types of health care in the UK, but that the evidence is often methodologically inadequate, making it difficult to draw firm conclusions. In particular, it is difficult to establish the causes of inequities which in turn limits the scope for recommending appropriate policy to reduce inequities of access. The theoretical framework and the lessons learned from the UK are of direct relevance to researchers from other countries seeking to examine equity of access in a wide variety of institutional settings.
... information technology professionals and developers. Conducting trainings/webinars on issues related to accessible technology in the workplace, including use of emerging technologies to facilitate employment and... of the Assistant Secretary for Office of Disability Employment Program Accessible Technology Action...
... Federal Aviation Administration 14 CFR Chapter 1 Airport Improvement Program (AIP): Policy Regarding Access to Airports From Residential Property; Correction AGENCY: Federal Aviation Administration (FAA... paragraph in the Proposed Policy Regarding Access to Airports From Residential Property that was published...
Whetten, Justin; van der Goes, David N; Tran, Huy; Moffett, Maurice; Semper, Colin; Yonas, Howard
Access to Critical Cerebral Emergency Support Services (ACCESS) was developed as a low-cost solution to providing neuro-emergent consultations to rural hospitals in New Mexico that do not offer comprehensive stroke care. ACCESS is a two-way audio-visual program linking remote emergency department physicians and their patients to stroke specialists. ACCESS also has an education component in which hospitals receive training from stroke specialists on the triage and treatment of patients. This study assessed the clinical and economic outcomes of the ACCESS program in providing services to rural New Mexico from a healthcare payer perspective. A decision tree model was constructed using findings from the ACCESS program and existing literature, the likelihood that a patient will receive a tissue plasminogen activator (tPA), cost of care, and resulting quality adjusted life years (QALYs). Data from the ACCESS program includes emergency room patients in rural New Mexico from May 2015 to August 2016. Outcomes and costs have been estimated for patients who were taken to a hospital providing neurological telecare and patients who were not. The use of ACCESS decreased neuro-emergent stroke patient transfers from rural hospitals to urban settings from 85% to 5% (no tPA) and 90% to 23% (tPA), while stroke specialist reading of patient CT/MRI imaging within 3 h of onset of stroke symptoms increased from 2% to 22%. Results indicate that use of ACCESS has the potential to save $4,241 ($3,952-$4,438) per patient and increase QALYs by 0.20 (0.14-0.22). This increase in QALYs equates to ∼73 more days of life at full health. The cost savings and QALYs are expected to increase when moving from a 90-day model to a lifetime model. The analysis demonstrates potential savings and improved quality-of-life associated with the use of ACCESS for patients presenting to rural hospitals with acute ischemic stroke (AIS).
Albert, Dayna; Fortin, Rebecca; Lessio, Anne; Herrera, Christine; Hanning, Rhona; Rush, Brian
Best practices identified solely on the strength of research evidence may not be entirely relevant or practical for use in community-based public health and the practice of chronic disease prevention. Aiming to bridge the gap between best practices literature and local knowledge and expertise, the Ontario Public Health Association, through the Toward Evidence-Informed Practice initiative, developed a set of resources to strengthen evidence-informed decision making in chronic disease prevention programs. A Program Assessment Tool, described in this article, emphasizes better processes by incorporating review criteria into the program planning and implementation process. In a companion paper, “Strengthening Chronic Disease Prevention Programming: The Toward Evidence-Informed Practice (TEIP) Program Evidence Tool,” we describe another tool, which emphasizes better evidence by providing guidelines and worksheets to identify, synthesize, and incorporate evidence from a range of sources (eg, peer-reviewed literature, gray literature, local expertise) to strengthen local programs. The Program Assessment Tool uses 19 criteria derived from literature on best and promising practices to assess and strengthen program planning and implementation. We describe the benefits, strengths, and challenges in implementing the tool in 22 community-based chronic disease prevention projects in Ontario, Canada. The Program Assessment Tool helps put best processes into operation to complement adoption and adaptation of evidence-informed practices for chronic disease prevention. PMID:23721789
Yamato, Tiê P; Arora, Mohit; Stevens, Matthew L; Elkins, Mark R; Moseley, Anne M
To quantify the relationship between the number of times articles are accessed on the Physiotherapy Evidence Database (PEDro) and the article characteristics. A secondary aim was to examine the relationship between accesses and the number of citations of articles. The study was conducted to derive prediction models for the number of accesses of articles indexed on PEDro from factors that may influence an article's accesses. All articles available on PEDro from August 2014 to January 2015 were included. We extracted variables relating to the algorithm used to present PEDro search results (research design, year of publication, PEDro score, source of systematic review (Cochrane or non-Cochrane)) plus language, subdiscipline of physiotherapy, and whether articles were promoted to PEDro users. Three predictive models were examined using multiple regression analysis. Citation and journal impact factor were downloaded. There were 29,313 articles indexed in this period. We identified seven factors that predicted the number of accesses. More accesses were noted for factors related to the algorithm used to present PEDro search results (synthesis research (i.e., guidelines and reviews), recent articles, Cochrane reviews, and higher PEDro score) plus publication in English and being promoted to PEDro users. The musculoskeletal, neurology, orthopaedics, sports, and paediatrics subdisciplines were associated with more accesses. We also found that there was no association between number of accesses and citations. The number of times an article is accessed on PEDro is partly predicted by how condensed and high quality the evidence it contains is. Copyright © 2017 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.
Araújo, Roque da Silva; Arcuri, Edna Apparecida Moura; Lopes, Victor Cauê
to verify causes of inactivity in the Home Delivery Medicament Program, as referred by users from a Primary Health Care Service in São Paulo, comparing them to the causes registered in the program and analyzing them in the theoretical model Concept of Access to Health. cross-sectional study, interviewing 111 inactive users; and documentary study in the program records. half of the users did not know the condition of inactivity. Discrepancies were found between the user's and the program's information, observing different levels of agreement: Absence of physician and administrative staff member 0%; Transfer to other service 25%; Death 50%; Option to quit 50%; Address change 57% and Change in therapeutic schedule 80%. The users' feeling of accepting the program was observed. In the health access concept, inactivity can be explained in the information dimension, in the degree of asymmetry between the patient's and the health professional's knowledge, identified through the indicators: education, knowledge and information sources. due to the low education level, the user does not assimilate the information on the steps of the program flowchart, does not return for the assessment that guarantees its continuity. Consequently, (s)he stops receiving the medication and spends a long time without treatment, increasing the cardiovascular risk of hypertensive (92% of the sample), diabetic (44%) and dyslipidemic patients (31%). verificar causas de inatividade no Programa Remédio em Casa, referidas por usuários de Unidade Básica de Saúde de São Paulo, comparando-as às registradas pelo programa e analisando-as no modelo teórico Conceito de Acesso à Saúde. estudo transversal entrevistando 111 usuários inativos; e documental, nos registros do programa. metade dos usuários desconhecia a condição de inatividade. Constatadas discrepâncias nas informações usuário versus programa, observando-se diferentes níveis de concordância: Falta de médico e funcion
Office of Postsecondary Education, US Department of Education, 2012
The International Education Programs Service (IEPS) administers 14 education programs. These programs are complementary in nature and designed to benefit a variety of audiences through training programs, research, start-up or enhancement projects, and fellowships. This paper provides brief descriptions of these programs.
... provide accommodations requiring the assistance of other persons (e.g., American Sign Language interpreters, communication access realtime translation (CART) providers, transcribers, captioners, and readers...
... Rural Utilities Service Rural Broadband Access Loans and Loan Guarantees Program AGENCY: Rural Utilities... for the Rural Broadband Access Loans and Loan Guarantees Program for fiscal year (FY) 2011. A Notice..., 2011, at 76 FR 13797, prior to the passage of a final appropriations bill identifying a definite...
Reese, Robert J; Slone, Norah C; Soares, Neelkamal; Sprang, Rob
Families with a child diagnosed with attention-deficit hyperactivity disorder completed an 8-session parenting program, the Group Triple P Positive Parenting Program, provided by videoconferencing technology. Families reported improved child behavior (effect size of d = -1.23) and decreased parent distress (d = -0.34). Parent training implemented with videoconferencing technology can be an effective way of delivering evidence-based services to families with specialized needs. (c) 2012 APA, all rights reserved.
Hinds, Richard M; Klifto, Christopher S; Naik, Amish A; Sapienza, Anthony; Capo, John T
The Internet is a common resource for applicants of hand surgery fellowships, however, the quality and accessibility of fellowship online information is unknown. The objectives of this study were to evaluate the accessibility of hand surgery fellowship Web sites and to assess the quality of information provided via program Web sites. Hand fellowship Web site accessibility was evaluated by reviewing the American Society for Surgery of the Hand (ASSH) on November 16, 2014 and the National Resident Matching Program (NRMP) fellowship directories on February 12, 2015, and performing an independent Google search on November 25, 2014. Accessible Web sites were then assessed for quality of the presented information. A total of 81 programs were identified with the ASSH directory featuring direct links to 32% of program Web sites and the NRMP directory directly linking to 0%. A Google search yielded direct links to 86% of program Web sites. The quality of presented information varied greatly among the 72 accessible Web sites. Program description (100%), fellowship application requirements (97%), program contact email address (85%), and research requirements (75%) were the most commonly presented components of fellowship information. Hand fellowship program Web sites can be accessed from the ASSH directory and, to a lesser extent, the NRMP directory. However, a Google search is the most reliable method to access online fellowship information. Of assessable programs, all featured a program description though the quality of the remaining information was variable. Hand surgery fellowship applicants may face some difficulties when attempting to gather program information online. Future efforts should focus on improving the accessibility and content quality on hand surgery fellowship program Web sites.
Saurman, Emily; Lyle, David; Kirby, Sue; Roberts, Russell
The Mental Health Emergency Care-Rural Access Program (MHEC-RAP) is a telehealth solution providing specialist emergency mental health care to rural and remote communities across western NSW, Australia...
The open access model, where researchers can publish their work and make it freely available to the whole medical community, is gaining ground over the traditional type of publication. However, fees are to be paid by either the authors or their institutions. The purpose of this paper is to assess the proportion and type of open access evidence-based articles in the form of systematic reviews and meta-analyses in the field of musculoskeletal disorders and orthopedic surgery. PubMed database was searched and the results showed a maximal number of hits for low back pain and total hip arthroplasty. We demonstrated that despite a 10-fold increase in the number of evidence-based publications in the past 10 years, the rate of free systematic reviews in the general biomedical literature did not change for the last two decades. In addition, the average percentage of free open access systematic reviews and meta-analyses for the commonest painful musculoskeletal conditions and orthopedic procedures was 20% and 18%, respectively. Those results were significantly lower than those of the systematic reviews and meta-analyses in the remaining biomedical research. Such findings could indicate a divergence between the efforts engaged at promoting evidence-based principles and those at disseminating evidence-based findings in the field of musculoskeletal disease and trauma. The high processing fee is thought to be a major limitation when considering open access model for publication. © 2015 Chinese Cochrane Center, West China Hospital of Sichuan University and Wiley Publishing Asia Pty Ltd.
... multichannel video programming distributor that uses the same distribution technology as the competitor... authority to fashion appropriate sanctions for violations of its protective orders, including but not...
Isehunwa, Oluwaseyi O; Carlton, Erik L; Wang, Yang; Jiang, Yu; Kedia, Satish; Chang, Cyril F; Fijabi, Daniel; Bhuyan, Soumitra S
There is little research at the national level on access to employee wellness programs and the use of preventive care services. This study examined the use of seven preventive care services among U.S working adults with access to employee wellness programs. The study population comprised 17,699 working adults aged ≥18 years, obtained from the 2015 National Health Interview Survey. Multivariate logistic regression models examined the relationship between access to employee wellness programs and use of seven preventive care services: influenza vaccination, blood pressure check, diabetes check, cholesterol check, Pap smear test, mammogram, and colon cancer screening. Data analysis began in Fall 2016. Overall, 46.6% of working adults reported having access to employee wellness programs in 2015. Working adults with access to employee wellness programs had higher odds of receiving influenza vaccination (OR=1.57, 95% CI=1.43, 1.72, paccess to employee wellness programs and the use of Pap smear test and colon cancer screening services. Using a nationally representative sample of individuals, this study found a positive association between access to employee wellness programs and the use of preventive care services. The results support favorable policies to encourage implementing wellness programs in all worksites, especially those with <50 employees. Copyright © 2017 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
Laura J. McLachlin; Emilyn A. Sheffield; Donald A. Penland; Charles W. Nelson
The Heritage Corridors Project was a unique partnership between the California Department of Parks and Recreation, the California State University, and the Across California Conservancy. The purpose of the project was to develop a map of selected northern California outdoor recreation and heritage sites. Data about facility accessibility improvements (restrooms, clear...
... programming. 76.1507 Section 76.1507 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) BROADCAST... access to satellite cable programming. (a) Any provision that applies to a cable operator under §§ 76... provides video programming on its open video system, except as limited by paragraph (a) (1)-(3) of this...
Grembowski, D; Milgrom, P M
OBJECTIVE: Washington State's Access to Baby and Child Dent stry (ABCD) Program, first implemented in Spokane County in 1995, offers extended dental benefits to participating Medicaid-enrolled children and higher fees for certified providers. This study aimed to determine the program's effect on children's dental utilization and dental fear, and on parent satisfaction and knowledge. METHODS: The study used a posttest-only comparison group design. Trained interviewers conducted telephone interviews with 465 parents of chi dren ages 13 to 36 months (49% ABCD, 51% Medicaid-enrolled children not in ABCD). One year later, 282 of 465 parents completed a follow-up survey. Utilization and expenditures were calculated from Medicaid claims. RESULTS: Forty-three percent of children in the ABCD Program visited a dentist in the follow-up year, compared with 12% of Medicaid-enrolled children not in the ABCD Program. An ABCD child was 5.3 times as likely to have had at least one dental visit as a child not in the program. ABCD children were 4 to 13 times as likely to have used specific dental services. Parents of ABCD children were more likely to report having ever tried to make a dental appointment, less likely to report that their children were fearful of the dentist, and were more satisfied, compared to parents of non-ABCD children. CONCLUSION: The authors conclude that the ABCD Program was effective in increasing access for preschool children enrolled in Medicaid, reducing dental fear, and increasing parent satisfaction. PMID:11236017
....150 Section 1600.150 Foreign Relations JAPAN-UNITED STATES FRIENDSHIP COMMISSION ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE JAPAN-UNITED STATES FRIENDSHIP... action that it can demonstrate would result in a fundamental alteration in the nature of a program or...
Craig, Dana; Etcheverry, Jose; Ferris, Stefan
This Note provides an analysis of Mexico's "Telesecundaria" program within the context of Mexico's new education reform framework offering a succinct background of the project, as well as key policy lessons that can be useful for other jurisdictions interested in the development of distance education programs. This Note uses a literature…
Full Text Available Abstract Exceptional pupils enrolled in Canadian French immersion programs rarely have access to the same range of special education programs and services that are available to students in the regular English program. More often than not, students with special needs are encouraged to transfer to English programs to access necessary support services. This counselling-out process perpetuates the elitist status commonly attributed to French immersion programs. From a critical pedagogy perspective, this inquiry examines the lack of incentive on the part of multiple French immersion stakeholders to accommodate students with special needs. It further attempts to unveil the myths created by these stakeholders to better understand this discriminatory educational practice. The impact of federal and provincial funding models on access to special education programs and services is discussed, and the application of funding allocations by English-language district school boards is explored. The inquiry concludes with recommendations to promote more inclusionary practices.
GAO General Accounting Office GME Graduate Medical Education GMO General Medical Officer GPA Grade Point Average xiv HPLRP Health...uniformed services as they transform themselves to meet new challenges, the departments concerned must offer, in addition to challenging and rewarding...9 Title 37 U.S.C. § 1008, “Presidential recommendations concerning adjustments and changes in pay and allowances,” last accessed November
Full Text Available This paper assesses whether eligibility for conditional cash transfer programs has been manipulated, as well as the impact of this phenomenon on time allocation within households. To perform this analysis, we use data from the 2006 PNAD (Brazilian national household survey and investigate the eligibility manipulation for the Bolsa Família (Family Stipend program during this time period. The program assists families with a monthly per capita income of around R$120.00 (US$60.00. By applying the tests developed by McCrary (2008, we find suggestive evidence that individuals manipulate their income by voluntarily reducing their labor supply in order to become eligible to the program. Moreover, the reduction in labor supply is greater among women, especially single or divorced mothers. This evidence raises some concern about the unintended consequences related to the eligibility criteria utilized by Bolsa Família, as well as the program's impact on individuals living in extreme poverty.
..., movie studio, and other businesses with some of Comcast's cable programming and online content... number of cable subscribers and homes passed by a single MSO in particular markets (accomplished via...
..., fishing, wildlife observation, photography, and environmental education and interpretation. Eligibility... hunting, fishing, wildlife-observation, photography, environmental education and interpretation, or other... Environmental Programs Division (CEPD), U.S. Department of Agriculture (USDA) FSA CEPD, STOP 0513, 1400...
... Federal Aviation Administration 14 CFR Chapter I Airport Improvement Program (AIP): Policy Regarding Access to Airports From Residential Property AGENCY: Federal Aviation Administration (FAA). ACTION: Final... through-the-fence access to a federally-obligated airport from an adjacent or nearby property, when that...
... Federal Aviation Administration 14 CFR Chapter I Airport Improvement Program (AIP): Policy Regarding Access to Airports From Residential Property AGENCY: Federal Aviation Administration (FAA), DOT. ACTION... policy, based on Federal law, concerning through-the-fence access to a federally obligated airport from...
... Federal Aviation Administration Airport Improvement Program (AIP): Interim Policy Regarding Access to Airports From Residential Property AGENCY: Federal Aviation Administration (FAA). ACTION: Interim policy... clarifying FAA policy concerning through-the-fence access to a federally-obligated airport from an adjacent...
... Administration (FTA), DOT. ACTION: Notice of Availability of Fiscal Year 2009 Funds: Solicitation of Grant...) announces the availability of funds in Fiscal Year (FY) 2009 for the Over-the-Road Bus (OTRB) Accessibility... OTRB Accessibility Program makes funds available to private operators of over-the-road buses to finance...
Libben, Maya R; Titone, Debra A
Current models of bilingualism (e.g., BIA+) posit that lexical access during reading is not language selective. However, much of this research is based on the comprehension of words in isolation. The authors investigated whether nonselective access occurs for words embedded in biased sentence contexts (e.g., A. I. Schwartz & J. F. Kroll, 2006). Eye movements were recorded as French-English bilinguals read English sentences containing cognates (e.g., piano), interlingual homographs (e.g., coin, meaning corner in French), or matched control words. Sentences provided a low or high semantic constraint for target-language meanings. Both early-stage comprehension measures (e.g., first fixation duration, gaze duration, and skipping) and late-stage comprehension measures (e.g., go-past time and total reading time) showed significant cognate facilitation and interlingual homograph interference for low-constraint sentences. For high-constraint sentences, however, only early-stage comprehension measures were consistent with nonselective access. There was no evidence of cognate facilitation or interlingual homograph interference for late-stage comprehension measures. Thus, nonselective bilingual lexical access at early stages of comprehension is rapidly resolved in semantically biased contexts at later stages of comprehension. (c) 2009 APA, all rights reserved
Kolomaznik, I. (HGF VSB-TU Ostrava, Ostrava-Poruba (Czech Republic))
The program system has been developed to store and process data. The Rockware system can be used for graphic outputs and some special operations and calculations. This system allows graphic outputs based on text files which contain graphic instructions. A modern database program Microsoft Access 97 is used for data storage, whereas the Borland compiler Delphi 3 serves as the programming medium, and the Topol program of the Help Service Mapping Company is used for graphic outputs. 3 figs.
Kolomaznik, I. [HGF VSB-TU Ostrava, Ostrava-Poruba (Czech Republic)
The program system has been developed to store and process data. The Rockware system can be used for graphic outputs and some special operations and calculations. This system allows graphic outputs based on text files which contain graphic instructions. A modern database program Microsoft Access 97 is used for data storage, whereas the Borland compiler Delphi 3 serves as the programming medium, and the Topol program of the Help Service Mapping Company is used for graphic outputs. 3 figs.
Mahmud, Aidalina; Aljunid, Syed Mohamed
Access to healthcare is essential in the pursuit of universal health coverage. Components of access are availability, accessibility (spatial and non-spatial), affordability and acceptability. Measuring spatial accessibility is common approach to evaluating access to health care. This study aimed to determine the availability and spatial accessibility of subsidised mammogram screening in Peninsular Malaysia. Availability was determined from the number and distribution of facilities. Spatial accessibility was determined using the travel impedance approach to represent the revealed access as opposed to potential access measured by other spatial measurement methods. The driving distance of return trips from the respondent's residence to the facilities was determined using a mapping application. The travel expenditure was estimated by multiplying the total travel distance by a standardised travel allowance rate, plus parking fees. Respondents in this study were 344 breast cancer patients who received treatment at 4 referral hospitals between 2015 and 2016. In terms of availability, there were at least 6 major entities which provided subsidised mammogram programs. Facilities with mammogram involved with these programs were located more densely in the central and west coast region of the Peninsula. The ratio of mammogram facility to the target population of women aged 40-74 years ranged between 1: 10,000 and 1:80,000. In terms of accessibility, of the 3.6% of the respondents had undergone mammogram screening, their mean travel distance was 53.4 km (SD = 34.5, range 8-112 km) and the mean travel expenditure was RM 38.97 (SD = 24.00, range RM7.60-78.40). Among those who did not go for mammogram screening, the estimated travel distance and expenditure had a skewed distribution with median travel distance of 22.0 km (IQR 12.0, 42.0, range 2.0-340.0) and the median travel cost of RM 17.40 (IQR 10.40, 30.00, range 3.40-240.00). Higher travel impedance was noted among those who
Flanigan, Amber; Salm Ward, Trina
Evidence for the connection between physical and mental health is growing, as is interest in providing a holistic, mind-body approach to improving mental health and wellness. A needs assessment in northeast Georgia identified several regional health priorities, including mental health and substance abuse, access to care, and cardiovascular health. The study's purpose is threefold: to (1) review evidence for integrated mind-body wellness services, (2) explore the feasibility of implementing wellness services in a small mental health agency serving northeast Georgia, and (3) conduct a brief survey assessing interest in a wellness program. The literature search identified articles within the past 10 years with these key words: "yoga," "mental health," "wellness program," "complementary alternative medicine," "tai chi," "mindfulness," "meditation," and "nutrition." The survey was distributed to the agency's affiliates. The literature review identified strong evidence for an integrated mind-body wellness program that includes yoga, tai chi, mindfulness meditation, and nutrition education. Among 73 survey respondents, 86 percent indicated interest in wellness services, and 85 percent agreed that wellness services are important to mental health and well-being. Authors suggest a model to incorporate a holistic wellness program to complement mental health services and help facilitate physical and mental health. © 2017 National Association of Social Workers.
Sanchez, Sheila M.; Huerta, Adrian H.; Venegas, Kristan M.
This study highlights the narratives of five Latino males from three different postsecondary institutions--a community college, a four-year public state college, and a large private research university--and the impact of their participation in college preparation programs. The data is drawn from a study in which the impact of college preparation…
Ramsey, Jennifer; Gorgol, Laura
In 2001, the Bill & Melinda Gates Foundation launched a 10-year, multi-million dollar initiative, the Washington State Achievers Program (WSA), to increase opportunities for low-income students to attend postsecondary institutions in Washington State. The Bill & Melinda Gates Foundation granted funds to the College Success Foundation…
.... 1600.149 Section 1600.149 Foreign Relations JAPAN-UNITED STATES FRIENDSHIP COMMISSION ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE JAPAN-UNITED STATES FRIENDSHIP... unusable by handicapped persons, be denied the benefits of, be excluded from participation in, or otherwise...
The Women in Machining (WIM) program is a Machine Action Project (MAP) initiative that was developed in response to a local skilled metalworking labor shortage, despite a virtual absence of women and people of color from area shops. The project identified post-war stereotypes and other barriers that must be addressed if women are to have an equal…
... audio-visual materials and devices to depict those portions of an historic property that cannot... result in a fundamental alteration in the nature of a program or activity or in undue financial and... agency has the burden of proving that compliance with § 51-10.150(a) would result in such alteration or...
... include— (i) Using audio-visual materials and devices to depict those portions of an historic property... demonstrate would result in a fundamental alteration in the nature of a program or activity or in undue... such alteration or burdens. The decision that compliance would result in such alteration or burdens...
... audio-visual materials and devices to depict those portions of an historic property that cannot... fundamental alteration in the nature of a program or activity or in undue financial and administrative burdens... has the burden of proving that compliance with § 2205.150(a) would result in such alteration or...
... audio-visual materials and devices to depict those portions of an historic property that cannot... fundamental alteration in the nature of a program or activity or in undue financial and administrative burdens... has the burden of proving that compliance with § 2706.150(a) would result in such alteration or...
... include— (i) Using audio-visual materials and devices to depict those portions of an historic property... demonstrate would result in a fundamental alteration in the nature of a program or activity or in undue... such alteration or burdens. The decision that compliance would result in such alteration or burdens...
... include— (i) Using audio-visual materials and devices to depict those portions of an historic property... demonstrate would result in a fundamental alteration in the nature of a program or activity or in undue... such alteration or burdens. The decision that compliance would result in such alteration or burdens...
...— (i) Using audio-visual materials and devices to depict those portions of an historic property that... demonstrate would result in a fundamental alteration in the nature of a program or activity or in undue... alteration or burdens. The decision that compliance would result in such alteration or burdens must be made...
... include— (i) Using audio-visual materials and devices to depict those portions of an historic property... can demonstrate would result in a fundamental alteration in the nature of a program or activity or in...) would result in such alteration or burdens. The decision that compliance would result in such alteration...
...) Using audio-visual materials and devices to depict those portions of an historic property that cannot... fundamental alteration in the nature of a program or activity or in undue financial and administrative burdens... has the burden of proving that compliance with § 15.150(a) would result in such alteration or burdens...
... Office (Appendix A) or Blenda Younger, Office of Program Management, (202) 366-2053. Corrections On page... the Special Warranty for the Over-the-Road Bus Accessibility Program that is most current as of the... thereto. Any U.S. DOL Special Warranty that may be provided and any documents cited therein are...
... Transit Administration (FTA), DOT. ACTION: Notice of Availability of Fiscal Year 2012 Funds: Solicitation... availability of funds in Fiscal Year (FY) 2012 for the Over-the-Road Bus Accessibility (OTRB) Program... OTRB program makes funds available to private operators of over-the-road buses to finance the...
... 16 Commercial Practices 1 2010-01-01 2010-01-01 false Program accessibility: Electronic and information technology. 6.152 Section 6.152 Commercial Practices FEDERAL TRADE COMMISSION ORGANIZATION, PROCEDURES AND RULES OF PRACTICE ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE FEDERAL TRADE...
Dryman, M Taylor; McTeague, Lisa M; Olino, Thomas M; Heimberg, Richard G
Internet-delivered cognitive-behavioral therapy (ICBT) has been established as both efficacious and effective in reducing symptoms of social anxiety. However, most research has been conducted in controlled settings, and little is known regarding the utility of such programs in an open-access format. The present study examined the use, adherence, and effectiveness of Joyable, an open-access, Internet-delivered, coach-supported CBT-based intervention for social anxiety. Participants were 3,384 registered users (Mage [SD] = 29.82 [7.89]; 54% male) that created an account between 2014 and 2016. Characteristics of use, factors related to attrition and adherence, and within-group outcomes were examined. The primary outcome measure was the Social Phobia Inventory. On average, participants remained in the program for 81.02 days (SD = 60.50), during which they completed 12.14 activities (SD = 11.09) and 1.53 exposures (SD = 3.18). About half (57%) had contact with a coach. Full adherence to the program was achieved by 16% of participants, a rate higher than previously published open-access studies of ICBT. Social anxiety symptoms were significantly reduced for participants that engaged in the program, with medium within-group effects from baseline through the cognitive restructuring module (d = 0.63-0.76) and large effects from baseline through the exposure module (d = 1.40-1.83). Response rates were high (72%). Exposures and coach contact were significant predictors of retention and outcome. This open-access online CBT-based program is effective in reducing social anxiety symptoms and has the potential to extend Internet-based mental health services to socially anxious individuals unwilling or unable to seek face-to-face evidence-based therapy. (PsycINFO Database Record (c) 2017 APA, all rights reserved).
Previous research suggests that late bilinguals who speak typologically distant languages are the least likely to show evidence of non-selective lexical access processes. This study puts this claim to test by using the gating task to determine whether words beginning with speech sounds that are phonetically similar in Arabic and English (e.g., [b,d,m,n]) give rise to selective or non-selective lexical access processes in late Arabic-English bilinguals. The results show that an acoustic-phonetic input (e.g., [bæ]) that is consistent with words in Arabic (e.g., [bædrun] "moon") and English (e.g., [bæd] "bad") activates lexical representations in both languages of the bilingual. This non-selective activation holds equally well for mixed lists with words from both Arabic and English and blocked lists consisting only of Arabic or English words. These results suggest that non-selective lexical access processes are the default mechanism even in late bilinguals of typologically distant languages.
McNamee, Paul; Ternent, Laura; Hussein, Julia
The goal of improving the health status of people living in developing countries has received increasing priority in recent years. To achieve this goal, evidence is needed regarding methods for optimal allocation of expenditure within particular program areas. Among several competing programs, a commitment has been made to improve maternal health as part of the Millennium Development Goal targets. While there is a growing body of cost-effectiveness evidence relating to maternal healthcare programs, underutilization of services is still pervasive, especially among poorer groups of the population. A major reason for such underutilization lies in underlying adverse socioeconomic factors, or barriers, which impede healthcare use. This article reviews the evidence from studies that have conducted multivariate analyses to quantify the effects of education, economic status and distance barriers on service use. It is concluded that it is not possible to state categorically whether one particular barrier is more important than others and that efforts should continue to consider demand-side barriers more fully, along with supply-side barriers.
APL provides convenient associative data manipulation functions in a high level language. Six statements were added to PL/1 via a preprocessor: CREATE, INSERT, FIND, FOR EACH, REMOVE, and DELETE. They allow complete control of all data base operations. During execution, data base management programs perform the functions required to support the APL language. VAAM is the data base management system designed to support the APL language. APL/VAAM is used by CADANCE, an interactive graphic computer system. VAAM is designed to support heavily referenced files. Virtual memory files, which utilize the paging mechanism of the operating system, are used. VAAM supports a full network data structure. The two basic blocks in a VAAM file are entities and sets. Entities are the basic information element and correspond to PL/1 based structures defined by the user. Sets contain the relationship information and are implemented as arrays.
Full Text Available Emergency contraception pills (ECP are among the 13 essential commodities in the framework for action established by the UN Commission on Life-Saving Commodities for Women and Children. Despite having been on the market for nearly 20 years, a number of barriers still limit women's access to ECP in low- and middle-income countries (LMIC including limited consumer knowledge and poor availability. This paper reports the results of a review to synthesise the current evidence on service delivery strategies to improve access to ECP.A narrative synthesis methodology was used to examine peer reviewed research literature (2003 to 2013 from diverse methodological traditions to provide critical insights into strategies to improve access from a service delivery perspective. The studies were appraised using established scoring systems and the findings of included papers thematically analysed and patterns mapped across all findings using concept mapping.Ten papers were included in the review. Despite limited research of adequate quality, promising strategies to improve access were identified including: advance provision of ECP; task shifting and sharing; intersectoral collaboration for sexual assault; m-health for information provision; and scale up through national family planning programs.There are a number of gaps in the research concerning service delivery and ECP in LMIC. These include a lack of knowledge concerning private/commercial sector contributions to improving access, the needs of vulnerable groups of women, approaches to enhancing intersectoral collaboration, evidence for social marketing models and investment cases for ECP.
Dawson, Angela; Tran, Nguyen-Toan; Westley, Elizabeth; Mangiaterra, Viviana; Festin, Mario
Emergency contraception pills (ECP) are among the 13 essential commodities in the framework for action established by the UN Commission on Life-Saving Commodities for Women and Children. Despite having been on the market for nearly 20 years, a number of barriers still limit women's access to ECP in low- and middle-income countries (LMIC) including limited consumer knowledge and poor availability. This paper reports the results of a review to synthesise the current evidence on service delivery strategies to improve access to ECP. A narrative synthesis methodology was used to examine peer reviewed research literature (2003 to 2013) from diverse methodological traditions to provide critical insights into strategies to improve access from a service delivery perspective. The studies were appraised using established scoring systems and the findings of included papers thematically analysed and patterns mapped across all findings using concept mapping. Ten papers were included in the review. Despite limited research of adequate quality, promising strategies to improve access were identified including: advance provision of ECP; task shifting and sharing; intersectoral collaboration for sexual assault; m-health for information provision; and scale up through national family planning programs. There are a number of gaps in the research concerning service delivery and ECP in LMIC. These include a lack of knowledge concerning private/commercial sector contributions to improving access, the needs of vulnerable groups of women, approaches to enhancing intersectoral collaboration, evidence for social marketing models and investment cases for ECP.
Lindsay, Jan A; Kauth, Michael R; Hudson, Sonora; Martin, Lindsey A; Ramsey, David J; Daily, Lawrence; Rader, John
Increasing access to psychotherapy for posttraumatic stress disorder (PTSD) is a primary focus of the Department of Veterans Affairs (VA) healthcare system. Delivery of treatment via video telehealth can expand availability of treatment and be equally effective as in-person treatment. Despite VA efforts, barriers to establishing telehealth services remain, including both provider acceptance and organizational obstacles. Thus, development of specific strategies is needed to implement video telehealth services in complex healthcare systems, like the VA. This project was guided by the Promoting Action on Research Implementation in Health Services framework and used external facilitation to increase access to psychotherapy via video telehealth. The project was conducted at five VA Medical Centers and their associated community clinics across six states in the South Central United States. Over a 21-month period, 27 video telehealth clinics were established to provide greater access to evidence-based psychotherapies for PTSD. Examination of change scores showed that participating sites averaged a 3.2-fold increase in unique patients and a 6.5-fold increase in psychotherapy sessions via video telehealth for PTSD. Differences between participating and nonparticipating sites in both unique patients and encounters were significant (p=0.041 and p=0.009, respectively). Two groups emerged, separated by degree of engagement in the facilitation intervention. Facilitation was perceived as useful by providers. To our knowledge, this is the first prospective study of external facilitation as an implementation strategy for telehealth. Our findings suggest that external facilitation is an effective and acceptable strategy to support providers as they establish clinics and make complex practice changes, such as implementing video telehealth to deliver psychotherapy.
Wilson, Paul M; Farley, Kate; Bickerdike, Liz; Booth, Alison; Chambers, Duncan; Lambert, Mark; Thompson, Carl; Turner, Rhiannon; Watt, Ian S
The Health and Social Care Act mandated research use as a core consideration of health service commissioning arrangements in England. We undertook a controlled before and after study to evaluate whether access to a demand-led evidence briefing service improved the use of research evidence by commissioners compared with less intensive and less targeted alternatives. Nine Clinical Commissioning Groups (CCGs) in the North of England received one of three interventions: (A) access to an evidence briefing service; (B) contact plus an unsolicited push of non-tailored evidence; or (C) unsolicited push of non-tailored evidence. Data for the primary outcome measure were collected at baseline and 12 months using a survey instrument devised to assess an organisations' ability to acquire, assess, adapt and apply research evidence to support decision-making. Documentary and observational evidence of the use of the outputs of the service were sought. Over the course of the study, the service addressed 24 topics raised by participating CCGs. At 12 months, the evidence briefing service was not associated with increases in CCG capacity to acquire, assess, adapt and apply research evidence to support decision-making, individual intentions to use research findings or perceptions of CCG relationships with researchers. Regardless of intervention received, participating CCGs indicated that they remained inconsistent in their research-seeking behaviours and in their capacity to acquire research. The informal nature of decision-making processes meant that there was little traceability of the use of evidence. Low baseline and follow-up response rates and missing data limit the reliability of the findings. Access to a demand-led evidence briefing service did not improve the uptake and use of research evidence by NHS commissioners compared with less intensive and less targeted alternatives. Commissioners appear well intentioned but ad hoc users of research. Further research is required on
Alborz, Alison; McNally, Rosalind; Glendinning, Caroline
People with learning disabilities are more prone to a wide range of additional physical and mental health problems than the general population. Our aim was to map the issues and review the evidence on access to health care for these patients. The review sought to identify theory, evidence and gaps in knowledge relating to the help-seeking behaviour of people with learning disabilities and their carers, barriers and problems they experience accessing the full range of health services, and practical and effective interventions aiming to improve access to health care. A three-strand approach was adopted, involving searches of electronic databases, a consultation exercise and a mail shot to researchers and learning disability health professionals. Evidence relevant to our model of 'access' was evaluated for scientific rigour and selected papers synthesized. Overall, a lack of rigorous research in this area was noted and significant gaps in the evidence base were apparent. Evidence was identified on the difficulties in identifying health needs among people with learning disabilities and the potentially empowering or obstructive influence of third parties on access to health care. Barriers to access identified within health services included problems with communication, inadequate facilities, rigid procedures and lack of appropriate interpersonal skills among mainstream health care professionals in caring for these patients. A number of innovations designed to improve access were identified, including a communication aid, a prompt card to support general practitioners, health check programmes and walk-in clinics. There are important gaps in the knowledge base on access to health care for this group. While these need to be addressed, developing strategies to overcome identified barriers should be a priority, along with fuller evaluation of existing innovations.
Bassilios, Bridget; Nicholas, Angela; Reifels, Lennart; King, Kylie; Fletcher, Justine; Machlin, Anna; Ftanou, Maria; Blashki, Grant; Burgess, Philip; Pirkis, Jane
Introduced in July 2001, Australian Access to Allied Psychological Services (ATAPS) was the inaugural national policy initiative to provide community access to government-funded psychological services in primary care. Our aim was to examine the achievements of ATAPS in relation to its stated objectives using a set of indicators that largely drew on data from a minimum data set that we designed for the evaluation of ATAPS. We used de-identified professional-, consumer- and session-level data from the minimum dataset, and secondary analyses of our quantitative and qualitative data collected for a series of specific evaluation studies. Available data covered the period from 1 July 2003 to 31 December 2012. Approximately 350,000 referrals were made to the ATAPS program over the 9.5 year analysis period, 79 % of which resulted in services. Over 1.4 million sessions were offered. Overall, 29 % of consumers were male, 4 % children, and 3 % Aboriginal people; 54 % of consumers had depression and 41 % an anxiety disorder; at least 60 % were on low incomes; and around 50 % resided outside of major cities. The most common interventions delivered were cognitive and behavioural therapies. Selected outcome measures indicated improvement in mental health symptoms. Access to Allied Psychological Services achieved its objectives within a decade of operation. The program delivered evidence-based services to a substantial number of consumers who were disadvantaged and historically would not have accessed services. Importantly, where data were available, there were indications that ATAPS achieved positive clinical outcomes for consumers. This suggests that ATAPS carved an important niche by successfully addressing unmet need of hard-to-reach consumers and through means that were not available via other programs. It will be interesting to see the effects from July 2016 of the reform of ATAPS, which will see ATAPS subsumed under psychological services commissioned by regional
Walsh et al. (2012) emphasized the importance of obtaining evidence to assess the effects of management actions on state variables relevant to objectives of conservation programs. They focused on malleefowl Leipoa ocellata, ground-dwelling Australian megapodes listed as vulnerable. They noted that although fox Vulpes vulpes baiting is the main management action used in malleefowl conservation throughout southern Australia, evidence of the effectiveness of this action is limited and currently debated. Walsh et al. (2012) then used data from 64 sites monitored for malleefowl and foxes over 23 years to assess key functional relationships relevant to fox control as a conservation action for malleefowl. In one set of analyses, Walsh et al. (2012) focused on two relationships: fox baiting investment versus fox presence, and fox presence versus malleefowl population size and rate of population change. Results led to the counterintuitive conclusion that increases in investments in fox control produced slight decreases in malleefowl population size and growth. In a second set of analyses, Walsh et al. (2012) directly assessed the relationship between investment in fox baiting and malleefowl population size and rate of population change. This set of analyses showed no significant relationship between investment in fox population control and malleefowl population growth. Both sets of analyses benefited from the incorporation of key environmental covariates hypothesized to influence these management relationships. Walsh et al. (2012) concluded that "in most situations, malleefowl conservation did not effectively benefit from fox baiting at current levels of investment." In this commentary, I discuss the work of Walsh et al. (2012) using the conceptual framework of structured decision making (SDM). In doing so, I accept their analytic results and associated conclusions as accurate and discuss basic ideas about evidence, conservation and limits to management.
Vaagan, Robert; Koehler, Wallace
Introduction: In 1999-2000, a Norwegian youth cracked a DVD-access code and published a decryption program on the Internet. He was sued by the US DVD Copy Control Association (DVD-CCA) and the Norwegian Motion Picture Association (MAP), allies of the US Motion Picture Association of America (MPAA), arrested by Norwegian police and charged with…
... From the Federal Register Online via the Government Publishing Office NATIONAL CREDIT UNION ADMINISTRATION Office of Small Credit Unions (OSCUI) Grant Program Access for Credit Unions AGENCY: National Credit Union Administration (NCUA). ACTION: Notice of Funding Opportunity. SUMMARY: The National Credit...
... Commodity Credit Corporation Notice of Funds Availability: Inviting Applications for the Market Access... assistance for generic or brand promotion activities. For generic activities, funding priority is given to... government agencies can participate directly in the brand program. The MAP generally operates on a...
... Commodity Credit Corporation Notice of Funds Availability: Inviting Applications for the Market Access... marketing and promotion activities. MAP participants may receive assistance for generic or brand promotion... brand program. The MAP generally operates on a reimbursement basis. III. Eligibility Information 1...
... preschool through grade 12, or a student enrolled in postsecondary education or training who has a parent or... Doc No: 2013-12491] DEPARTMENT OF EDUCATION Applications for New Awards; Child Care Access Means Parents in School Program AGENCY: Office of Postsecondary Education, Department of Education. ACTION...
... (download plus upload speeds) for both fixed and mobile broadband service and the broadband lending speed will be a minimum bandwidth of 5 megabits per second for both fixed and mobile service to the customer...; ] DEPARTMENT OF AGRICULTURE Rural Utilities Service Rural Broadband Access Loans and Loan Guarantees Program...
... Customer Information and Customer Notice AGENCY: Office of Thrift Supervision (OTS), Treasury. ACTION... of Proposal: Interagency Guidance on Response Programs for Unauthorized Access to Customer Information and Customer Notice. OMB Number: 1550-0110. Form Numbers: N/A. Regulation requirement: 12 CFR Part...
... Management Measures for the Atlantic Sea Scallop Fishery § 648.60 Sea scallop area access program....83(a)(1), and the additional restrictions for Atlantic cod, haddock, and yellowtail flounder... (d)(4). (A) Atlantic cod. Such vessel may bring onboard and possess only up to 100 lb (45.4 kg) of...
Ooms, L.; Veenhof, C.
Introduction: The Dutch government stimulates sport and physical activity opportunities in the neighborhood to make it easier for people to adopt a physically active lifestyle. Seven National Sports Federations (NSFs) were funded to develop easily accessible sporting programs, targeted at groups
Snowden, Lonnie R; McClellan, Sean R
We investigated the extent to which implementing language assistance programming through contracting with community-based organizations improved the accessibility of mental health care under Medi-Cal...
Kramer, C. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Martin, E. Fadrhonc [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Thompson, P. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Goldman, C. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)
Estimates of the total opportunity for investment in cost-effective energy efficiency in the United States are typically in the range of several hundred billion dollars (Choi Granade, et al., 2009 and Fulton & Brandenburg, 2012).1,2 To access this potential, many state policymakers and utility regulators have established aggressive energy efficiency savings targets. Current levels of taxpayer and utility bill-payer funding for energy efficiency is only a small fraction of the total investment needed to meet these targets (SEE Action Financing Solutions Working Group, 2013). Given this challenge, some energy efficiency program administrators are working to access private capital sources with the aim of amplifying the funds available for investment. In this context, efficient access to secondary market capital has been advanced as one important enabler of the energy efficiency industry “at scale.”3 The question of what role secondary markets can play in bringing energy efficiency to scale is largely untested despite extensive attention from media, technical publications, advocates, and others. Only a handful of transactions of energy efficiency loan products have been executed to date, and it is too soon to draw robust conclusions from these deals. At the same time, energy efficiency program administrators and policymakers face very real decisions regarding whether and how to access secondary markets as part of their energy efficiency deployment strategy.
... competition is an increase in employment in the video programming sector of the economy. The relationship... on Commission precedent in which the Commission has considered certain Regional Sports Networks.... Conversely, when programming is non- replicable and valuable to consumers, such as regional sports...
Full Text Available Increasing access to clinically beneficial targeted cancer medicines is a challenge in every country due to their high cost. We describe the interplay of innovative policies and programs involving multiple stakeholders to facilitate access to these medicines in Thailand, as well as the utilization of selected targeted therapies over time.We selected two medicines on the 2013 Thai national list of essential medicines (NLEM [letrozole and imatinib] and three unlisted medicines for the same indications [trastuzumab, nilotinib and dasatinib]. We created timelines of access policies and programs for these products based on scientific and grey literature. Using IMS Health sales data, we described the trajectories of sales volumes of the study medicines between January 2001 and December 2012. We compared estimated average numbers of patients treated before and after the implementation of policies and programs for each product.Different stakeholders implemented multiple interventions to increase access to the study medicines for different patient populations. During 2007-2009, the Thai Government created a special NLEM category with different coverage requirements for payers and issued compulsory licenses; payers negotiated prices with manufacturers and engaged in pooled procurement; pharmaceutical companies expanded patient assistance programs and lowered prices in different ways. Compared to before the interventions, estimated numbers of patients treated with each medicine increased significantly afterwards: for letrozole from 645 (95% CI 366-923 to 3683 (95% CI 2,748-4,618; for imatinib from 103 (95% CI 72-174 to 350 (95% CI 307-398; and for trastuzumab from 68 (95% CI 45-118 to 412 (95% CI 344-563.Government, payers, and manufacturers implemented multi-pronged approaches to facilitate access to targeted cancer therapies for the Thai population, which differed by medicine. Routine monitoring is needed to assess clinical and economic impacts of these
Padmanabhan, Poornima; Wise, Alyssa Friend
Low-cost laptop programs attempt to address gaps in access to computers in developing countries. However, the translation of computing access from intention to actuality is mediated by many situational factors. This research presents a case study of how access to a set of laptops donated to a school for socially disadvantaged children in India was…
Leynes, P Andrew; Crawford, Jarret T; Radebaugh, Anne M; Taranto, Elizabeth
Source memory for the speaker's voice (male or female) was investigated when semantic knowledge (gender stereotypes) could and could not inform the episodic source judgment while event-related potentials (ERPs) were recorded. Source accuracy was greater and response times were faster when stereotypes could predict the speaker's voice at test. Recollection supported source judgments in both conditions as indicated by significant parietal "old/new" ERP effects (500-800ms). Prototypical late ERP effects (the right frontal "old/new" effect and the late posterior negativity, LPN) were evident when source judgment was based solely on episodic memory. However, these two late ERP effects were diminished and a novel, frontal-negative ERP with left-central topography was observed when stereotypes aided source judgments. This pattern of ERP activity likely reflects activation of left frontal or left temporal lobes when semantic knowledge, in the form of a gender stereotype, is accessed to inform the episodic source judgment. Copyright © 2012 Elsevier B.V. All rights reserved.
Bassilios, Bridget; Telford, Nicolas; Rickwood, Debra; Spittal, Matthew J; Pirkis, Jane
Access to Allied Psychological Services (ATAPS) was introduced in 2001 by the Australian Government to provide evidence-based psychological interventions for people with high prevalence disorders. headspace, Australia's National Youth Mental Health Foundation, was established in 2006 to promote and facilitate improvements in the mental health, social wellbeing and economic participation of young people aged 12-25 years. Both programs provided free or low cost psychological services. This paper aims to describe the uptake of psychological services by people aged 12-25 years via ATAPS and headspace, the characteristics of these clients, the types of services received and preliminary client outcomes achieved. Data from 1 July 2009 to 30 June 2012 were sourced from the respective national web-based minimum datasets used for routine data collection in ATAPS and headspace. In total, 20,156 and 17,337 young people accessed two or more psychological services via ATAPS and headspace, respectively, in the 3-year analysis period. There were notable differences between the clients of, and the services delivered by, the programs. ATAPS clients were less likely to be male (31 vs 39%) and to reside in major cities (51 vs 62%) than headspace clients; ATAPS clients were also older (18-21 vs 15-17 years modal age group). There was some variation in the number and types of psychological sessions that young people received via the programs but the majority received at least one session of cognitive behavioural therapy. Based on limited available outcome data, both programs appear to have produced improvements in clients' mental health; specifically, psychological distress as assessed by the Kessler-10 (K-10) was reduced. ATAPS and headspace have delivered free or low-cost psychological services to 12-25 year olds with somewhat different characteristics. Both programs have had promising effects on mental health. ATAPS and headspace have operated in a complementary fashion to fill a
Vandelanotte, Corneel; Kirwan, Morwenna; Rebar, Amanda; Alley, Stephanie; Short, Camille; Fallon, Luke; Buzza, Gavin; Schoeppe, Stephanie; Maher, Carol; Duncan, Mitch J
Background It has been shown that physical activity is more likely to increase if web-based interventions apply evidence-based components (e.g. self-monitoring) and incorporate interactive social media applications (e.g. social networking), but it is unclear to what extent these are being utilized in the publicly available web-based physical activity interventions. The purpose of this study was to evaluate whether freely accessible websites delivering physical activity interventions use evide...
Army’s New Non-Citizen Recruting Program,” online http://www.scribd.com/doc/12866758/Margaret-Stock. Last accessed in February 2011. 89 Stock... Recruting Program.” Online at http://www.scribd.com/doc/12866758/Margaret-Stock. Last accessed in February 2011. United States Army, Field Manual 3-24
de Moel-Mandel, Caroline; Shelley, Julia M
In Australia, about one in four pregnancies results in an induced abortion. The termination of a pregnancy is still, however, a criminal act in most jurisdictions, and access to abortion is not without barriers. This paper analyses existing access barriers and their implications. Databases and the grey literature were searched for publications that examined any legal and/or non-legal abortion access barrier applicable to Australia (2000-2016). Only those barriers that had been demonstrated to be the most restrictive were included and categorised. From the initial 410 studies, only 20 publications were identified that matched the inclusion criteria. They indicated that access barriers do indeed exist in Australia. In many parts of Australia, abortion is only legal under strict conditions. Relatively strong evidence was found on the limited abortion access of rural women and of an imminent shortage in the provision of late abortions. For other barriers only limited research evidence existed, or merely opinions were expressed. Very few studies were undertaken to link barriers to outcomes. Although this review can form a base for the national improvement of abortion access, the gap found in Australian research demonstrates a need for additional studies.
Love, Susan M; Sanders, Matthew R; Turner, Karen M T; Maurange, Marianne; Knott, Theresa; Prinz, Ronald; Metzler, Carol; Ainsworth, Andrew T
The aim of this study was to examine the feasibility (accessibility, engagement and impact) of adding social media and gaming features (e.g., social sharing with anonymity, badges to incentivize skills practice, an accredited facilitator for support) and access via smartphones to an evidenced-based parenting program, Triple P Online. The highly vulnerable population included 155 disadvantaged, high-risk parents (e.g., 76% had a family annual income of less than $15,000; 41% had been incarcerated; 38% were in drug/alcohol treatment; and 24% had had a child removed due to maltreatment). The ethnic groups most commonly identified were African American (24%) and Hispanic (66%). Respondents were primarily mothers (86%) from five community programs in Los Angeles. The study used a single group repeated measures design (pre, post, 6-month follow-up). Data collected included standardized self-report measures, post-intervention focus groups and interviews, website usage reports, and Google Analytics. Significant multivariate ANOVA time effects were found, demonstrating reductions in child behavioral problems, reduced lax/permissive and over-reactive parenting, and decreased parental stress. No effects were found for parental confidence, attributions, or depression and anxiety (which were in the normal range at baseline). Positive effects were maintained or improved at 6-month follow-up. The participants engaged in the online community and valued its flexibility, anonymity, and shared learning. This foundational implementation trial provides support for future rigorous evaluation of social media and gaming features as a medium for increasing parental engagement in evidence-based parenting programs online--a public health approach to protect and improve the development of vulnerable children. Copyright © 2016 Elsevier Ltd. All rights reserved.
Full Text Available Introduction. In 1999-2000, a Norwegian youth cracked a DVD-access code and published a decryptation program on the Internet. He was sued by the US DVD Copy Control Association (DVD-CCA and the Norwegian Motion Picture Association (MAP, allies of the US Motion Picture Association of America (MPAA, arrested by Norwegian police and charged with data crime. Two Norwegian court rulings in 2003 unanimously ruled that the program did not amount to a breach of Norwegian law, and he was fully acquitted. In the US, there have been related cases, some with other outcomes. Method. Based on a theoretical framework developed by Zwass, the paper discusses these court rulings and the wider issues of intellectual property rights versus public access rights. Analysis. The DVD-Jon case illustrates that intellectual property rights can conflict with public access rights, as the struggle between proprietary software and public domain software, as well as the SPARC and Open Archives Initiative reflect. Results. An assessment of the DVD-Jon case based on the Zwass framework does not give a clear information ethics answer. The analysis depends on whether one ascribes to consequentialist (e.g., utilitarian or de-ontological reflection, and also on which side of the digital gap is to be accorded most weight. Conclusion. While copyright interests are being legally strengthened, there may be ethically- grounded access rights that outweigh property rights.
Jin, Hao-Qiang; Jost, Gabriele; Biegel, Bryan A. (Technical Monitor)
The purpose of this study is to evaluate the feasibility of remote memory access (RMA) programming on shared memory parallel computers. We discuss different RMA based implementations of selected CFD application benchmark kernels and compare them to corresponding message passing based codes. For the message-passing implementation we use MPI point-to-point and global communication routines. For the RMA based approach we consider two different libraries supporting this programming model. One is a shared memory parallelization library (SMPlib) developed at NASA Ames, the other is the MPI-2 extensions to the MPI Standard. We give timing comparisons for the different implementation strategies and discuss the performance.
Haacker-Santos, R.; Allen, L.; Batchelor, R. L.
As undergraduate research experiences have become an unofficial pre-requisite to enter graduate school programs in the sciences, we have to make sure that these experiences are inclusive and accessible to all students. Program managers who make a conscious effort to recruit students from traditionally under-represented groups, including veterans, non-traditional students or students with disabilities, are often unaware of the financial and program implications these students require, and discover that their current program design might inadvertently exclude or not fully support these students. The SOARS Program, an undergraduate-to-graduate bridge program in the atmospheric sciences, has supported this group of students for over 15 years. We have found that we needed to adjust some program elements and secure extra funding sources to holistically support our students in their research experience, however, the program and the students have reaped tremendous benefits. Involving non-traditional students or veterans in our program has raised the maturity level and problem solving skills of the group, and having students with disabilities participate has been a vehicle for broadening perspective and diverse knowledge into the field of study, e.g. researching weather and climate beyond what you can 'see'. This presentation will highlight some of the findings from the SOARS program experience, and will share practices for recruitment and holistic support to ensure student success. We will share resources and tips on inclusive program design, including working with students with family commitments or physical disabilities, and will report on the enormous program benefits and peer learning these students have brought to the student cohorts and research labs they are working in.
Schroeder, Krista; Ratcliffe, Sarah J; Perez, Adriana; Earley, David; Bowman, Cory; Lipman, Terri H
The purpose of this study was to evaluate Dance for Health, an intergenerational program to increase access to physical activity in an underserved, high risk urban community. Dance for Health was developed using community-based participatory research methods and evaluated using an observational study design. The program entailed two hour line dancing sessions delivered by trained dance instructors in the neighborhood recreation center. The weekly sessions were delivered for one month in the spring and one month in the fall from 2012-2016. Nurse practitioner students mentored local high school students to assess outcomes: achievement of target heart rate, Borg Rating of Perceived Exertion, number of pedometer steps during dance session, Physical Activity Enjoyment Scale, and adiposity. Analytic methods included descriptive statistics and mixed effects models. From 2012-2016, 521 participants ranging from 2-79 years attended Dance for Health. Approximately 50% of children and 80% of adults achieved target heart rate. Achievement of target heart rate was not related to perceived exertion, though it was related to pedometer steps in adults. All participants rated the program highly for enjoyment. There was no change in adiposity. Dance for Health demonstrated high levels of community engagement and enjoyment. It led to adequate levels of exertion, particularly for adults. Our evaluation can inform program refinement and future intergenerational physical activity programs. Dance is an enjoyable, culturally appropriate, low cost method for increasing access to physical activity for children and families. Copyright © 2017 Elsevier Inc. All rights reserved.
This article aims to study youth employability on the job access channel that provided their entry into the labor market. We examine the determinants of the formal and informal job access channels. For this purpose, we estimate a Multinomial Logit model of access channels controlling for selection bias. We use the youth sample of the French National Labor Force Survey (Enquête "Emploi") conducted by the INSEE. Our data provide a set of relevant variables required to identify the model which a...
Lievens, Y; De Schutter, H; Stellamans, K; Rosskamp, M; Van Eycken, L
Underutilisation of radiotherapy has been observed worldwide. To evaluate the current situation in Belgium, optimal utilisation proportions (OUPs) adopted from the European SocieTy for Radiotherapy and Oncology - Health Economics in Radiation Oncology (ESTRO-HERO) project were compared to actual utilisation proportions (AUPs) and with radiotherapy advised during the multidisciplinary cancer team (MDT) meetings. In addition, the impact of independent variables was analysed. AUPs and advised radiotherapy were calculated overall and by cancer type for 110,810 unique cancer diagnoses in 2009-2010. Radiotherapy utilisation was derived from reimbursement data and distinguished between palliative and curative intent external beam radiotherapy (EBRT) and/or brachytherapy (BT). Sensitivity analyses regarding the influence of the follow-up period, the survival length and patient's age were performed. Advised radiotherapy was calculated based on broad treatment categories as reported at MDT meetings. The overall AUP of 37% (39% including BT) was lower than the OUP of 53%, but in line with advised radiotherapy (35%). Large variations by tumour type were observed: in some tumours (e.g. lung and prostate cancer) AUP was considerably lower than OUP, whereas in others there was reasonable concordance (e.g. breast and rectal cancer). Overall, 84% of treatments started within 9 months following diagnosis. Survival time influenced AUP in a cancer type-dependent way. Elderly patients received less radiotherapy. Although the actually delivered radiotherapy in Belgium aligns well to MDT advices, it is lower than the evidence-based optimum. Further analysis of potential barriers is needed for radiotherapy forecasting and planning, and in order to promote adequate access to radiotherapy. Copyright © 2017 Elsevier Ltd. All rights reserved.
David McKenzie; Christopher Woodruff
A strong theoretical argument for focusing on access to finance is that financial market imperfections can result in large inefficiencies, as firms with productive investment opportunities underinvest...
... of Property Disposition Program multifamily housing facilities. 9.152 Section 9.152 Housing and Urban... housing facilities. (a) Substantial alteration. If the agency undertakes alterations to a PDP multifamily... in a PDP multifamily housing project shall, to the maximum extent feasible, be made to be readily...
Lynch, Sarah; Hayes, Sharon; Napolitano, Melissa; Hufnagel, Katrina
Background More than one third of college students who are overweight or obese are in need of weight loss programs tailored to college students. However, the availability and accessibility of these programs is unknown. Objective The aim of this study is to examine the availability and ease of access to weight loss programs for students at 10 universities with the largest undergraduate enrollment. Methods The 10 public universities with the largest student bodies with a mean (SD) undergraduate...
Bernstein, Adam; Chorpita, Bruce F; Daleiden, Eric L; Ebesutani, Chad K; Rosenblatt, Abram
This study empirically examined options for building an evidence-informed service array, comparing strategies to maximize the application of evidence-based treatment literature in a clinical service system. The overall goal was to determine the smallest set of treatments that could serve the largest percentage of clients. Solutions to this problem differ depending on how one defines "treatment." Treatments were conceptualized as (a) programs (integrated treatments produced by specific research laboratories or investigators), and (b) collections of their constituent common procedures, referred to as practice elements. Programs listed by 2 separate government-sanctioned registries were selected to illustrate the effects of "program" conceptualizations, and all available clinical trials testing the programs were analyzed. Practice elements were identified from these same studies and from studies of other treatments that met a standard of evidence but had not been organized into programs on these lists. Relevance mapping methodology was used to identify optimal sets of programs and practice elements. Among a large, diverse clinical population, results identified 11%-22% of youths for whom practice elements provide an evidence-informed treatment option whereas no programs meeting the standard of evidence were available on the registries. Results for the practice elements were able to be matched by a hybrid combination: "best" programs, which were then extended by practice elements. These results demonstrated that there are multiple ways to conceptualize treatments when planning a service array, and these options have significant implications regarding who can be served by treatments supported by evidence. (c) 2015 APA, all rights reserved).
Tennant, Jonathan P.; Waldner, François; Jacques, Damien C.; Masuzzo, Paola; Collister, Lauren B.; Hartgerink, C.H.J.
Ongoing debates surrounding Open Access to the scholarly literature are multifaceted and complicated by disparate and often polarised viewpoints from engaged stakeholders. At the current stage, Open Access has become such a global issue that it is critical for all involved in scholarly publishing,
Rotger, Gabriel Pons; Sick Nielsen, Thomas
This study examines the effect of accessibility to urban jobs via a public transport system on individual earnings. The effect of improved public transport based accessibility on earnings and commuting behaviour is determined by exploiting the exogenous variation in access to a public rail...... and Metro system due to the construction of a new terminal Metro station connecting southern townships to the city centre of Copenhagen. The results show that public transport based job accessibility has a positive and permanent effect on individual earnings. The increase in earnings is associated...... with a change in commuting patterns as the improved access to public transport facilitates a shift from employment within the township to better paid jobs in the city centre, as well as in other suburbs of the Copenhagen metropolitan area....
Pons Rotger, Gabriel Angel; Nielsen, Thomas Alexander Sick
This study examines the effect of accessibility to urban jobs via a public transport system on individual earnings and commuting behaviour. The effect of improved public transport based accessibility on these outcomes is determined by exploiting the exogenous variation in access to a public rail...... and Metro system resulting from the construction of a new terminal Metro station connecting southern townships to Copenhagen city centre. The results show that public transport based job accessibility has a positive and permanent effect on individual earnings. The increase in earnings is associated...... with a change in commuting patterns as the improved access to public transport facilitates a shift from employment within the township to better paid jobs in the city centre, as well as in other suburbs of the Copenhagen Metropolitan area...
Soares, Neelkamal S; Hobson, Wendy L; Ruch-Ross, Holly; Finneran, Maureen; Varrasso, Denia A; Keller, David
The CATCH (Community Access to Child Health) Program, which supports pediatricians who engage with the community to improve child health, increase access to health care, and promote advocacy through small seed grants, was last evaluated in 1998. The objective was to describe the characteristics of CATCH grant recipients and projects and assess the community impact of funded projects. Prospective data was collected from CATCH applications (grantee characteristics, topic area and target population for projects funded from 2006-2012) and post-project 2-year follow-up survey (project outcomes, sustainability, and impact for projects funded from 2008 through 2010). From 2006 through 2012, the CATCH Program awarded 401 projects to grantees working mostly in general pediatrics. Eighty-five percent of projects targeted children covered by Medicaid, 33% targeted uninsured children, and 75% involved a Latino population. Main topic areas addressed were nutrition, access to health care, and medical home. Sixty-nine percent of grantees from 2008 to 2010 responded to the follow-up survey. Ninety percent reported completing their projects, and 86% of those projects continued to exist in some form. Grantees reported the development of community partnerships (77%) and enhanced recognition of child health issues in the community (73%) as the most frequent changes due to the projects. The CATCH Program funds community-based projects led by pediatricians that address the medical home and access to care. A majority of these projects and community partnerships are sustained beyond their original CATCH funding and, in many cases, are leveraged into additional financial or other community support.
Petrakis, P. L.
TimeSet is a shareware program for accessing digital time services by telephone. At its initial release, it was capable of capturing time signals only from the U.S. Naval Observatory to set a computer's clock. Later the ability to synchronize with the National Institute of Standards and Technology was added. Now, in Version 7.10, TimeSet is able to access three additional telephone time services in Europe - in Sweden, Austria, and Italy - making a total of five official services addressable by the program. A companion program, TimeGen, allows yet another source of telephone time data strings for callers equipped with TimeSet version 7.10. TimeGen synthesizes UTC time data strings in the Naval Observatory's format from an accurately set and maintained DOS computer clock, and transmits them to callers. This allows an unlimited number of 'freelance' time generating stations to be created. Timesetting from TimeGen is made feasible by the advent of Becker's RighTime, a shareware program that learns the drift characteristics of a computer's clock and continuously applies a correction to keep it accurate, and also brings .01 second resolution to the DOS clock. With clock regulation by RighTime and periodic update calls by the TimeGen station to an official time source via TimeSet, TimeGen offers the same degree of accuracy within the resolution of the computer clock as any official atomic time source.
Tennant, Jonathan P; Waldner, François; Jacques, Damien C; Masuzzo, Paola; Collister, Lauren B; Hartgerink, Chris H J
Ongoing debates surrounding Open Access to the scholarly literature are multifaceted and complicated by disparate and often polarised viewpoints from engaged stakeholders. At the current stage, Open Access has become such a global issue that it is critical for all involved in scholarly publishing, including policymakers, publishers, research funders, governments, learned societies, librarians, and academic communities, to be well-informed on the history, benefits, and pitfalls of Open Access. In spite of this, there is a general lack of consensus regarding the potential pros and cons of Open Access at multiple levels. This review aims to be a resource for current knowledge on the impacts of Open Access by synthesizing important research in three major areas: academic, economic and societal. While there is clearly much scope for additional research, several key trends are identified, including a broad citation advantage for researchers who publish openly, as well as additional benefits to the non-academic dissemination of their work. The economic impact of Open Access is less well-understood, although it is clear that access to the research literature is key for innovative enterprises, and a range of governmental and non-governmental services. Furthermore, Open Access has the potential to save both publishers and research funders considerable amounts of financial resources, and can provide some economic benefits to traditionally subscription-based journals. The societal impact of Open Access is strong, in particular for advancing citizen science initiatives, and leveling the playing field for researchers in developing countries. Open Access supersedes all potential alternative modes of access to the scholarly literature through enabling unrestricted re-use, and long-term stability independent of financial constraints of traditional publishers that impede knowledge sharing. However, Open Access has the potential to become unsustainable for research communities if
Tennant, Jonathan P.; Waldner, François; Jacques, Damien C.; Masuzzo, Paola; Collister, Lauren B.; Hartgerink, Chris. H. J.
Ongoing debates surrounding Open Access to the scholarly literature are multifaceted and complicated by disparate and often polarised viewpoints from engaged stakeholders. At the current stage, Open Access has become such a global issue that it is critical for all involved in scholarly publishing, including policymakers, publishers, research funders, governments, learned societies, librarians, and academic communities, to be well-informed on the history, benefits, and pitfalls of Open Access. In spite of this, there is a general lack of consensus regarding the potential pros and cons of Open Access at multiple levels. This review aims to be a resource for current knowledge on the impacts of Open Access by synthesizing important research in three major areas: academic, economic and societal. While there is clearly much scope for additional research, several key trends are identified, including a broad citation advantage for researchers who publish openly, as well as additional benefits to the non-academic dissemination of their work. The economic impact of Open Access is less well-understood, although it is clear that access to the research literature is key for innovative enterprises, and a range of governmental and non-governmental services. Furthermore, Open Access has the potential to save both publishers and research funders considerable amounts of financial resources, and can provide some economic benefits to traditionally subscription-based journals. The societal impact of Open Access is strong, in particular for advancing citizen science initiatives, and leveling the playing field for researchers in developing countries. Open Access supersedes all potential alternative modes of access to the scholarly literature through enabling unrestricted re-use, and long-term stability independent of financial constraints of traditional publishers that impede knowledge sharing. However, Open Access has the potential to become unsustainable for research communities if
Emily Saurman; David Lyle; Sue Kirby; Russell Roberts
The Mental Health Emergency Care-Rural Access Program (MHEC-RAP) is a telehealth solution providing specialist emergency mental health care to rural and remote communities across western NSW, Australia. This is the first time and motion (T&M) study to examine program efficiency and capacity for a telepsychiatry program. Clinical services are an integral aspect of the program accounting for 6% of all activities and 50% of the time spent conducting program activities, but half of this time ...
Vincenzo Atella; Mariacristina Rossi
The paper develops a simple two-period model relating child labor, child school attendance and child health care access in LDCs showing that child labor is positively correlated to access to health care services. In fact, higher medical expenditure generates better health and, therefore, higher child productivity. Accumulation of human capital, which generates higher future utility, comes at the expense of current productivity and consumption. The optimal choice of child labor is such that th...
Rowland, Sandi; Leider, Jonathon P; Davidson, Clare; Brady, Joanne; Knudson, Alana
To characterize the expansion of a community dental access program (CDP) in rural Maryland providing urgent dental care to low-income individuals, as well as the CDP's impact on dental-related visits to a regional emergency department (ED). We used de-identified CDP and ED claims data to construct a data set of weekly counts of CDP visits and dental-related ED visits among Maryland adults. A time series model examined the association over time between visits to the CDP and ED visits for fiscal years (FYs) 2011 through 2015. The CDP served approximately 1600 unique clients across 2700 visits during FYs 2011 through 2015. The model suggested that if the CDP had not provided services during that time period, about 670 more dental-related visits to the ED would have occurred, resulting in $215 000 more in charges. Effective ED dental diversion programs can result in substantial cost savings to taxpayers, and more appropriate and cost-effective care for the patient. Community dental access programs may be a viable way to patch the dental safety net in rural communities while holistic solutions are developed.
Margherio, Cara; Horner-Devine, M. Claire; Mizumori, Sheri J. Y.; Yen, Joyce W.
BRAINS: Broadening the Representation of Academic Investigators in NeuroScience is a National Institutes of Health–funded, national program that addresses challenges to the persistence of diverse early-career neuroscientists. In doing so, BRAINS aims to advance diversity in neuroscience by increasing career advancement and retention of post-PhD, early-career neuroscientists from underrepresented groups (URGs). The comprehensive professional development program is structured to catalyze conversations specific to URGs in neuroscience and explicitly addresses factors known to impact persistence such as a weak sense of belonging to the scientific community, isolation and solo status, inequitable access to resources that impact career success, and marginalization from informal networks and mentoring relationships. While we do not yet have data on the long-term impact of the BRAINS program on participants’ career trajectory and persistence, we introduce the BRAINS program theory and report early quantitative and qualitative data on shorter-term individual impacts within the realms of career-advancing behaviors and career experiences. These early results suggest promising, positive career productivity, increased self-efficacy, stronger sense of belonging, and new perspectives on navigating careers for BRAINS participants. We finish by discussing recommendations for future professional development programs and research designed to broaden participation in the biomedical and life sciences. PMID:27587858
Muldoon, Katherine A; Muzaaya, Godfrey; Betancourt, Theresa S; Ajok, Mirriam; Akello, Monica; Petruf, Zaira; Nguyen, Paul; Baines, Erin K; Shannon, Kate
.... Among a group of young female abductees in northern Uganda, this study examined access to post-abduction reintegration programming and tested for between group differences in mental health status...
Nikitin, Sergey; Zaitseva, Natalia; Demina, Olga; Solovieva, Vera; Mazin, Evgeny; Mikhalev, Sergey; Smolov, Maxim; Rubinov, Anatoly; Vlasov, Peter; Lepikhin, Dmitry; Khachko, Denis; Fokin, Valery; Queen, Cary; Zosimov, Viktor
We have constructed a very large virtual diversity space containing more than 1013 chemical compounds. The diversity space is built from about 400 combinatorial libraries, which have been expanded by choosing sizeable collections of suitable R-groups that can be attached to each link point of their scaffolds. These R-group collections have been created by selecting reagents that have drug-like properties from catalogs of available chemicals. As members of known combinatorial libraries, the compounds in the diversity space are in general synthetically accessible and useful as potential drug leads. Hence, the diversity space can be used as a vast source of compounds by a de novo drug design program. For example, we have used such a program to generate inhibitors of HIV integrase enzyme that exhibited activity in the micromolar range.
Craig Rushing, Stephanie; Jessen, Cornelia; Gorman, Gwenda; Torres, Jennifer; Lambert, William E; Prokhorov, Alexander V; Miller, Leslie; Allums-Featherston, Kelly; Addy, Robert C; Peskin, Melissa F; Shegog, Ross
Background American Indian and Alaska Native (AI/AN) youth face multiple health challenges compared to other racial/ethnic groups, which could potentially be ameliorated by the dissemination of evidence-based adolescent health promotion programs. Previous studies have indicated that limited trained personnel, cultural barriers, and geographic isolation may hinder the reach and implementation of evidence-based health promotion programs among AI/AN youth. Although Internet access is variable in AI/AN communities across the United States, it is swiftly and steadily improving, and it may provide a viable strategy to disseminate evidence-based health promotion programs to this underserved population. Objective We explored the potential of using the Internet to disseminate evidence-based health promotion programs on multiple health topics to AI/AN youth living in diverse communities across 3 geographically dispersed regions of the United States. Specifically, we assessed the Internet’s potential to increase the reach and implementation of evidence-based health promotion programs for AI/AN youth, and to engage AI/AN youth. Methods This randomized controlled trial was conducted in 25 participating sites in Alaska, Arizona, and the Pacific Northwest. Predominantly AI/AN youth, aged 12-14 years, accessed 6 evidence-based health promotion programs delivered via the Internet, which focused on sexual health, hearing loss, alcohol use, tobacco use, drug use, and nutrition and physical activity. Adult site coordinators completed computer-based education inventory surveys, connectivity and bandwidth testing to assess parameters related to program reach (computer access, connectivity, and bandwidth), and implementation logs to assess barriers to implementation (program errors and delivery issues). We assessed youths’ perceptions of program engagement via ratings on ease of use, understandability, credibility, likeability, perceived impact, and motivational appeal, using
Markham, Christine M; Craig Rushing, Stephanie; Jessen, Cornelia; Gorman, Gwenda; Torres, Jennifer; Lambert, William E; Prokhorov, Alexander V; Miller, Leslie; Allums-Featherston, Kelly; Addy, Robert C; Peskin, Melissa F; Shegog, Ross
American Indian and Alaska Native (AI/AN) youth face multiple health challenges compared to other racial/ethnic groups, which could potentially be ameliorated by the dissemination of evidence-based adolescent health promotion programs. Previous studies have indicated that limited trained personnel, cultural barriers, and geographic isolation may hinder the reach and implementation of evidence-based health promotion programs among AI/AN youth. Although Internet access is variable in AI/AN communities across the United States, it is swiftly and steadily improving, and it may provide a viable strategy to disseminate evidence-based health promotion programs to this underserved population. We explored the potential of using the Internet to disseminate evidence-based health promotion programs on multiple health topics to AI/AN youth living in diverse communities across 3 geographically dispersed regions of the United States. Specifically, we assessed the Internet's potential to increase the reach and implementation of evidence-based health promotion programs for AI/AN youth, and to engage AI/AN youth. This randomized controlled trial was conducted in 25 participating sites in Alaska, Arizona, and the Pacific Northwest. Predominantly AI/AN youth, aged 12-14 years, accessed 6 evidence-based health promotion programs delivered via the Internet, which focused on sexual health, hearing loss, alcohol use, tobacco use, drug use, and nutrition and physical activity. Adult site coordinators completed computer-based education inventory surveys, connectivity and bandwidth testing to assess parameters related to program reach (computer access, connectivity, and bandwidth), and implementation logs to assess barriers to implementation (program errors and delivery issues). We assessed youths' perceptions of program engagement via ratings on ease of use, understandability, credibility, likeability, perceived impact, and motivational appeal, using previously established measures. Sites
Perea, Manuel; Jiménez, María; Gomez, Pablo
Although there is consensus that adult readers have fast access to abstract letter/word representations, the developmental trajectory of such access has not been mapped out yet. To examine whether developmental readers have rapid access to abstract representations during the early stages of word processing, we conducted a masked priming lexical decision experiment with two groups of young readers (third and fifth graders) and a group of young adults. We selected two types of words: (a) words composed of cross-case letters that are visually dissimilar (DIS words; e.g., arte/ARTE [Spanish for art]) and (b) words composed of cross-case letters that are visually similar (SIM words; e.g., vivo/VIVO [Spanish for alive]). For young adults and fifth graders, response times for DIS and SIM words were very similar in the matched- and mismatched-case identity priming conditions, which in turn produced shorter responses than the unrelated condition (i.e., ARTE-ARTE=arte-ARTEARTE). This is consistent with the idea that there is fast access to abstract representations. In contrast, this process does not seem to be fully operative in third graders, as revealed by the pattern of data with DIS words (ARTE-ARTEarte-ARTE=edad-ARTE). These findings have relevant implications for developmental models of visual word recognition and for the use of masked priming experiments with developmental readers. Copyright © 2014 Elsevier Inc. All rights reserved.
Guardiola, Jorge; Gonzalez-Gomez, Francisco; Grajales, Angel Lendechy
The literature on happiness or subjective well-being has explored the determinants of happiness without taking into consideration the role that water plays. In this paper we attempt to draw attention to water in subjective well-being studies. Approximately one hundred million people do not have access to water. A lack of clean water causes…
Hoffimann, Elaine; Barros, Henrique; Ribeiro, Ana Isabel
Background: The provision of green spaces is an important health promotion strategy to encourage physical activity and to improve population health. Green space provision has to be based on the principle of equity. This study investigated the presence of socioeconomic inequalities in geographic accessibility and quality of green spaces across Porto neighbourhoods (Portugal). Methods: Accessibility was evaluated using a Geographic Information System and all the green spaces were audited using the Public Open Space Tool. Kendall's tau-b correlation coefficients and ordinal regression were used to test whether socioeconomic differences in green space quality and accessibility were statistically significant. Results: Although the majority of the neighbourhoods had an accessible green space, mean distance to green space increased with neighbourhood deprivation. Additionally, green spaces in the more deprived neighbourhoods presented significantly more safety concerns, signs of damage, lack of equipment to engage in active leisure activities, and had significantly less amenities such as seating, toilets, cafés, etc. Conclusions: Residents from low socioeconomic positions seem to suffer from a double jeopardy; they lack both individual and community resources. Our results have important planning implications and might contribute to understanding why deprived communities have lower physical activity levels and poorer health.
Serna, Gabriel R.; Woulfe, Rebecca
Social reproduction theory identifies schooling as a primary means for the perpetuation of the dominant class's ideologies, values, and power. The ability to access college is so closely tied to these constructs that it contributes to this dominance and marginalization. Social stratification is not only mirrored in higher education, but the…
Wang, Hua; Norton, Edward C; Rozier, R Gary
To provide national estimates of implementation effects of the State Children's Health Insurance Program (SCHIP) on dental care access and use for low-income children. The 1997-2002 National Health Interview Survey. The study design is based on variation in the timing of SCHIP implementation across states and among children observed before and after implementation. Two analyses were conducted. The first estimated the total effect of SCHIP implementation on unmet need for dental care due to cost in the past year and dental services use for low-income children (family income below state SCHIP eligibility thresholds) using county and time fixed effects models. The second analysis estimated differences in dental care access and use among low-income children with SCHIP or Medicaid coverage and their uninsured counterparts, using instrumental variables methods to control for selection bias. Both analyses controlled for child and family characteristics. When SCHIP had been implemented for more than 1 year, the probability of unmet dental care needs for low-income children was lowered by 4 percentage points. Compared with their uninsured counterparts, those who had SCHIP or Medicaid coverage were less likely to report unmet dental need by 8 percentage points (standard error: 2.3), and more likely to have visited a dentist within 6 or 12 months by 17 (standard error: 3.7) and 23 (standard error: 3.6) percentage points, respectively. SCHIP program type had no differential effects. Consistent results from two analytical approaches provide evidence that SCHIP implementation significantly reduced financial barriers for dental care for low-income children in the U.S. Low-income children enrolled in SCHIP or Medicaid had substantially increased use of dental care than the uninsured.
Alexandros V. Gerbessiotis
Full Text Available In this work we make a strong case for remote memory access (RMA as the effective way to program a parallel computer by proposing a framework that supports RMA in a library independent, simple and intuitive way. If one uses our approach the parallel code one writes will run transparently under MPI-2 enabled libraries but also bulk-synchronous parallel libraries. The advantage of using RMA is code simplicity, reduced programming complexity, and increased efficiency. We support the latter claims by implementing under this framework a collection of benchmark programs consisting of a communication and synchronization performance assessment program, a dense matrix multiplication algorithm, and two variants of a parallel radix-sort algorithm and examine their performance on a LINUX-based PC cluster under three different RMA enabled libraries: LAM MPI, BSPlib, and PUB. We conclude that implementations of such parallel algorithms using RMA communication primitives lead to code that is as efficient as the message-passing equivalent code and in the case of radix-sort substantially more efficient. In addition our work can be used as a comparative study of the relevant capabilities of the three libraries.
Souto-Otero, Manuel; Huisman, Jeroen; Beerkens, Maarja; de Wit, Hans; Vujic, Suncica
In this article, we look at the barriers to international student mobility, with particular reference to the European Erasmus program. Much is known about factors that support or limit student mobility, but very few studies have made comparisons between participants and nonparticipants. Making use of a large data set on Erasmus and non-Erasmus…
Muhoro, Peter N.
The history of development shows convincingly that no country has substantially reduced poverty without massively increasing the use of electricity. The development of micro-enterprises in rural areas of Uganda is linked with increased access and use of electricity services. In this study, I combine quantitative and qualitative methods, including informal surveys, intra-business energy allocation studies and historical analysis, to analyze off-grid electricity access among micro-enterprises in rural western Uganda. I explore the linkages between of grid electricity access and the influence it has on micro- enterprises. Data is obtained from 56 micro-enterprises located in 11 village-towns within 3 districts in Uganda. In studying the micro-enterprises. the focus is on the services that are provided by electricity from modern energy carriers. The type of equipment used, forms of transportation, technical support, level of understanding and education of the entrepreneur, financing for energy equipment, and the role of donors are discussed in this thesis. Qualitative methods are used to allow for new insights and prioritization of concepts to emerge from the field rattier than from theory. Micro-enterprises in rural Uganda create income for the poor; they are resources for poverty reduction. With price adjustments, it becomes possible for those who live below the poverty line, nominally less than $1 a day, to afford the products and services and therefore mitigating the vicious cycle of poverty. Energy consumption among the micro-enterprises is at an average of 0.13kWh/day. The cost of accessing this amount of electricity attributes to about 50% of total revenue. I find that the "practices" used in off-grid electricity access lead to situations where the entrepreneurs have to evaluate pricing and output of products and services to generate higher profits. Such numbers indicate the need for appropriate technologies and profitable policies to be implemented. The data
Leadbeater, Bonnie J; Gladstone, Emilie J; Sukhawathanakul, Paweena
Substantial research illuminates many factors effecting the implementation of evidence-based mental health promotion programs in schools; however, research on how schools plan for sustaining their investments in these programs is limited. In this qualitative study, we elicited descriptions of opportunities and challenges for sustainability. We interviewed 24 individuals from schools involved in a longitudinal, qualitative research project that followed uptake and implementation of the evidence-based WITS Programs across 2 years (Leadbeater et al. 2012). WITS stands for Walk away, Ignore, Talk it out and Seek help and the online WITS Programs focus on preventing peer victimization ( www.witsprograms.ca ). Our findings suggest that sustainability planning in schools is not merely a next step following high quality implementation, but rather involves multiple ongoing processes that need to be anticipated and supported by school leadership and program champions and developers in order to realize investments in evidence-based programs.
Myra, D.; Ready, C.
The Yakima Tributary Access and Habitat Program (YTAHP) was organized to restore salmonid passage to Yakima tributaries that historically supported salmonids and to improve habitat in areas where access is restored. This program intends to (a) screen unscreened diversion structures to prevent fish entrainment into artificial waterways; (b) provide for fish passage at man-made barriers, such as diversion dams, culverts, siphons and bridges; and (c) provide information and assistance to landowners interested in to contributing to the improvement of water quality, water reliability and stream habitat. The YTAHP developed from a number of groups actively engaged in watershed management, and/or habitat restoration within the Yakima River Basin. These groups include the Washington State Fish and Wildlife (WDFW), Kittitas County Conservation District (KCCD), North Yakima Conservation District (NYCD), Kittitas County Water Purveyors (KCWP), and Ahtanum Irrigation District (AID). The US Bureau of Reclamation (Reclamation) and Yakama Nation (YN) both participated in the development of the objectives of YTAHP. Other entities that will be involved during permitting or project review may include the YN, the federal Natural Resources Conservation Service (NRCS), the US Fish and Wildlife Service (USFWS), the National Marine Fisheries Service (NMFS), and US Army Corps of Engineers (COE). The objectives of YTAHP are listed below and also include subtasks detailed in the report: (1) Conduct Early Action Projects; (2) Review Strategic Plan; (3) Restore Access, including stream inventory, prioritization, implementation; and (4) Provide opportunities to improve habitat and conserve resources. The BPA YTAHP funding supported activities of the program which are described in this report. These activities are primarily related to objective 1 (conduct early action projects) and parts of objectives 2-4. The work supported by YTAHP funding will support a series of scheduled projects and be
Waterlander, Wilma; Whittaker, Robyn; McRobbie, Hayden; Dorey, Enid; Ball, Kylie; Maddison, Ralph; Myers Smith, Katie; Crawford, David; Jiang, Yannan; Gu, Yulong; Michie, Jo; Ni Mhurchu, Cliona
There is a critical need for weight management programs that are effective, cost efficient, accessible, and acceptable to adults from diverse ethnic and socioeconomic backgrounds. mHealth (delivered via mobile phone and Internet) weight management programs have potential to address this need. To maximize the success and cost-effectiveness of such an mHealth approach it is vital to develop program content based on effective behavior change techniques, proven weight management programs, and closely aligned with participants' needs. This study aims to develop an evidence-based mHealth weight management program (Horizon) using formative research and a structured content development process. The Horizon mHealth weight management program involved the modification of the group-based UK Weight Action Program (WAP) for delivery via short message service (SMS) and the Internet. We used an iterative development process with mixed methods entailing two phases: (1) expert input on evidence of effective programs and behavior change theory; and (2) target population input via focus group (n=20 participants), one-on-one phone interviews (n=5), and a quantitative online survey (n=120). Expert review determined that core components of a successful program should include: (1) self-monitoring of behavior; (2) prompting intention formation; (3) promoting specific goal setting; (4) providing feedback on performance; and (5) promoting review of behavioral goals. Subsequent target group input confirmed that participants liked the concept of an mHealth weight management program and expressed preferences for the program to be personalized, with immediate (prompt) and informative text messages, practical and localized physical activity and dietary information, culturally appropriate language and messages, offer social support (group activities or blogs) and weight tracking functions. Most target users expressed a preference for at least one text message per day. We present the prototype m
Full Text Available Jennifer Manlove, Heather Fish, Kristin Anderson Moore Child Trends, Bethesda, MD, USA Background: US adolescents have high rates of teen pregnancy, childbearing, and sexually transmitted infections (STIs, highlighting the need to identify and implement effective programs that will help improve teen sexual and reproductive health. Materials and methods: This review identified 103 random-assignment evaluations of 85 programs that incorporated intent-to-treat analyses and assessed impacts on pregnancy, childbearing, STIs, and their key determinants – sexual activity, number of sexual partners, condom use, and other contraceptive use – among teens. This review describes the evidence base for five broad program approaches, including abstinence education, comprehensive sex education, clinic-based programs, youth development programs, and parent–youth relationship programs. We also describe programs with impacts on key outcomes, including pregnancy/childbearing, STIs, and those that found impacts on both sexual activity and contraceptive use. Results: Our review identified 52 effective programs: 38 with consistent impacts on reproductive health outcomes, and 14 with mixed findings (across subpopulations, follow-ups, or multiple measures of a single outcome. We found that a variety of program approaches produced impacts on sexual and reproductive health outcomes. Parent–youth relationship programs and clinic-based program evaluations more frequently showed impacts than other program approaches, although we also identified a number of abstinence-education, comprehensive sex education, and youth-development programs with impacts on sexual and reproductive health outcomes. Overall, we identified nine program evaluations with impacts on teen pregnancies or births, five with impacts on reducing STIs, and 15 with impacts on both delaying/reducing sexual activity and increasing contraceptive use (including condom use. Conclusion: Future efforts should
Al-Zanoon, Noor; Dambacher, Michael; Kuperman, Victor
Recent corpus studies of eye-movements in reading revealed a substantial increase in saccade amplitudes and fixation durations as the eyes move over the first words of a sentence. This start-up effect suggests a global oculomotor program, which operates on the level of an entire line, in addition to the well-established local programs operating within the visual span. The present study investigates the nature of this global program experimentally and examines whether the start-up effect is predicated on generic visual or specific linguistic characteristics and whether it is mainly reflected in saccade amplitudes, fixation durations or both measures. Eye movements were recorded while 38 participants read (a) normal sentences, (b) sequences of randomly shuffled words and (c) sequences of z-strings. The stimuli were, therefore, similar in their visual features, but varied in the amount of syntactic and lexical information. Further, the stimuli were composed of words or strings that either varied naturally in length (Nonequal condition) or were all restricted to a specific length within a sentence (Equal). The latter condition constrained the variability of saccades and served to dissociate effects of word position in line on saccade amplitudes and fixation durations. A robust start-up effect emerged in saccade amplitudes in all Nonequal stimuli, and-in an attenuated form-in Equal sentences. A start-up effect in single fixation durations was observed in Nonequal and Equal normal sentences, but not in z-strings. These findings support the notion of a global oculomotor program in reading particularly for the spatial characteristics of motor planning, which rely on visual rather than linguistic information.
Acevedo-Gil, Nancy; Zerquera, Desiree D.
This chapter examines community college first-year experience programs using critical race theory and ecological theory. The study draws on diverse students' experiences with access, support, and long-term success within community colleges to assess how these programs foster student success, as told through the voices of student participants.
... Service 7 CFR Part 205 National Organic Program; Notice on the Ruminant Slaughter Stock Provision of the... National Organic Program (NOP) to amend the provision on ruminant slaughter stock under the NOP regulations... ruminant slaughter stock requirements as codified by the final rule on access to pasture published on...
Kraemer, Klaus; de Pee, Saskia; Badham, Jane
The workshop involved key researchers from academic and development organizations reviewing what we have learned about multiple micronutrients and applying that knowledge to providing guidance to public health policy and program design. The participants highlighted the importance of evidence-based interventions, not to restrict evidence slanted toward one single origin but to appreciate the totality of evidence from history, epidemiology, basic science, randomized-controlled studies, and meta-analyses to inform policy and guideline development for the implementation of effective programs. It has to be understood and accepted that although the need for an evidence-based approach to nutritional recommendations is fundamental and cannot be disputed, there are distinct differences between evidence-based medicine and evidence-based nutrition practice. The level of confidence and certainty needed to launch programs to reduce micronutrient deficiencies can be different from what is required to treat a disease. An effective approach would be to ensure that both research and programs at scale are running in parallel and that both receive adequate attention and funding to fine tune the program or stop it when it is no longer required. There was much valuable discussion on the topic of what types of research methodologies are suitable for what type of intervention and, importantly, what is required before public health policy can be set. This paper is an introduction to a series of articles in this supplement that discuss the evidence on multiple micronutrients and what is required to establish policies and launch effective multiple micronutrient programs.
Saha, Somen; Annear, Peter Leslie
It is a challenge for the poor to overcome the barriers to accessing health services. Membership-based microfinance with associated health programmes can improve health outcomes for the poor. This study reviewed the evidence published between 1993 and 2013 on the role of membership-based microfinance with associated health programmes in improving health outcomes for the poor in South Asia. A total of 661 papers were identified and 26 selected for inclusion, based on the relevance and rigour of the research methods. Of these 26, five were evidence reviews. Of the remaining 21 papers, 12 were from India, seven from Bangladesh, and one each from Sri Lanka and Indonesia. Three papers addressed more than one theme. Five key themes emerged from the review: (i) the impact of microfinance programmes on the social and economic situation of the poor; (ii) the impact of microfinance programmes on community health; (iii) the impact of integrated microfinance health programmes on raising client awareness; (iv) the impact of integrated microfinance health programmes on financing health care; and (v) the impact of integrated microfinance health programmes on affordable health-care products and services. The review provides new evidence on the pathways through which microfinance helps to improve population health and value for money for such programmes. Among countries with large populations in the informal sector, there is a strong case for policy-makers to support these groups in providing access to life-saving health care among the poor.
Auert, Elle-Jane; Trembath, David; Arciuli, Joanne; Thomas, Donna
The aim of this study was to explore the expectations, awareness, and experiences of parents in their efforts to access evidence-based speech-language pathology (SLP) services for their children with autism spectrum disorders (ASD). Four focus groups were conducted with 20 parents of pre school aged children with ASD and transcripts were analysed using thematic analysis. Two themes emerged to account for the participants' expectations, awareness, and experiences. The two themes, "Speech-language pathology: More than just a business", and "Parents and power", represented the complex interaction between factors including the parents' access to information, their involvement in the therapy process, and their sense of empowerment. The parents in this study expressed a strong desire for evidence-based practice (EBP) to be employed. However, the parents had different views on how EBP should be achieved. The findings of this study demonstrate the importance of involving parents in therapeutic relationships as partners in the decision-making process. This means providing parents with comprehensive information, including research evidence to support the clinical decisions that need to be made, and respecting parents' preferences in the therapy process.
Hickman, Louise D; DiGiacomo, Michelle; Phillips, Jane; Rao, Angela; Newton, Phillip J; Jackson, Debra; Ferguson, Caleb
The nursing profession has a significant evidence to practice gap in an increasingly complex and dynamic health care environment. To evaluate effectiveness of teaching and learning strategies related to a capstone project within a Masters of Nursing program that encourage the development of evidence based practice capabilities. Systematic review that conforms to the PRISMA statement. Master's Nursing programs that include elements of a capstone project within a university setting. MEDLINE, CINAHL, Cochrane Database of Systematic Reviews, ERIC and PsycInfo were used to search for RCT's or quasi experimental studies conducted between 1979 and 9 June 2017, published in a peer reviewed journal in English. Of 1592 studies, no RCT's specifically addressed the development of evidence based practice capabilities within the university teaching environment. Five quasi-experimental studies integrated blended learning, guided design processes, small group work, role play and structured debate into Masters of Nursing research courses. All five studies demonstrated some improvements in evidence based practice skills and/or research knowledge translation, with three out of five studies demonstrating significant improvements. There is a paucity of empirical evidence supporting the best strategies to use in developing evidence based practice skills and/or research knowledge translation skills for Master's Nursing students. As a profession, nursing requires methodologically robust studies that are discipline specific to identify the best approaches for developing evidence-based practice skills and/or research knowledge translation skills within the university teaching environment. Provision of these strategies will enable the nursing profession to integrate the best empirical evidence into nursing practice. Copyright © 2018. Published by Elsevier Ltd.
Palmer, Emma; Hart, Steve; Freeman, Patricia R
To describe the development and delivery of a comprehensive training program for Kentucky pharmacists to enable dispensation of naloxone per protocol. In May 2015, the Kentucky Board of Pharmacy (KBP) promulgated regulations outlining the requirements for pharmacists to initiate the dispensing of naloxone under a physician-approved protocol. The Advancing Pharmacy Practice in Kentucky Coalition, a partnership between Kentucky's Colleges of Pharmacy, KBP, and state and local pharmacists associations, developed and offered educational programming to fulfill this regulation. Pharmacists who completed the 90-minute program could apply to KBP for registration as a naloxone-certified pharmacist. The program consists of a 90-minute session covering naloxone access, opioid overdoses, the pharmacology and use of naloxone, protocol development, patient identification, and resources. Sessions were offered live and via webinar. Sessions have also been incorporated into the pharmacy curriculum at the 2 colleges of pharmacy in Kentucky. Between June 28, 2015, and June 1, 2016, a total of 1254 pharmacists and 348 student pharmacists completed training. Of those, 646 (52%) have applied to KBP and received naloxone-certified status. The program was well received, with 87% of learners ranking the usefulness of the information presented as excellent. Learners cited screening tips, protocol information, patient screening information, and education resources as information they will implement in their practice. The swift deployment of training to a wide variety of pharmacy professionals has resulted in a substantial number of naloxone-certified pharmacists across Kentucky. Through a coordinated training initiative involving all major pharmacy stakeholders, we reached many individuals rapidly, documenting the value of this approach for future training endeavors. This educational initiative may enhance pharmacy practice across Kentucky and the nation by expanding and educating on the
Margherio, Cara; Horner-Devine, M Claire; Mizumori, Sheri J Y; Yen, Joyce W
Broadening the Representation of Academic Investigators in NeuroScience is a National Institutes of Health-funded, national program that addresses challenges to the persistence of diverse early-career neuroscientists. In doing so, BRAINS aims to advance diversity in neuroscience by increasing career advancement and retention of post-PhD, early-career neuroscientists from underrepresented groups (URGs). The comprehensive professional development program is structured to catalyze conversations specific to URGs in neuroscience and explicitly addresses factors known to impact persistence such as a weak sense of belonging to the scientific community, isolation and solo status, inequitable access to resources that impact career success, and marginalization from informal networks and mentoring relationships. While we do not yet have data on the long-term impact of the BRAINS program on participants' career trajectory and persistence, we introduce the BRAINS program theory and report early quantitative and qualitative data on shorter-term individual impacts within the realms of career-advancing behaviors and career experiences. These early results suggest promising, positive career productivity, increased self-efficacy, stronger sense of belonging, and new perspectives on navigating careers for BRAINS participants. We finish by discussing recommendations for future professional development programs and research designed to broaden participation in the biomedical and life sciences. © 2016 C. Margherio et al. CBE—Life Sciences Education © 2016 The American Society for Cell Biology. This article is distributed by The American Society for Cell Biology under license from the author(s). It is available to the public under an Attribution–Noncommercial–Share Alike 3.0 Unported Creative Commons License (http://creativecommons.org/licenses/by-nc-sa/3.0).
Gupta, Nabanita Datta; Nilsson, Anton; Kedir, Abdu
injuries and increasing the probability of obtaining a high-school degree. We find, however, no effects of the second reform and little impact of any of the reforms on mortality. Effects of spirits (reform 3) are driven by males, and there is no consistent evidence on differential impacts by socioeconomic......-term outcomes, we bring comprehensive evidence on the health and education effects of three reforms, which affected alcohol availability along different dimensions and margins – 1) establishing an off-premise alcohol purchase age of 15 (1998), 2) raising the off-premise alcohol purchase age to 16 (2004), and 3...
This paper analyzes the impact of two anti-crime programs implemented in Chile in the late 1990s. The first (Quadrant Plan) is related to enhancing the quality of police work and the second one (Secure County Plan) to the involvement of the community in designing specific projects aimed at reducing the crime rate. It is found that only the Quadrant Plan has been successful in terms of reducing crime rates and has caused its impact through the effect of arrests in deterring crime. The Secure C...
Robson, James Paul
The number of clients with end-stage renal disease and acute kidney injury requiring kidney replacement therapy is at an all-time high. At the end of 2010, the number of persons in the United States with end-stage renal disease totaled 594,374. Because the majority of clients select hemodialysis, understanding best-practice techniques to prevent infection is paramount. The purpose of this article is to review best-practice recommendations for care of the 3 major vascular access devices used for hemodialysis, with a particular focus on infection prevention recommendations. Implications for infusion nurses are also discussed.
Kim, Kirang; Hong, Seo Ah; Yun, Sung Ha; Ryou, Hyun Joo; Lee, Sang Sun; Kim, Mi Kyung
The objective of this study was to evaluate the effect of a healthy school tuck shop program, developed as a way of creating a healthy and nutritional school environment, on students' access to healthy foods. Five middle schools and four high schools (775 students) participated in the healthy school tuck shop program, and nine schools (1,282 students) were selected as the control group. The intervention program included restriction of unhealthy foods sold in tuck shops, provision of various f...
Myung, Jong-yoon; Blumstein, Sheila E; Yee, Eiling; Sedivy, Julie C; Thompson-Schill, Sharon L; Buxbaum, Laurel J
Apraxic patients are known for deficits in producing and comprehending skilled movements. Two experiments tested their implicit and explicit knowledge about manipulable objects in order to examine whether such deficits accompany impairment in the conceptual representation of manipulation features. An eyetracking method was used to test implicit knowledge (Experiment 1): participants viewed a visual display on a computer screen and touched the corresponding object in response to an auditory input. Manipulation relationship among objects was not task-relevant, and thus the assessment of manipulation knowledge was implicit. Like the non-apraxic control patients, apraxic patients fixated on an object picture (e.g., "typewriter") that was manipulation-related to a target word (e.g., 'piano') significantly more often than an unrelated object picture (e.g., "bucket") as well as a visual control (e.g., "couch"). However, this effect emerged later than in the non-apraxic control group, suggesting impaired access to manipulation features in the apraxic group. In the semantic judgment task (Experiment 2), participants were asked to make an explicit judgment about the relationship of picture triplets of manipulable objects by choosing the pair with similar manipulation features. Apraxic patients performed significantly worse on this task than the non-apraxic control group. Both implicit and explicit measures of manipulation knowledge show that apraxia is not merely a perceptuomotor deficit of skilled movements, but results in a concomitant impairment in representing manipulation features and accessing them for cognitive processing. Copyright 2009 Elsevier Inc. All rights reserved.
Nadash, Pamela; Miller, Edward Alan; Porell, Frank W; Birchander, Ellen; Glickman, Lillian; Burr, Jeffrey A
This article describes the online Management of Aging Services Masters Program at the University of Massachusetts Boston and reports on a recent Program review. The Program has experienced rapid growth, evolving from seven matriculating students in 2003 to 108 in 2012. It has graduated 125 students and boasts a 78% completion rate. The authors describe the Program and report on faculty and student perceptions of performance. The Program demonstrates sound pedagogical practice for online education, incorporating techniques to foster community and encourage students and faculty interaction. Distance learning holds considerable promise for expanding access to gerontological education to reach future aging services professionals.
Full Text Available Appropriate wireless access point deployment (APD is essential for ensuring seamless user communication. Optimal APD enables good telecommunication quality, balanced capacity loading, and optimal deployment costs. APD is a typical NP-complex problem because improving wireless networking infrastructure has multiple objectives (MOs. This paper proposes a method that integrates a goal-programming-driven model (PM and a genetic algorithm (GA to resolve the MO-APD problem. The PM identifies the target deployment subject of four constraints: budget, coverage, capacity, and interference. The PM also calculates dynamic capacity requirements to replicate real wireless communication. Three experiments validate the feasibility of the PM. The results demonstrate the utility and stability of the proposed method. Decision makers can easily refer to the PM-identified target deployment before allocating APs.
McClellan, Sean R.
Objectives. We investigated the extent to which implementing language assistance programming through contracting with community-based organizations improved the accessibility of mental health care under Medi-Cal (California’s Medicaid program) for Spanish-speaking persons with limited English proficiency, and whether it reduced language-based treatment access disparities. Methods. Using a time series nonequivalent control group design, we studied county-level penetration of language assistance programming over 10 years (1997–2006) for Spanish-speaking persons with limited English proficiency covered under Medi-Cal. We used linear regression with county fixed effects to control for ongoing trends and other influences. Results. When county mental health plans contracted with community-based organizations, those implementing language assistance programming increased penetration rates of Spanish-language mental health services under Medi-Cal more than other plans (0.28 percentage points, a 25% increase on average; P language-related disparities. Conclusions. Mental health treatment programs operated by community-based organizations may have moderately improved access after implementing required language assistance programming, but the programming did not reduce entrenched disparities in the accessibility of mental health services. PMID:23865663
Snowden, Lonnie R; McClellan, Sean R
We investigated the extent to which implementing language assistance programming through contracting with community-based organizations improved the accessibility of mental health care under Medi-Cal (California's Medicaid program) for Spanish-speaking persons with limited English proficiency, and whether it reduced language-based treatment access disparities. Using a time series nonequivalent control group design, we studied county-level penetration of language assistance programming over 10 years (1997-2006) for Spanish-speaking persons with limited English proficiency covered under Medi-Cal. We used linear regression with county fixed effects to control for ongoing trends and other influences. When county mental health plans contracted with community-based organizations, those implementing language assistance programming increased penetration rates of Spanish-language mental health services under Medi-Cal more than other plans (0.28 percentage points, a 25% increase on average; P language-related disparities. Mental health treatment programs operated by community-based organizations may have moderately improved access after implementing required language assistance programming, but the programming did not reduce entrenched disparities in the accessibility of mental health services.
Lee, L. R.; Montague, K. A.; Charvat, J. M.; Wear, M. L.; Thomas, D. M.; Van Baalen, M.
Since the 2010 NASA directive to make the Life Sciences Data Archive (LSDA) and Lifetime Surveillance of Astronaut Health (LSAH) data archives more accessible by the research and operational communities, demand for astronaut medical data has increased greatly. LSAH and LSDA personnel are working with Human Research Program on many fronts to improve data access and decrease lead time for release of data. Some examples include the following: Feasibility reviews for NASA Research Announcement (NRA) data mining proposals; Improved communication, support for researchers, and process improvements for retrospective Institutional Review Board (IRB) protocols; Supplemental data sharing for flight investigators versus purely retrospective studies; Work with the Multilateral Human Research Panel for Exploration (MHRPE) to develop acceptable data sharing and crew consent processes and to organize inter-agency data coordinators to facilitate requests for international crewmember data. Current metrics on data requests crew consenting will be presented, along with limitations on contacting crew to obtain consent. Categories of medical monitoring data available for request will be presented as well as flow diagrams detailing data request processing and approval steps.
Walker, Tarik; Deutchman, Mark; Ingram, Beth; Walker, Ely; Westfall, John M
Colorectal cancer (CRC) is a significant source of morbidity and mortality in the United States. Colonoscopy can be an extension of the care provided by a family physician to help substantially reduce CRC morbidity and mortality. Family physicians trained in colonoscopy can provide access to care in rural and medically underserved areas. The Department of Family Medicine and the Colorado Area Health Education Center (AHEC) developed the Endoscopy Training for Primary Care (ETPC) program to teach primary care physicians to perform colonoscopy. The program included online didactic education, a formal endoscopy simulator experience, and proctoring by a current endoscopist. Participants completed a baseline and follow-up survey assessing CRC screening knowledge and the effectiveness of the endoscopy training for ongoing screening activities. To date, 94 practitioners and health professional students have participated in the study. Ninety-one (97%) completed the online didactic portion of the training. Sixty-five participants (77%) were physicians or medical students, and the majority (64%) was in the field of family medicine. The year 4 (2011) follow-up cohort was comprised of 62% respondents working in an urban background and 26% in rural communities. Many participants remain in a queue for proctoring by a trained endoscopist. Several participants are successfully performing a significant number of colonoscopies. ETPC program showed success in recruiting a large number of physicians and students to participate in training. The program enhanced perceptions about the value of colon cancer screening and providing screening endoscopy in primary care practice. Providing sites for simulation training throughout Colorado provided opportunity for providers in rural regions to participate. As a result of this training, thousands of patients underwent testing to prevent colon cancer. Future research relating to colonoscopy training by family physicians should focus on quality
... of Justice Programs Vehicular Digital Multimedia Evidence Recording System (VDMERS) Standard...) will make available to the general public three draft documents related to Vehicular Digital Multimedia Evidence Recording Systems (VDMERSs) used by law enforcement agencies: 1. Draft VDMERS Standard for Law...
Tabak, R G; Eyler, A A; Dodson, E A; Brownson, R C
Improving population health often involves policy changes that are the result of complex advocacy efforts. Information exchanges among researchers, advocates, and policymakers is paramount to policy interventions to improve health outcomes. This information may include evidence on what works well for whom and cost-effective strategies to improve outcomes of interest. However, this information is not always readily available or easily communicated. The purposes of this paper are to describe ways advocates seek information for health policy advocacy and to compare advocate demographics. Cross-sectional telephone survey. Seventy-seven state-level advocates were asked about the desirable characteristics of policy-relevant information including methods of obtaining information, what makes it useful, and what sources make evidence most reliable/trustworthy. Responses were explored for the full sample and variety of subsamples (i.e. gender, age, and position on social and fiscal issues). Differences between groups were tested using t-tests and one-way analysis of variance. On average, advocates rated frequency of seeking research information as 4.3 out of five. Overall, advocates rated the Internet as the top source, rated unbiased research and research with relevancy to their organization as the most important characteristics, and considered information from their organization as most reliable/believable. When ratings were examined by subgroup, the two characteristics most important for each question in the total sample (listed above) emerged as most important for nearly all subgroups. Advocates are a resource to policymakers on health topics in the policy process. This study, among the first of its kind, found that advocates seek research information, but have a need for evidence that is unbiased and relevant to their organizations and report that university-based information is reliable. Researchers and advocates should partner so research is useful in advocating for
Myra, David (South Central Washington Resource Conservation and Development Council, Ellensburg, WA); Ready, Carol A. (Kittitas County Water Purveyors, Ellensburg, WA)
This report covers activities conducted by the Yakima Tributary Access and Habitat Program under Bonneville Power Administration (BPA) grant project No. 2002-025-00 for fiscal year 2002. The Yakima Tributary Access and Habitat Program (YTAHP, Program) was organized to restore salmonid passage to Yakima tributaries that historically supported salmonids and improve habitat in areas where access is restored. Specifically, this program is designed to (a) screen unscreened diversion structures to prevent fish entrainment into artificial waterways; (b) provide for fish passage at man-made barriers, such as diversion dams, culverts, siphons and bridges; and (c) provide information and assistance to landowners interested in to contributing to the improvement of water quality, water reliability and stream habitat. The YTAHP developed from a number of groups actively engaged in watershed management, and/or habitat restoration within the Yakima River Basin. These groups include the Washington State Fish and Wildlife (WDFW), Kittitas County Conservation District (KCCD), North Yakima Conservation District (NYCD), Kittitas County Water Purveyors (KCWP), and Ahtanum Irrigation District (AID). The US Bureau of Reclamation (Reclamation) and Yakama Nation (YN) both participated in the development of the objectives of YTAHP. Other entities that will be involved during permitting or project review may include the YN, the federal Natural Resources Conservation Service (NRCS), the US Fish and Wildlife Service (USFWS), the National Marine Fisheries Service (NMFS), and US Army Corps of Engineers (COE). Achievements of YTAHP with BPA Action Plan funding during FY 2002 were to: (1) Establish contracts with RC&D and YTAHP participants. (2) Determine contract mechanism for MWH engineering services. (3) Provide engineering designs and services for 11 early action projects, including inverted siphons, pump and gravity diversion screening, diversion metering, rock weirs for improved fish passage
Meyer, Erik; Van Klaveren, Chris
Policies that aim at improving student achievement frequently increase instructional time, for example by means of an extended day program. There is, however, hardly any evidence that these programs are effective, and the few studies that allow causal inference indicate that we should expect neutral
Godijn, R.J.; Theeuwes, J.
Participant's were required to make a saccade to a uniquely colored target while ignoring the presentation of an onset distractor. The results provide evidence for a competitive integration model of saccade programming that assumes endogenous and exogenous saccades are programmed in a common saccade
Advocates for Youth, 2015
Decades of research have identified dozens of programs that are effective in helping young people reduce their risk for pregnancy, HIV, and STDs. These evidence-based programs utilize strategies that include the provision of accurate, honest information about abstinence as well as contraception and can serve as the foundation for comprehensive sex…
Wike, Traci L.; Bledsoe, Sarah E.; Bellamy, Jennifer L.; Grady, Melissa D.
Websites represent a visible medium for social work programs to communicate information about social work research, academics, and professional training priorities, including evidence-based practice (EBP). However, few studies have examined the content of social work program websites. This exploratory study aimed to answer the question: Are EBP…
Zeblisky, Kathy; Birr, Rebecca A; Sjursen Guerrero, Anne Marie
Librarians for the joint Phoenix Children's Hospital/Maricopa Medical Center Pediatric Residency Program were asked to assist on the Evidence-Based Medicine (EBM) Subcommittee for the program. Faculty was open to recommendations for revising and improving the curriculum and desired librarian assistance in completing the task. The annual program review and conference evaluations revealed a gap between the objectives of the EBM curriculum and the residents' perceived abilities to integrate knowledge into meaningful literature searches. This column demonstrates how librarians can collaborate with their residency programs to revise and improve processes to effect change in their program's EBM curriculum.
Manlove, Jennifer; Fish, Heather; Moore, Kristin Anderson
Background US adolescents have high rates of teen pregnancy, childbearing, and sexually transmitted infections (STIs), highlighting the need to identify and implement effective programs that will help improve teen sexual and reproductive health. Materials and methods This review identified 103 random-assignment evaluations of 85 programs that incorporated intent-to-treat analyses and assessed impacts on pregnancy, childbearing, STIs, and their key determinants – sexual activity, number of sexual partners, condom use, and other contraceptive use – among teens. This review describes the evidence base for five broad program approaches, including abstinence education, comprehensive sex education, clinic-based programs, youth development programs, and parent–youth relationship programs. We also describe programs with impacts on key outcomes, including pregnancy/childbearing, STIs, and those that found impacts on both sexual activity and contraceptive use. Results Our review identified 52 effective programs: 38 with consistent impacts on reproductive health outcomes, and 14 with mixed findings (across subpopulations, follow-ups, or multiple measures of a single outcome). We found that a variety of program approaches produced impacts on sexual and reproductive health outcomes. Parent–youth relationship programs and clinic-based program evaluations more frequently showed impacts than other program approaches, although we also identified a number of abstinence-education, comprehensive sex education, and youth-development programs with impacts on sexual and reproductive health outcomes. Overall, we identified nine program evaluations with impacts on teen pregnancies or births, five with impacts on reducing STIs, and 15 with impacts on both delaying/reducing sexual activity and increasing contraceptive use (including condom use). Conclusion Future efforts should conduct replications of existing program evaluations, identify implementation components linked to impacts
Full Text Available Adverse fetal environments are associated with depression, reduced cognitive ability and increased stress responsiveness in later life, but underlying mechanisms are unknown. Environmental pressures on the fetus, resulting from variations in placental function and maternal nutrition, health and stress might alter neurodevelopment, promoting the development of some brain regions over others. As asymmetry of cerebral activity, with greater right hemisphere activity, has been associated with psychopathology, we hypothesized that regional specialization during fetal life might be reflected persistently in the relative activity of the cerebral hemispheres. We tested this hypothesis in 140 healthy 8-9 year-old children, using tympanic membrane temperature to assess relative blood flow to the cerebral hemispheres at rest and following psychosocial stress (Trier Social Stress Test for Children. Their birth weight and placental weight had already been measured when their mothers took part in a previous study of pregnancy outcomes. We found that children who had a smaller weight at birth had evidence of greater blood flow to the right hemisphere than to the left hemisphere (r = -.09, P = .29 at rest; r = -.18, P = .04 following stress. This finding was strengthened if the children had a relatively low birth weight for their placental weight (r = -.17, P = .05 at rest; r = -.31, P = .0005 following stress. Our findings suggest that lateralization of cerebral activity is influenced persistently by early developmental experiences, with possible consequences for long-term neurocognitive function.
S9 MOW CRD Graduate Health Sciences Education (GHSE) (SGS O&M); SGS R&D; Tri-Service Nursing Research Program (TSNRP): Defense Medical Research...Practice Program Implementation presented at/published to 2017 Triservice Nursing Research and Evidence-Based Practice Dissemination Course, Ellicott...residency programs. 3. Please know that if you are a Graduate Health Sciences Education student and your department has told you they cannot fund your
Whitty, Geoff; Hayton, Annette; Tang, Sarah
This paper considers the history of access to higher education in England and reviews the evidence on the progress made in widening participation and ensuring "fair access" under the New Labour governments of 1997-2010 and, insofar as is possible, under the Coalition government that has been in office since 2010. While recognising that…
Winter, Samantha C; Barchi, Francis
Violence against women (VAW) is a serious public health and human rights concern. Literature suggests sanitation conditions in developing countries may be potential neighborhood-level risk factors contributing to VAW, and that this association may be more important in highly socially disorganized neighborhoods. This study analyzed 2008 Kenya Demographic Health Survey's data and found women who primarily practice open defecation (OD), particularly in disorganized communities, had higher odds of experiencing recent non-partner violence. This study provides quantitative evidence of an association between sanitation and VAW that is attracting increasing attention in media and scholarly literature throughout Kenya and other developing countries.
Full Text Available The present study provides evidence that the activation strength produced by emotional stimuli must pass a threshold level in order to be consciously perceived, contrary to the assumption of continuous quality of representation. An analysis of receiver operating characteristics (ROC for attentional blink performance was used to distinguish between two (continuous vs. threshold models of emotion perception by inspecting two different ROC’s shapes. Across all conditions, the results showed that performance in the attentional blink task was better described by the two-limbs ROC predicted by the Krantz threshold model than by the curvilinear ROC implied by the signal-detection theory.
Background The use of evidence in decision-making at the program management level is a priority in health care organizations. The objective of this study was to identify potential barriers and facilitators experienced by managers to the use of evidence in program management within health care organizations. Methods The authors conducted a comprehensive search for published, peer-reviewed and grey literature that explores the use of evidence in program management. Two reviewers selected relevant studies from which data was extracted using a standard data abstraction form and tabulated for qualitative analysis. The results were summarized through narrative review. The quality of the included studies was assessed using published criteria for the critical appraisal of qualitative, quantitative and mixed methods research. Results Fourteen papers were included in the review. Barriers and facilitators were categorized into five main thematic areas: (1) Information, (2) Organization – Structure and Process, (3) Organization – Culture, (4) Individual, and (5) Interaction. Conclusion This paper reviews the literature on barriers and facilitators to evidence-informed decision-making experienced by program management decision-makers within health care organizations. The multidimensional solutions required to promote evidence-informed program management can be developed through an understanding of the existing barriers and facilitators of evidence-use. PMID:24731719
Urban, Jennifer Brown; Hargraves, Monica; Trochim, William M
Evolutionary theory, developmental systems theory, and evolutionary epistemology provide deep theoretical foundations for understanding programs, their development over time, and the role of evaluation. This paper relates core concepts from these powerful bodies of theory to program evaluation. Evolutionary Evaluation is operationalized in terms of program and evaluation evolutionary phases, which are in turn aligned with multiple types of validity. The model of Evolutionary Evaluation incorporates Chen's conceptualization of bottom-up versus top-down program development. The resulting framework has important implications for many program management and evaluation issues. The paper illustrates how an Evolutionary Evaluation perspective can illuminate important controversies in evaluation using the example of the appropriate role of randomized controlled trials that encourages a rethinking of "evidence-based programs". From an Evolutionary Evaluation perspective, prevailing interpretations of rigor and mandates for evidence-based programs pose significant challenges to program evolution. This perspective also illuminates the consequences of misalignment between program and evaluation phases; the importance of supporting both researcher-derived and practitioner-derived programs; and the need for variation and evolutionary phase diversity within portfolios of programs. Copyright © 2014 Elsevier Ltd. All rights reserved.
Full Text Available The central assumption of behavioral ecology is that natural selection has shaped individuals with the capacity to make decisions that balance the fitness costs and benefits of behavior. A number of factors shape the fitness costs and benefits of maternal care, but we lack a clear understanding how they, taken together, play a role in the decision-making process. In animal studies, the use of experimental methods has allowed for the tight control of these factors. Standard experimentation is inappropriate in human behavioral ecology, but vignette experiments may solve the problem. I used a confounded factorial vignette experiment to gather 640 third-party judgments about the maternal care decisions of hypothetical women and their children from 40 female karo Batak respondents in rural Indonesia. This allowed me to test hypotheses derived from parental investment theory about the relative importance of five binary factors in shaping maternal care decisions with regard to two distinct scenarios. As predicted, access to resources--measured as the ability of a woman to provide food for her children--led to increased care. A handful of other factors conformed to prediction, but they were inconsistent across scenarios. The results suggest that mothers may use simple heuristics, rather than a full accounting for costs and benefits, to make decisions about maternal care. Vignettes have become a standard tool for studying decision making, but have made only modest inroads to evolutionarily informed studies of human behavior.
The central assumption of behavioral ecology is that natural selection has shaped individuals with the capacity to make decisions that balance the fitness costs and benefits of behavior. A number of factors shape the fitness costs and benefits of maternal care, but we lack a clear understanding how they, taken together, play a role in the decision-making process. In animal studies, the use of experimental methods has allowed for the tight control of these factors. Standard experimentation is inappropriate in human behavioral ecology, but vignette experiments may solve the problem. I used a confounded factorial vignette experiment to gather 640 third-party judgments about the maternal care decisions of hypothetical women and their children from 40 female karo Batak respondents in rural Indonesia. This allowed me to test hypotheses derived from parental investment theory about the relative importance of five binary factors in shaping maternal care decisions with regard to two distinct scenarios. As predicted, access to resources--measured as the ability of a woman to provide food for her children--led to increased care. A handful of other factors conformed to prediction, but they were inconsistent across scenarios. The results suggest that mothers may use simple heuristics, rather than a full accounting for costs and benefits, to make decisions about maternal care. Vignettes have become a standard tool for studying decision making, but have made only modest inroads to evolutionarily informed studies of human behavior.
Bastani, Peivand; Mehralian, Gholamhossein; Dinarvand, Rasoul
The aim of this study was to review the current methods of pharmaceutical purchasing by Iranian insurance organizations within the World Bank conceptual framework model so as to provide applicable pharmaceutical resource allocation and purchasing (RAP) arrangements in Iran. This qualitative study was conducted through a qualitative document analysis (QDA), applying the four-step Scott method in document selection, and conducting 20 semi-structured interviews using a triangulation method. Furthermore, the data were analyzed applying five steps framework analysis using Atlas-ti software. The QDA showed that the purchasers face many structural, financing, payment, delivery and service procurement and purchasing challenges. Moreover, the findings of interviews are provided in three sections including demand-side, supply-side and price and incentive regime. Localizing RAP arrangements as a World Bank Framework in a developing country like Iran considers the following as the prerequisite for implementing strategic purchasing in pharmaceutical sector: The improvement of accessibility, subsidiary mechanisms, reimbursement of new drugs, rational use, uniform pharmacopeia, best supplier selection, reduction of induced demand and moral hazard, payment reform. It is obvious that for Iran, these customized aspects are more various and detailed than those proposed in a World Bank model for developing countries.
Perea, Manuel; Comesaña, Montserrat; Soares, Ana P; Moret-Tatay, Carmen
More than 100 years ago, Huey (1908/1968) indicated that the upper part of words was more relevant for perception than the lower part. Here we examined whether mutilated words, in their upper/lower portions (e.g., ), can automatically access their word units in the mental lexicon. To that end, we conducted four masked repetition priming experiments with the lexical decision task. Results showed that mutilated primes produced a sizeable masked repetition priming effect. Furthermore, the magnitude of the masked repetition priming effect was greater when the upper part of the primes was preserved than when the lower portion was preserved-this was the case not only when the mutilated words were presented in lower case but also when the mutilated words were presented in upper case. Taken together, these findings suggest that the front-end of computational models of visual-word recognition should be modified to provide a more realistic account at the level of letter features.
Webber, David; Zhang, Rui; Schimel, Jeff; Blatter, Jamin
The meaning maintenance model proposes that violations to one's expectations will cause subsequent meaning restoration. In attempts to distinguish meaning maintenance mechanisms from mechanisms of terror management, previous research has failed to find increased death-thought accessibility (DTA) in response to various meaning threats. The present research suggests that this failure may have resulted from methodological differences in the way researchers measured DTA. Studies 1a and 1b found that by replacing this method with a standard method employed when studying worldview and self-esteem threats, DTA increased in response to two different meaning violations. Study 2 found increased DTA, but only among individuals high in personal need for structure, when using this standard DTA procedure, but not when using the procedure taken from previous meaning maintenance studies. Interestingly, these studies did not find increased meaning restoration, so an additional study (Study 3) was designed to provide a theoretically informed examination of this null effect. A meaning restoration effect was observed after removing the standard DTA assessment procedure, but only among participants high in personal need for structure. Implications for the threat-compensation literature are discussed. © 2015 The British Psychological Society.
Full Text Available The contribution of orthographic and phonological codes to written production remains controversial. We report results using a picture-word interference task in which participants were asked to write (Experiments 1 and 2 or to speak (Experiment 3 the names of pictures while trying to ignore visual distractors, and the interval between the target and distractor onset was varied. Distractors were orthographically plus phonologically related, orthographically related, phonologically related or unrelated to picture names. For written production, we found an exclusive orthographic effect at an early stage, reflecting a fast and direct link between meaning and graphemic lexicon, and we demonstrated that orthographic codes can be accessed directly from meaning in healthy adults. We also found orthographic and phonological effects at a later stage, reflecting a slow and indirect link between meaning and graphemic lexicon via phonology. Furthermore, the absence of an interaction effect of orthographic and phonological facilitation on written latencies suggests that the two effects are additive in general and that they might occur independently in written production in Chinese. For spoken production, we found that orthographic and phonological effects occur simultaneously in spoken production and that the two effects are additive at an early stage but interactive at a later stage. The temporal courses and their interplay of orthographic and phonological effects are dissociative in written and spoken production. Our findings thus support the orthography autonomy hypothesis, rather than the obligatory phonological mediation hypothesis, in written production in Chinese (as a non-alphabetic script.
Karlin, Bradley E; Cross, Gerald
Replies to comments by H. Holt and L. E. Beutler (see record 2014-40532-003), M. M. Steenkamp and B. Litz (see record 2014-40532-004), and L. R. Greene (see record 2014-40532-006) on the original article by B. E. Karlin and G. Cross (see record 2013-31043-001) on the national dissemination and implementation of evidence-based psychotherapies in the U.S. Department of Veterans Affairs health care system. Karlin and Cross comment on and clarify key issues raised in the commentaries and related aspects of the dissemination and implementation model. At the same time, several of the issues raised in the commentaries are beyond the scope of the original article, including issues related to specific research or the relative effectiveness of psychotherapies, on which there is rich discussion and debate in other contexts. (PsycINFO Database Record (c) 2014 APA, all rights reserved).
Uneke, Chigozie Jesse; Ezeoha, Abel Ebeh; Uro-Chukwu, Henry; Ezeonu, Chinonyelum Thecla; Ogbu, Ogbonnaya; Onwe, Friday; Edoga, Chima
Information and communication technology (ICT) tools are known to facilitate communication and processing of information and sharing of knowledge by electronic means. In Nigeria, the lack of adequate capacity on the use of ICT by health sector policymakers constitutes a major impediment to the uptake of research evidence into the policymaking process. The objective of this study was to improve the knowledge and capacity of policymakers to access and utilize policy relevant evidence. A modified "before and after" intervention study design was used in which outcomes were measured on the target participants both before the intervention is implemented and after. A 4-point likert scale according to the degree of adequacy; 1 = grossly inadequate, 4 = very adequate was employed. This study was conducted in Ebonyi State, south-eastern Nigeria and the participants were career health policy makers. A two-day intensive ICT training workshop was organized for policymakers who had 52 participants in attendance. Topics covered included: (i). intersectoral partnership/collaboration; (ii). Engaging ICT in evidence-informed policy making; use of ICT for evidence synthesis; (iv) capacity development on the use of computer, internet and other ICT. The pre-workshop mean of knowledge and capacity for use of ICT ranged from 2.19-3.05, while the post-workshop mean ranged from 2.67-3.67 on 4-point scale. The percentage increase in mean of knowledge and capacity at the end of the workshop ranged from 8.3%-39.1%. Findings of this study suggest that policymakers' ICT competence relevant to evidence-informed policymaking can be enhanced through training workshop.
Uneke, Chigozie Jesse; Ezeoha, Abel Ebeh; Uro-Chukwu, Henry; Ezeonu, Chinonyelum Thecla; Ogbu, Ogbonnaya; Onwe, Friday; Edoga, Chima
Information and communication technology (ICT) tools are known to facilitate communication and processing of information and sharing of knowledge by electronic means. In Nigeria, the lack of adequate capacity on the use of ICT by health sector policymakers constitutes a major impediment to the uptake of research evidence into the policymaking process. The objective of this study was to improve the knowledge and capacity of policymakers to access and utilize policy relevant evidence. A modified “before and after” intervention study design was used in which outcomes were measured on the target participants both before the intervention is implemented and after. A 4-point likert scale according to the degree of adequacy; 1 = grossly inadequate, 4 = very adequate was employed. This study was conducted in Ebonyi State, south-eastern Nigeria and the participants were career health policy makers. A two-day intensive ICT training workshop was organized for policymakers who had 52 participants in attendance. Topics covered included: (i). intersectoral partnership/collaboration; (ii). Engaging ICT in evidence-informed policy making; use of ICT for evidence synthesis; (iv) capacity development on the use of computer, internet and other ICT. The pre-workshop mean of knowledge and capacity for use of ICT ranged from 2.19-3.05, while the post-workshop mean ranged from 2.67-3.67 on 4-point scale. The percentage increase in mean of knowledge and capacity at the end of the workshop ranged from 8.3%-39.1%. Findings of this study suggest that policymakers’ ICT competence relevant to evidence-informed policymaking can be enhanced through training workshop. PMID:26448807
Lievens, Filip; Patterson, Fiona; Corstjens, Jan; Martin, Stuart; Nicholson, Sandra
Widening access promotes student diversity and the appropriate representation of all demographic groups. This study aims to examine diversity-related benefits of the use of situational judgement tests (SJTs) in the UK Clinical Aptitude Test (UKCAT) in terms of three demographic variables: (i) socio-economic status (SES); (ii) ethnicity, and (iii) gender. Outcomes in medical and dental school applicant cohorts for the years 2012 (n = 15 581) and 2013 (n = 15 454) were studied. Applicants' scores on cognitive tests and an SJT were linked to SES (parents' occupational status), ethnicity (White versus Black and other minority ethnic candidates), and gender. Firstly, the effect size for SES was lower for the SJT (d = 0.13-0.20 in favour of the higher SES group) than it was for the cognitive tests (d = 0.38-0.35). Secondly, effect sizes for ethnicity of the SJT and cognitive tests were similar (d = ~ 0.50 in favour of White candidates). Thirdly, males outperformed females on cognitive tests, whereas the reverse was true for SJTs. When equal weight was given to the SJT and the cognitive tests in the admission decision and when the selection ratio was stringent, simulated scenarios showed that using an SJT in addition to cognitive tests might enable admissions boards to select more students from lower SES backgrounds and more female students. The SJT has the potential to appropriately complement cognitive tests in the selection of doctors and dentists. It may also put candidates of lower SES backgrounds at less of a disadvantage and may potentially diversify the student intake. However, use of the SJT applied in this study did not diminish the role of ethnicity. Future research should examine these findings with other SJTs and other tests internationally and scrutinise the causes underlying the role of ethnicity. © 2016 John Wiley & Sons Ltd.
Smolka, Eva; Gondan, Matthias; Rösler, Frank
The lexical representation of complex words in Indo-European languages is generally assumed to depend on semantic compositionality. This study investigated whether semantically compositional and noncompositional derivations are accessed via their constituent units or as whole words. In an overt visual priming experiment (300 ms stimulus onset asynchrony, SOA), event-related potentials (ERPs) were recorded for verbs (e.g., ziehen, “pull”) that were preceded by purely semantically related verbs (e.g., zerren, “drag”), by morphologically related and semantically compositional verbs (e.g., zuziehen, “pull together”), by morphologically related and semantically noncompositional verbs (e.g., erziehen, “educate”), by orthographically similar verbs (e.g., zielen, “aim”), or by unrelated verbs (e.g., tarnen, “mask”). Compared to the unrelated condition, which evoked an N400 effect with the largest amplitude at centro-parietal recording sites, the N400 was reduced in all other conditions. The rank order of N400 amplitudes turned out as follows: morphologically related and semantically compositional ≈ morphologically related and semantically noncompositional primes produced similar N400 modulations—irrespective of their semantic compositionality. The control conditions with orthographic similarity confirmed that these morphological effects were not the result of a simple form overlap between primes and targets. Our findings suggest that the lexical representation of German complex verbs refers to their base form, regardless of meaning compositionality. Theories of the lexical representation of German words need to incorporate this aspect of language processing in German. PMID:25767442
Smyth, Daniel; Francheville, Jordan W; Rankin, Robin; Beck, Jeremy; Hoare, Connie; Materniak, Stefanie; German, Greg; Barrett, Lisa; Bunimov-Wall, Natalie
The availability of curative hepatitis C therapies has created an opportunity to improve delivery and access. Local providers, government, industry, and community groups in Prince Edward Island developed an innovative province-wide care model. Our goal was to describe the first year of program implementation. Using a community based prospective observational study design, all chronic hepatitis C referrals received from April 2015 to April 2016 were recorded in a database. Primary analysis assessed the time from referral to assessment/treatment, as well as the number of referrals, assessments, and treatment initiations. Secondary objectives included: 1) Treatment effectiveness using intention-to-treat analysis; and 2) Patient treatment experience assessed using demographics, adverse events, and medication adherence. During the study period 242 referrals were received, 123 patients were seen for intake assessments, and 93 initiated direct-acting antiviral therapy based on medical need. This is compared to 4 treatment initiations in the previous 2 years. The median time from assessment to treatment initiation was 3 weeks. Eighty-two of 84 (97.6%, 95% CI 91.7 - 99.7%) patients for whom outcome data were available achieved sustained virologic response at 12 weeks post-treatment; 1 was lost to follow-up and 1 died from an unrelated event. In the voluntary registry, 39.7% of patients reported missed treatment doses. In conclusion, results from the first 12 months of this multi-phase hepatitis C elimination strategy demonstrate improved access to treatment, and high rates of safe engagement and cure for patients living with chronic hepatitis C genotype 1 infections.
Full Text Available This article describes the Blueprints database of evidence-based programs (EBPs and its potential application in children's services in European countries. It outlines relevant aspects of the European context, including a tendency to be skeptical about programs imported from the US, and the need for a pan-European source of information about EBPs across multiple outcome areas. It then describes the standards of evidence used by Blueprints, which cover intervention specificity, evaluation quality, intervention impact, and system readiness. The criteria for determining that a program is "Model" and "Promising" are outlined. The article then summarizes the process by which the standards were developed and some of the issues that were harder to resolve. It also sketches the process by which a program reaches the Blueprints database, and provides three examples of programs approved by Blueprints and implemented in Europe: a home-visiting program for mothers of infants; a parent skills training program; and a therapeutic intervention for families of chronic offenders. A brief indication is also given of how the wider pool of programs reviewed fare against the standards of evidence. Finally, the article summarizes future directions for the work, with a particular emphasis on how Blueprints might become widely used in Europe.
Wilfley, Denise E.; Staiano, Amanda E.; Altman, Myra; Lindros, Jeanne; Lima, Angela; Hassink, Sandra G.; Dietz, William H.; Cook, Stephen
Objectives To improve systems of care to advance implementation of the U.S. Preventive Services Task Force recommendations for childhood obesity treatment (i.e. clinicians offer/refer children with obesity to intensive, multicomponent behavioral interventions of >25 hours over 6–12 months to improve weight status) and to expand payment for these services. Methods In July 2015, forty-three cross-sector stakeholders attended a conference supported by the Agency for Healthcare Research and Quality, American Academy of Pediatrics Institute for Healthy Childhood Weight, and The Obesity Society. Plenary sessions presenting scientific evidence and clinical and payment practices were interspersed with breakout sessions to identify consensus recommendations. Results Consensus recommendations for childhood obesity treatment included: family-based multicomponent behavioral therapy; integrated care model; and multi-disciplinary care team. The use of evidence-based protocols, a well-trained healthcare team, medical oversight, and treatment at or above the minimum dose (e.g. >25 hours) are critical components to ensure effective delivery of high-quality care and to achieve clinically meaningful weight loss. Approaches to secure reimbursement for evidence-based obesity treatment within payment models were recommended. Conclusion Continued cross-sector collaboration is crucial to ensure a unified approach to increase payment and access for childhood obesity treatment and to scale-up training to ensure quality of care. PMID:27925451
Wilfley, Denise E; Staiano, Amanda E; Altman, Myra; Lindros, Jeanne; Lima, Angela; Hassink, Sandra G; Dietz, William H; Cook, Stephen
To improve systems of care to advance implementation of the U.S. Preventive Services Task Force recommendations for childhood obesity treatment (i.e., clinicians offer/refer children with obesity to intensive, multicomponent behavioral interventions of >25 h over 6 to 12 months to improve weight status) and to expand payment for these services. In July 2015, 43 cross-sector stakeholders attended a conference supported by the Agency for Healthcare Research and Quality, American Academy of Pediatrics Institute for Healthy Childhood Weight, and The Obesity Society. Plenary sessions presenting scientific evidence and clinical and payment practices were interspersed with breakout sessions to identify consensus recommendations. Consensus recommendations for childhood obesity treatment included: family-based multicomponent behavioral therapy; integrated care model; and multidisciplinary care team. The use of evidence-based protocols, a well-trained healthcare team, medical oversight, and treatment at or above the minimum dose (e.g., >25 h) are critical components to ensure effective delivery of high-quality care and to achieve clinically meaningful weight loss. Approaches to secure reimbursement for evidence-based obesity treatment within payment models were recommended. Continued cross-sector collaboration is crucial to ensure a unified approach to increase payment and access for childhood obesity treatment and to scale up training to ensure quality of care. © 2016 The Obesity Society.
Rothman, David J; Blackwood, Kristy L; Adair, Whitney; Rothman, Sheila M
To evaluate the Washington State Health Technology Assessment Program (WHTAP). Washington State Health Technology Assessment Program proceedings in Seattle, Washington. We assessed the program through observation of its proceedings over a 5-year period, 2009-2014. We conducted detailed analyses of the documents it produced and reviewed relevant literature. Washington State Health Technology Assessment Program is unique compared to other state and federal programs. It has successfully applied evidence-based medicine to health care decision making, limited by the strength of available data. It claims cost savings, but they are not substantiated. Washington State Health Technology Assessment Program is a useful model for other states considering implementation of technology assessment programs. We provide key lessons for improving WHTAP's process. © Health Research and Educational Trust.
Full Text Available Although clinical pharmacy training in Pakistan is a novelty in the undergraduate pharmacy curriculum, it has significantly improved the practical knowledge of the undergraduate students with regards practice of pharmacy in health care settings. The implementation of the curriculum change was a major innovation but the possible negative implications were not contemplated at the time of execution and combined with a failure in regular review and assessment of the plan. This led to undesirable outcomes such as breaching of health care protocols and ethics by students, inadequate aptitude and poor clinical research skills. These shortcomings were analyzed and an evidence based improvement program known as the Evidence Based Improvement (EBI initiative was designed containing structured modules to empower undergraduates in those areas. It was implemented by the authorities and has led to positive outcomes which render it very useful and this improvement program can serve as a guide to develop clinical pharmacy training programs in those countries where the practice of pharmacy is evolving.
Muldoon, Katherine A; Muzaaya, Godfrey; Betancourt, Theresa S; Ajok, Mirriam; Akello, Monica; Petruf, Zaira; Nguyen, Paul; Baines, Erin K; Shannon, Kate
Reintegration programs are commonly offered to former combatants and abductees to acquire civilian status and support services to reintegrate into post-conflict society. Among a group of young female abductees in northern Uganda, this study examined access to post-abduction reintegration programming and tested for between group differences in mental health status among young women who had accessed reintegration programming compared to those who self-reintegrated. This cross-sectional study analysed interviews from 129 young women who had previously been abducted by the Lords Resistance Army (LRA). Data was collected between June 2011-January 2012. Interviews collected information on abduction-related experiences including age and year of abduction, manner of departure, and reintegration status. Participants were coded as 'reintegrated' if they reported ≥1 of the following reintegration programs: traditional cleansing ceremony, received an amnesty certificate, reinsertion package, or had gone to a reception centre. A t-test was used to measure mean differences in depression and anxiety measured by the Acholi Psychosocial Assessment Instrument (APAI) to determine if abductees who participated in a reintegration program had different mental status from those who self-reintegrated. From 129 young abductees, 56 (43.4%) had participated in a reintegration program. Participants had been abducted between 1988-2010 for an average length of one year, the median age of abduction was 13 years (IQR:11-14) with escaping (76.6%), being released (15.6%), and rescued (7.0%) being the most common manner of departure from the LRA. Traditional cleansing ceremonies (67.8%) were the most commonly accessed support followed by receiving amnesty (37.5%), going to a reception centre (28.6%) or receiving a reinsertion package (12.5%). Between group comparisons indicated that the mental health status of abductees who accessed ≥1 reintegration program were not significantly different from
Vander Kloet, Marie
It is increasingly understood that university education must be accessible to persons with disabilities. The responsibility to make the university accessible is arguably shared by all of us and yet, the extent to which it has become fully accessible is certainly suspect. By undertaking qualitative, discursive analysis of websites, online texts and…
Ehlmann, Bethany L.; Swayze, Gregg A.; Milliken, Ralph E.; Mustard, John F.; Clark, Roger N.; Murchie, Scott L.; Breit, George N.; Wray, James J.; Gondet, Brigitte; Poulet, Francois; Carter, John; Calvin, Wendy M.; Benzel, William M.; Seelos, Kimberly D.
Cross crater is a 65 km impact crater, located in the Noachian highlands of the Terra Sirenum region of Mars (30°S, 158°W), which hosts aluminum phyllosilicate deposits first detected by the Observatoire pour la Minéralogie, L’Eau, les Glaces et l’Activitié (OMEGA) imaging spectrometer on Mars Express. Using high-resolution data from the Mars Reconnaissance Orbiter, we examine Cross crater’s basin-filling sedimentary deposits. Visible/shortwave infrared (VSWIR) spectra from the Compact Reconnaissance Imaging Spectrometer for Mars (CRISM) show absorptions diagnostic of alunite. Combining spectral data with high-resolution images, we map a large (10 km × 5 km) alunite-bearing deposit in southwest Cross crater, widespread kaolin-bearing sediments with variable amounts of alunite that are layered in waters at the time of its formation. Waters in Cross crater were likely supplied by regionally upwelling groundwaters as well as through an inlet valley from a small adjacent depression to the east, perhaps occasionally forming a lake or series of shallow playa lakes in the closed basin. Like nearby Columbus crater, Cross crater exhibits evidence for acid sulfate alteration, but the alteration in Cross is more extensive/complete. The large but localized occurrence of alunite suggests a localized, high-volume source of acidic waters or vapors, possibly supplied by sulfurous (H2S- and/or SO2-bearing) waters in contact with a magmatic source, upwelling steam or fluids through fracture zones. The unique, highly aluminous nature of the Cross crater deposits relative to other martian acid sulfate deposits indicates acid waters, high water throughput during alteration, atypically glassy and/or felsic materials, or a combination of these conditions.
Novel Humanitarian Aid Program: The Glivec International Patient Assistance Program-Lessons Learned From Providing Access to Breakthrough Targeted Oncology Treatment in Low- and Middle-Income Countries.
Garcia-Gonzalez, Pat; Boultbee, Paula; Epstein, David
Imatinib was the first targeted therapy approved for the treatment of cancer. With its approval, it was immediately clear to Novartis that this breakthrough therapy would require an innovative approach to worldwide access, with special consideration of low- and middle-income countries. Lack of government reimbursement, universal health care, or health insurance coverage, few trained specialty physicians or diagnostic services, and poor health care infrastructure were, and continue to be, contributing barriers to access to treatment in low- and middle-income countries. The Glivec International Patient Assistance Program (GIPAP) is an international drug donation program established by Novartis Pharma AG and implemented in partnership with The Max Foundation, a nonprofit, nongovernmental organization. GIPAP was established in 2001, essentially in parallel with the first approval of imatinib for chronic myeloid leukemia. Since 2001, GIPAP has made imatinib accessible to all medically and financially eligible patients within 80 countries on an ongoing basis as long as their physicians prescribe it and no other means of access exists. To date, more than 49,000 patients have benefited from GIPAP, and 2.3 million monthly doses of imatinib have been approved through the program. GIPAP represents an innovative drug donation model that has set the standard for access programs for other targeted or innovative therapies. The purpose of this article is to describe the structure of GIPAP, as well as important lessons that have contributed to the success of the program. This article may assist other companies with the development of successful and far-reaching patient assistance programs in the future.
Lindo, Jason M; Siminski, Peter; Yerokhin, Oleg
A large literature has documented significant public health benefits associated with the minimum legal drinking age in the USA, particularly because of the resulting effects on motor vehicle accidents. These benefits form the primary basis for continued efforts to restrict youth access to alcohol. It is important to keep in mind that policymakers have a wide variety of alcohol-control options available to them, and understanding how these policies may complement or substitute for one another can improve policy making moving forward. Towards this end, we propose that investigating the causal effects of the minimum legal drinking age in New South Wales, Australia, provides a particularly informative case study, because Australian states are among the world leaders in their efforts against drunk driving. Using an age-based regression discontinuity design applied to restricted-use data from several sources, we find no evidence that legal access to alcohol has effects on motor vehicle accidents of any type in New South Wales, despite having large effects on drinking and on hospitalizations due to alcohol abuse. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.
Gutierrez, Ericson L; Piazza, Marina; Gutierrez-Aguado, Alfonso; Hijar, Gisely; Carmona, Gloria; Caballero, Patricia; Reyes, Nora; Canelo, Carlos; Aparco, Juan Pablo; Tejada, Romina A; Bolaños-Díaz, Rafael; Saravia, Silvia; Gozzer, Ernesto
This article analyzes some examples about how the Ministry of Health of Peru has used evidence for policy and program formulation, implementation and evaluation. It describes the process by which health budget programs are based and strengthened with scientific evidence. Provides an overview about how the development of clinical guidelines methodology is facilitating the generation of high quality evidence based clinical guidelines.It presents some examples of specific information needs of the Ministry of Health to which the Instituto Nacional de Salud has responded, and the impact of that collaboration. Finally, the article proposes future directions for the use of research methodology especially relevant for the development and evaluation of policy and programs, as well as the development of networks of health technology assessment at the national and international level.
Full Text Available Abstract Background Although evidence-based interventions to reach the Millennium Development Goals for Maternal and Neonatal mortality reduction exist, they have not yet been operationalised and scaled up in Sub-Saharan African cultural and health systems. A key concern is whether these internationally recommended practices are acceptable and will be demanded by the target community. We explored the acceptability of these interventions in two rural districts of Uganda. Methods We conducted 10 focus group discussions consisting of mothers, fathers, grand parents and child minders (older children who take care of other children. We also did 10 key informant interviews with health workers and traditional birth attendants. Results Most maternal and newborn recommended practices are acceptable to both the community and to health service providers. However, health system and community barriers were prevalent and will need to be overcome for better neonatal outcomes. Pregnant women did not comprehend the importance of attending antenatal care early or more than once unless they felt ill. Women prefer to deliver in health facilities but most do not do so because they cannot afford the cost of drugs and supplies which are demanded in a situation of poverty and limited male support. Postnatal care is non-existent. For the newborn, delayed bathing and putting nothing on the umbilical cord were neither acceptable to parents nor to health providers, requiring negotiation of alternative practices. Conclusion The recommended maternal-newborn practices are generally acceptable to the community and health service providers, but often are not practiced due to health systems and community barriers. Communities associate the need for antenatal care attendance with feeling ill, and postnatal care is non-existent in this region. Health promotion programs to improve newborn care must prioritize postnatal care, and take into account the local socio-cultural situation
Full Text Available Abstract Background This study implemented and evaluated a point-of-care, wireless Internet access using smart phones for information retrieval during daily clinical rounds and academic activities of internal medicine residents in a community hospital. We did the project to assess the feasibility of using smart phones as an alternative to reach online medical resources because we were unable to find previous studies of this type. In addition, we wanted to learn what Web-based information resources internal medicine residents were using and whether providing bedside, real-time access to medical information would be perceived useful for patient care and academic activities. Methods We equipped the medical teams in the hospital wards with smart phones (mobile phone/PDA hybrid devices to provide immediate access to evidence-based resources developed at the National Library of Medicine as well as to other medical Websites. The emphasis of this project was to measure the convenience and feasibility of real-time access to current medical literature using smart phones. Results The smart phones provided real-time mobile access to medical literature during daily rounds and clinical activities in the hospital. Physicians found these devices easy to use. A post-study survey showed that the information retrieved was perceived to be useful for patient care and academic activities. Conclusion In community hospitals and ambulatory clinics without wireless networks where the majority of physicians work, real-time access to current medical literature may be achieved through smart phones. Immediate availability of reliable and updated information obtained from authoritative sources on the Web makes evidence-based practice in a community hospital a reality.
León, Sergio A; Fontelo, Paul; Green, Linda; Ackerman, Michael; Liu, Fang
This study implemented and evaluated a point-of-care, wireless Internet access using smart phones for information retrieval during daily clinical rounds and academic activities of internal medicine residents in a community hospital. We did the project to assess the feasibility of using smart phones as an alternative to reach online medical resources because we were unable to find previous studies of this type. In addition, we wanted to learn what Web-based information resources internal medicine residents were using and whether providing bedside, real-time access to medical information would be perceived useful for patient care and academic activities. We equipped the medical teams in the hospital wards with smart phones (mobile phone/PDA hybrid devices) to provide immediate access to evidence-based resources developed at the National Library of Medicine as well as to other medical Websites. The emphasis of this project was to measure the convenience and feasibility of real-time access to current medical literature using smart phones. The smart phones provided real-time mobile access to medical literature during daily rounds and clinical activities in the hospital. Physicians found these devices easy to use. A post-study survey showed that the information retrieved was perceived to be useful for patient care and academic activities. In community hospitals and ambulatory clinics without wireless networks where the majority of physicians work, real-time access to current medical literature may be achieved through smart phones. Immediate availability of reliable and updated information obtained from authoritative sources on the Web makes evidence-based practice in a community hospital a reality.
Watts, Sarah E; Andrews, Gavin
Mental disorders are widespread and universal. They are frequently accompanied by considerable harmful consequences for the individual and come at a significant economic cost to a community. Yet while effective evidence based prevention and treatment exists, there are a number of barriers to access, implement and disseminate. Cognitive behavior therapy programs, such as those available at www.thiswayup.com.au are widely available using the Internet in high income countries, such as Australia. With the ubiquitous uptake of Internet users globally, it is suggested that low and middle income countries should consider ways to embrace and scale up these cost effective programs. An explanation of why and some suggestions as to how this can be done are presented. Crown Copyright © 2014. Published by Elsevier B.V. All rights reserved.
Ramamurthy, M. K.
Increasingly, the conduct of science requires close international collaborations to share data, information, knowledge, expertise, and other resources. This is particularly true in the geosciences where the highly connected nature of the Earth system and the need to understand global environmental processes have heightened the importance of scientific partnerships. As geoscience studies become a team effort involving networked scientists and data providers, it is crucial that there is open and reliable access to earth system data of all types, software, tools, models, and other assets. That environment demands close attention to security-related matters, including the creation of trustworthy cyberinfrastructure to facilitate the efficient use of available resources and support the conduct of science. Unidata and EarthCube, both of which are NSF-funded and community-driven programs, recognize the importance of collaborations and the value of networked communities. Unidata, a cornerstone cyberinfrastructure facility for the geosciences, includes users in nearly 180 countries. The EarthCube initiative is aimed at transforming the conduct of geosciences research by creating a well-connected and facile environment for sharing data and in an open, transparent, and inclusive manner and to accelerate our ability to understand and predict the Earth system. We will present the Unidata and EarthCube community perspectives on the approaches to balancing an environment that promotes open and collaborative eScience with the needs for security and communication, including what works, what is needed, the challenges, and opportunities to advance science.
Ooms, L.; Veenhof, C.
Introduction: The Dutch government stimulates sport and physical activity opportunities in the neighborhood to make it easier for people to adopt a physically active lifestyle. Seven National Sports Federations (NSFs) were funded to develop easily accessible sporting programs, targeted at groups
This article examines how three urban elementary school teachers adapted pedagogical strategies from a school district--adopted core reading program to increase their students' access to the curriculum. Using teacher interviews and classroom observations to construct a descriptive case study of teacher adaptation, analysis reveals that the…
Zaidi, Shehla; Riaz, Atif; Rabbani, Fauziah; Azam, Syed Iqbal; Imran, Syeda Nida; Pradhan, Nouhseen Akber; Khan, Gul Nawaz
The case of contracting out government health services to non-governmental organizations (NGOs) has been weak for maternal, newborn, and child health (MNCH) services, with documented gains being mainly in curative services. We present an in-depth assessment of the comparative advantages of contracting out on MNCH access, quality, and equity, using a case study from Pakistan. An end-line, cross-sectional assessment was conducted of government facilities contracted out to a large national NGO and government-managed centres serving as controls, in two remote rural districts of Pakistan. Contracting out was specific for augmenting MNCH services but without contractual performance incentives. A household survey, a health facility survey, and focus group discussions with client and spouses were used for assessment. Contracted out facilities had a significantly higher utilization as compared to control facilities for antenatal care, delivery, postnatal care, emergency obstetric care, and neonatal illness. Contracted facilities had comparatively better quality of MNCH services but not in all aspects. Better household practices were also seen in the district where contracting involved administrative control over outreach programs. Contracting was also faced with certain drawbacks. Facility utilization was inequitably higher amongst more educated and affluent clients. Contracted out catchments had higher out-of-pocket expenses on MNCH services, driven by steeper transport costs and user charges for additional diagnostics. Contracting out did not influence higher MNCH service coverage rates across the catchment. Physical distances, inadequate transport, and low demand for facility-based care in non-emergency settings were key client-reported barriers. Contracting out MNCH services at government health facilities can improve facility utilization and bring some improvement in quality of services. However, contracting out of health facilities is insufficient to increase
Choma, Kim; McKeever, Amy E
The literature reports great variation in the knowledge levels and application of the recent changes of cervical cancer screening guidelines into clinical practice. Evidence-based screening guidelines for the prevention and early detection of cervical cancer offers healthcare providers the opportunity to improve practice patterns among female adolescents by decreasing psychological distress as well as reducing healthcare costs and morbidities associated with over-screening. The purpose of this pilot intervention study was to determine the effects of a Web-based continuing education unit (CEU) program on advanced practice nurses' (APNs) knowledge of current cervical cancer screening evidence-based recommendations and their application in practice. This paper presents a process improvement project as an example of a way to disseminate updated evidence-based practice guidelines among busy healthcare providers. This Web-based CEU program was developed, piloted, and evaluated specifically for APNs. The program addressed their knowledge level of cervical cancer and its relationship with high-risk human papillomavirus. It also addressed the new cervical cancer screening guidelines and the application of those guidelines into clinical practice. Results of the study indicated that knowledge gaps exist among APNs about cervical cancer screening in adolescents. However, when provided with a CEU educational intervention, APNs' knowledge levels increased and their self-reported clinical practice behaviors changed in accordance with the new cervical cancer screening guidelines. Providing convenient and readily accessible up-to-date electronic content that provides CEU enhances the adoption of clinical practice guidelines, thereby decreasing the potential of the morbidities associated with over-screening for cervical cancer in adolescents and young women. © 2014 Sigma Theta Tau International.
Haas, B J; Salzberg, S L; Zhu, W; Pertea, M; Allen, J E; Orvis, J; White, O; Buell, C R; Wortman, J R
EVidenceModeler (EVM) is presented as an automated eukaryotic gene structure annotation tool that reports eukaryotic gene structures as a weighted consensus of all available evidence. EVM, when combined with the Program to Assemble Spliced Alignments (PASA), yields a comprehensive, configurable annotation system that predicts protein-coding genes and alternatively spliced isoforms. Our experiments on both rice and human genome sequences demonstrate that EVM produces automated gene structure annotation approaching the quality of manual curation.
Bellström, Peter; Kilbrink, Nina
In this chapter we describe a pilot survey on applying problem-based learning (PBL) in an undergraduate programming course. During the course the students have applied PBL as a complement to traditional teaching and learning techniques. The PBL problem in this survey combines both knowledge about programming and knowledge about databases. We argue that to handle programming the students have to learn programming according to the deep approach to learning in order to be able to apply their knowledge in new programming situations and contexts. The result from this pilot survey indicates from both a tutor and a student perspective that PBL could be one method to reach a deeper understanding on how to access databases in a programming language.
Mann-Salinas, Elizabeth; Hayes, Elizabeth; Robbins, Johnnie; Sabido, Jean; Feider, Laura; Allen, David; Yoder, Linda
To provide a systematic review of the literature regarding development of an evidence-based Precepting Program for nurses transitioning to burn specialty practice. Burned patients are admitted to specialty Burn Centers where highly complex nursing care is provided. Successful orientation and integration into such a specialized work environment is a fundamental component of a nurse's ability to provide safe and holistic patient care. A systematic review of the literature was performed for the period 1995-2011 using electronic databases within PUBMED and Ovid search engines. Databases included Medline, CINHAL, ProQuest for Dissertations and Thesis, and Cochran Collaboration using key search terms: preceptor, preceptee, preceptorship, precept*, nurs*, critical care, personality types, competency-based education, and learning styles. Nurses graded the level and quality of evidence of the included articles using a modified 7-level rating system and the Johns Hopkins Nursing Quality of Evidence Appraisal during journal-club meetings. A total of 43 articles related to competency (n=8), knowledge acquisition and personality characteristics (n=8), learning style (n=5), preceptor development (n=7), and Precepting Programs (n=14). A significant clinical gap existed between the scientific evidence and actual precepting practice of experienced nurses at the Burn Center. Based on this extensive review of the literature, it was determined that a sufficient evidence base existed for development of an evidence-based Precepting Program. Copyright © 2013 Elsevier Ltd and ISBI. All rights reserved.
Saurman, Emily; Lyle, David; Kirby, Sue; Roberts, Russell
The Mental Health Emergency Care-Rural Access Program (MHEC-RAP) is a telehealth solution providing specialist emergency mental health care to rural and remote communities across western NSW, Australia. This is the first time and motion (T&M) study to examine program efficiency and capacity for a telepsychiatry program. Clinical services are an integral aspect of the program accounting for 6% of all activities and 50% of the time spent conducting program activities, but half of this time is spent completing clinical paperwork. This finding emphasizes the importance of these services to program efficiency and the need to address variability of service provision to impact capacity. Currently, there is no efficiency benchmark for emergency telepsychiatry programs. Findings suggest that MHEC-RAP could increase its activity without affecting program responsiveness. T&M studies not only determine activity and time expenditure, but have a wider application assessing program efficiency by understanding, defining, and calculating capacity. T&M studies can inform future program development of MHEC-RAP and similar telehealth programs, both in Australia and overseas. PMID:25089774
Gandhi, Allison Gruner; Murphy-Graham, Erin; Petrosino, Anthony; Chrismer, Sara Schwartz; Weiss, Carol H.
In an effort to promote evidence-based practice, government officials, researchers, and program developers have developed lists of model programs in the prevention field. This article reviews the evidence used by seven best-practice lists to select five model prevention programs. The authors' examination of this research raises questions about the…
Nguyen, Natalie T.; Duff, J. Paul; Gavier-Widén, Dolores; Grillo, Tiggy; He, Hongxuan; Lee, Hang; Ratanakorn, Parntep; Rijks, Jolianne M.; Ryser-Degiorgis, Marie-Pierre; Sleeman, Jonathan M.; Stephen, Craig; Tana, Toni; Uhart, Marcela; Zimmer , Patrick
SummaryThis report summarizes a Wildlife Disease Association sponsored workshop held in 2016. The overall objective of the workshop was to use available evidence and selected subject matter expertise to define the essential functions of a National Wildlife Health Program and the resources needed to deliver a robust and reliable program, including the basic infrastructure, workforce, data and information systems, governance, organizational capacity, and essential features, such as wildlife disease surveillance, diagnostic services, and epidemiological investigation. This workshop also provided the means to begin the process of defining the essential attributes of a national wildlife health program that could be scalable and adaptable to each nation’s needs.
Michael J. Stewart
Full Text Available Background: Providing efficient and effective aged care services is one of the greatest public policy concerns currently facing governments. Increasing the integration of care services has the potential to provide many benefits including increased access, promoting greater efficiency, and improving care outcomes. There is little research, however, investigating how integrated aged care can be successfully achieved. The PRISMA (Program of Research to Integrate Services for the Maintenance of Autonomy project, from Quebec, Canada, is one of the most systematic and sustained bodies of research investigating the translation and outcomes of an integrated care policy into practice. The PRISMA research program has run since 1988, yet there has been no independent systematic review of this work to draw out the lessons learnt.Methods: Narrative review of all literature emanating from the PRISMA project between 1988 and 2012. Researchers accessed an online list of all published papers from the program website. The reference lists of papers were hand searched to identify additional literature. Finally, Medline, Pubmed, EMBASE and Google Scholar indexing databases were searched using key terms and author names. Results were extracted into specially designed spread sheets for analysis.Results: 45 journal articles and two books authored or co-authored by the PRISMA team were identified. Research was primarily concerned with: the design, development and validation of screening and assessment tools; and results generated from their application. Both quasi-experimental and cross sectional analytic designs were used extensively. Contextually appropriate expert opinion was obtained using variations on the Delphi Method. Literature analysis revealed the structures, processes and outcomes which underpinned the implementation. PRISMA provides evidence that integrating care for older persons is beneficial to individuals through reducing incidence of functional
Michael J. Stewart
Full Text Available Background: Providing efficient and effective aged care services is one of the greatest public policy concerns currently facing governments. Increasing the integration of care services has the potential to provide many benefits including increased access, promoting greater efficiency, and improving care outcomes. There is little research, however, investigating how integrated aged care can be successfully achieved. The PRISMA (Program of Research to Integrate Services for the Maintenance of Autonomy project, from Quebec, Canada, is one of the most systematic and sustained bodies of research investigating the translation and outcomes of an integrated care policy into practice. The PRISMA research program has run since 1988, yet there has been no independent systematic review of this work to draw out the lessons learnt. Methods: Narrative review of all literature emanating from the PRISMA project between 1988 and 2012. Researchers accessed an online list of all published papers from the program website. The reference lists of papers were hand searched to identify additional literature. Finally, Medline, Pubmed, EMBASE and Google Scholar indexing databases were searched using key terms and author names. Results were extracted into specially designed spread sheets for analysis. Results: 45 journal articles and two books authored or co-authored by the PRISMA team were identified. Research was primarily concerned with: the design, development and validation of screening and assessment tools; and results generated from their application. Both quasi-experimental and cross sectional analytic designs were used extensively. Contextually appropriate expert opinion was obtained using variations on the Delphi Method. Literature analysis revealed the structures, processes and outcomes which underpinned the implementation. PRISMA provides evidence that integrating care for older persons is beneficial to individuals through reducing incidence of functional
Kendall, Alta B; Scott, Patricia A; Karlsen, Kristine A
First released in 1996, the S.T.A.B.L.E.® Program has provided evidence-based education in the postresuscitation and pretransport stabilization care of sick newborns to more than a quarter million multidisciplinary perinatal healthcare team members from around the world. The program, aimed at preventing the leading causes of neonatal mortality, continues to be the subject of published peer-reviewed research and is periodically updated to ensure relevancy and inclusion of current best evidence. S.T.A.B.L.E. is a mnemonic for the 6 essential assessment parameters taught in the program: Sugar and Safe care, Temperature, Airway, Blood pressure, Lab work, and Emotional support. This mnemonic was specifically chosen to serve as a memory tool to remind staff of "what to do" during those infrequent but stressful times when they were expected to assess and stabilize sick newborns. Course completion of the S.T.A.B.L.E. Program is obtained as a result of didactic training and successful completion of content testing. The program's test questions are periodically evaluated and revised on the basis of psychometric analysis. The 6th edition of the S.T.A.B.L.E. Program learner/provider manual is scheduled for release in 2012 and will reflect the latest in stabilization guidelines throughout the program's 6 modules and supplemental content.
Castellano, Daniel; Antón Aparicio, Luis M; Esteban, Emilio; Sánchez-Hernández, Alfredo; Germà, Jose Ramón; Batista, Norberto; Maroto, Pablo; Pérez-Valderrama, Begoña; Luque, Raquel; Méndez-Vidal, María José
Based on the TROPIC study results, cabazitaxel was approved for the management of metastatic castration-resistant prostate cancer (mCRPC) progressing on or after docetaxel. This multi-centre program provided early access to cabazitaxel to patients with mCRPC before its commercialization. Safety data from 153 Spanish patients receiving cabazitaxel 25 mg/m(2) i.v. Q3W, plus oral prednisone/prednisolone 10 mg daily, are reported. Median age of patients was 70 years (26.8% ≥ 75 years), 94.1 and 26.8% had bone and visceral metastasis, respectively. Most had an Eastern Cooperative Oncology Group ≤ 1 (88.9%) and had received a median of 8.0 cycles of last docetaxel treatment. The median of cabazitaxel cycles and cumulative dose were 6.0 (Interquartile range [IQR]: 4.0; 8.0) and 148.9 (IQR: 98.2; 201.4) mg/m(2), respectively. Adverse events (AEs) possibly related to cabazitaxel occurred in 143 (93.5%) patients. The most frequent grade ≥ 3 AEs were neutropenia (n = 25, 16.3%) and asthenia (n = 17, 11.1%). Febrile neutropenia and grade ≥ 3 diarrhea occurred in 5.2% of the patients each. There were five (3.3%) possibly treatment-related deaths, mainly infection-related. G-CSFs were used in 114 (74.5%) patients, generally as prophylaxis (n = 107; 69.9%). Grade ≥ 3 peripheral neuropathy and nail disorders were uncommon. Cabazitaxel administration, in a real-world setting, is tolerated by Spanish patients with mCRPC, and the AEs are manageable.
Wheldall, Robyn; Glenn, Katharine; Arakelian, Sarah; Madelaine, Alison; Reynolds, Meree; Wheldall, Kevin
This study aimed to provide evidence regarding the efficacy of an early literacy preparation program, "PreLit", designed to improve the skills of young Australian children. Participants comprised 240 children in eight schools attending their first year of schooling. Children in the four experimental group schools received instruction in…
Tucker, Pamela D.; Anderson, Erin; Reynolds, Amy L.; Mawhinney, Hanne
This document analysis provides a summary of the research from high-impact journals published between 2008 and 2013 with the explicit purpose of determining the extent to which the current empirical evidence supports the individual 2011 Educational Leadership Constituent Council Program Standards and their elements. We found that the standards are…
Raiten, Daniel J; Sakr Ashour, Fayrouz A; Ross, A Catharine
/Policies and Interpretation of Research Evidence (INSPIRE) is to provide guidance for those users represented by the global food and nutrition enterprise. These include researchers (bench and clinical), clinicians providing care/treatment, those developing and evaluating programs/interventions at scale, and those responsible...... of the bidirectional relations between nutritional status and the development and function of the immune and inflammatory response and 2) the specific impact of the inflammatory response on the selection, use, and interpretation of nutrient biomarkers. The goal of the Inflammation and Nutritional Science for Programs...... for generating evidence-based policy. The INSPIRE process included convening 5 thematic working groups (WGs) charged with developing summary reports around the following issues: 1) basic overview of the interactions between nutrition, immune function, and the inflammatory response; 2) examination of the evidence...
Gunnell, David; Knipe, Duleeka; Chang, Shu-Sen; Pearson, Melissa; Konradsen, Flemming; Lee, Won Jin; Eddleston, Michael
Pesticide self-poisoning accounts for 14-20% of suicides worldwide. Regulation aimed at restricting access to pesticides or banning highly hazardous pesticides is one approach to reducing these deaths. We systematically reviewed the evidence of the effectiveness of pesticide regulation in reducing the incidence of pesticide suicides and overall suicides. We did a systematic review of the international evidence. We searched MEDLINE, PsycINFO, and Embase for studies published between Jan 1, 1960, and Dec 31, 2016, which investigated the effect of national or regional bans, and sales or import restrictions, on the availability of one or more pesticides and the incidence of suicide in different countries. We excluded other interventions aimed at limiting community access to pesticides. We extracted data from studies presenting pesticide suicide data and overall suicide data from before and after national sales restrictions. Two reviewers independently assessed papers for inclusion, extracted data, and assessed risk of bias. We undertook a narrative synthesis of the data in each report, and where data were available for the years before and after a ban, we pooled data for the 3 years before and the 3 years after to obtain a crude estimate of the effect of the ban. This study is registered through PROSPERO, number CRD42017053329. We identified 27 studies undertaken in 16 countries-five low-income or middle-income countries (Bangladesh, Colombia, India, Jordan and Sri Lanka), and 11 high-income countries (Denmark, Finland, Germany, Greece, Hungary, Ireland, Japan, South Korea, Taiwan, UK, and USA). Assessments largely focused on national bans of specific pesticides (12 studies of bans in six countries-Jordan, Sri Lanka, Bangladesh, Greece [Crete], South Korea, and Taiwan) or sales restrictions (eight studies of restrictions in five countries- India, Denmark, Ireland, the UK and the USA). Only five studies used optimum analytical methods. National bans on commonly ingested
... System (ADAMS): You may access publicly available documents online in the NRC Library at http://www.nrc...), that integrates the performance requirements contained within 10 CFR 73.56, ``Personnel Access Authorization Requirements for Nuclear Power Plants,'' and the criminal history checks of 10 CFR 73.57...
In recent years, several writing centers have been set up in colleges and universities of Taiwan. Almost at the same time, many self-access learning centers are being designed and built on campuses all over the island. Whether these two institutes function jointly or independently, dissatisfaction arises. In order to run the self-access learning…
A Pilot Randomized Controlled Trial of the ACCESS Program: A Group Intervention to Improve Social, Adaptive Functioning, Stress Coping, and Self-Determination Outcomes in Young Adults with Autism Spectrum Disorder.
Oswald, Tasha M; Winder-Patel, Breanna; Ruder, Steven; Xing, Guibo; Stahmer, Aubyn; Solomon, Marjorie
The purpose of this pilot randomized controlled trial was to investigate the acceptability and efficacy of the Acquiring Career, Coping, Executive control, Social Skills (ACCESS) Program, a group intervention tailored for young adults with autism spectrum disorder (ASD) to enhance critical skills and beliefs that promote adult functioning, including social and adaptive skills, self-determination skills, and coping self-efficacy. Forty-four adults with ASD (ages 18-38; 13 females) and their caregivers were randomly assigned to treatment or waitlist control. Compared to controls, adults in treatment significantly improved in adaptive and self-determination skills, per caregiver report, and self-reported greater belief in their ability to access social support to cope with stressors. Results provide evidence for the acceptability and efficacy of the ACCESS Program.
Kaye, D L; Fornari, V; Scharf, M; Fremont, W; Zuckerbrot, R; Foley, C; Hargrave, T; Smith, B A; Wallace, J; Blakeslee, G; Petras, J; Sengupta, S; Singarayer, J; Cogswell, A; Bhatia, I; Jensen, P
Although, child mental health problems are widespread, few get adequate treatment, and there is a severe shortage of child psychiatrists. To address this public health need many states have adopted collaborative care programs to assist primary care to better assess and manage pediatric mental health concerns. This report adds to the small literature on collaborative care programs and describes one large program that covers most of New York state. CAP PC, a component program of New York State's Office of Mental Health (OMH) Project TEACH, has provided education and consultation support to primary care providers covering most of New York state since 2010. The program is uniquely a five medical school collaboration with hubs at each that share one toll free number and work together to provide education and consultation support services to PCPs. The program developed a clinical communications record to track information about all consultations which forms the basis of much of this report. 2-week surveys following consultations, annual surveys, and pre- and post-educational program evaluations have also been used to measure the success of the program. CAP PC has grown over the 6years of the program and has provided 8013 phone consultations to over 1500 PCPs. The program synergistically provided 17,523 CME credits of educational programming to 1200 PCPs. PCP users of the program report very high levels of satisfaction and self reported growth in confidence. CAP PC demonstrates that large-scale collaborative consultation models for primary care are feasible to implement, popular with PCPs, and can be sustained. The program supports increased access to child mental health services in primary care and provides child psychiatric expertise for patients who would otherwise have none. Copyright © 2017. Published by Elsevier Inc.
Dunn, Andrea L; Buller, David B; Dearing, James W; Cutter, Gary; Guerra, Michele; Wilcox, Sara; Bettinghaus, Erwin P
BACKGROUND: There is a scarcity of research studies that have examined academic-commercial partnerships to disseminate evidence-based physical activity programs. Understanding this approach to dissemination is essential because academic-commercial partnerships are increasingly common. Private companies have used dissemination channels and strategies to a degree that academicians have not, and declining resources require academicians to explore these partnerships. PURPOSE: This paper describes a retrospective case-control study design including the methods, demographics, organizational decision-making, implementation rates, and marketing strategy for Active Living Every Day (ALED), an evidence-based lifestyle physical activity program that has been commercially available since 2001. Evidence-based public health promotion programs rely on organizations and targeted sectors to disseminate these programs although relatively little is known about organizational-level and sector-level influences that lead to their adoption and implementation. METHODS: Cases (n=154) were eligible if they had signed an ALED license agreement with Human Kinetics (HK), publisher of the program's textbooks and facilitator manuals, between 2001 and 2008. Two types of controls were matched (2:2:1) and stratified by sector and region. Active controls (Control 1; n=319) were organizations that contacted HK to consider adopting ALED. Passive controls (Control 2; n=328) were organizations that received unsolicited marketing materials and did not initiate contact with HK. We used Diffusion of Innovations Theory (DIT) constructs as the basis for developing the survey of cases and controls. RESULTS: Using the multi-method strategy recommended by Dillman, a total of n=801 cases and controls were surveyed. Most organizations were from the fitness sector followed by medical, nongovernmental, governmental, educational, worksite and other sectors with significantly higher response rates from government
Kalthoum Ibrahim Yousif
Full Text Available End-stage renal disease is a worldwide problem that requires highly skilled nursing care. Hemodialysis (HD is a corner-stone procedure in the management of most patients who require renal replacement therapy. Adequate vascular access is essential for the successful use of HD. Appropriate knowledge in taking care of vascular access is essential for minimizing complications and accurately recognizing vascular access-related problems. This study was to evaluate the effect of an educational program for vascular access care on nurses’ knowledge at nine dialysis centers in Khartoum State. This was a Quasi experimental study (pre-and post-test for the same group. Sixty-one nurses working in these HD centers were chosen by simple random sampling method. A structured face-to-face interview questionnaire based on the Kidney Dialysis Outcome Quality Initiative (K/DOQI clinical practice guidelines for vascular access care was used. Instrument validity was determined through content validity by a panel of experts. Reliability of the instrument was tested by a pilot study to test the knowledge scores for 15 nurses. The Pearson correlation coefficient obtained was (r = 0.82. Data collection was taken before and after the educational intervention. A follow-up test was performed three month later, using the same data collection tools. Twenty-two individual variables assessing the knowledge levels in aspects related to the six K/DOQI guidelines showed improvement in all scores of the nurses’ knowledge after the educational intervention; and the differences from the preeducational scores were statistically significant (P < 0.001. The study showed that a structured educational program based on the K/DOQI clinical practice guidelines had a significant impact on the dialysis nurses knowledge in caring for vascular access in HD patients. The knowledge level attained was maintained for at least three months after the educational intervention.
Yousif, Kalthoum Ibrahim; Abu-Aisha, Hasan; Abboud, Omar Ibrahim
End-stage renal disease is a worldwide problem that requires highly skilled nursing care. Hemodialysis (HD) is a corner-stone procedure in the management of most patients who require renal replacement therapy. Adequate vascular access is essential for the successful use of HD. Appropriate knowledge in taking care of vascular access is essential for minimizing complications and accurately recognizing vascular access-related problems. This study was to evaluate the effect of an educational program for vascular access care on nurses' knowledge at nine dialysis centers in Khartoum State. This was a Quasi experimental study (pre-and post-test for the same group). Sixty-one nurses working in these HD centers were chosen by simple random sampling method. A structured face-to-face interview questionnaire based on the Kidney Dialysis Outcome Quality Initiative (K/DOQI) clinical practice guidelines for vascular access care was used. Instrument validity was determined through content validity by a panel of experts. Reliability of the instrument was tested by a pilot study to test the knowledge scores for 15 nurses. The Pearson correlation coefficient obtained was (r = 0.82). Data collection was taken before and after the educational intervention. A follow-up test was performed three month later, using the same data collection tools. Twenty-two individual variables assessing the knowledge levels in aspects related to the six K/DOQI guidelines showed improvement in all scores of the nurses' knowledge after the educational intervention; and the differences from the preeducational scores were statistically significant (P < 0.001). The study showed that a structured educational program based on the K/DOQI clinical practice guidelines had a significant impact on the dialysis nurses knowledge in caring for vascular access in HD patients. The knowledge level attained was maintained for at least three months after the educational intervention.
Benyo, Theresa L.
Integration of a supersonic inlet simulation with a computer aided design (CAD) system is demonstrated. The integration is performed using the Project Integration Architecture (PIA). PIA provides a common environment for wrapping many types of applications. Accessing geometry data from CAD files is accomplished by incorporating appropriate function calls from the Computational Analysis Programming Interface (CAPRI). CAPRI is a CAD vendor neutral programming interface that aids in acquiring geometry data directly from CAD files. The benefits of wrapping a supersonic inlet simulation into PIA using CAPRI are; direct access of geometry data, accurate capture of geometry data, automatic conversion of data units, CAD vendor neutral operation, and on-line interactive history capture. This paper describes the PIA and the CAPRI wrapper and details the supersonic inlet simulation demonstration.
Berger, Hana; Eylon, Bat-Sheva; Bagno, Esther
The present study examined continuity of learning between face-to-face and online environments in a "blended" professional development program designed for 16 physics teachers. The program had nine face-to-face meetings as well as continuous online exchanges between them through a website. The program focused on "knowledge integration" (KI) innovative activities in physics classes using an "evidence-based" approach: The teachers implemented the activities, collected and analyzed data about their practice and their students' learning, and reflected on the evidence with their peers. Five reflective tools were used to promote continuity: Your Comments, Hot Polls, Smashing Sentences, Hot Reports, and Mini Research. Continuity was assessed with regard to the ideas discussed by the teachers and the reasoning patterns that they employed. Analysis of the online exchanges in relation to teachers' face-to-face discourse revealed that the teachers discussed the same ideas (KI, evidence and learner-centered pedagogies), employed the same reasoning patterns (e.g., forming generalizations), and extended ideas in re-visitation. The online and face-to-face environments played different and complementary roles in the teachers' learning. This study shows that appropriate use of an online environment in a blended program can lead to a continuous course of learning and can transform a "9 once-a-month-meetings" workshop into a "9-month" workshop.
... that these proposed changes would do much to advance the practice of evidence-based medicine and would... evidence-based guidelines; (3) ensures that the periodic and regular review of such orders and protocols is...-10.pdf ), where we pointed out our strong support of the use of evidence-based protocols, developed...
... 34 Education 3 2010-07-01 2010-07-01 false Grants for Access and Persistence Program (GAP) State Grant Allotment Case Study A Appendix A to Subpart C of Part 692 Education Regulations of the Offices of...) State Grant Allotment Case Study ER29OC09.010 ER29OC09.011 ER29OC09.012 ER29OC09.013 ER29OC09.014...
Rotheram-Borus, Mary Jane; Swendeman, Dallas; Rotheram-Fuller, Erin; Youssef, Maryann K
Family Coaching is proposed as a new delivery format for evidence-based prevention programs (EBPPs). Three recent developments in health promotion support the potential efficacy of Family Coaching: (1) renewed interest in integrated prevention programs for multiple risk factors and behavior changes, (2) broad and long-term impacts of family-based interventions, and (3) popular acceptance of "coaching" as a nonstigmatizing, goal-focused intervention strategy. Family coaches are community members and paraprofessionals trained in common elements of EBPP. Family Coaching has specific goals, is short term, and has definable outcomes. Coaches frame the program's goals to be consistent with the family's values, normalize the family's experience, assess their strengths, and help the family set goals and develop skills and routines to problem solve challenging situations. Broad dissemination of EBPP will be facilitated with delivery formats that are flexible to meet families' priorities and providers' desires and capacities to tailor programs to local contexts.
Nicklin, Wendy; Stipich, Nina
The Executive Training for Research Application (EXTRA) is a new training program that aims to increase the skills of health services executives and their organizations to use research evidence in healthcare management and decision-making. This paper describes the goals and rationale of the EXTRA program and its learning objectives and curriculum, and reports on some early baseline evaluative research. In particular, the authors address the opportunities that EXTRA offers to leaders in the nursing profession to transform the practice of nursing and patient care, and the unique opportunities that the program offers for collaboration across the healthcare professions and disciplines. While the EXTRA training program requires substantive investment of time and commitment by healthcare leaders and their organizations, it offers great potential for increasing research application in healthcare leadership decision-making. It is therefore a potential long-term lever of cultural decision-making change within healthcare organizations.
... for an association, business, labor union, etc.). You may review DOT's complete Privacy Act Statement..., Preserving Rights and Powers, to prohibit new residential through-the-fence access. In that Notice, there was...
Vandelanotte, Corneel; Kirwan, Morwenna; Rebar, Amanda; Alley, Stephanie; Short, Camille; Fallon, Luke; Buzza, Gavin; Schoeppe, Stephanie; Maher, Carol; Duncan, Mitch J
It has been shown that physical activity is more likely to increase if web-based interventions apply evidence-based components (e.g. self-monitoring) and incorporate interactive social media applications (e.g. social networking), but it is unclear to what extent these are being utilized in the publicly available web-based physical activity interventions. The purpose of this study was to evaluate whether freely accessible websites delivering physical activity interventions use evidence-based behavior change techniques and provide social media applications. In 2013, a systematic search strategy examined 750 websites. Data was extracted on a wide range of variables (e.g. self-monitoring, goal setting, and social media applications). To evaluate website quality a new tool, comprising three sub-scores (Behavioral Components, Interactivity and User Generated Content), was developed to assess implementation of behavior change techniques and social media applications. An overall website quality scored was obtained by summing the three sub-scores. Forty-six publicly available websites were included in the study. The use of self-monitoring (54.3%), goal setting (41.3%) and provision of feedback (46%) was relatively low given the amount of evidence supporting these features. Whereas the presence of features allowing users to generate content (73.9%), and social media components (Facebook (65.2%), Twitter (47.8%), YouTube (48.7%), smartphone applications (34.8%)) was relatively high considering their innovative and untested nature. Nearly all websites applied some behavioral and social media applications. The average Behavioral Components score was 3.45 (±2.53) out of 10. The average Interactivity score was 3.57 (±2.16) out of 10. The average User Generated Content Score was 4.02 (±2.77) out of 10. The average overall website quality score was 11.04 (±6.92) out of 30. Four websites (8.7%) were classified as high quality, 12 websites (26.1%) were classified as moderate
Full Text Available Shared memory applications running transparently on top of NUMA architectures often face severe performance problems due to bad data locality and excessive remote memory accesses. Optimizations with respect to data locality are therefore necessary, but require a fundamental understanding of an application's memory access behavior. The information necessary for this cannot be obtained using simple code instrumentation due to the implicit nature of the communication handled by the NUMA hardware, the large amount of traffic produced at runtime, and the fine access granularity in shared memory codes. In this paper an approach to overcome these problems and thereby to enable an easy and efficient optimization process is presented. Based on a low-level hardware monitoring facility in coordination with a comprehensive visualization tool, it enables the generation of memory access histograms capable of showing all memory accesses across the complete address space of an application's working set. This information can be used to identify access hot spots, to understand the dynamic behavior of shared memory applications, and to optimize applications using an application specific data layout resulting in significant performance improvements.
National Oceanic and Atmospheric Administration, Department of Commerce — This is a compilation of several data sets related to the Galveston Texas Seaturtle Headstart program. Most notable is the Kemp's ridley headstart program...
... enactments are a source of further evidence of housing discrimination ] based on sexual orientation or gender...., Laws Prohibiting Discrimination Based on Sexual Orientation and Gender Identity (Institute of Real... exclusion or discrimination on the basis of sexual orientation or gender identity in HUD programs. Such...
Lynette H. Bikos
Full Text Available This study investigated the acquisition, interpretation, and utilization of research evidence in the 4-H Youth Development Program from the frame of Social Cognitive Theory. Utilizing Consensual Qualitative Research, we interviewed twenty 4-H faculty, staff, and volunteers from seven states. Results indicated four domains, which covered participants’ definitions of research utilization, their experiences utilizing research, the process of acquiring and distributing research, and barriers and facilitators to research utilization. Participants described research use primarily in terms of improving 4-H programs. They discussed their level of confidence (i.e. self-efficacy in finding and applying research evidence and their beliefs about the outcomes of research utilization (i.e. outcomes expectancy. Participants mentioned such barriers as not knowing where to look for research, lack of time, lack of funding, and difficulty applying research findings to their work. The facilitators included support from other 4-H colleagues and availability of 4-H specific conferences, publications, and curriculum databases.
Wilson, Zakiya S.; Iyengar, Sitharama S.; Pang, Su-Seng; Warner, Isiah M.; Luces, Candace A.
Increasing college degree attainment for students from disadvantaged backgrounds is a prominent component of numerous state and federal legislation focused on higher education. In 1999, the National Science Foundation (NSF) instituted the "Computer Science, Engineering, and Mathematics Scholarships" (CSEMS) program; this initiative was designed to provide greater access and support to academically talented students from economically disadvantaged backgrounds. Originally intended to provide financial support to lower income students, this NSF program also advocated that additional professional development and advising would be strategies to increase undergraduate persistence to graduation. This innovative program for economically disadvantaged students was extended in 2004 to include students from other disciplines including the physical and life sciences as well as the technology fields, and the new name of the program was Scholarships for Science, Technology, Engineering and Mathematics (S-STEM). The implementation of these two programs in Louisiana State University (LSU) has shown significant and measurable success since 2000, making LSU a Model University in providing support to economically disadvantaged students within the STEM disciplines. The achievement of these programs is evidenced by the graduation rates of its participants. This report provides details on the educational model employed through the CSEMS/S-STEM projects at LSU and provides a path to success for increasing student retention rates in STEM disciplines. While the LSU's experience is presented as a case study, the potential relevance of this innovative mentoring program in conjunction with the financial support system is discussed in detail.
Gershman, Jennifer A; Gershman, Jason A; Fass, Andrea D; Popovici, Ioana
The purpose of this study is to assess Florida physicians' attitudes and knowledge toward accessing the state's prescription drug monitoring program (PDMP). Five thousand medical doctors and osteopathic physicians licensed in Florida were randomly selected for a voluntary and anonymous 15-question self-administered survey approved by the Institutional Review Board. Surveys were distributed through U.S. postal service mail. Likert-scale questions were used to assess prior knowledge (1 = none to 5 = excellent) and attitudes toward accessing the PDMP (1 = strongly disagree to 5 = strongly agree). The study yielded a response rate of 7.8%, 71.5% of whom agreed or strongly agreed that the PDMP is a useful tool. Among participants that have access and answered the PDMP usefulness question, 94.8% agree or strongly agree that it is a useful tool. There were 63 out of 64 physicians (98.4%) who conducted 25 or more searches who agreed or strongly agreed that the PDMP is a useful tool for monitoring patients' controlled substance histories. There were 72.5% of participants with access that answered the "doctor shopping" question who agreed that "doctor shopping" will decrease. Among the 64 most frequent PDMP users, 69.4% agreed or strongly agreed that they have prescribed fewer controlled substances after accessing the PDMP. The study revealed that a majority of participants believe that the PDMP is a useful tool for monitoring patients' controlled substance histories. More continuing education programs should be provided to Florida physicians to enhance their knowledge regarding PDMPs. Wiley Periodicals, Inc.
Gudlavalleti, Murthy Venkata S; John, Neena; Allagh, Komal; Sagar, Jayanthi; Kamalakannan, Sureshkumar; Ramachandra, Srikrishna S
Data shows that people with disability are more disadvantaged in accessing health, education and employment opportunities compared to people without a disability. There is a lack of credible documented evidence on health care access and barriers to access from India. The South India Disability Evidence (SIDE) Study was undertaken to understand the health needs of people with disabilities, and barriers to accessing health services. The study was conducted in one district each in two States (Andhra Pradesh and Karnataka) in 2012. Appropriate age and sex-matched people without a disability were recruited to compare with people with disability who were identified through a population-based survey and available government disability records by trained key informants. These people were then examined by a medical team to confirm the diagnosis. Investigators administered questionnaire schedules to people with and without a disability to harness information on employment and health service access, utilization and barriers. A total of 839 people with disabilities and 1153 age and sex matched people without a disability, aged 18 years or more were included. People with disability had significantly lower employment rates. On univariate analysis, people with disability (18.4%) needed to visit a hospital significantly more often in the preceding year compared to people without a disability (8.8%) (X2- 40.0562; P disability and the risk was significantly higher in males compared to females with disability. People with disability faced significantly more barriers to accessing health services compared to people without a disability. Barriers included ignorance regarding availability of services, costs of services and transportation. This study highlights the challenges that people with disability face in accessing health-care and employment opportunities. The study findings have public health implications and should be used for planning need-based appropriate strategies to
This dissertation is concerned with the design and study of an evidence-based approach to the professional development of high-school physics teachers responding to the need to develop effective continuing professional development programs (CPD) in domains that require genuine changes in teachers' views, knowledge, and practice. The goals of the thesis were to design an evidence-based model for the CPD program, to implement it with teachers, and to study its influence on teachers' knowledge, views, and practice, as well as its impact on students' learning. The program was developed in three consecutive versions: a pilot, first, and second versions. Based on the pilot version (that was not part of this study), we developed the first version of the program in which we studied difficulties in employing the evidence-based and blended-learning approaches. According to our findings, we modified the strategies for enacting these approaches in the second version of the program. The influence of the program on the teachers and students was studied during the enactment of the second version of the program. The model implemented in the second version of the program was characterized by four main design principles: 1. The KI and evidence aspects are acquired simultaneously in an integrated manner. 2. The guidance of the teachers follows the principles of cognitive apprenticeship both in the evidence and the KI aspects. 3. The teachers experience the innovative activities as learners. 4. The program promotes continuity of teachers' learning through a structured "blended learning" approach. The results of our study show that this version of the program achieved its goals; throughout the program the teachers progressed in their knowledge, views, and practice concerning the knowledge integration, and in the evidence and learner-centered aspects. The results also indicated that students improved their knowledge of physics and knowledge integration skills that were developed
Williams, Rhonda; Woodell, Carol; McCarville, Erin; Damitz, Maureen; Banks, Tinesha; Montoya, Jorge; Lesch, Julie Kennedy; Peretz, Patricia; Lara, Marielena
Successful chronic disease project management, especially of multiyear initiatives using evidence-based interventions (EBIs), is of great importance to funders, health care decision makers, and researchers, particularly in light of limited funding. However, a gap in knowledge may exist regarding which attributes and skills are most desirable in a program manager to help him or her ensure successful implementation of EBIs. Although some literature examines the dynamics contributing to the success of community coalitions, public health leadership, and community health education, there is minimal literature exploring the significance of a program manager's role in the conceptualization, implementation, and sustainability of initiatives to improve patient and community health. The authors present their experiences as participants in a large-scale asthma initiative implemented in priority communities, as well as results of a survey distributed among all personnel of the program sites. The survey aimed to assess the key skills and attributes, in addition to contextual factors, that contribute to the strength of a program manager overseeing EBIs in asthma initiatives. The results suggest that certain attributes and skills are desirable in recruiting and hiring of a program manager, especially when augmented by ongoing skill-building training, and can help ensure program and research success.
Full Text Available This study aims at providing evidence of the effectiveness of the Program-Guide to Develop Emotional Competences in promoting positive parenting. Contextual, institutional, methodological and professional issues were taken into account to develop a social innovation experience to support parenting as a preventive measure to family conflicts. The study describes both the contents of the Program-Guide and the methodological and evaluation issues that trained professionals need to consider when delivering the Program-Guide to families in natural contexts. Information was gathered and analyzed from 259 parents with children of ages 1-18 who participated in 26 parent training groups. A pre- and post-test design showed that after finishing the sessions parents perceived themselves more competent as parents according to the five dimensions of parenting competences considered: (1 emotional self-regulation abilities; (2 self-esteem and assertiveness; (3 communication strategies; (4 strategies to solve conflicts and to negotiate; and (5 strategies to establish coherent norms, limits and consequences to promote positive discipline. The study presents a discussion on these results from evidence-based parenting programs, as well as some strengths and limitations of the study, together with some suggestions for further research.
Plecki, Margaret L.; Elfers, Ana M.; Nakamura, Yugo
In this article, the authors consider what can be learned from limited forms of evidence, for purposes of accountability and improvement of teacher education programs. They begin with a review of recent research on how evidence has been used to examine the effectiveness of teacher preparation and development. Using empirical evidence from a state…
Lokuge, Kamalini; Thurber, Katherine; Calabria, Bianca; Davis, Meg; McMahon, Kathryn; Sartor, Lauren; Lovett, Raymond; Guthrie, Jill; Banks, Emily
Indigenous Australians experience a disproportionately higher burden of disease compared to non-Indigenous Australians. High-quality evaluation of Indigenous health programs is required to inform health and health services improvement. We aimed to quantify methodological and other characteristics of Australian Indigenous health program evaluations published in the peer-reviewed literature. Systematic review of peer-reviewed literature (November 2009-2014) on Indigenous health program evaluation. We identified 118 papers describing evaluations of 109 interventions; 72.0% were university/research institution-led. 82.2% of evaluations included a quantitative component; 49.2% utilised quantitative data only and 33.1% used both quantitative and qualitative data. The most common design was a before/after comparison (30.5%, n=36/118). 7.6% of studies (n=9/118) used an experimental design: six individual-level and three cluster-randomised controlled trials. 56.8% (67/118) reported on service delivery/process outcomes (versus health or health risk factor outcomes) only. Given the number of Indigenous health programs that are implemented, few evaluations overall are published in the peer-reviewed literature and, of these, few use optimal methodologies such as mixed methods and experimental design. Implications for public health: Multiple strategies are required to increase high-quality, accessible evaluation in Indigenous health, including supporting stronger research-policy-practice partnerships and capacity building for evaluation by health services and government. © 2017 The Authors.
Burke, Kathleen G; Johnson, Tonya; Sites, Christine; Barnsteiner, Jane
: Background: The Institute of Medicine (IOM) and the Quality and Safety Education for Nurses (QSEN) project have identified six nursing competencies and supported their integration into undergraduate and graduate nursing curricula nationwide. But integration of those competencies into clinical practice has been limited, and evidence for the progression of competency proficiency within clinical advancement programs is scant. Using an evidence-based approach and building on the competencies identified by the IOM and QSEN, a team of experts at an academic health system developed eight competency domains and 186 related knowledge, skills, and attitudes (KSAs) for professional nursing practice. The aim of our study was to validate the eight identified competencies and 186 related KSAs and determine their developmental progression within a clinical advancement program. Using the Delphi technique, nursing leadership validated the newly identified competency domains and KSAs as essential to practice. Clinical experts from 13 Magnet-designated hospitals with clinical advancement programs then participated in Delphi rounds aimed at reaching consensus on the developmental progression of the 186 KSAs through four levels of clinical advancement. Two Delphi rounds resulted in consensus by the expert participants. All eight competency domains were determined to be essential at all four levels of clinical practice. At the novice level of practice, the experts identified a greater number of KSAs in the domains of safety and patient- and family-centered care. At more advanced practice levels, the experts identified a greater number of KSAs in the domains of professionalism, teamwork, technology and informatics, and continuous quality improvement. Incorporating the eight competency domains and the 186 KSAs into a framework for clinical advancement programs will likely result in more clearly defined role expectations; enhance accountability; and elevate and promote nursing practice
Amy L. Chang
Full Text Available The American Society for Microbiology (ASM established its ASM-NSF (National Science Foundation Biology Scholars Program (BSP to promote undergraduate education reform by 1 supporting biologists to implement evidence-based teaching practices, 2 engaging life science professional societies to facilitate biologists’ leadership in scholarly teaching within the discipline, and 3 participating in a teaching community that fosters disciplinary-level science, technology, engineering, and mathematics (STEM reform. Since 2005, the program has utilized year-long residency training to provide a continuum of learning and practice centered on principles from the scholarship of teaching and learning (SoTL to more than 270 participants (“scholars” from biology and multiple other disciplines. Additionally, the program has recruited 11 life science professional societies to support faculty development in SoTL and discipline-based education research (DBER. To identify the BSP’s long-term outcomes and impacts, ASM engaged an external evaluator to conduct a study of the program’s 2010–2014 scholars (n = 127 and society partners. The study methods included online surveys, focus groups, participant observation, and analysis of various documents. Study participants indicate that the program achieved its proposed goals relative to scholarship, professional society impact, leadership, community, and faculty professional development. Although participants also identified barriers that hindered elements of their BSP participation, findings suggest that the program was essential to their development as faculty and provides evidence of the BSP as a model for other societies seeking to advance undergraduate science education reform. The BSP is the longest-standing faculty development program sponsored by a collective group of life science societies. This collaboration promotes success across a fragmented system of more than 80 societies representing the life
... Commodity Credit Corporation Notice of Funds Availability: Inviting Applications for the Market Access... Notice of Funds Availability. DATES: All applications must be received by 5 p.m. Eastern Daylight Time... overseas marketing and promotion activities. MAP participants may receive assistance for generic or brand...
... Commodity Credit Corporation Notice of Funds Availability: Inviting Applications for the Market Access... publish a notice in the Federal Register rescinding this Notice of Funds Availability. DATES: All... marketing and promotion activities. MAP Participants may receive assistance for generic or brand promotion...
Greenberg, Maya Delgado; Kuns, Jerry
Accessible Global Positioning Systems (GPS) are changing the way many people with visual impairments (that is, those who are blind or have low vision) travel. GPS provides real-time orientation information so that a traveler with a visual impairment can make informed decisions about path of travel and destination. Orientation and mobility (O&M)…
... Customer Information and Customer Notice AGENCY: Office of Thrift Supervision (OTS), Treasury. ACTION... for Unauthorized Access to Customer Information and Customer Notice. OMB Number: 1550-0110. Form...) Ensure the security and confidentiality of customer records and information; (2) protect against any...
... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND... data more accessible and user-friendly. FOR FURTHER INFORMATION CONTACT: Daniel W. Sigelman, Office of... INFORMATION: FDA is announcing the availability of a report entitled ``Food and Drug Administration...
...-party device (e.g., a laptop, tablet, smart phone) or if additional services are required to make use of... computers without conditional access capability, mobile devices (such as tablets and smartphones) that do... televisions--a function that digital tuning adapters (``DTAs'') and similar devices perform today. These...
Fonjungo, Peter N; Boeras, Debrah I; Zeh, Clement; Alexander, Heather; Parekh, Bharat S; Nkengasong, John N
Access to point-of-care testing (POCT) improves patient care, especially in resource-limited settings where laboratory infrastructure is poor and the bulk of the population lives in rural settings. However, because of challenges in rolling out the technology and weak quality assurance measures, the promise of human immunodeficiency virus (HIV)-related POCT in resource-limited settings has not been fully exploited to improve patient care and impact public health. Because of these challenges, the Joint United Nations Programme on HIV/AIDS (UNAIDS), in partnership with other organizations, recently launched the Diagnostics Access Initiative. Expanding HIV programs, including the "test and treat" strategies and the newly established UNAIDS 90-90-90 targets, will require increased access to reliable and accurate POCT results. In this review, we examine various components that could improve access and uptake of quality-assured POC tests to ensure coverage and public health impact. These components include evaluation, policy, regulation, and innovative approaches to strengthen the quality of POCT. © The Author 2015. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail email@example.com.
Lishness, Alan [Gulf Of Maine Research Inst., Portland, ME (United States); Peake, Leigh [Gulf Of Maine Research Inst., Portland, ME (United States)
Under Phase I of the Smart Grid Data Access Pilot Program, the Gulf of Maine Research Institute (GMRI) partnered with Central Maine Power (CMP), and the Maine Mathematics and Science Alliance (MMSA) and engaged key vendors Tilson Government Services, LLC (Tilson), and Image Works to demonstrate the efficacy of PowerHouse, an interactive online learning environment linking middle school students with their home electricity consumption data provided through CMP’s Advanced Metering Infrastructure (AMI). The goal of the program is to harness the power of youth to alter home energy consumption behaviors using AMI data. Successful programs aimed at smoking cessation, recycling, and seat belt use have demonstrated the power of young people to influence household behaviors. In an era of increasing concern about energy costs, availability, and human impacts on global climate, GMRI sought to demonstrate the effectiveness of a student-focused approach to understanding and managing household energy use. We also sought to contribute to a solid foundation of science-literate students who can analyze evidence to find solutions to increasingly complex energy challenges.
Watkins, Adam M.; Lizotte, Alan J.
The aim of this research is to assess if home firearm access increases the risk of nonfatal suicidal attempts among adolescents. Such a gun focus has largely been limited to case-control studies on completed suicides. This line of research has found that household gun access increases the risk of suicide due to features of available firearms…
Full Text Available The implementation of a knowledge management program in an organization has the potential of im-proving customer services, quickly bringing new products to market, and reducing cost of business operations. Information technologies are often used in knowledge management programs in informing clients and employees of latest innovation/development in the business sector as well as sharing knowledge among the employees. The key professionals involved in knowledge management programs are information technologists and human resource managers but the information professionals also have a role to play as they are traditionally known as good managers of explicit knowledge. Hence, the aim of this study is to provide empirical evidence of the role of information professionals in knowledge management programs. 386 information professionals working in Canadian organizations were selected from the Special Libraries Association's Who's Who in Special Libraries 2001/2002, and a questionnaire with a stamped self-addressed envelope for its return was sent to each one of them. 63 questionnaires were completed and returned, and 8 in-depth interviews conducted. About 59% of the information professionals surveyed are working in organizations that have knowledge management programs with about 86% of these professionals being involved in the programs. Factors such as gender, age, and educational background (i.e. highest educational qualifications and discipline did not seem to have any relationship with involvement in knowledge management programs. Many of those involved in the programs are playing key roles, such as the design of the information architecture, development of taxonomy, or con-tent management of the organization's intranet. Others play lesser roles, such as providing information for the intranet, gathering competitive intelligence, or providing research services as requested by the knowledge management team.
..., Office of Program Management, 202-366-3800, for general information about the OTRB Program. Contact... FTA's Transportation Electronic Awards Management System (TEAM) for the projects identified in Tables... under the Special Warranty Provisions of the Department of Labor Guidelines ``Section 5333(b), Federal...
Wainer, Allison L.; Ingersoll, Brooke R.
Systematic research focused on developing and improving strategies for the dissemination and implementation of effective ASD services is essential. An innovative and promising area of research is the use of telehealth programs to train parents of children with ASD in intervention techniques. A hybrid telehealth program, combining self-directed…
In 1999, the Bill & Melinda Gates Foundation began an innovative scholarship program that provides full financial support to low-income minority students across the United States. The Gates Millennium Scholars (GMS) program has already awarded more than 10,000 scholarships to exceptional students, with the ultimate goal of funding at least…
Warschauer, Mark; Zheng, Binbin; Niiya, Melissa; Cotten, Shelia; Farkas, George
Seeking to improve teaching and learning and to narrow gaps between students of high and low socioeconomic status, many school districts in the United States are implementing one-to-one laptop programs. In this comparative case study, we examine one-to-one laptop programs in Colorado, California, and Alabama, all of which deployed low-cost netbook…
Forsell, Marianne; Kullberg, Erika; Hoogstraate, Janet; Johansson, Olle; Sjögren, Petteri
Increasing evidence shows strong statistical correlations between improved oral hygiene and reduction in the incidence, and mortality, from health care-associated pneumonia among elderly. Therefore, it is important that nursing staff are well educated in oral hygiene. The objective was to describe the design of a new oral hygiene educational program for nursing staff, where the theoretical parts of the education were integrated with evidence about the preventive effect of improved oral care on respiratory tract infections and health care-associated pneumonia among hospitalized or nursing home resident older people. An educational model was translated into three educational steps: hands-on training, group discussions, and a theoretical lecture including scientific evidence about the preventive effect of oral hygiene on respiratory tract infections, and health care-associated pneumonia, among older people. Evidence-based oral hygiene education seems to be a feasible way to increase the motivation for daily oral care tasks among nursing staff, and thus to improve the oral hygiene status among the nursing home resident elderly. Further studies are, however, needed to further evaluate the effect of evidence-based oral hygiene educations in different health care settings and over longer time periods. Copyright © 2010 Elsevier Ltd. All rights reserved.
Full Text Available This article examines whether the state, through conditional cash transfer programs (CCT, can reduce the poverty and extremely poverty in societies marred by high levels of income concentration. We focus on one of the most unequal countries in the globe, Brazil, and analyze the extent to which this country's CCT program - Bolsa Família (BF, Family Grant program - is able to improve the life chances of extremely poor beneficiaries, through the three major goals of PBF: First, to immediately end hunger; second, to create basic social rights related to healthcare and education; finally, considering also complementary policies, to integrate adults into the job market. The analysis relies on a quantitative survey with 4,000 beneficiaries and a qualitative survey comprised of in-depth interviews with 38 program's participants from all the regions of the country in 2008, it means that this study is about the five first years of the PBF. In order to answer the research questions, we ran four probit analyses related: a the determinants of the realization of prenatal care; b the determinants of food security among BF beneficiaries, c the determinants that adult BF recipients will return to school, d the determinants that a BF beneficiary will obtain a job. Important results from the study are: First, those who before their participation on PBF were at the margins have now been able to access healthcare services on a more regular basis. Thus, the women at the margins who were systematically excluded - black women, poorly educated and from the North - now, after their participation in the CCT program, have more access to prenatal care and can now count with more availability of public healthcare network. Second, before entering the Bolsa Família program, 50.3% of the participants faced severe food insecurity. This number went down to 36.8% in very five years. Men are more likely than women; non-blacks more likely than blacks; and South and Centre
Stewart, Shannon C. [Bonneville Power Administration (BPA), Portland, OR (United States)
The Bonneville Power Administration (BPA) is proposing to fund a canal-stream crossing and fish screen improvement project on Cooke Creek in Kittitas County, Washington. The project proposes to place the Ellensburg Water Company’s (EWC) main canal into a siphon passing underneath Cooke Creek, to build a fish screen on the EWC diversion on Cooke Creek, and to restore the Cooke Creek channel to a more natural state. The goal of this project is to improve fish habitat conditions in the Yakima River Basin and to protect ESA listed Mid-Columbia steelhead and bull trout. This project is part of the Yakima Tributary Access and Habitat Program, which works with landowners, water purveyors, and municipalities to restore fish passage to Yakima River tributaries that historically supported salmonids and to improve habitat in areas where access is restored.
Full Text Available With the objective to improve access to safe abortion services in India, the Ministry of Health and Welfare, with approval of the Law Ministry, published draft amendments of the MTP Act on October 29, 2014. Instead of the expected support, the amendments created a heated debate within professional medical associations of India. In this commentary, we review the evidence in response to the current discourse with regard to the amendments. It would be unfortunate if unsubstantiated one-sided arguments would impede the intention of improving access to safe abortion care in India.
Wu, Esther X W; Gilani, Syed Omer; van Boxtel, Jeroen J A; Amihai, Ido; Chua, Fook Kee; Yen, Shih-Cheng
Previous studies have shown that saccade plans during natural scene viewing can be programmed in parallel. This evidence comes mainly from temporal indicators, i.e., fixation durations and latencies. In the current study, we asked whether eye movement positions recorded during scene viewing also reflect parallel programming of saccades. As participants viewed scenes in preparation for a memory task, their inspection of the scene was suddenly disrupted by a transition to another scene. We examined whether saccades after the transition were invariably directed immediately toward the center or were contingent on saccade onset times relative to the transition. The results, which showed a dissociation in eye movement behavior between two groups of saccades after the scene transition, supported the parallel programming account. Saccades with relatively long onset times (>100 ms) after the transition were directed immediately toward the center of the scene, probably to restart scene exploration. Saccades with short onset times (programming of saccades during scene viewing. Additionally, results from the analyses of intersaccadic intervals were also consistent with the parallel programming hypothesis.
Rangel Gomez, Maria Gudelia; Tonda, Josana; Zapata, G Rogelio; Flynn, Michael; Gany, Francesca; Lara, Juanita; Shapiro, Ilan; Rosales, Cecilia Ballesteros
While individuals of Mexican origin are the largest immigrant group living in the U.S., this population is also the highest uninsured. Health disparities related to access to health care, among other social determinants, continue to be a challenge for this population. The government of Mexico, in an effort to address these disparities and improve the quality of life of citizens living abroad, has partnered with governmental and non-governmental health-care organizations in the U.S. by developing and implementing an initiative known as Ventanillas de Salud -Health Windows-(VDS). The VDS is located throughout the Mexican Consular network and aim to increase access to health care and health literacy, provide health screenings, and promote healthy lifestyle choices among low-income and immigrant Mexican populations in the U.S.
Gooch, Barbara F; Griffin, Susan O; Gray, Shellie Kolavic; Kohn, William G; Rozier, R Gary; Siegal, Mark; Fontana, Margherita; Brunson, Diane; Carter, Nancy; Curtis, David K; Donly, Kevin J; Haering, Harold; Hill, Lawrence F; Hinson, H Pitts; Kumar, Jayanth; Lampiris, Lewis; Mallatt, Mark; Meyer, Daniel M; Miller, Wanda R; Sanzi-Schaedel, Susan M; Simonsen, Richard; Truman, Benedict I; Zero, Domenick T
School-based sealant programs (SBSPs) increase sealant use and reduce caries. Programs target schools that serve children from low-income families and focus on sealing newly erupted permanent molars. In 2004 and 2005, the Centers for Disease Control and Prevention (CDC), Atlanta, sponsored meetings of an expert work group to update recommendations for sealant use in SBSPs on the basis of available evidence regarding the effectiveness of sealants on sound and carious pit and fissure surfaces, caries assessment and selected sealant placement techniques, and the risk of caries' developing in sealed teeth among children who might be lost to follow-up. The work group also identified topics for which additional evidence review was needed. The work group used systematic reviews when available. Since 2005, staff members at CDC and subject-matter experts conducted several independent analyses of topics for which no reviews existed. These reviews include a systematic review of the effectiveness of sealants in managing caries. The evidence supports recommendations to seal sound surfaces and noncavitated lesions, to use visual assessment to detect surface cavitation, to use a toothbrush or handpiece prophylaxis to clean tooth surfaces, and to provide sealants to children even if follow-up cannot be ensured. These recommendations are consistent with the current state of the science and provide appropriate guidance for sealant use in SBSPs. This report also may increase practitioners' awareness of the SBSP as an important and effective public health approach that complements clinical care.
Loman, Nicholas J; Pallen, Mark J
Pallen Mark J
... Governmental Affairs Bureau, 202-418-2498 (voice), 202-418-1169 (TTY), or [email protected] (e-mail); or... gaps in video programming through the provision of video description on television and closed...
National Oceanic and Atmospheric Administration, Department of Commerce — This data type was designed for analyzed wave data originating from the National Ocean Service (NOS) Coastal Wave Program. The data are organized into 3 record...
Shimizu, Tadashi; Ueda, Masahiro; Toyoyama, Mikoto; Ohmori, Shiho; Takagaki, Nobumasa
This study evaluated the effect of an evidence-based medicine (EBM) educational program on EBM-related knowledge and skills of pharmacists and pharmacy students. Our preliminary educational program included the following four sessions: 1) ice breaker, 2) formulation of answerable clinical questions from virtual clinical scenario using the PICO criteria, 3) critical appraisal of the literature using a checklist, and 4) critical appraisal of the results and integrating the evidence with experience and patients values. Change in knowledge and skills related to EBM were evaluated using pre- and post-seminar 4-point scale questionnaires comprising of 14 questions. A total of 23 pharmacists, 1 care manager, and 5 pharmacy students participated in our EBM educational seminar. Knowledge and skills related to several variables improved significantly post-seminar (pre-seminar 2.80 versus 3.26 post-seminar; p<0.001). Specifically, the skills of formulating answerable clinical questions from virtual clinical scenario and critical appraisal of the literature using a checklist improved. Our findings suggested that EBM educational program using problem-based learning was effective in improving EBM-related knowledge and skills of pharmacists and pharmacy students.
Dalle Molle, R; Bischoff, A R; Portella, A K; Silveira, P P
Increased energy consumption is one of the major factors implicated in the epidemic of obesity. There is compelling evidence, both clinical and experimental, that fetal paucity of nutrients may have programming effects on feeding preferences and behaviors that can contribute to the development of diseases. Clinical studies in different age groups show that individuals born small for their gestational age (SGA) have preferences towards highly caloric foods such as carbohydrates and fats. Some studies have also shown altered eating behaviors in SGA children. Despite an apparent discrepancy in different age groups, all studies seem to converge to an increased intake of palatable foods in SGA individuals. Small nutrient imbalances across lifespan increase the risk of noncommunicable diseases in adult life. Homeostatic factors such as altered responses to leptin and insulin and alterations in neuropeptides associated with appetite and satiety are likely involved. Imbalances between homeostatic and hedonic signaling are another proposed mechanism, with the mesocorticolimbic dopaminergic pathway having differential reward and pleasure responses when facing palatable foods. Early exposure to undernutrition also programs hypothalamic-pituitary-adrenal axis, with SGA having higher levels of cortisol in different ages, leading to chronic hyperactivity of this neuroendocrine axis. This review summarizes the clinical and experimental evidence related to fetal programming of feeding preferences by SGA.
Gayet, S.; Paffen, C.L.E.; Guggenmos, M.; Sterzer, P.; Stigchel, S. van der
Visual working memory (VWM) allows for keeping relevant visual information available after termination of its sensory input. Storing information in VWM, however, affects concurrent conscious perception of visual input: initially suppressed visual input gains prioritized access to consciousness when
Andrews, Christina M.; D’Aunno, Thomas A.; Pollack, Harold A.; Friedmann, Peter D.
This article examines changes from 2005 to 2011 in the use of an evidence-based clinical innovation, buprenorphine use, among a nationally representative sample of opioid treatment programs and identifies characteristics associated with its adoption. We apply a model of the adoption of clinical innovations that focuses on the work needs and characteristics of staff; organizations’ technical and social support for the innovation; local market dynamics and competition; and state policies governing the innovation. Results indicate that buprenorphine use increased 24% for detoxification and 47% for maintenance therapy between 2005 and 2011. Buprenorphine use was positively related to reliance on private insurance and availability of state subsidies to cover its cost and inversely related to the percentage of clients who injected opiates, county size, and local availability of methadone. The results indicate that financial incentives and market factors play important roles in opioid treatment programs’ decisions to adopt evidence-based clinical innovations such as buprenorphine use. PMID:24051897
Mindy Renfro; Donna Bernhardt Bainbridge; Matthew Lee Smith; Matthew Lee Smith
INTRODUCTION: Evidence-based fall prevention (EBFP) programs significantly decrease fall risk, falls, and fall-related injuries in community-dwelling older adults. To date, EBFP programs are only validated for use among people with normal cognition and, therefore, are not evidence-based for adults with intellectual and/or developmental disorders (IDD) such as Alzheimer’s disease and related dementias (ADRD), cerebral vascular accident (CVA), or traumatic brain injury (TBI). BACKGROUND: Adults...
Renfro, Mindy; Bainbridge, Donna B.; Smith, Matthew Lee
Introduction Evidence-based fall prevention (EBFP) programs significantly decrease fall risk, falls, and fall-related injuries in community-dwelling older adults. To date, EBFP programs are only validated for use among people with normal cognition and, therefore, are not evidence-based for adults with intellectual and/or developmental disorders (IDD) such as Alzheimer?s disease and related dementias, cerebral vascular accident, or traumatic brain injury. Background Adults with IDD experience ...
Raiten, Daniel J; Sakr Ashour, Fayrouz A; Ross, A Catharine; Meydani, Simin N; Dawson, Harry D; Stephensen, Charles B; Brabin, Bernard J; Suchdev, Parminder S; van Ommen, Ben
An increasing recognition has emerged of the complexities of the global health agenda—specifically, the collision of infections and noncommunicable diseases and the dual burden of over- and undernutrition. Of particular practical concern are both 1) the need for a better understanding of the bidirectional relations between nutritional status and the development and function of the immune and inflammatory response and 2) the specific impact of the inflammatory response on the selection, use, and interpretation of nutrient biomarkers. The goal of the Inflammation and Nutritional Science for Programs/Policies and Interpretation of Research Evidence (INSPIRE) is to provide guidance for those users represented by the global food and nutrition enterprise. These include researchers (bench and clinical), clinicians providing care/treatment, those developing and evaluating programs/interventions at scale, and those responsible for generating evidence-based policy. The INSPIRE process included convening 5 thematic working groups (WGs) charged with developing summary reports around the following issues: 1) basic overview of the interactions between nutrition, immune function, and the inflammatory response; 2) examination of the evidence regarding the impact of nutrition on immune function and inflammation; 3) evaluation of the impact of inflammation and clinical conditions (acute and chronic) on nutrition; 4) examination of existing and potential new approaches to account for the impact of inflammation on biomarker interpretation and use; and 5) the presentation of new approaches to the study of these relations. Each WG was tasked with synthesizing a summary of the evidence for each of these topics and delineating the remaining gaps in our knowledge. This review consists of a summary of the INSPIRE workshop and the WG deliberations. © 2015 American Society for Nutrition.
Raiten, Daniel J; Ashour, Fayrouz A Sakr; Ross, A Catharine; Meydani, Simin N; Dawson, Harry D; Stephensen, Charles B; Brabin, Bernard J; Suchdev, Parminder S; van Ommen, Ben
An increasing recognition has emerged of the complexities of the global health agenda—specifically, the collision of infections and noncommunicable diseases and the dual burden of over- and undernutrition. Of particular practical concern are both 1) the need for a better understanding of the bidirectional relations between nutritional status and the development and function of the immune and inflammatory response and 2) the specific impact of the inflammatory response on the selection, use, and interpretation of nutrient biomarkers. The goal of the Inflammation and Nutritional Science for Programs/Policies and Interpretation of Research Evidence (INSPIRE) is to provide guidance for those users represented by the global food and nutrition enterprise. These include researchers (bench and clinical), clinicians providing care/treatment, those developing and evaluating programs/interventions at scale, and those responsible for generating evidence-based policy. The INSPIRE process included convening 5 thematic working groups (WGs) charged with developing summary reports around the following issues: 1) basic overview of the interactions between nutrition, immune function, and the inflammatory response; 2) examination of the evidence regarding the impact of nutrition on immune function and inflammation; 3) evaluation of the impact of inflammation and clinical conditions (acute and chronic) on nutrition; 4) examination of existing and potential new approaches to account for the impact of inflammation on biomarker interpretation and use; and 5) the presentation of new approaches to the study of these relations. Each WG was tasked with synthesizing a summary of the evidence for each of these topics and delineating the remaining gaps in our knowledge. This review consists of a summary of the INSPIRE workshop and the WG deliberations. PMID:25833893
Swart, Estelle; Chataika, Tsitsi; Bell, Diane
This article provides some insights into the challenges regarding inclusion in higher education of students with disabilities. It does this by elucidating aspects of the proceedings of the Education Commission at the African Network on Evidence-to-Action on Disability (AfriNEAD) Symposium, which took place in Zimbabwe in November 2011. The presentations specifically focused on the education of people with disabilities from early childhood through to higher education. This article, however, is informed by presentations focusing on increasing access to higher education. The article is focused on the implementation of evidence in practice, research and policies stemming from rigorous debate and scientific foundations, whilst taking into account the dynamic realities of the higher education context. Themes such as the systemic approach needed for inclusion to be successful, increasing access and the dynamic role of students with disabilities are highlighted. PMID:28730011
Lyner-Cleophas, Marcia; Swart, Estelle; Chataika, Tsitsi; Bell, Diane
This article provides some insights into the challenges regarding inclusion in higher education of students with disabilities. It does this by elucidating aspects of the proceedings of the Education Commission at the African Network on Evidence-to-Action on Disability (AfriNEAD) Symposium, which took place in Zimbabwe in November 2011. The presentations specifically focused on the education of people with disabilities from early childhood through to higher education. This article, however, is informed by presentations focusing on increasing access to higher education. The article is focused on the implementation of evidence in practice, research and policies stemming from rigorous debate and scientific foundations, whilst taking into account the dynamic realities of the higher education context. Themes such as the systemic approach needed for inclusion to be successful, increasing access and the dynamic role of students with disabilities are highlighted.
Sarah E Wilson
Full Text Available To evaluate the direct and indirect population impact of rotavirus (RV immunization on hospitalizations and emergency department (ED visits for acute gastroenteritis (AGE in Ontario before and after the publicly-funded RV immunization program.Administrative data was used to identify ED visits and hospitalizations for all Ontarians using ICD-10 codes. We used two outcome definitions: RV-specific AGE (RV-AGE and codes representing RV-, other viral and cause unspecified AGE ("overall AGE". The pre-program and public program periods were August 1, 2005 to July 31, 2011; and August 1, 2011 to March 31, 2013, respectively. A negative binominal regression model that included the effect of time was used to calculate rates and rate ratios (RRs and 95% confidence intervals (CIs for RV-AGE and overall AGE between periods, after adjusting for age, seasonality and secular trends. Analyses were conducted for all ages combined and age stratified.Relative to the pre-program period, the adjusted RRs for RV-AGE and overall AGE hospitalizations in the public program period were 0.29 (95%CI: 0.22-0.39 and 0.68 (95%CI: 0.62-0.75, respectively. Significant reductions in RV-AGE hospitalizations were noted overall and for the following age bands: = 65 years (RR 0.80, 95%CI: 0.72-0.90. The program was associated with adjusted RRs of 0.32 (95% CI: 0.20-0.52 for RV-AGE ED visits and 0.90 (95% CI: 0.85-0.96 for overall AGE ED visits.This large, population-based study provides evidence of the impact of RV vaccine in preventing hospitalizations and ED visits for RV-AGE and overall AGE, including herd effects.
Moon S. Chen, Jr
Full Text Available This paper describes the development and implementation of a Hmong Cervical Cancer Intervention Program utilizing a patient navigation model to raise cervical cancer awareness for Hmong women through educational workshops and to assist Hmong women in obtaining a Pap test. Out of 402 women who participated in a baseline survey, the Patient Navigation Program was able to enroll 109 participants who had not had a Pap test in the past 3 years and had never had a Pap test. Through utilization of outreach, an awareness campaign and patient navigation support, at least 38 percent of 109 participants obtained a Pap test. Overall, 21 workshops and 43 outreach activities were conducted by the Hmong Women’s Heritage Association, leading to 63 percent of those enrolled in the Patient Navigation Program who could be contacted to obtain a Pap test.
Richard C. Palmer
Full Text Available Introduction. This study aimed to examine how well an evidence-based physical activity program could be translated for wide scale dissemination and adoption to increase physical activity among community-dwelling older adults. Methods. Between October 2009 and December 2012, reach, fidelity, dosage, ease of implementation, and barriers to translation of EnhanceFitness (EF were assessed. To assess effectiveness, a pretest-posttest design was used to measure increases in functional fitness (chair stands, arm curls, and the up-and-go test. Results. Fourteen community-based agencies offered 126 EF classes in 83 different locations and reached 4,490 older adults. Most participants were female (72%. Thirty-eight percent of participants did not complete the initial 16-week EF program. The 25% who received the recommended dose experienced an increase in upper and lower body strength and mobility. Further, participants reported high satisfaction with the program. Conclusion. EF was successfully implemented in a variety of settings throughout South Florida and reached a large number of older adults. However, challenges were encountered in ensuring that those who participated received a program dose that would lead to beneficial gains in functional fitness.
Cohodes, Sarah; Kleiner, Samuel; Lovenheim, Michael F.; Grossman, Daniel
Public health insurance programs comprise a large share of federal and state government expenditure, and these programs are due to be expanded as part of the 2010 Affordable Care Act. Despite a large literature on the effects of these programs on health care utilization and health outcomes, little prior work has examined the long-term effects of…
Hossain, M W; Khan, H T; Begum, A
This paper studies the effectiveness of "Jiggasha," an innovative communication approach for the promotion of family planning in Dhaka, Bangladesh. Data from the 1996 Jiggasha follow-up survey were used, which gathered information by interviewing a network sample of 1862 married women and a subsample of 608 men. The study used the sample constituted by women respondents and included data on socioeconomic and demographic characteristics of the respondents and their knowledge, attitude and practice relating to contraceptives. Findings showed that Jiggasha respondents have more access to radio than television. All respondents reported having a radio in their homes and they emphasized the importance of broadcasting more family planning messages via both electronic media. Only 16% of the women in the study setting were exposed to group meetings. Of the respondents reporting participation in group meetings, 38.25% joined in a Jiggasha meeting, 23.15% in a Grameen Bank group meeting, and 4.70% in a Bangladesh Rural Advancement Committee group meeting. Logistic regression analysis indicated more access to Jiggashas among women over 30 years of age than among the younger age groups. Religion and education levels of respondents have significant impact on access to Jiggashas. Husbands' approval plays an important role among the Jiggasha respondents in using family planning method. This study provides important information for policy-makers to make family planning program a success.
Evenson, Kelly R; Wen, Fang; Lee, Sarah M; Heinrich, Katie M; Eyler, Amy
A Healthy People 2010 developmental objective (22-12) was set to increase the proportion of the nation's public and private schools that provide access to their physical activity spaces and facilities for all persons outside of normal school hours. The purpose of this study was to describe the prevalence of indoor and outdoor facilities at schools and the availability of those facilities to the public in 2000 and 2006. In 2000 and 2006, the School Health Policies and Programs Study (SHPPS) was conducted in each state and in randomly selected districts, schools, and classrooms. This analysis focused on the school level questionnaire from a nationally representative sample of public and nonpublic elementary, middle, and high schools (n = 921 in 2000 and n = 984 in 2006). No meaningful changes in the prevalence of access to school physical activity facilities were found from 2000 to 2006, for youth or adult community sports teams, classes, or open gym. These national data indicate a lack of progress from 2000 and 2006 toward increasing the proportion of the nation's public and private schools that provide access to their physical activity facilities for all persons outside of normal school hours.
...) because the release of the disclosure accounting would permit the subject of an investigation to obtain valuable information concerning the nature of that investigation. This would permit record subjects to impede the investigation, e.g., destroy evidence, intimidate potential witnesses, or flee the area to...
Sigal, Amanda; Sandler, Irwin; Wolchik, Sharlene; Braver, Sanford
Most parent education programs are designed to improve child well-being following divorce by changing some aspect of parenting. However, there has been relatively little discussion of what aspects of parenting are most critical and the effectiveness of programs to change different aspects of parenting. This paper addresses these issues by: 1. Distinguishing three aspects of post-divorce parenting that have been targeted in parent education programs; 2. Reviewing evidence of the relations between each aspect of parenting and the well-being of children and; 3. Critically reviewing evidence that parent education programs have been successful in changing each aspect of post-divorce parenting. PMID:21552360
ABSTRACT The Centennial Vision of the American Occupational Therapy Association (AOTA) projects that by 2017 all occupational therapy (OT) practice areas will be supported by evidence. Achieving this goal requires preparing clinicians with the skills to assimilate, analyze, and apply research to their areas of practice and communicate the value of OT services to consumers and payers. These skills are at the heart of evidence-based practice (EBP). Educators must be prepared to teach EBP skills in both entry-level and postprofessional programs. This article outlines how EBP can be taught to postprofessional occupational therapy clinical doctoral students using a distance education format. Key features of a successful EBP course include having access to full-text electronic articles, opportunities for students to explore the literature in their own areas of interest, consistent and timely feedback on written work and discussion topics, and opportunities to collaborate with peers.
Armentano, T.V.; Loucks, O.L.
The goal of The Institute of Energy (TIE) 1977 to 1979 ACCESS program was to define the national need for ecological and environmental data and the extent to which present data documentation and archiving are meeting this need. The principal steps focussed on current data documentation and research in government, private and academic sectors of the natural science technical community, particularly as they bear on the accessibility of environmental data to secondary users. The extent to which existing data services are satisfying the needs of data users also was emphasized. The results indicate that the potential contributions which existing data and models could make are not being achieved because of inconsistencies in data documentation, inadequate communication between data suppliers and data users, and a lack of overall coordination of the data bases in national research and monitoring programs. A nationally coordinated network is proposed which focuses on regional data centers and ties together the hierarchy of data bases (national, state, and local) with the broad spectrum of potential users. The network concept includes immediate development of a comprehensive catalog of data resources in each region, with later production of a data abstract journal as one of two methods for communicating between regional and local data centers and the user community.
... Regional Office for grant-specific issues; or Blenda Younger, Office of Program Management, 202-366-4345... FTA's Transportation Electronic Awards Management System (TEAM) for the projects identified in Tables... under the Special Warranty Provisions of the Department of Labor Guidelines ``Section 5333(b), Federal...
maximize workplace efficiency. As a result of targeting these high-quality applicants and creating more efficient leadership training programs, these...organization, which is known for exceptionally high safety standards and performance, small inefficiencies in the areas of teamwork and leadership ...recruiting needs. We found that the Navy is inadequately assessing applicant skills and attributes through its primary use of cognitive testing
Freedman, Darcy A; Flocke, Susan; Shon, En-Jung; Matlack, Kristen; Trapl, Erika; Ohri-Vachaspati, Punam; Osborne, Amanda; Borawski, Elaine
Evaluate farmers' market (FM) use patterns among Supplemental Nutrition Assistance Program (SNAP) recipients. Cross-sectional survey administered June to August, 2015. Cleveland and East Cleveland, OH. A total of 304 SNAP recipients with children. Participants lived within 1 mile of 1 of 17 FMs. Most were African American (82.6%) and female (88.1%), and had received SNAP for ≥5 years (65.8%). Patterns of FM shopping, awareness of FM near home and of healthy food incentive program, use of SNAP to buy fruits and vegetables and to buy other foods at FMs, receipt of healthy food incentive program. Two-stage cluster analysis to identify segments with similar FM use patterns. Bivariate statistics including chi-square and ANOVA to evaluate main outcomes, with significance at P ≤ .05. A total of 42% reported FM use in the past year. Current FM shoppers (n = 129) were segmented into 4 clusters: single market, public market, multiple market, and high frequency. Clusters differed significantly in awareness of FM near home and the incentive program, use of SNAP to buy fruit and vegetables at FMs, and receipt of incentive. Findings highlight distinct types of FM use and had implications for tailoring outreach to maximize first time and repeat use of FMs among SNAP recipients. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.
York, Eric James
Growing out of research in Technical Communication, Composition Studies, and Writing Program Administration, the articles in this dissertation explicitly seek to address changes in the practices and products of writing and writing studies wrought by the so-called "digital revolution" in communication technology, which has been ongoing in…
..., requirements, and standards of the Architectural Barriers Act (42 U.S.C. 4151-4157), as established in 41 CFR...) NATIONAL COMMISSION ON LIBRARIES AND INFORMATION SCIENCE ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY NATIONAL COMMISSION ON LIBRARIES AND INFORMATION SCIENCE...
.... An article published in 2004 in the Journal of the American Medical Association (Berwick, D.M. and... environment'' as they ``engender trust in families, creating a better working relationship between hospital... technical assistance programs (such as Medicare Learning Network at http://www.cms.gov/MLNGenInfo/ ) to make...
Weiner Bryan J
Full Text Available Abstract Background Foundations and public agencies commonly fund focused initiatives for individual grantees. These discrete, stand-alone initiatives can risk failure by being carried out in isolation. Fostering synergy among grantees' initiatives is one strategy proposed for promoting the success and impact of grant programs. We evaluate an explicit strategy to build synergy within the Robert Wood Johnson Foundation's Southern Rural Access Program (SRAP, which awarded grants to collaboratives within eight southeastern U.S. states to strengthen basic health care services in targeted rural counties. Methods We interviewed 39 key participants of the SRAP, including the program director within each state and the principal subcontractors heading the program's funded initiatives that supported heath professionals' recruitment, retention and training, made loans to health care providers, and built networks among providers. Interews were recorded and transcribed. Two investigators independently coded the transcripts and a third investigator distilled the main points. Results Participants generally perceived that the SRAP yielded more synergies than other grant programs in which they had participated and that these synergies added to the program's impact. The synergies most often noted were achieved through relationship building among grantees and with outside agencies, sharing information and know-how, sharing resources, combining efforts to yield greater capacity, joining voices to advocate for common goals, and spotting gaps in services offered and then filling these gaps. The SRAP's strategies that participants felt fostered synergy included targeting funding to culturally and geographically similar states, supporting complementary types of initiatives, promoting opportunities to network through semi-annual meetings and regular conference calls, and the advocacy efforts of the program's leadership. Participants noted that synergies were sometimes
Gorman, Dennis M.; Huber, J. Charles, Jr.
This study explores the possibility that any drug prevention program might be considered "evidence-based" given the use of data analysis procedures that optimize the chance of producing statistically significant results by reanalyzing data from a Drug Abuse Resistance Education (DARE) program evaluation. The analysis produced a number of…
Burke, Eva; Gold, Judy; Razafinirinasoa, Lalaina; Mackay, Anna
Young people often express a preference for seeking family planning information and services from the private sector. However, in many Marie Stopes International (MSI) social franchise networks, the proportion of young clients, and particularly those under 20 years of age, remains low. Marie Stopes Madagascar (MSM) piloted a youth voucher program that joins a supply-side intervention-youth-friendly social franchisee training and quality monitoring-with a corresponding demand-side-component, free vouchers that reduce financial barriers to family planning access for young people. Young people identified by MSM's community health educators (CHEs) received a free voucher redeemable at a BlueStar social franchisee for a package of voluntary family planning and sexually transmitted infection (STI) information and services. BlueStar social franchisees-private providers accredited by MSM-are reimbursed for the cost of providing these services. We reviewed service statistics data from the first 18 months of the youth voucher program, from July 2013 to December 2014, as well as client demographic profile data from July 2015. Findings: Between July 2013 and December 2014, 58,417 vouchers were distributed to young people by CHEs through a range of community mobilization efforts, of which 43,352 (74%) were redeemed for family planning and STI services. Most clients (78.5%) chose a long-acting reversible contraceptive (LARC), and just over half (51%) of young people benefited from STI counseling as part of their voucher service. Most (78%) services were provided in the Analamanga region (the capital and its surroundings), which was expected given the population density in this region and the high concentration of BlueStar franchisees. The client profile data snapshot from July 2015 revealed that 69% of voucher clients had never previously used a contraceptive method, and 96% of clients were aged 20 or younger, suggesting that the voucher program is successfully reaching the
Timko, Christine; Below, Maureen; Schultz, Nicole R; Brief, Deborah; Cucciare, Michael A
Although completion of detoxification (detox) and a successful transition from detox to substance use disorder (SUD) treatment and/or mutual-help groups are associated with better SUD outcomes, many patients do not complete detox or do not receive SUD care following detox. The purpose of this structured evidence review, summarizing data extraction on a yield of 26 articles, is to identify patient, program, and system factors associated with the outcomes of completion of alcohol detox and successful transitions from alcohol detox to SUD treatment and mutual-help group participation. The review found wide variability among studies in the rates at which patients complete a detox episode (45 to 95%) and enter SUD treatment or mutual-help groups after detox (14 to 92%). Within program factors, behavioral practices that contribute to both detox completion and transitioning to SUD care after detox entail involving the patient's family and utilizing motivational-based approaches. Such practices should be targeted at younger patients, who are less likely to complete detox. Although more studies using a randomized controlled trial design are needed, the evidence suggests that barriers to detox completion and transition to SUD care can be overcome to improve patient outcomes. Published by Elsevier Inc.
Maruthur, Nisa; Mathioudakis, Nestoras; Spanakis, Elias; Rubin, Daniel; Zilbermint, Mihail; Hill-Briggs, Felicia
Purpose of Review The goal of this review is to describe diabetes within a population health improvement framework and to review the evidence for a diabetes population health continuum of intervention approaches, including diabetes prevention and chronic and acute diabetes management, to improve clinical and economic outcomes. Recent Findings Recent studies have shown that compared to usual care, lifestyle interventions in prediabetes lower diabetes risk at the population-level and that group-based programs have low incremental medial cost effectiveness ratio for health systems. Effective outpatient interventions that improve diabetes control and process outcomes are multi-level, targeting the patient, provider, and healthcare system simultaneously and integrate community health workers as a liaison between the patient and community-based healthcare resources. A multi-faceted approach to diabetes management is also effective in the inpatient setting. Interventions shown to promote safe and effective glycemic control and use of evidence-based glucose management practices include provider reminder and clinical decision support systems, automated computer order entry, provider education, and organizational change. Summary Future studies should examine the cost-effectiveness of multi-faceted outpatient and inpatient diabetes management programs to determine the best financial models for incorporating them into diabetes population health strategies. PMID:28567711
MicroShield® is a comprehensive photon/gamma ray shielding and dose assessment programme. It is widely used for designing shields, estimating source strength from radiation measurements, minimising exposure to people, and teaching shielding principles. Integrated tools allow the graphing of results, material and source file creation, source inference with decay (dose-to-Bq calculations accounting for decay and daughter buildup), the projection of exposure rate versus time as a result of decay, access to material and nuclide data, and decay heat calculations. The latest version is able to export results using Microsoft Office (formatted and colour-coded for readability). Sixteen geometries accommodate offset dose points and as many as ten standard shields plus source self-shielding and cylinder cladding are available. The library data (radionuclides, attenuation, build-up and dose conversion) reflect standard data from ICRP 38 and 107* as well as ANSI/ANS standards and RSICC publicat...
Vachharajani, Tushar J; Moossavi, Shahriar; Salman, Loay; Wu, Steven; Dwyer, Amy C; Ross, Jamie; Dukkipati, Ramanath; Maya, Ivan D; Yevzlin, Alexander S; Agarwal, Anil; Abreo, Kenneth D; Work, Jack; Asif, Arif
The development of interventional nephrology has undoubtedly led to an improvement in patient care at many facilities across the United States. However, these services have traditionally been offered by interventional nephrologists in the private practice arena. While interventional nephrology was born in the private practice setting, several academic medical centers across the United States have now developed interventional nephrology programs. University Medical Centers (UMCs) that offer interventional nephrology face challenges, such as smaller dialysis populations, limited financial resources, and real or perceived political "turf" issues." Despite these hurdles, several UMCs have successfully established interventional nephrology as an intricate part of a larger nephrology program. This has largely been accomplished by consolidating available resources and collaborating with other specialties irrespective of the size of the dialysis population. The collaboration with other specialties also offers an opportunity to perform advanced procedures, such as application of excimer laser and endovascular ultrasound. As more UMCs establish interventional nephrology programs, opportunities for developing standardized training centers will improve, resulting in better quality and availability of nephrology-related procedures, and providing an impetus for research activities. © 2011 Wiley Periodicals, Inc.
Perinatal drug and alcohol use is associated with serious medical and psychiatric morbidity for pregnant and postpartum women and their newborns. Participation in prenatal care has been shown to improve outcomes, even in the absence of treatment for substance use disorders. Unfortunately, women with substance use disorders often do not receive adequate prenatal care. Barriers to accessing care for pregnant women with substance use disorders include medical and psychiatric comorbidities, transportation, caring for existing children, housing and food insecurity, and overall lack of resources. In a health care system where care is delivered by each discipline separately, lack of communication between providers causes poorly coordinated services and missed opportunities. The integration of mental health and substance use treatment services in medical settings is a goal of health care reform. However, this approach has not been widely promoted in the context of maternity care. The Dartmouth-Hitchcock Medical Center Perinatal Addiction Treatment Program provides an integrated model of care for pregnant and postpartum women with substance use disorders, including the colocation of midwifery services in the context of a dedicated addiction treatment program. A structured approach to screening and intervention for drug and alcohol use in the outpatient prenatal clinic facilitates referral to treatment at the appropriate level. Providing midwifery care within the context of a substance use treatment program improves access to prenatal care, continuity of care throughout pregnancy and the postpartum, and availability of family planning services. The evolution of this innovative approach is described. This article is part of a special series of articles that address midwifery innovations in clinical practice, education, interprofessional collaboration, health policy, and global health. © 2015 by the American College of Nurse-Midwives.
Crochet, Patrice; Aggarwal, Rajesh; Knight, Sophie; Berdah, Stéphane; Boubli, Léon; Agostini, Aubert
Substantial evidence in the scientific literature supports the use of simulation for surgical education. However, curricula lack for complex laparoscopic procedures in gynecology. The objective was to evaluate the validity of a program that reproduces key specific components of a laparoscopic hysterectomy (LH) procedure until colpotomy on a virtual reality (VR) simulator and to develop an evidence-based and stepwise training curriculum. This prospective cohort study was conducted in a Marseille teaching hospital. Forty participants were enrolled and were divided into experienced (senior surgeons who had performed more than 100 LH; n = 8), intermediate (surgical trainees who had performed 2-10 LH; n = 8) and inexperienced (n = 24) groups. Baselines were assessed on a validated basic task. Participants were tested for the LH procedure on a high-fidelity VR simulator. Validity evidence was proposed as the ability to differentiate between the three levels of experience. Inexperienced subjects performed ten repetitions for learning curve analysis. Proficiency measures were based on experienced surgeons' performances. Outcome measures were simulator-derived metrics and Objective Structured Assessment of Technical Skills (OSATS) scores. Quantitative analysis found significant inter-group differences between experienced intermediate and inexperienced groups for time (1369, 2385 and 3370 s; p training curriculum using a structured scientific methodology.
Green Sally E
Full Text Available Abstract The Neurotrauma Evidence Translation (NET program was funded in 2009 to increase the uptake of research evidence in the clinical care of patients who have sustained traumatic brain injury. This paper reports the rationale and plan for this five-year knowledge translation research program. The overarching aims of the program are threefold: to improve outcomes for people with traumatic brain injury; to create a network of neurotrauma clinicians and researchers with expertise in knowledge translation and evidence-based practice; and to contribute knowledge to the field of knowledge translation research. The program comprises a series of interlinked projects spanning varying clinical environments and disciplines relevant to neurotrauma, anchored within four themes representing core knowledge translation activities: reviewing research evidence; understanding practice; developing and testing interventions for practice change; and building capacity for knowledge translation in neurotrauma. The program uses a range of different methods and study designs, including: an evidence fellowship program; conduct of and training in systematic reviews; mixed method study designs to describe and understand factors that influence current practices (e.g., semi-structured interviews and surveys; theory-based methods to develop targeted interventions aiming to change practice; a cluster randomised trial to test the effectiveness of a targeted theory-informed intervention; stakeholder involvement activities; and knowledge translation events such as consensus conferences.
Palmer, Robert T.; Davis, Ryan J.
Researchers, policymakers, and administrations have shown great concern over the efficacy of college remediation, which has prompted some states to eliminate remedial programs from public 4-year institutions. However, research suggests that eliminating these programs may have unintended consequences on college access and opportunity for…
Vogler, Sabine; Habimana, Katharina; Arts, Danielle
To analyse the impact of deregulation in community pharmacy on accessibility of medicines, quality of pharmacy services and costs. We analysed and compared community pharmacy systems in five rather deregulated countries (England, Ireland, the Netherlands, Norway, Sweden) and four rather regulated countries (Austria, Denmark, Finland, Spain). Data were collected by literature review, a questionnaire survey and interviews. Following a deregulation, several new pharmacies and dispensaries of Over-the-Counter (OTC) medicines tended to be established, predominantly in urban areas. Unless prevented by regulation, specific stakeholders, e.g. wholesalers, were seen to gain market dominance which limited envisaged competition. There were indications for an increased workload for pharmacists in some deregulated countries. Economic pressure to increase the pharmacy turnover through the sale of OTC medicines and non-pharmaceuticals was observed in deregulated and regulated countries. Prices of OTC medicines were not found to decrease after a deregulation in pharmacy. Access to pharmacies usually increases after a deregulation but this is likely to favour urban populations with already good accessibility. Policy-makers are recommended to take action to ensure equitable accessibility and sustainable competition in a more deregulated environment. No association between pharmaceutical expenditure and the extent of regulation/deregulation appears to exist. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.
Yue, Jinxing; Alter, Kai; Howard, David; Bastiaanse, Roelien
An auditory habituation design was used to investigate whether lexical-level phonological representations in the brain can be rapidly accessed after the onset of a spoken word. We studied the N1 component of the auditory event-related electrical potential, and measured the amplitude decrements of N1
Adamson, John; Brown, Howard
This study reports on the steering of a self-access learning center in a Japanese university by its "middle management" committee over the first years of its operation. Middle management practice was informed by an ethnographic archive of various facets of center use, particularly concerning language policy and curriculum integration, issues about…
Kennedy, Ann B.; Trilk, Jennifer L.
Background and Purpose Evidence suggests that para-athletes are injured more often than able-bodied athletes. The benefits of massage therapy for these disabled athletes are yet to be explored. This paper documents the process followed for creating a massage program for elite paracycling athletes with the goal to assess effects on recovery, rest, performance, and quality of life both on and off the bike. Setting Massage therapists’ private practices throughout the United States. Participants A United States Paracycling team consisting of 9 elite athletes: 2 spinal cord injury, 2 lower limb amputation, 1 upper limb amputation, 1 transverse myelitis, 1 stroke, 1 traumatic brain injury, and 1 visually impaired. Design The process used to develop a massage therapy program for para-cyclists included meetings with athletes, coaching staff, team exercise physiologist, and sports massage therapists; peer-reviewed literature was also consulted to address specific health conditions of para-athletes. Results Team leadership and athletes identified needs for quicker recovery, better rest, and improved performance in elite paracyclists. This information was used to generate a conceptual model for massage protocols, and led to creation of the intake and exit questionnaires to assess patient health status and recovery. Forms also were created for a general health intake, therapist information, and a therapist’s SOAAP notes. Discussion The conceptual model and questionnaires developed herein will help to operationalize an exploratory study investigating the feasibility of implementing a standardized massage therapy program for a decentralized elite paracycling team. PMID:26388960
Kennedy, Ann B; Trilk, Jennifer L
Evidence suggests that para-athletes are injured more often than able-bodied athletes. The benefits of massage therapy for these disabled athletes are yet to be explored. This paper documents the process followed for creating a massage program for elite paracycling athletes with the goal to assess effects on recovery, rest, performance, and quality of life both on and off the bike. Massage therapists' private practices throughout the United States. A United States Paracycling team consisting of 9 elite athletes: 2 spinal cord injury, 2 lower limb amputation, 1 upper limb amputation, 1 transverse myelitis, 1 stroke, 1 traumatic brain injury, and 1 visually impaired. The process used to develop a massage therapy program for para-cyclists included meetings with athletes, coaching staff, team exercise physiologist, and sports massage therapists; peer-reviewed literature was also consulted to address specific health conditions of para-athletes. Team leadership and athletes identified needs for quicker recovery, better rest, and improved performance in elite paracyclists. This information was used to generate a conceptual model for massage protocols, and led to creation of the intake and exit questionnaires to assess patient health status and recovery. Forms also were created for a general health intake, therapist information, and a therapist's SOAAP notes. The conceptual model and questionnaires developed herein will help to operationalize an exploratory study investigating the feasibility of implementing a standardized massage therapy program for a decentralized elite paracycling team.
Sanders, Matthew R.; Kirby, James N.
A consumer perspective can contribute much to enhancing the “ecological fit” of population level parenting interventions so they meet the needs of parents. This approach involves building relationships with consumer groups and soliciting consumer input into the relevance and acceptability of interventions, clarifying the enablers and barriers to engagement and involvement of parents, and clarifying variables that influence a parent’s program completion. The adoption of a more collaborative approach to working with consumers is important if meaningful population level change in the prevalence of serious social, emotional and behavioral problems in children and young people is to be achieved. Parents seeking assistance for their children’s behavior come from a diverse range of socioeconomic backgrounds, educational levels, cultures and languages. This paper examines consumer engagement strategies that can be employed throughout the process of program development, evaluation, training and dissemination and in “scaling up” the intervention. We argue that a multi-level public health approach to parenting intervention requires a strong consumer perspective to enable interventions to be more responsive to the preferences and needs of families and to ensure improved population reach of interventions. Examples from large scale dissemination trials are used to illustrate how consumer input can result in an increasingly differentiated suite of evidence-based parenting programs. PMID:22440062
Ullmann, Gerhild; Williams, Harriet G; Plass, Cora F
Falls among older adults are a serious public health issue, and fear of falling can limit mobility, which in turn increases fall risk. A Matter of Balance/Volunteer Lay Leader Model is an evidence-based program designed to address fear of falling. The objective of this study was to describe implementation, dissemination, and outcomes of this program in 3 regions of South Carolina with a predominantly African American and largely underserved population. We developed partnerships throughout the state, organized master and lay leader trainings, and documented numbers of lay leaders, programs offered, demographic characteristics of participants, program fidelity, and attendance. Outcome measures were self-reported confidence to prevent and manage falls and a quantitative measure of functional mobility. Both measures were assessed at baseline and after program completion. Older adults (N = 235) attended 18 classes at 16 sites. Barriers to implementation were program teams' limited familiarity with the concept of evidence-based programs and the importance of adhering to program content. Facilitators were state-level leadership and a history of state, regional, and local groups collaborating successfully on other projects. Outcomes indicated greater confidence in managing falls and carrying out activities of daily living. Mobility improved significantly, suggesting a reduced risk for falls. Evidence-based programs such as A Matter of Balance/Volunteer Lay Leader Model can be successfully disseminated in underserved areas. Outcomes indicate that participation in fall prevention programs can benefit groups of predominantly African American older adults.
Since 1990, high school students in Washington have had the choice of earning college credit through the Running Start program. Running start is a dual enrollment and dual credit program that allows eleventh and twelfth grade high school students to take college courses at any of Washington's 34 community and technical colleges, Central Washington…
Anderson, S; Shannon, K; Li, J; Lee, Y; Chettiar, J; Goldenberg, S; Krüsi, A
Despite a large body of evidence globally demonstrating that the criminalization of sex workers increases HIV/STI risks, we know far less about the impact of criminalization and policing of managers and in-call establishments on HIV/STI prevention among sex workers, and even less so among migrant sex workers. Analysis draws on ethnographic fieldwork and 46 qualitative interviews with migrant sex workers, managers and business owners of in-call sex work venues in Metro Vancouver, Canada. The criminalization of in-call venues and third parties explicitly limits sex workers' access to HIV/STI prevention, including manager restrictions on condoms and limited onsite access to sexual health information and HIV/STI testing. With limited labour protections and socio-cultural barriers, criminalization and policing undermine the health and human rights of migrant sex workers working in -call venues. This research supports growing evidence-based calls for decriminalization of sex work, including the removal of criminal sanctions targeting third parties and in-call venues, alongside programs and policies that better protect the working conditions of migrant sex workers as critical to HIV/STI prevention and human rights.
Madeline Carpinelli Wallack
Full Text Available Purpose: The 340B Drug Pricing Program is a federal program designed to reduce the amount that safety net providers spend on outpatient drugs. The Patient Protection and Affordable Health Care Act of 2010 extended eligibility for 340B to critical access hospitals (CAHs for all drugs except those designated as “orphan.” Because this policy is unprecedented, this study quantifies the gross financial impact that this exemption has on a group of CAHs. Methods: Drug spending for 2010 from 18 CAHs in Minnesota and Wisconsin are reviewed to identify the prevalence of orphan drug purchases and to calculate the price differentials between the 340B price and the hospitals’ current cost. Results: The 18 CAHs’ purchases of orphan drugs comprise an average of 44% of the total annual drug budgets, but only 5% of units purchased, thus representing a very high proportion of their expenditures. In the aggregate, the 18 hospitals would have saved $3.1 million ($171,000 average per hospital had purchases of drugs with orphan designations been made at the 340B price. Because CAH claims for Medicare are reimbursed on a cost-basis, the Federal government is losing an opportunity for savings. Conclusion: The high prevalence of orphan drug use and considerable potential for cost reduction through the 340B program demonstrate the loss of benefit to the hospitals, Federal government and the states.
Full Text Available Silvia Coretti,1 Federica Romano,1 Valentina Orlando,2 Paola Codella,1 Sabrina Prete,1 Eugenio Di Brino,1 Matteo Ruggeri1 1Post-Graduate School of Economics and Management (ALTEMS, Università Cattolica del Sacro Cuore, Rome, Italy; 2Center of Pharmacoeconomics (CIRFF, Department of Pharmacy, Federico II University, Naples, Italy Background: Hepatitis C is a liver infection caused by hepatitis C virus. Its main complications are cirrhosis and liver cancer. According to the World Health Organization (WHO, more than 185 million people worldwide are infected with hepatitis C virus and, of these, 350,000 die every year. Due to the high disease prevalence and the existence of effective (and expensive medical treatments able to dramatically change the prognosis, early detection programs can potentially prevent the development of serious chronic conditions, improve health, and save resources. Objective: To summarize the available evidence on the cost-effectiveness of screening programs for hepatitis C. Methods: A literature search was performed on PubMed and Scopus search engines. Trip database was queried to identify reports produced by the major Health Technology Assessment (HTA agencies. Three reviewers dealt with study selection and data extraction blindly. Results: Ten papers eventually met the inclusion criteria. In studies focusing on asymptomatic cohorts of individuals at general risk the cost/quality adjusted life year of screening programs ranged between US $4,200 and $50,000/quality adjusted life year gained, while in those focusing on specific risk factors the incremental cost-effectiveness ratio ranged between $848 and $128,424/quality adjusted life year gained. Age of the target population and disease prevalence were the main cost-effectiveness drivers. Conclusion: Our results suggest that, especially in the long run, screening programs represent a cost-effective strategy for the management of hepatitis C. Keywords: hepatitis C, screening
Asgary-Eden, Veronica; Lee, Catherine M
Adoption of evidence-based programs for families by community agencies requires an understanding of variables that influence implementation. Managers and service providers from 64 community agencies reported on variables that affected the implementation of Triple P, an evidence-based parenting program. Both types of stakeholders reported adequate office resources; over half the managers and over two-thirds of service providers reported adequate training. Adequate office resources and positive agency characteristics, including organizational climate, were associated with higher program usage. Service providers' reports of the variables impacted their individual adherence rates; managers had broader perspectives of the quality of implementation in their organizations.
Full Text Available Introduction: Health care is one of the most important sectors in the development of each country and disparities in their distribution will reduce the level of development. The aim of this study was to examine the access to healthcare and degree of development in health care resources in the west of Iran in 2011. Method: This was a cross-sectional and retrospective study. The study setting was 51 cities of five western provinces of Iran, including Kermanshah, Kurdistan, Ilam, Lorestan and Hamadan. For assessing these towns in terms of the degree of development in healthcare resources by the numerical taxonomy technique, 23 indicators of health resources were selected and obtained from the statistics yearbook. The data was analyzed by EXCEL software. Results:Our study showed that the highest and lowest access to health care based on numerical taxonomy belonged to cities of Kermanshah (0.61 and Salas Babajani (1.07. Also, most towns of Ilam, Lorestan and Kurdistan provinces are underdeveloped and developing, while the most towns of Kermanshah and Hamadan provinces were placed in the developed region. Conclusion: This study showed that there was a large gap between the cities of one province and also among the provinces in terms of the access to and degree of development in health care resources. Therefore, it is suggested that a higher priority in terms of health resource allocation should be placed on the developing and underdeveloped areas in order to reduce these disparities.
Bracarda, Sergio; Gernone, Angela; Gasparro, Donatello; Marchetti, Paolo; Ronzoni, Monica; Bortolus, Roberto; Fratino, Lucia; Basso, Umberto; Mazzanti, Roberto; Messina, Caterina; Tucci, Marcello; Boccardo, Francesco; Cartenì, Giacomo; Pinto, Carmine; Fornarini, Giuseppe; Mattioli, Rodolfo; Procopio, Giuseppe; Chiuri, Vincenzo; Scotto, Tiziana; Dondi, Davide; Di Lorenzo, Giuseppe
Cabazitaxel is a novel taxane that is approved for use in metastatic castration-resistant prostate cancer based on the Phase III TROPIC study, which showed improved overall survival with cabazitaxel/prednisone versus mitoxantrone/prednisone. A global early-access program was initiated in order to provide early access to cabazitaxel in docetaxel-pretreated patients and to obtain real-world data. We report interim safety results from an Italian prospective, single-arm, multicenter, open-label trial of 218 patients receiving cabazitaxel 25 mg/m2 every 3 weeks plus prednisolone 10 mg/day, until disease progression, unacceptable toxicity, investigator's decision or death. Patients completing treatment received a median of six cabazitaxel cycles. The most common grade 3/4 adverse events were neutropenia (33.9%), leukopenia (15.6%), anemia (6%) and asthenia (6%). No peripheral neuropathy or nail disorders were observed. These results confirm that cabazitaxel has a manageable safety profile in daily clinical practice and support its use in patients with prostate cancer who progress during or after a docetaxel-based therapy.
Daniel J. Whitaker
Full Text Available Little is known about how the knowledge, attitudes, and behaviors of the public child welfare work force influence implementation of evidence-based practice (EBP as most research has focused on the private workforce. This paper reports on public child welfare staff knowledge, attitudes, and practices in a state implementing the EBP, SafeCare®. A survey of public child welfare staff (N = 222 was conducted to assess knowledge, familiarity, and referral barriers and practices. Knowledge of and familiarity with SafeCarewere low, especially among front line staff (case managers. Attitudes toward SafeCare were fairly positive, but somewhat less so than attitudes toward a standard, non-evidenced based parenting program. Case managers were significantly less likely to have made a referral (15% than other staff (46%. Job tenure had few effects on familiarity, knowledge, attitudes, or referrals. The strongest predictors of having made referrals were familiarity with SafeCare and job position.
Middlebrooks, Reginald; Carter-Templeton, Heather; Mund, Angela R
. Describe interventions of the programs reviewed in the article that directly affect barriers to clinical nurses' adoption of EBP or the use of research. DISCLOSURE STATEMENT Neither the planners nor the author have any conflicts of interest to disclose. Individual barriers such as a lack of research awareness, electronic database navigation skills, and research comprehension prevent nurses from implementing evidence-based practice (EBP). The aim of this review article is to examine EBP programs and their influence on individual barriers among workforce nurses. A keyword search of online databases was conducted for original research published from 2004- 2015. A review of cited references and footnote searching of significant articles was conducted to identify additional relevant articles. Twenty articles met the inclusion criteria. Although there was great variation among EBP programs, the majority of participants reported increased awareness, value, belief, knowledge, and skill as it relates to research utilization and EBP. This review suggests that individual barriers to EBP may be influenced by clinically based EBP programs. However, a lack of randomized controlled studies and inconsistencies in measurement make it difficult to recommend best practices for developing EBP programs for nurses in the clinical setting. J Contin Educ Nurs. 2016;47(9):398-406. Copyright 2016, SLACK Incorporated.
Bassareo, Pier Paolo; Mussap, Michele; Bassareo, Valentina; Flore, Giovanna; Mercuro, Giuseppe
Atherosclerosis, in turn preceded by endothelial dysfunction, underlies a series of important cardiovascular diseases. Reduced bioavailability of endothelial nitric oxide, by increasing vascular tone and promoting platelet aggregation, leukocyte adhesion, and smooth muscle cell proliferation, plays a key role in the onset of the majority of cardiovascular diseases. In addition, high blood levels of asymmetric dimethylarginine, a potent inhibitor of nitric oxide synthesis, are associated with future development of adverse cardiovascular events and cardiac death. Recent reports have demonstrated that another methylarginine, i.e., symmetric dimethylarginine, is also involved in the onset of endothelial dysfunction and hypertension. Almost a decade ago, prematurity at birth and intrauterine growth retardation were first associated with a potential negative influence on the cardiovascular apparatus, thus constituting risk factors or leading to early onset of cardiovascular diseases. This condition is referred to as cardiovascular perinatal programming. Accordingly, cardiovascular morbidity and mortality are higher among former preterm adults than in those born at term. The aim of this paper was to undertake a comprehensive literature review focusing on cellular and biochemical mechanisms resulting in both reduced nitric oxide bioavailability and increased methylarginine levels in subjects born preterm. Evidence of the involvement of these compounds in the perinatal programming of cardiovascular risk are also discussed. Copyright © 2015 Elsevier B.V. All rights reserved.
Guzmán, Javier; Kessler, Ronald C; Squicciarini, Ana Maria; George, Myriam; Baer, Lee; Canenguez, Katia M; Abel, Madelaine R; McCarthy, Alyssa; Jellinek, Michael S; Murphy, J Michael
Skills for Life (SFL) is the largest school-based mental health program in the world, screening and providing services to more than 1,000,000 students in Chile over the past decade. This is the first external evaluation of the program. Of the 8,372 primary schools in Chile in 2010 that received public funding, one-fifth (1,637) elected to participate in SFL. Each year, all first- and third-grade students in these schools are screened with validated teacher- and parent-completed measures of psychosocial functioning (the Teacher Observation of Classroom Adaptation-Re-Revised [TOCA-RR] and the Pediatric Symptom Checklist-Chile [PSC-CL]). Students identified as being at risk on the TOCA-RR in first grade are referred to a standardized 10-session preventive intervention in second grade. This article explores the relationships between workshop participation and changes in TOCA-RR and PSC-CL scores, attendance, and promotion from third to fourth grades. In all, 16.4% of students were identified as being at-risk on the TOCA-RR. Statistically significant relationships were found between the number of workshop sessions attended and improvements in behavioral and academic outcomes after controlling for nonrandom selection into exposure and loss to follow-up. Effect sizes for the difference between attending most (7-10) versus fewer (0-6) sessions ranged from 0.08 to 0.16 standard deviations. This study provides empirical evidence that a large-scale mental health intervention early in schooling is significantly associated with improved behavioral and academic outcomes. Future research is needed to implement more rigorous experimental evaluation of the program, to examine longer-term effects, and to investigate possible predictors of heterogeneity of treatment response. Copyright © 2015 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.
Full Text Available Perceptual correlates of Turkish word stress and their contribution to lexical access were studied using the mismatch negativity (MMN component in event-related potentials (ERPs. The MMN was expected to indicate if segmentally identical Turkish words were distinguished on the sole basis of prosodic features such as fundamental frequency (f0, spectral emphasis (SE and duration. The salience of these features in lexical access was expected to be reflected in the amplitude of MMN responses. In a multi-deviant oddball paradigm, neural responses to changes in f0, SE, and duration individually, as well as to all three features combined, were recorded for words and pseudowords presented to 14 native speakers of Turkish. The word and pseudoword contrast was used to differentiate language-related effects from acoustic-change effects on the neural responses. First and in line with previous findings, the overall MMN was maximal over frontal and central scalp locations. Second, changes in prosodic features elicited neural responses both in words and pseudowords, confirming the brain’s automatic response to any change in auditory input. However, there were processing differences between the prosodic features, most significantly in f0: While f0 manipulation elicited a slightly right-lateralized frontally-maximal MMN in words, it elicited a frontal P3a in pseudowords. Considering that P3a is associated with involuntary allocation of attention to salient changes, the manipulations of f0 in the absence of lexical processing lead to an intentional evaluation of pitch change. f0 is therefore claimed to be lexically specified in Turkish. Rather than combined features, individual prosodic features differentiate language-related effects from acoustic-change effects. The present study confirms that segmentally identical words can be distinguished on the basis of prosodic information alone, and establishes the salience of f0 in lexical access.
Mirzoyan, Lusine; Berendes, Sima; Jeffery, Caroline; Thomson, Joanna; Ben Othman, Hussain; Danon, Leon; Turki, Abdullah A; Saffialden, Rabea; Valadez, Joseph J
Libya had one of the world's largest nosocomial HIV outbreaks in the late 1990 s leading to the detention of 6 foreign medical workers. They were released in 2007 after the Libyan Government and the European Union agreed to humanitarian cooperation that included the development of Libya's first National HIV Strategy and the research reported in this article. Despite the absence of sound evidence on the status and dynamics of Libya's HIV epidemic, some officials posited that injecting drug use was the main mode of transmission. We therefore sought to assess HIV prevalence and related risk factors among people who inject drugs (PWID) in Tripoli. We conducted a cross-sectional survey among 328 PWID in Tripoli using respondent-driven sampling. We collected behavioral data and blood samples for HIV, hepatitis C virus, and hepatitis B virus testing. We estimate an HIV prevalence of 87%, hepatitis C virus prevalence of 94%, and hepatitis B virus prevalence of 5%. We detected injecting drug use-related and sexual risk factors in the context of poor access to comprehensive services for HIV prevention and mitigation. For example, most respondents (85%) reported having shared needles. In this first biobehavioral survey among PWID in Libya, we detected one of the highest (or even the highest) levels of HIV infection worldwide in the absence of a comprehensive harm-reduction program. There is an urgent need to implement an effective National HIV Strategy informed by the results of this research, especially because recent military events and related sociopolitical disruption and migration might lead to a further expansion of the epidemic.
Unroe, Kathleen T; Hollmann, Peter A; Goldstein, Alanna C; Malone, Michael L
Commencing in 2017, the Medicare Access and CHIP Reauthorization Act (MACRA) of 2015 will change how Medicare pays health professionals. By enacting MACRA, Congress brought an end to the (un)sustainable growth rate formula while also setting forth a vision for how to transform the U.S. healthcare system so that clinicians deliver higher-quality care with smarter spending by the Centers for Medicare and Medicaid Services (CMS). In October 2016, CMS released the first of what stakeholders anticipate will be a number of (annual) rules related to implementation of MACRA. CMS received extensive input from stakeholders including the American Geriatrics Society. Under the Quality Payment Program, CMS streamlined multiple Medicare value-based payment programs into a new Merit-based Incentive Payment System (MIPS). CMS also outlined how it will provide incentives for participation in Advanced Alternative Payment Models (called APMs). Although Medicare payments to geriatrics health professionals will not be based on the new MIPS formula until 2019, those payments will be based upon performance during a 90-day period in 2017. This article defines geriatrics health professionals as clinicians who care for a predominantly older adult population and who are eligible to bill under the Medicare Physician Fee Schedule. Given the current paucity of eligible APMs, this article will focus on MIPS while providing a brief overview of APMs. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.
Ning, Sheyang; Ogura Iwasaki, Tomoko; Takeuchi, Ken
In order to decrease program bit error rate (BER) of array-level operation in AlxOy resistive random access memory (ReRAM), program BERs are compared by using 4 × 4 basic set and reset with verify methods on multiple 1024-bit-pages in 50 nm, mega-bit class ReRAM arrays. Further, by using an optimized reset method, 8.5% total BER reduction is obtained after 104 write cycles due to avoiding under-reset or weak reset and ameliorating over-reset caused wear-out. Then, under-set and over-set are analyzed by tuning the set word line voltage (VWL) of ±0.1 V. Moderate set current shows the best total BER. Finally, 2000 write cycles are applied at 125 and 25 °C, respectively. Reset BER increases 28.5% at 125 °C whereas set BER has little difference, by using the optimized reset method. By applying write cycles over a 25 to 125 to 25 °C temperature variation, immediate reset BER change can be found after the temperature transition.
Farran, Dale C.
The proposition that expanding pre-K will improve later achievement for children from low-income families is premature. Premature as well is the presumption that solid research exists to guide the content and structure of pre-K programs. Despite more than 50 years of preliminary work on pre-K as an early intervention for young children from poor…
Coalition for Evidence-Based Policy, 2010
U.S. social programs, set up to address important problems, often fall short by funding specific models/strategies ("interventions") that are not effective. When evaluated in scientifically-rigorous studies, social interventions in K-12 education, job training, crime prevention, and other areas are frequently found ineffective or…
Full Text Available This paper applies the Blundell and Bond system generalised method of moments (GMM two-step estimator to examine the impact of age and collateral value on debt financing, using a panel of 177 non-financial companies listed on the Johannesburg Stock Exchange over the period 1999 to 2009. The results show that South African firms have target leverage ratios and adjust their capital structures from time to time to achieve their respective targets, that the relationship between firm age and debt financing is non-monotonic, and that firms with higher collateral value are likely to face fewer constraints on borrowing and therefore have greater access to medium-term and long-term debts. Robustness tests also reveal that during start-up and maturity stages, a firm’s access to debt markets is significantly influenced by investments in assets that are acceptable to external creditors as collateral. These findings suggest that debt financing policies could be more critical for firms in the start-up and maturity stages.
Martin, Donna; Albensi, Lisa; Van Haute, Stephanie; Froese, Maria; Montgomery, Mary; Lam, Mavis; Gierys, Kendra; Lajeunesse, Rob; Guse, Lorna; Basova, Nataliya
In 2013, an observational survey was conducted among 242 in-patients in a community hospital with a pressure ulcer (PU) prevalence of 34.3%. An evidence-based pressure ulcer prevention program (PUPP) was then implemented including a staff awareness campaign entitled "Healthy Skin Wins" with an online tutorial about PU prevention. To determine the effectiveness of the PUPP in reducing the prevalence of PUs, to determine the effectiveness of the online tutorial in increasing hospital staff's knowledge level about PU prevention, and to explore frontline staff's perspectives of the PUPP. This was a mixed methods study. A repeat observational survey discerned if the PUPP reduced PU prevalence. A pre-test post-test design was used to determine whether hospital staff's knowledge of PU prevention was enhanced by the online tutorial. Qualitative interviews were conducted with nurses, allied health professionals, and health care aides to explore staff's perspectives of the PUPP. A comparison of initial and repeat observational surveys (n = 239) identified a statistically significant reduction in the prevalence of PU to 7.53% (p tutorial enhanced staff knowledge level with a statistically significantly higher mean post-test score (n = 80). Thirty-five frontline staff shared their perspectives of the PUPP with "it's definitely a combination of everything" and "there's a disconnect between what's needed and what's available" as the main themes. Incorporating evidence-based PU prevention into clinical practice greatly reduced the prevalence of PUs among hospital in-patients. Due to the small sample size for the pre-test post-test component, the effectiveness of the online tutorial in improving the knowledge level of PU prevention among hospital staff requires further research. Evidence-based PU prevention strategies are facilitated by using a multidisciplinary approach. Educational tools about PU prevention must target all members of the healthcare team including healthcare
Lusk, Pamela; Melnyk, Bernadette Mazurek
TOPIC Evidence–based CBT skills building intervention – COPE -for depressed and anxious teens in brief 30 minute outpatient visits. PURPOSE Based on COPE training workshops, this paper provides an overview of the COPE program, it’s development, theoretical foundation, content of the sessions and lessons learned for best delivery of COPE to individuals and groups in psychiatric settings, primary care settings and schools. SOURCES Published literature and clinical examples CONCLUSION With the COPE program, the advanced practice nurse in busy outpatient practice can provide timely, evidence-based therapy for adolescents and use the full extent of his/her advanced practice nursing knowledge and skills. PMID:23351105
Te-I Albert Tsai
Full Text Available New Urbanist development in the U.S. aims at enhancing a sense of community and seeks to return to the design of early transitional neighborhoods which have pedestrian-oriented environments with retail shops and services within walking distances of housing. Meanwhile, 6000 of Taiwan’s community associations have been running community empowerment programs supported by the Council for Cultural Affairs that have helped many neighborhoods to rebuild so-called community cohesion. This research attempts to evaluate whether neighborhoods with facilities near housing and shorter travel distances within a neighborhood would promote stronger social interactions and form a better community attachment than neighborhoods that have various opportunities for residents to participate in either formal or informal social gatherings. After interviewing and surveying residents from 19 neighborhoods in Taipei’s Beitou District, and correlating the psychological sense of community with inner neighborhood’s daily travel distances and numbers of participatory activities held by community organizations under empowerment programs together with frequencies of regular individual visits and casual meetings, statistical evidence yielded that placing public facilities near residential locations is more effective than providing various programs for elevating a sense of community.
Briske, D D; Bestelmeyer, B T; Brown, J R; Brunson, M W; Thurow, T L; Tanaka, J A
The Conservation Effects Assessment Project (CEAP) was created in response to a request from the Office of Management and Budget that the U.S. Department of Agriculture, Natural Resource Conservation Service (USDA-NRCS) document the societal benefits anticipated to accrue from a major increase in conservation funding authorized by the 2002 Farm Bill. A comprehensive evaluation of the efficacy of rangeland conservation practices cost-shared with private landowners was unable to evaluate conservation benefits because outcomes were seldom documented. Four interrelated suppositions are presented to examine the causes underlying minimal documentation of conservations outcomes. These suppositions are (1) the benefits of conservation practices are considered a certainty so that documentation in not required, (2) there is minimal knowledge exchange between the USDA-NRCS and research organizations, (3) and a paucity of conservation-relevant science, as well as (4) inadequate technical support for land owners following implementation of conservation practices. We then follow with recommendations to overcome potential barriers to documentation of conservation outcomes identified for each supposition. Collectively, this assessment indicates that the existing conservation practice standards are insufficient to effectively administer large conservation investments on rangelands and that modification of these standards alone will not achieve the goals explicitly stated by CEAP. We recommend that USDA-NRCS modify its conservation programs around a more comprehensive and integrative platform that is capable of implementing evidence-based conservation. Collaborative monitoring organized around landowner-agency-scientist partnerships would represent the focal point of a Conservation Program Assessment Network (CPAN). The primary network objective would be to establish missing information feedback loops between conservation practices and their agricultural and environmental outcomes
Lavin, Tina; Preen, David B; Newnham, Elizabeth A
Background The impact of birth with poor access to skilled obstetric care such as home birth on children's long term development is unknown. This study explores the health, growth and cognitive development of children surviving homebirth in the Vietnam Young Lives sample during early childhood. Methods The Young Lives longitudinal cohort study was conducted in Vietnam with 1812 children born in 2001/2 with follow-up at 1, 5, and 8 years. Data were collected on height/weight, health and cognitive development (Peabody Picture Vocabulary test). Statistical models adjusted for sociodemographic and pregnancy-related factors. Results Children surviving homebirth did not have significantly poorer long-term health, greater stunting after adjusting for sociodemographic/pregnancy-related factors. Rural location, lack of household education, ethnic minority status and lower wealth predicted greater stunting and poorer scores on Peabody Vocabulary test. Conclusions Social disadvantage rather than homebirth influenced children's health, growth and development.
Fang, Yu; Wagner, Anita K; Yang, Shimin; Jiang, Minghuan; Zhang, Fang; Ross-Degnan, Dennis
Limited access to essential medicines is a global problem. Improving availability and affordability of essential medicines is a key objective of the National Essential Medicine Policy (NEMP) in China. In its initial implementation in 2009, the NEMP targeted primary hospitals with policies designed to increase availability of essential medicines and reduce patients' economic burden from purchasing medicines. We assessed medicine availability and price during the early years of the health reform in Shaanxi Province in underdeveloped western China. We undertook two public (hospitals) and private (pharmacy) sector surveys of prices and availability of medicines, in September, 2010 and April, 2012, by a standard methodology developed by WHO and Health Action International. We measured medicine availability in outlets at the time of the surveys and inflation-adjusted median unit prices (MUPs), taking 2010 as the base year. We used general estimating equations to calculate the significance of differences in availability from 2010 to 2012 and the Wilcoxon signed rank test to calculate the significance of differences in adjusted median prices. We collected data from 50 public sector hospitals and 36 private sector retail pharmacies in 2010 and 72 public hospitals and 72 retail pharmacies in 2012. Mean availability of surveyed medicines was low in both the public and private sectors; availability of many essential medicines decreased from 2010 to 2012, particularly in primary hospitals (from 27·4% to 22·3% for lowest priced generics; pFund (71103141/G0308), the China Medical Board Faculty Development Awards, the Fundamental Research Funds for the Central Universities (2011jdhz62), the Shaanxi Provincial Social Science Fund (10E066), and the Harvard Medical School Pharmaceutical Policy Research Fellowship. Copyright © 2013 Fang et al. Open Access article distributed under the terms of CC BY-NC-ND. Published by .. All rights reserved.
Allison P Hawkes
Full Text Available A large local health department in Colorado partnered with 15 school districts to develop an approach to evaluate changes in access to healthy foods in reimbursable school lunches and a la carte offerings.School district nutrition managers were engaged at the start of this project. Health department dietitians developed criteria to classify food items as "Lower Fat and less added Sugar" (LFS and "Higher Fat and more added Sugar" (HFS based on the percentage of calories from fat and grams of added sugar. Lunch production sheets were obtained for two time periods, food items and the number of planned servings recorded. LFS and HFS planned servings were summed for each time period, and a LFS to HFS ratio calculated by dividing LFS planned servings by HFS planned servings. Additional analyses included calculating LFS: HFS ratios by school district, and for a la carte offerings.In 2009, the LFS: HFS ratio was 2.08, in 2011, 3.71 (P<0.0001. The method also detected changes in ratios at the school district level. For a la carte items, in 2009 the ratio of LFS: HFS was 0.53, and in 2011, 0.61 (not statistically significant.This method detected an increase in the LFS: HFS ratio over time and demonstrated that the school districts improved access to healthful food/drink by changing the contents of reimbursable school lunches. The evaluation method discussed here can generate information that districts can use in helping sustain and expand their efforts to create healthier environments for children and adults. Although federal regulations now cover all food and beverages served during the school day, there are still opportunities to improve and measure changes in food served in other settings such as child care centers, youth correction facilities, or in schools not participating in the National School Lunch Program.
Newton, Amanda S; Wozney, Lori; Bagnell, Alexa; Fitzpatrick, Eleanor; Curtis, Sarah; Jabbour, Mona; Johnson, David; Rosychuk, Rhonda J; Young, Michael; Ohinmaa, Arto; Joyce, Anthony; McGrath, Patrick
There is a demand to make first-line treatments, including cognitive behavioural therapy (CBT) for adolescent anxiety disorders, more widely available. Internet-based CBT is proposed to circumvent access and availability barriers and reduce health care system costs. Recent reviews suggest more evidence is needed to establish the treatment effects of Internet-based CBT in children and adolescents and to determine related economic impacts. This pilot trial aims to collect the necessary data to inform the planning of a full-scale RCT to test the effectiveness of the Internet-based CBT program Breathe (Being Real, Easing Anxiety: Tools Helping Electronically). We are conducting a 27-month, 2-arm parallel-group, pilot randomized controlled trial (RCT). Outcomes will inform the planning of a full-scale RCT aimed to test the effectiveness of Internet-based CBT with a population of adolescents with moderate to mild anxiety problems. In the pilot RCT we will: (1) define a minimal clinically important difference (MCID) for the primary outcome measure (total anxiety score using the Multidimensional Anxiety Scale for Children); (2) determine a sample size for the full-scale RCT; (3) estimate recruitment and retention rates; (4) measure intervention acceptability to inform critical intervention changes; (5) determine the use of co-interventions; and (6) conduct a cost-consequence analysis to inform a cost-effectiveness analysis in the full-scale RCT. Adolescents aged 13-17 years seeking care for an anxiety complaint from a participating emergency department, mobile or school-based crisis team, or primary care clinic are being screened for interest and eligibility. Enrolled adolescents are being randomly allocated to either 8 weeks of Internet-based CBT with limited telephone and e-mail support, or a control group with access to a static webpage listing anxiety resources. Adolescents are randomly assigned using a computer generated allocation sequence. Data are being collected
Hodge, Lauren M; Turner, Karen M T; Sanders, Matthew R; Forster, Michell
This paper evaluates program, workplace and process factors associated with implementation and sustainment of an evidence-based parenting support program (EBP) in disadvantaged communities. Correlation analyses and binary logistic regressions were used to assess the associations between key implementation support factors and program implementation (at 18 months) and sustainment (at 36 months) post training with (N=35) Australian Aboriginal and Torres Strait Islander family support providers using the Triple P - Positive Parenting Program in Indigenous child protection agencies. This study demonstrated that for implementation at 18 months, there was a trend for implementing providers to report higher levels of partnership support, perceived program benefit, workplace support and workplace cohesion. However, the only significant relationship was with partnership support (r=.31 pprogram implementation. For sustained implementation at 36 months, no relationship was found between sustainment and program characteristics, workplace characteristics, supervision and peer support or sustainability planning. Supportive coaching was the only significant correlate (r=0.46, pp=0.009] in the program sustainment model. Overall, these findings suggest the need for further exploration of program and workplace variables and provide evidence to consider incorporating partnership support and supportive coaching in real world implementation models to improve the likelihood of EBP implementation and sustainment in Indigenous communities. Copyright © 2017 Elsevier Ltd. All rights reserved.
Hole, Grete Oline; Brenna, Sissel Johansson; Graverholt, Birgitte; Ciliska, Donna; Nortvedt, Monica Wammen
Health care professionals are expected to build decisions upon evidence. This implies decisions based on the best available, current, valid and relevant evidence, informed by clinical expertise and patient values. A multi-professional master's program in evidence-based practice was developed and offered. The aims of this study were to explore how students in this program viewed their ability to apply evidence-based practice and their perceptions of what constitute necessary conditions to implement evidence-based practice in health care organizations, one year after graduation. A qualitative descriptive design was chosen to examine the graduates' experiences. All students in the first two cohorts of the program were invited to participate. Six focus-group interviews, with a total of 21 participants, and a telephone interview of one participant were conducted. The data was analyzed thematically, using the themes from the interview guide as the starting point. The graduates reported that an overall necessary condition for evidence-based practice to occur is the existence of a "readiness for change" both at an individual level and at the organizational level. They described that they gained personal knowledge and skills to be "change-agents" with "self-efficacy, "analytic competence" and "tools" to implement evidence based practice in clinical care. An organizational culture of a "learning organization" was also required, where leaders have an "awareness of evidence- based practice", and see the need for creating "evidence-based networks". One year after graduation the participants saw themselves as "change agents" prepared to improve clinical care within a learning organization. The results of this study provides useful information for facilitating the implementation of EBP both from educational and health care organizational perspectives.
O'Regan, Kevin; Marsden, Paul; Sayers, Gerardine; Morrissey, Mary; Hegarty, Heather; Allen, Michael; O'Connor, Owen J; Malone, Dermot; Maher, Michael M
The aim of this study was to evaluate the effectiveness of the medium of videoconferencing for the delivery of a course for radiology residents in practice-based learning (PBL), including evidence-based practice, at centers geographically separated from the principal teaching site. Twenty-one participants (second-year radiology residents) at 8 centers in a radiology training program were included. The course in PBL was delivered over 16 weekly 1-hour sessions. There were 8 local education site coordinators (staff radiologists), who had completed an intensive 1-day course at the principal teaching site. The host site was linked to the participant sites using videoconferencing technology. Course evaluation included 1) a 5-point Likert-type scale and an open-ended evaluation questionnaire midway through the course (week 8) and a summation questionnaire after its completion (week 16) and 2) a consultation forum held during the penultimate session. The data responses to the questionnaires were entered in a spreadsheet, and the data were analyzed. Qualitative data were manually coded and analyzed for common themes. Descriptive statistical analyses were performed. Eighty-five percent of evaluation questionnaires and 53% of summation questionnaires were returned. The overall satisfaction of the participants with course content was high, with median rating of 4 on the 5-point scale. All participants agreed that videoconferencing as a medium did not hinder adequate discussion among centers and worked well as an interactive teaching method (median, 4). Local coordinators were satisfied with local technical support and training (median, 4), and overall, the module was rated highly, with ratings of 4 from both residents and local coordinators. Seventy-one percent of residents and 86% of local coordinators reported that they would have been unable to participate in the course without videoconferencing. All participants completed the course requirements satisfactorily. The
Taber, J.; Toigo, M.; Bravo, T. K.; Hubenthal, M.; McQuillan, P. J.; Welti, R.
The IRIS Education and Outreach Program has been an integral part of IRIS for the past 10 years and during that time has worked to advance awareness and understanding of seismology and earth science while inspiring careers in geophysics. The focus on seismology and the use of seismic data has allowed the IRIS E&O program to develop and disseminate a unique suite of products and services for a wide range of audiences. One result of that effort has been increased access to the IRIS Data Management System by non-specialist audiences and simplified use of location and waveform data. The Seismic Monitor was one of the first Web-based tools for observing near-real-time seismicity. It continues to be the most popular IRIS web page, and thus it presents aspects of seismology to a very wide audience. For individuals interested in more detailed ground motion information, waveforms can be easily viewed using the Rapid Earthquake Viewer, developed by the University of South Carolina in collaboration with IRIS E&O. The Seismographs in Schools program gives schools the opportunity to apply for a low-cost educational seismograph and to receive training for its use in the classroom. To provide better service to the community, a new Seismographs in Schools website was developed in the past year with enhanced functions to help teachers improve their teaching of seismology. The site encourages schools to make use of seismic data and communicate with other educational seismology users throughout the world. Users can view near-real-time displays of other participating schools, upload and download data, and use the “find a teacher” tool to contact nearby schools that also may be operating seismographs. In order to promote and maintain program participation and communication, the site features a discussion forum to encourage and support the growing global community of educational seismograph users. Any data that is submitted to the Seismographs in Schools Website is also accessible
Boyce, Karen Stradford; Travers, Madeline; Rothbart, Betty; Santiago, Vivian; Bedell, Jane
Lesbian, gay, bisexual, and transgender (LGBT) youth show higher rates of sexual risk behaviors than heterosexual and cisgender youth; yet, most school-based sexual health education is largely heteronormative and cisnormative and does not recognize the spectrum of sexual and gender identity. New York City's Departments of Health and Education collaborated to create an LGBT-inclusive supplement to the Reducing the Risk curriculum and implement it in 21 South Bronx high schools. Teachers completed an electronic survey to report the number of students reached and an online log to measure curriculum adherence. Students were administered an anonymous 74-item pre- and posttest to measure demographics, sexual health knowledge, and student satisfaction with the curriculum. Chi-square and t tests were used to assess differences in student demographics and changes in knowledge scores. Reducing the Risk was implemented in 21 schools reaching 230 classes and 5,673 students; with 161 classes receiving the supplement. Teachers reported completing an average of 70% of LGBT supplement activities. Students who received the supplement reported higher satisfaction and greater knowledge scores than students who did not. New York City experience shows that being more inclusive of LGBT teens while implementing preexisting evidence-based sexual and reproductive health programs is possible and replicable.
Alexander M. Vaiserman
Full Text Available Consistent evidence from both experimental and human studies suggest that inadequate nutrition in early life can contribute to risk of developing metabolic disorders including type 2 diabetes (T2D in adult life. In human populations, most findings supporting a causative relationship between early-life malnutrition and subsequent risk of T2D were obtained from quasi-experimental studies (‘natural experiments’. Prenatal and/or early postnatal exposures to famine were demonstrated to be associated with higher risk of T2D in many cohorts around the world. Recent studies have highlighted the importance of epigenetic regulation of gene expression as a possible major contributor to the link between the early-life famine exposure and T2D in adulthood. Findings from these studies suggest that prenatal exposure to the famine may result in induction of persistent epigenetic changes that have adaptive significance in postnatal development but can predispose to metabolic disorders including T2D at the late stages of life. In this review, quasi-experimental data on the developmental programming of T2D are summarized and recent research findings on changes in DNA methylation that mediate these effects are discussed.
Miles, Eleanor; Sheeran, Paschal; Baird, Harriet; Macdonald, Ian; Webb, Thomas L; Harris, Peter R
Can self-control be improved through practice? Several studies have found that repeated practice of tasks involving self-control improves performance on other tasks relevant to self-control. However, in many of these studies, improvements after training could be attributable to methodological factors (e.g., passive control conditions). Moreover, the extent to which the effects of training transfer to real-life settings is not yet clear. In the present research, participants (N = 174) completed a 6-week training program of either cognitive or behavioral self-control tasks. We then tested the effects of practice on a range of measures of self-control, including lab-based and real-world tasks. Training was compared with both active and no-contact control conditions. Despite high levels of adherence to the training tasks, there was no effect of training on any measure of self-control. Trained participants did not, for example, show reduced ego depletion effects, become better at overcoming their habits, or report exerting more self-control in everyday life. Moderation analyses found no evidence that training was effective only among particular groups of participants. Bayesian analyses suggested that the data were more consistent with a null effect of training on self-control than with previous estimates of the effect of practice. The implication is that training self-control through repeated practice does not result in generalized improvements in self-control. (PsycINFO Database Record (c) 2016 APA, all rights reserved).
Full Text Available Introduction: Type 2 diabetes mellitus (T2D has become the main type of diabetes in children and it is expected that in countries with high income diabetes it is projected to be one of the leading causes of death by 2030. Another fact is that programs and tests diagnosing pre-diabetes type 2 (T2P-DMC are missing. Methods: The aim of the paper is to present the steps for the synthesis of the evidence within the brand new type of the systematic review (SR: SR of diagnostic test accuracy (DTA. Using the acronym PIRD it was developed a review question, search strategy and inclusion and exclusion criteria. Results: The initial search was done in two databases (MedLine and Cinahl with 2 025 results. The second search after the improvement of the sensitivity and the specificity was done in 15 databases with 3 681 results. Conclusion: This methodological paper introduces how to conduct the systematic review protocols of diagnostic test accuracy on the example of T2P-DMC.
Dodson, Kimberly D.; Cabage, Leann N.; Klenowski, Paul M.
Faith-based organizations administer many of the prison-based programs aimed at reducing recidivism. Many of these organizations also manage treatment programs for substance abusers, at-risk juveniles, and ex-offenders. Much of the research on religiosity and delinquency indicates that the two are inversely related. Therefore, it seems plausible…
Riemann-Lorenz, Karin; Eilers, Marlene; von Geldern, Gloria; Schulz, Karl-Heinz; Köpke, Sascha; Heesen, Christoph
Background Dietary factors have been discussed to influence risk or disease course of multiple sclerosis (MS). Specific diets are widely used among patients with MS. Objective To design and pilot-test an evidence based patient education program on dietary factors in MS. Methods We performed a systematic literature search on the effectiveness of dietary interventions in MS. A web-based survey among 337 patients with MS and 136 healthy controls assessed knowledge, dietary habits and information needs. An interactive group education program was developed and pilot-tested. Results Fifteen randomised-controlled trials (RCTs) were included in the systematic review. Quality of evidence was low and no clear benefit could be seen. Patients with MS significantly more often adhered to a `Mediterranean Diet`(29.7% versus 14.0%, p<0.001) compared to controls. 143 (42%) of the patients with MS had tried special MS diets. Important information needs addressed effectiveness of MS diets (44%) and relation between nutrition and MS (43%). A pilot test of our newly developed patient education program with 13 participants showed excellent comprehensibility and the MS-specific content was judged as very important. However, the poor evidence base for dietary approaches in MS was perceived disappointing. Conclusions Development and pilot-testing of an evidence-based patient education program on nutrition and MS is feasible. Patient satisfaction with the program suffers from the lack of evidence. Further research should focus on generating evidence for the potential influence of lifestyle habits (diet, physical activity) on MS disease course thus meeting the needs of patients with MS. PMID:27764237
Ruhrmann, Georg; Guenther, Lars; Kessler, Sabrina Heike; Milde, Jutta
For laypeople, media coverage of science on television is a gateway to scientific issues. Defining scientific evidence is central to the field of science, but there are still questions if news coverage of science represents scientific research findings as certain or uncertain. The framing approach is a suitable framework to classify different media representations; it is applied here to investigate the frames of scientific evidence in film clips (n=207) taken from science television programs. Molecular medicine is the domain of interest for this analysis, due to its high proportion of uncertain and conflicting research findings and risks. The results indicate that television clips vary in their coverage of scientific evidence of molecular medicine. Four frames were found: Scientific Uncertainty and Controversy, Scientifically Certain Data, Everyday Medical Risks, and Conflicting Scientific Evidence. They differ in their way of framing scientific evidence and risks of molecular medicine. © The Author(s) 2013.
Ganser, Helene G; Münzer, Annika; Seitz, Diana C M; Witt, Andreas; Goldbeck, Lutz
Victims of child abuse and neglect are more likely to develop emotional and behavioral problems than their non-abused peers. In many cases they do not receive evidence based treatments. Based on pilot studies and clinical experience, a structured and manualized case-management protocol was developed to provide child welfare professionals guidance, direction and support in helping these families find and engage in appropriate treatment. The protocol is described. A survey among child welfare workers indicates a lack of knowledge about mental disorders in victims of child abuse as well as an insufficient cooperation between the child welfare and the mental healthcare system. Child welfare workers who have applied the manual evaluate it positively. This study shows that the structured case-management can be implemented in a child welfare setting.
Yun, John T.
A new report published by the Manhattan Institute for Education Policy, "The Effect of Special Education Vouchers on Public School Achievement: Evidence from Florida's McKay Scholarship Program," attempts to examine the complex issue of how competition introduced through school vouchers affects student outcomes in public schools. The…
McWilliam, Jenna; Brown, Jacquie; Sanders, Matthew R; Jones, Liz
Evidence-based programs are considered critical in the human services field if major social and health problems are to be addressed. Despite the large number of programs that have been developed and implemented, there is much to learn about how to effectively implement these programs in community settings. One perspective that is rarely represented in the literature is that of the purveyor organization (an organization that actively works to disseminate and support the implementation of a program or practice). This paper introduces the Triple P Implementation Framework, developed by the program's purveyor organization, and discusses principles underlying the design and implementation of the Framework. The Framework incorporates two key underlying principles of the Triple P system: minimal sufficiency and self-regulation. Lessons learned from the application of these principles and the implementation process are discussed, along with directions for future research.
August, Gerald J; Winters, Ken C; Realmuto, George M; Tarter, Ralph; Perry, Cheryl; Hektner, Joel M
This article examines the challenges faced by developers of youth drug abuse prevention programs in transporting scientifically proven or evidence-based programs into natural community practice systems. Models for research on the transfer of prevention technology are described with specific emphasis given to the relationship between efficacy and effectiveness studies. Barriers that impede the successful integration of efficacy methods within effectiveness studies (e.g., client factors, practitioner factors, intervention structure characteristics, and environmental and organizational factors) are discussed. We present a modified model for program development and evaluation that includes a new type of research design, the hybrid efficacy-effectiveness study that addresses program transportability. The utility of the hybrid study is illustrated in the evaluation of the Early Risers "Skills for Success" prevention program.
Boykan, Rachel; Jacobson, Robert M
The research sought to identify the general use of medical librarians in pediatric residency training, to define the role of medical librarians in teaching evidence-based medicine (EBM) to pediatric residents, and to describe strategies and curricula for teaching EBM used in pediatric residency training programs. We sent a 13-question web-based survey through the Association of Pediatric Program Directors to 200 pediatric residency program directors between August and December 2015. A total of 91 (46%) pediatric residency program directors responded. Most (76%) programs had formal EBM curricula, and more than 75% of curricula addressed question formation, searching, assessment of validity, generalizability, quantitative importance, statistical significance, and applicability. The venues for teaching EBM that program directors perceived to be most effective included journal clubs (84%), conferences (44%), and morning report (36%). While 80% of programs utilized medical librarians, most of these librarians assisted with scholarly or research projects (74%), addressed clinical questions (62%), and taught on any topic not necessarily EBM (58%). Only 17% of program directors stated that librarians were involved in teaching EBM on a regular basis. The use of a librarian was not associated with having an EBM curriculum but was significantly associated with the size of the program. Smaller programs were more likely to utilize librarians (100%) than were medium (71%) or large programs (75%). While most pediatric residency programs have an EBM curriculum and engage medical librarians in various ways, librarians' expertise in teaching EBM is underutilized. Programs should work to better integrate librarians' expertise, both in the didactic and clinical teaching of EBM.
Gayet, Surya; van Maanen, Leendert; Heilbron, Micha; Paffen, Chris L E; Van der Stigchel, Stefan
The content of visual working memory (VWM) affects the processing of concurrent visual input. Recently, it has been demonstrated that stimuli are released from interocular suppression faster when they match rather than mismatch a color that is memorized for subsequent recall. In order to investigate the nature of the interaction between visual representations elicited by VWM and visual representations elicited by retinal input, we modeled the perceptual processes leading up to this difference in suppression durations. We replicated the VWM modulation of suppression durations, and fitted sequential sampling models (linear ballistic accumulators) to the response time data. Model comparisons revealed that the data was best explained by a decrease in threshold for visual input that matches the content of VWM. Converging evidence was obtained by fitting similar sequential sampling models (shifted Wald model) to published datasets. Finally, to confirm that the previously observed threshold difference reflected processes occurring before rather than after the stimuli were released from suppression, we applied the same procedure to the data of an experiment in which stimuli were not interocularly suppressed. Here, we found no decrease in threshold for stimuli that match the content of VWM. We discuss our findings in light of a preactivation hypothesis, proposing that matching visual input taps into the same neural substrate that is already activated by a representation concurrently maintained in VWM, thereby reducing its threshold for reaching visual awareness.
Rhodes, Lindsay A; Huisingh, Carrie E; McGwin, Gerald; Mennemeyer, Stephen T; Bregantini, Mary; Patel, Nita; Saaddine, Jinan; Crews, John E; Girkin, Christopher A; Owsley, Cynthia
To assess the impact of the education program of the Eye Care Quality and Accessibility Improvement in the Community (EQUALITY) telemedicine program on at-risk patients' knowledge about glaucoma and attitudes about eye care as well as to assess patient satisfaction with EQUALITY. New or existing patients presenting for a comprehensive eye exam (CEE) at one of two retail-based primary eye clinics were enrolled based on ≥1 of the following at-risk criteria for glaucoma: African Americans ≥40 years of age, Whites ≥50 years of age, diabetes, family history of glaucoma, and/or preexisting diagnosis of glaucoma. A total of 651 patients were enrolled. A questionnaire was administered prior to the patients' CEE and prior to the patients receiving any of the evidence-based eye health education program; a follow-up questionnaire was administered 2-4 weeks later by phone. Baseline and follow-up patient responses regarding knowledge about glaucoma and attitudes about eye care were compared using McNemar's test. Logistic regression models were used to assess the association of patient-level characteristics with improvement in knowledge and attitudes. Overall patient satisfaction was summarized. At follow-up, all patient responses in the knowledge and attitude domains significantly improved from baseline (P≤0.01 for all questions). Those who were unemployed (odds ratio =0.63, 95% confidence interval =0.42-0.95, P=0.026) or had lower education (odds ratio =0.55, 95% confidence interval =0.29-1.02, P=0.058) were less likely to improve their knowledge after adjusting for age, sex, race, and prior glaucoma diagnosis. This association was attenuated after further adjustment for other patient-level characteristics. Ninety-eight percent (n=501) of patients reported being likely to have a CEE within the next 2 years, whereas 63% (n=326) had a CEE in the previous 2 years. Patient satisfaction with EQUALITY was high (99%). Improved knowledge about glaucoma and a high intent to
Chamratrithirong, Aphichat; Ford, Kathleen; Punpuing, Sureeporn; Prasartkul, Pramote
Vulnerability to Human Immunodeficiency Virus (HIV) infection among factory workers is a global problem. This study investigated the effectiveness of an intervention to increase AIDS knowledge, perceived accessibility to condoms and condom use among young factory workers in Thailand. The intervention was a workplace program designed to engage the private sector in HIV prevention. A cross-sectional survey conducted in 2008 to measure program outcomes in factories in Thailand was used in this study. The workplace intervention included the development of policies for management of HIV-positive employees, training sessions for managers and workers, and distribution of educational materials and condoms. A multi-level analysis was used to investigate the effect of HIV/AIDS prevention program components at the workplace on HIV/AIDS knowledge, perceived accessibility to condoms and condom use with regular sexual partners among 699 young factory workers (aged 18-24 years), controlling for their individual socio-demographic characteristics. Interventions related to the management and services component including workplace AIDS policy formulation, condom services programs and behavioral change campaigns were found to be significantly related to increased AIDS knowledge, perceived accessibility to condoms and condom use with regular partners. The effect of the HIV/AIDS training for managers, peer leaders and workers was positive but not statistically significant. With some revision of program components, scaling up of workplace interventions and the engagement of the private sector in HIV prevention should be seriously considered.
Izumi, Betty T; Higgins, Cesar E; Baron, Andrea; Ness, Sylvia J; Allan, Bryan; Barth, Elizabeth T; Smith, Teresa M; Pranian, Katy; Frank, Brian
This study explored the feasibility of using a 23-week subsidized community-supported agriculture program to increase access to and intake of vegetables among Federally Qualified Health Center patients. Outcomes were measured using pre-post intervention surveys (n = 9). Process data were collected in post-intervention surveys and focus groups (n = 15). Most participants (77%) indicated that the program improved their health and all (100%) reported that they were eating a greater variety of vegetables because of their participation in the program. Three themes emerged from the focus groups: increased access to fresh and/or organic vegetables, improved diet quality, and the importance of social support during the program. Linking subsided community-supported agriculture programs with Federally Qualified Health Centers has the potential to increase access to and intake of vegetables among low-income patients. However, further research is needed with a larger sample size and a more robust study design. Copyright © 2017 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.
Keefe, Bruce D; Hibbard, Paul B; Watt, Simon J
When we grasp with one eye covered, the finger and thumb are typically opened wider than for binocularly guided grasps, as if to build a margin-for-error into the movement. Also, patients with visual form agnosia can have profound deficits in their (otherwise relatively normal) grasping when binocular information is removed. One interpretation of these findings is that there is a functional specialism for binocular vision in the control of grasping. Alternatively, cue-integration theory suggests that binocular and monocular depth cues are combined in the control of grasping, and so impaired performance reflects not the loss of 'critical' binocular cues, but increased uncertainty per se. Unfortunately, removing binocular information confounds removing particular (binocular) depth cues with an overall reduction in the available information, and so such experiments cannot distinguish between these alternatives. We measured the effects on visually open-loop grasping of selectively removing monocular (texture) or binocular depth cues. To allow meaningful comparisons, we made psychophysical measurements of the uncertainty in size estimates in each case, so that the informativeness of binocular and monocular cues was known in each condition. Consistent with cue-integration theory, removing either binocular or monocular cues resulted in similar increases in grip apertures. In a separate experiment, we also confirmed that changes in uncertainty per se (keeping the same depth cues available) resulted in larger grip apertures. Overall, changes in the margin-for-error in grasping movements were determined by the uncertainty in size estimates and not by the presence or absence of particular depth cues. Our data therefore argue against a binocular specialism for grasp programming. Instead, grip apertures were smaller when binocular and monocular cues were available than with either cue alone, providing strong evidence that the visuo-motor system exploits the redundancy available
Smelson, David A; Chinman, Matthew; McCarthy, Sharon; Hannah, Gordon; Sawh, Leon; Glickman, Mark
The Housing and Urban Development-Veterans Affairs Supportive Housing (HUD-VASH) program is one of the largest initiatives to end Veteran homelessness. However, mental health and substance use disorders continue to reduce client stability and impede program success. HUD-VASH programs do not consistently employ evidence-based practices that address co-occurring mental health and substance use disorders. This paper presents a study protocol to evaluate the implementation of an evidence-based, co-occurring disorder treatment called Maintaining Independence and Sobriety Through Systems Integration, Outreach, and Networking-Veterans Edition (MISSION-Vet) in HUD-VASH using an implementation strategy called Getting To Outcomes (GTO). In three large VA Medical Centers, this Hybrid Type III trial will randomize case managers and their clients by HUD-VASH sub-teams to receive either MISSION-Vet Implementation as Usual (IU-standard training and access to the MISSION-Vet treatment manuals) or MISSION-Vet implementation augmented by GTO. In addition to testing GTO, effectiveness of the treatment (MISSION-Vet) will be assessed using existing Veteran-level data from the HUD-VASH data monitoring system. This project will compare GTO and IU case managers and their clients on the following variables: (1) fidelity to the MISSION-Vet intervention; (2) proportion of time the Veteran is housed; (3) mental health, substance use, and functional outcomes among Veterans; and (4) factors key to the successful deployment of a new treatment as specified by the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) model. This project is an important step for developing an implementation strategy to increase adoption of evidence-based practice use in VA homeless programs, and to further examine efficacy of MISSION-Vet in HUD-VASH. This project has important implications for program managers, policy makers, and researchers within the homelessness field. VA Central IRB approval
Bigdeli, Maryam; Zafar, Shamsa; Assad, Hafeez; Ghaffar, Adbul
Severe pre-eclampsia and eclampsia are rare but serious complications of pregnancy that threaten the lives of mothers during childbirth. Evidence supports the use of magnesium sulfate (MgSO4) as the first line treatment option for severe pre-eclampsia and eclampsia. Eclampsia is the third major cause of maternal mortality in Pakistan. As in many other Low- and Middle-Income Countries (LMIC), it is suspected that MgSO4 is critically under-utilized in the country. There is however a lack of information on context-specific health system barriers that prevent optimal use of this life-saving medicine in Pakistan. Combining quantitative and qualitative methods, namely policy document review, key informant interviews, focus group discussions and direct observation at health facility, we explored context-specific health system barriers and enablers that affect access and use of MgSO4 for severe pre-eclampsia and eclampsia in Pakistan. Our study finds that while international recommendations on MgSO4 have been adequately translated in national policies in Pakistan, the gap remains in implementation of national policies into practice. Barriers to access to and effective use of MgSO4 occur at health facility level where the medicine was not available and health staff was reluctant to use it. Low price of the medicine and the small market related to its narrow indications acted as disincentives for effective marketing. Results of our survey were further discussed in a multi-stakeholder round-table meeting and an action plan for increasing access to this life-saving medicine was identified.
Full Text Available Severe pre-eclampsia and eclampsia are rare but serious complications of pregnancy that threaten the lives of mothers during childbirth. Evidence supports the use of magnesium sulfate (MgSO4 as the first line treatment option for severe pre-eclampsia and eclampsia. Eclampsia is the third major cause of maternal mortality in Pakistan. As in many other Low- and Middle-Income Countries (LMIC, it is suspected that MgSO4 is critically under-utilized in the country. There is however a lack of information on context-specific health system barriers that prevent optimal use of this life-saving medicine in Pakistan. Combining quantitative and qualitative methods, namely policy document review, key informant interviews, focus group discussions and direct observation at health facility, we explored context-specific health system barriers and enablers that affect access and use of MgSO4 for severe pre-eclampsia and eclampsia in Pakistan. Our study finds that while international recommendations on MgSO4 have been adequately translated in national policies in Pakistan, the gap remains in implementation of national policies into practice. Barriers to access to and effective use of MgSO4 occur at health facility level where the medicine was not available and health staff was reluctant to use it. Low price of the medicine and the small market related to its narrow indications acted as disincentives for effective marketing. Results of our survey were further discussed in a multi-stakeholder round-table meeting and an action plan for increasing access to this life-saving medicine was identified.
Squitieri, Lee; Chung, Kevin C
In 2015, the U.S. Congress passed the Medicare Access and Children's Health Insurance Program Reauthorization Act, which effectively repealed the Centers for Medicare and Medicaid Services sustainable growth rate formula and established the Centers for Medicare and Medicaid Services Quality Payment Program. The Medicare Access and Children's Health Insurance Program Reauthorization Act represents an unparalleled acceleration toward value-based payment models and a departure from traditional volume-driven fee-for-service reimbursement. The Quality Payment Program includes two paths for provider participation: the Merit-Based Incentive Payment System and Advanced Alternative Payment Models. The Merit-Based Incentive Payment System pathway replaces existing quality reporting programs and adds several new measures to create a composite performance score for each provider (or provider group) that will be used to adjust reimbursed payment. The advanced alternative payment model pathway is available to providers who participate in qualifying Advanced Alternative Payment Models and is associated with an initial 5 percent payment incentive. The first performance period for the Merit-Based Incentive Payment System opens January 1, 2017, and closes on December 31, 2017, and is associated with payment adjustments in January of 2019. The Centers for Medicare and Medicaid Services estimates that the majority of providers will begin participation in 2017 through the Merit-Based Incentive Payment System pathway, but aims to have 50 percent of payments tied to quality or value through Advanced Alternative Payment Models by 2018. In this article, the authors describe key components of the Medicare Access and Children's Health Insurance Program Reauthorization Act to providers navigating through the Quality Payment Program and discuss how plastic surgeons may optimize their performance in this new value-based payment program.
Marie Vander Kloet
It is increasingly understood that university education must be accessible to persons with disabilities. The responsibility to make the university accessible is arguably shared by all of us and yet, the extent to which it has become fully accessible is certainly suspect. By undertaking qualitative, discursive analysis of websites, online texts and other materials provided by Ontario’s teaching and learning centres, this paper seeks to do two things. First, it provides a critical overview of t...
Katoba, Juliet; Hangulu, Lydia; Mashamba-Thompson, Tivani Phosa
Point-of-care (POC) testing has been shown to help improve healthcare access in resource-limited settings. However, there is paucity of evidence on accessibility of POC testing for prevention of mother-to-child transmission (PMTCT) in resource-limited settings. We propose to conduct a systematic scoping review to map the evidence on POC testing services for PMTCT. A scoping review framework, proposed by Arksey and O'Malley, will guide the study. A comprehensive literature search will be performed in the following electronic databases: PubMed, Science Direct, Cochrane Central, Google Scholar and databases within EBSCOhost (Medline and CINAHL). The primary research articles published in peer-reviewed journals and grey articles addressing our question will be included. One reviewer will conduct title screening and the results will be exported to endnote library. Two independent reviewers will perform abstract, then full article screening in parallel. The same process shall be employed to extract data from eligible studies. Data analysis will involve a narrative summary of included studies and thematic content analysis aided by NVIVO software V.11. The mixed methods assessment tool will be used to assess the quality of studies that will be included. Ethical approval is not applicable to this study. The study findings will be disseminated through publication in a peer-reviewed journal and presentations at conferences related to syphilis, HIV, PMTCT, bacterial infections and POC diagnostics. CRD42017056267. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
Velasco, Veronica; Griffin, Kenneth W; Botvin, Gilbert J
Evidence-based preventive interventions for adolescent substance use, violence, and mental health issues are increasingly being adapted and disseminated internationally. In the present paper, we report the results of an effectiveness study that was part of a comprehensive initiative by a coalition of health promotion organizations in the Lombardy region of Italy to select, culturally adapt, implement, evaluate, and sustain an evidence-based drug abuse prevention program developed in the USA. Findings are presented from a large-scale effectiveness study of the Life Skills Training prevention program among over 3000 students attending 55 middle schools in Italy. The prevention program taught drug refusal skills, antidrug norms, personal self-management skills, and general social skills. Relative to comparison group students, students who received the prevention program were less likely to initiate smoking at the post-test and 2-year follow-up, and less likely to initiate weekly drunkenness at the 1-year follow-up. The program had direct positive effects on several cognitive, attitudinal, and skill variables believed to play a protective role in adolescent substance use. The findings from this study show that a drug abuse prevention program originally designed for adolescents in the USA is effective in a sample of Italian youth when a rigorous and systematic approach to cultural adaptation is followed that incorporates the input of multiple stakeholders.
Townsend, Stephanie M.; Campbell, Rebecca
This study examined the practices of 24 community-based rape prevention programs. Although these programs were geographically dispersed throughout one state, they were remarkably similar in their approach to rape prevention programming. DiMaggio and Powell's (1991) theory of institutional isomorphism was used to explain the underlying causes of…
Thompson David R
Full Text Available Abstract Background Despite favourable results from past meta-analyses, some recent large trials have not found Heart Failure (HF disease management programs to be beneficial. To explore reasons for this, we evaluated evidence from existing meta-analyses. Methods Systematic review incorporating meta-review was used. We selected meta-analyses of randomized controlled trials published after 1995 in English that examined the effects of HF disease management programs on key outcomes. Databases searched: MEDLINE, EMBASE, Cochrane Database of Systematic Reviews (CDSR, DARE, NHS EED, NHS HTA, Ageline, AMED, Scopus, Web of Science and CINAHL; cited references, experts and existing reviews were also searched. Results 15 meta-analyses were identified containing a mean of 18.5 randomized trials of HF interventions +/- 10.1 (range: 6 to 36. Overall quality of the meta-analyses was very mixed (Mean AMSTAR Score = 6.4 +/- 1.9; range 2-9. Reporting inadequacies were widespread around populations, intervention components, settings and characteristics, comparison, and comparator groups. Heterogeneity (statistical, clinical, and methodological was not taken into account sufficiently when drawing conclusions from pooled analyses. Conclusions Meta-analyses of heart failure disease management programs have promising findings but often fail to report key characteristics of populations, interventions, and comparisons. Existing reviews are of mixed quality and do not adequately take account of program complexity and heterogeneity.
Köklü, Seyfettin; Köksal, Iftihar; Akarca, Ulus Salih; Balkan, Ayhan; Güner, Rahmet; Demirezen, Aylin; Sahin, Memduh; Akhan, Sila; Ozaras, Reşat; Idilman, Ramazan
Background. Daclatasvir and asunaprevir dual therapy is approved for the treatment of HCV genotype 1b infection in several countries. To evaluate the efficacy and safety of daclatasvir and asunaprevir dual therapy in Turkish patients. Sixty-one patients with HCV genotype 1b were enrolled in the Turkish early access program. Most of the patients were in difficult-to-treat category. Patients were visited at each 4 week throughout the follow-up period. Laboratory findings and adverse events were recorded at each visit. Fifty-seven of 61 enrolled patients completed 24 weeks of treatment. Two patients died as a result of underlying diseases at 12-14th weeks of treatment. Two patients stopped the treatment early as a consequence of virological breakthrough, and 2 patients had viral relapse at the post-treatment follow-up. Overall SVR12 rates were 90% (55/61) and 93.2% (55/59) according to intention-to-treat (ITT) and per protocol (PP) analysis respectively. In ITT analysis, SVR12 was achieved by 93% (13/14) in relapsers, 80% (12/15) in interferon-ineligible patients and 91% (20/22) in previous nonresponder patients. SVR12 rates were 86.5% and 91.4% in patients with cirrhosis according to ITT and PP analysis respectively. SVR12 was 95.8% in non-cirrhosis group in both analysis. Patients with previous protease inhibitor experience had an SVR12 of 87.5%. Common adverse events developed in 28.8% of patients. There were no treatment related severe adverse event or grade-4 laboratory abnormality. Daclatasvir and asunaprevir dual therapy is found to be effective and safe in difficult-to-treat Turkish patients with HCV genotype 1b infection.
Estabrooks, Paul A; Smith-Ray, Renae L; Dzewaltowski, David A; Dowdy, Diane; Lattimore, Diana; Rheaume, Carol; Ory, Marcia G; Bazzarre, Terry; Griffin, Sarah F; Wilcox, Sara
Program sustainability in community and healthcare settings is critical to realizing the translation of research into practice. The purpose of this study is to describe the implementation and assessment of an intervention to increase organizational maintenance of evidence-based physical activity programs and the factors that impede or facilitate sustainability. All organizations implemented a sustainability action plan that included identifying factors related to sustainability, examining resources available, identifying program modifications to enhance sustainability, and long-term action planning. A mixed methods approach was used. Organizational (n = 12 sites) ability to demonstrate program effectiveness, align priorities with the organizational mission, and integrate the program within the existing infrastructure were strengths related to sustainability. Sites were more optimistic about program sustainability when they had less reliance on internal financial, but more reliance on internal human resources to run the program post-funding. The study resulted in a number of tools that can help community organizations plan for sustainability of physical activity programs.
Hennig, Teresa; Griffith, Geoffrey L
A comprehensive guide to programming for Access 2010 and 2007. Millions of people use the Access database applications, and hundreds of thousands of developers work with Access daily. Access 2010 brings better integration with SQL Server and enhanced XML support; this Wrox guide shows developers how to take advantage of these and other improvements. With in-depth coverage of VBA, macros, and other programming methods for building Access applications, this book also provides real-world code examples to demonstrate each topic.: Access is the leading database that is used worldwide; While VBA rem
Hein De Vries
Full Text Available eHealth programs have become very popular to help people to quit smoking. Yet, the efficacy of eHealth programs is dependent on the health communication theories used and applied in these programs. Computer tailored technology has shown to be an effective tool to help people to quit smoking. Programs with even one session can increase the success rates significantly. During this presentation I will discuss several computer tailored eHealth programs for smoking cessation that have been developed and tested at Maastricht University. I will discuss the theoretical grounding of these programs, their effects and the cost-effectiveness. Additionally I will also outline some potential innovations for eHealth programs, and will also share the results of a test comparing eHealth and mHealth.
Fisher, Karin; Smith, Tony; Nairn, Karen; Anderson, Donna
To better understand issues related to access to injecting equipment for people who inject drugs (PWID) in a rural area of New South Wales (NSW), Australia. Cross-sectional face-to-face survey using convenience and snowball sampling. Six regional and rural population centres in Northern NSW, within the Hunter New England Local Health District. The sample included 190 PWID who had accessed a needle and syringe program outlet within 4 weeks of the survey. Data include demographic information, preferred location for accessing injecting equipment, reasons for that preference, whether they obtained enough equipment, travelling distance to an NSP and self-reported hepatitis C virus status. Sixty percent self-identified as Aboriginal people. The median age of respondents was 32 years and 60% were men. A significantly larger proportion (P equipment at a community health facility (62.6%), as opposed to other secondary outlets, where they gained enough equipment (67.4%). Just over 80% said they were tested for HCV in the past year, with about 37% told they had tested positive. There are complex dimensions affecting how rural PWID access secondary NSP outlets. Although access is similarly limited as other rural health services because of the nature of injecting drug use and sensitivities existing in rural communities, there is potential for application of unique access models, such as, promoting secondary distribution networks. © 2016 National Rural Health Alliance Inc.
McClellan, Sean R; Wu, Frances M; Snowden, Lonnie R
Title VI of the 1964 Civil Rights Act prohibits federal funds recipients from providing care to limited English proficiency (LEP) persons more limited in scope or lower in quality than care provided to others. In 1999, the California Department of Mental Health implemented a "threshold language access policy" to meet its Title VI obligations. Under this policy, Medi-Cal agencies must provide language assistance programming in a non-English language where a county's Medical population contains either 3000 residents or 5% speakers of that language. We examine the impact of threshold language policy-required language assistance programming on LEP persons' access to mental health services by analyzing the county-level penetration rate of services for Russian, Spanish, and Vietnamese speakers across 34 California counties, over 10 years of quarterly data. Exploiting a time series with nonequivalent control group study design, we studied this phenomena using linear regression with random county effects to account for trends over time. Threshold language policy-required assistance programming led to an immediate and significant increase in the penetration rate of mental health services for Russian (8.2, P language speaking persons. Threshold language assistance programming was effective in increasing mental health access for Russian and Vietnamese, but not for Spanish-speaking LEP persons.
Behrman, Jere R; Parker, Susan W
Conditional cash transfer (CCT) programs link public transfers to human capital investment in the hopes of alleviating current poverty and reducing its intergenerational transmission. Whereas nearly all studies of their effects have focused on youth, CCT programs may also have an impact on aging adults by increasing household resources or inducing changes in allocations of time of household members, which may be of substantial interest, particularly given the rapid aging of most populations. This article contributes to this underresearched area by examining health and work impacts on the aging for the best-known and most influential of these programs, the Mexican PROGRESA/Oportunidades program. For a number of health indicators, the program appears to significantly improve health, with larger effects for recipients with a greater time receiving benefits from the program. Most of these health effects are concentrated on women.
Behrman, Jere R.
Conditional cash transfer (CCT) programs link public transfers to human capital investment in the hopes of alleviating current poverty and reducing its intergenerational transmission. Whereas nearly all studies of their effects have focused on youth, CCT programs may also have an impact on aging adults by increasing household resources or inducing changes in allocations of time of household members, which may be of substantial interest, particularly given the rapid aging of most populations. This article contributes to this underresearched area by examining health and work impacts on the aging for the best-known and most influential of these programs, the Mexican PROGRESA/Oportunidades program. For a number of health indicators, the program appears to significantly improve health, with larger effects for recipients with a greater time receiving benefits from the program. Most of these health effects are concentrated on women. PMID:23494570
Larson, David B; Chandler, Maria; Forman, Howard P
Managerial sciences are playing an increasingly prominent role in the organization and delivery of health care. Despite popular media reports that a rising number of physicians are acquiring a background in this discipline through MD/MBA (medical and master of business administration) programs, no recent study has verified this. This study measured changes in the number and nature of the affiliations between management and medicine in the form of MD/MBA programs in the United States. Surveys of admission officers of 125 U.S. allopathic medical schools and of the overseers of each joint MD/MBA degree program were administered in May-October 2001. Main outcome measures included program growth, curriculum and degree requirements, application and admission requirements, and program leadership and organization. The number of MD/MBA programs grew from six to 33 between 1993 and 2001, and 17 more medical schools were considering establishing the joint-degree program. Ten, 15, and 20 programs produced 27, 42, and 61 graduates in 1999, 2000, and 2001, respectively, and over 100 students were expected to graduate per year when all 33 programs matured. Program structures and oversight indicate a spectrum of philosophies regarding the appropriate level of integration of the two degrees. MD/MBA programs apparently attempt to complement medical education with management education rather than the converse. The growth in the numbers of MD/MBA programs and participants indicates rising cooperation between medical and business schools and increasing interest in management education early in the careers of graduating physicians.
Graversen, B.K.; van Ours, J.C.
This paper investigates how a mandatory activation program in Denmark affects the job finding rate of unemployed workers.The activation program was introduced in an experimental setting where about half of the workers who became unemployed in the period from November 2005 to March 2006 were randomly
Xia, Belle Selene
Previous research has shown that, despite the importance of programming education, there is limited research done on programming education experiences from the students' point of view and the need to do so is strong. By understanding the student behaviour, their learning styles, their expectation and motivation to learn, the quality of teaching…
Lee, Linda; Weston, W. Wayne; Hillier, Loretta M.
Introduction: Primary care is challenged to meet the needs of patients with dementia. A training program was developed to increase capacity for dementia care through the development of Family Health Team (FHT)-based interprofessional memory clinics. The interprofessional training program consisted of a 2-day workshop, 1-day observership, and 2-day…
Since 2006, the Department of Education in the Netherlands encourages the introduction of service learning programs at the level of secondary education. The goal of the programs is to promote civic-mindedness: civic engagement, awareness of values and norms, and active citizenship. Past studies of
Kusumawardhani, Prita Nurmalia
This paper examines the impact of the teacher certification program in Indonesia in 2007 and 2008 on student and teacher outcomes. I create a rule-based instrumental variable from discontinuities arising from the assignment mechanism of teachers into certification program. The thresholds are determined empirically. The study applies a two-sample…
Conclusions This study offers a theoretical basis to understand physicians' beliefs towards completing an internet-based continuing medical education (CME program on EBM. Based upon respondents' insights, several modifications were carried out to enhance the uptake of the program by physicians and, therefore, its implementation.
Thompson, Ruthanne; Serna, Victoria Faubion
Based on results from a 2008 research study of regional citizen knowledge concerning watershed issues, a water conservation education program was designed and implemented. Findings from the initial study demonstrated program success as evidenced by knowledge gain and willingness to "commit" to water saving behaviors in 94% of students. A…
Fogg, Neeta P.; Harrington, Paul E.
The Gaining Early Awareness and Readiness for Undergraduate Program, more commonly known as GEAR UP, is a product of federal legislation designed to increase high school completion and college attendance of low-income youth. It is a federally funded discretionary grant program that is planned, organized and operated at the state and local level.…
Fransen, Mirjam P; Dekker, Evelien; Timmermans, Daniëlle R M; Uiters, Ellen; Essink-Bot, Marie-Louise
To explore the accessibility of standardized printed information materials of the national Dutch colorectal cancer screening program among low health literate screening invitees and to assess the effect of the information on their knowledge about colorectal cancer and the screening program. Linguistic tools were used to analyze the text and design characteristics. The accessibility, comprehensibility and relevance of the information materials were explored in interviews and in observations (n=25). The effect of the information on knowledge was assessed in an online survey (n=127). The materials employed a simple text and design. However, respondents expressed problems with the amount of information, and the difference between screening and diagnostic follow-up. Knowledge significantly increased in 10 out of 16 items after reading the information but remained low for colorectal cancer risk, sensitivity of testing, and the voluntariness of colorectal cancer screening. Despite intelligible linguistic and design characteristics, screening invitees with low health literacy had problems in accessing, comprehending and applying standard information materials on colorectal cancer screening, and lacked essential knowledge for informed decision-making about participation. To enable equal access to informed decision-making, information strategies need to be adjusted to the skills of low health literate screening invitees. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.
Cheng, Yuan-Hsin; Field, William E; Tormoehlen, Roger L; French, Brian F
Purdue University's Agricultural Safety and Health Program (PUASHP) has collaborated with secondary agricultural education programs, including FFA Chapters, for over 70 years to deliver and promote agricultural safety and health programming. With support from a U.S. Department of Labor Susan Harwood Program grant, PUASHP utilized a Developing a Curriculum (DACUM) process to develop, implement, and evaluate an evidence-based curriculum for use with young and beginning workers, ages 16-20, exposed to hazards associated with grain storage and handling. The primary audience was students enrolled in secondary agricultural education programs. A review of the literature identified a gap in educational resources that specifically addresses this target population. The curriculum developed was based on fatality and injury incident data mined from Purdue's Agricultural Confined Space Incident Database and input from a panel of experts. The process identified 27 learning outcomes and finalized a pool of test questions, supported by empirical evidence and confirmed by a panel of experts. An alignment process was then completed with the current national standards for secondary agricultural education programs. Seventy-two youth, ages 16-20, enrolled in secondary-school agricultural education programs, and a smaller group of post-secondary students under the age of 21 interested in working in the grain industry pilot tested the curriculum. Based on student and instructor feedback, the curriculum was refined and submitted to OSHA for approval as part of OSHA's online training resources. The curriculum was delivered to 3,665 students, ages 16-20. A total of 346 pre- and post-tests were analyzed, and the results used to confirm content validity and assess knowledge gain. Findings led to additional modifications to curriculum content, affirmed knowledge gain, and confirmed appropriateness for use with secondary agricultural education programs. The curriculum has been promoted
Yasunaga, Masashi; Murayama, Yoh; Takahashi, Tomoya; Ohba, Hiromi; Suzuki, Hiroyuki; Nonaka, Kumiko; Kuraoka, Masataka; Sakurai, Ryota; Nishi, Mariko; Sakuma, Naoko; Kobayashi, Erika; Shinkai, Shoji; Fujiwara, Yoshinori
Compelling evidence supporting the benefits of social engagement in older adults has been increasingly discussed. However, knowledge regarding an intergenerational program is limited. Herein, we provide a targeted review of intergenerational programs by focusing on our novel interventional program, Research on Productivity through Intergenerational Sympathy. The Research on Productivity through Intergenerational Sympathy program is an intergenerational picture-book reading program launched in 2004. Participants were involved a 3-month intensive weekly training seminar comprising classes about book selection, reading techniques and basic knowledge of children's school life. Subsequently, they participated in group activities that involved playing a hand game, and reading picture books to children at kindergartens, elementary schools and public childcare centers, once every 1-2 weeks. The Research on Productivity through Intergenerational Sympathy program has shown improvement of physical and psychological functioning of older adults and healthy upbringing of children. Similarly, Experience Corps - designed to train and place volunteers in participating elementary schools for an academic year during which time they assist teachers - also showed positive effects for older adults' health status and the psychological/academic success of young children in the USA. Health promotion efforts for older adults must support social policy for the creation of meaningful service programs for older adults on a large social scale. As such, an intergenerational program based on the concept of social capital, defined as "features of social organization, such as trust, norms and networks, that can improve the efficacy of society by facilitating coordinated actions," is an effective and sustainable program for health promotion among older adults. © 2016 Japan Geriatrics Society.
Antonipillai, Valentina; Baumann, Andrea; Hunter, Andrea; Wahoush, Olive; O'Shea, Timothy
Changes to the Interim Federal Health Program (IFHP) in 2012 reduced health care access for refugees and refugee claimants, generating concerns among key stakeholders. In 2014, a new IFHP temporarily reinstated access to some health services; however, little is known about these changes, and more information is needed to map the IFHP's impact. This study explores barriers occurring during the time period of the IFHP reforms to health care access and provision for refugees. A stakeholder analysis, using 23 semi-structured interviews, was conducted to obtain insight into stakeholder perceptions of the 2014 reforms, as well as stakeholders' position and their influence to assess the acceptability of the IFHP changes. The majority of stakeholders expressed concerns about the 2014 IFHP changes as a result of the continuing barriers posed by the 2012 retrenchments and the emergence of new barriers to health care access and provision for refugees. Key barriers identified included lack of communication and awareness, lack of continuity and comprehensive care, negative political discourse and increased costs. A few stakeholders supported the reforms as they represented some, but limited, access to health care. Overall, the reforms to the IFHP in 2014 generated barriers to health care access and provision that contributed to confusion among stakeholders, the transfer of refugee health responsibility to provincial authorities and the likelihood of increased health outcome disparities, as refugees and refugee claimants chose to delay seeking health care. The study recommends that policy-makers engage with refugee health stakeholders to formulate a policy that improves health care provision and access for refugee populations.
Allison M. Schmidt
Full Text Available Tobacco use, the leading cause of preventable death in the U.S., can be reduced through state-level tobacco prevention and cessation programs. In the absence of research about how to communicate the need for these programs to policymakers, this qualitative study aimed to understand the motivations and priorities of policymakers in North Carolina, a state that enacted a strong tobacco control program from 2003–2011, but drastically reduced funding in recent years. Six former legislators (three Democrats, three Republicans and three lobbyists for health organizations were interviewed about their attitudes towards tobacco use, support of state-funded programs, and reactions to two policy briefs. Five themes emerged: (1 high awareness of tobacco-related health concerns but limited awareness of program impacts and funding, (2 the primacy of economic concerns in making policy decisions, (3 ideological differences in views of the state’s role in tobacco control, (4 the impact of lobbyist and constituent in-person appeals, and (5 the utility of concise, contextualized data. These findings suggest that building relationships with policymakers to communicate ongoing program outcomes, emphasizing economic data, and developing a constituent advocacy group would be valuable to encourage continued support of state tobacco control programs.
Full Text Available Chronic diseases are the most common, costly, and preventable of all health problems in the United States. Chronic diseases represent the leading causes of death and are experienced at higher rates by minority populations (CDC, 2012. Innovative community-based health promotion programs are recommended that meet the diverse needs of underserved populations (Yeary, et al., 2011. LifeSteps is being developed as an evidence-based health promotion program focusing on health and wellness, a domain area defined within the Occupational Therapy Practice Framework (OTPF, 2008. LifeSteps will utilize a client-centered approach to coach individuals in making health behavior changes. Fieldwork and service-learning components are incorporated integrating clinical practice, academic study, and collaboration with community providers. Program evaluation measures based on the Transtheoretical Model (TTM have been identified to address all phases of program planning. The LifeSteps health promotion program aligns with local, national, and international objectives and addresses the need for programs that meet the diverse needs of underserved populations. Occupational therapists are in a unique position for implementing community-based interventions that promote health and contribute to a healthier society.
Renfro, Mindy; Bainbridge, Donna B; Smith, Matthew Lee
Evidence-based fall prevention (EBFP) programs significantly decrease fall risk, falls, and fall-related injuries in community-dwelling older adults. To date, EBFP programs are only validated for use among people with normal cognition and, therefore, are not evidence-based for adults with intellectual and/or developmental disorders (IDD) such as Alzheimer's disease and related dementias, cerebral vascular accident, or traumatic brain injury. Adults with IDD experience not only a higher rate of falls than their community-dwelling, cognitively intact peers but also higher rates and earlier onset of chronic diseases, also known to increase fall risk. Adults with IDD experience many barriers to health care and health promotion programs. As the lifespan for people with IDD continues to increase, issues of aging (including falls with associated injury) are on the rise and require effective and efficient prevention. A modified group-based version of the Otago Exercise Program (OEP) was developed and implemented at a worksite employing adults with IDD in Montana. Participants were tested pre- and post-intervention using the Center for Disease Control and Prevention's (CDC) Stopping Elderly Accidents Deaths and Injuries (STEADI) tool kit. Participants participated in progressive once weekly, 1-h group exercise classes and home programs over a 7-week period. Discharge planning with consumers and caregivers included home exercise, walking, and an optional home assessment. Despite the limited number of participants ( n = 15) and short length of participation, improvements were observed in the 30-s Chair Stand Test, 4-Stage Balance Test, and 2-Minute Walk Test. Additionally, three individuals experienced an improvement in ambulation independence. Participants reported no falls during the study period. Promising results of this preliminary project underline the need for further study of this modified OEP among adults with IDD. Future multicenter study should include more
Johnson, Michelle; Stone, Susan; Lou, Christine; Ling, Jennifer; Claassen, Jennette; Austin, Michael J
Parent education programs may be offered or mandated at various stages of the child welfare services continuum. However, little is known regarding their efficacy in addressing the parenting problems that bring families to the attention of child welfare services. This article synthesizes outcome data generated from 58 parenting programs with families determined to be at-risk of child maltreatment and/or abusive or neglectful. It places parent education programs within the broader context of research on effective parenting as well as the leading etiological models of child maltreatment to assess the evaluations of these programs with regard to methodological rigor as well as theoretical salience. Practical and theoretical implications are presented along with recommendations for future research.
Salisbury, Dereck L; Whipple, Mary O; Burt, Marsha; Brown, Rebecca J L; Hirsch, Alan; Foley, Christopher; Treat-Jacobson, Diane
The purpose of this study was to implement and evaluate quality outcomes including referral, enrollment, and completion rates of a new peripheral artery disease (PAD)-specific supervised exercise therapy (SET) program within a preexisting clinical exercise wellness program and to evaluate the clinical effectiveness and patient-centered outcomes derived from 12 weeks of PAD-specific SET. Recruited participants completed an individualized, minimally supervised, PAD-specific SET program based on the AHA-ACC guidelines. Exercise workloads (metabolic equivalents of task [METs]) were tracked and evaluated throughout the program. Short Physical Performance Battery, 6-minute walk test (6MWT) Walking Impairment Questionnaire, Short-Form 36 (SF-36), and Peripheral Artery Disease Quality of Life Questionnaire (PADQOL) were assessed before and after the program. Paired t-tests were used to examine differences between baseline and follow-up outcome variables. On average, participants (n = 46) attended 23 (standard deviation [SD] 12.9) out of the possible 36 training sessions, for a 64% attendance rate. Among participants who used treadmill walking as the primary mode of exercise (n = 40), the overall mean MET level just prior to program completion was 3.79 (SD 1.49), which represented an increase of 0.92 (34%) METs compared to baseline (P < .001). Total distance on the 6MWT increased 115 (11%) feet (P = .011), which is considered a clinically meaningful improvement. Significant improvements were noted in the PADQOL: symptoms and limitations in physical functioning (P = .007). This study demonstrates that a minimally staffed PAD-specific SET program can improve functional performance in patients with claudication due to PAD and serves as a foundation to help build a clinically effective, Centers for Medicare and Medicaid reimbursed PAD-specific rehabilitation program. Copyright © 2017 Society for Vascular Nursing, Inc. Published by Elsevier Inc. All rights reserved.
Astrella, Julie A
Workplace wellness programs are expected to reduce employee healthcare costs, increase productivity, and provide a positive return on investment. A review of the literature from 2000 to 2016 was conducted to determine whether workplace wellness programs deliver a positive economic impact. Individual financial metrics and results varied; 6 of 7 studies reported a positive economic impact. Additional study is recommended because of the high-degree variability and lack of longitudinal data.
Mark Duggan; Robert Rosenheck; Perry Singleton
The U.S. Department of Veterans' Affairs (VA) currently provides disability benefits to 2.72 million veterans of U.S. military service through the Disability Compensation (DC) program. Until recently, the medical eligibility criteria for this program were the same across service eras, with the key condition being that the disability was caused or aggravated by military service. But in July of 2001, the VA relaxed the eligibility criteria for Vietnam veterans by including diabetes in the list ...
Lubogo, David; Ddamulira, John Bosco; Tweheyo, Raymond; Wamani, Henry
The HIV/AIDS health challenge continues to ravage many resource-constrained countries of the world. Approximately 75 % of all the global HIV/AIDS related deaths totaling 1.6 (1.4-1.9) million in 2012 occurred in sub-Saharan Africa, Uganda contributed 63,000 (52,000-81,000) to these deaths. Most of the morbidity and mortality associated with HIV/AIDS can be averted if individuals with HIV/AIDS have improved access to HIV care and treatment. The aim of this study therefore, was to explore the factors associated with access to HIV care services among HIV seropositive clients identified by a home based HIV counseling and testing program in Kumi district, eastern Uganda. In a cross sectional study conducted in February 2009, we explored predictor variables: socio-demographics, health facility and community factors related to access to HIV care and treatment. The main outcome measure was reported receipt of cotrimoxazole for prophylaxis. The majority [81.1 % (284/350)] of respondents received cotrimoxazole prophylaxis (indicating access to HIV care). The main factors associated with access to HIV care include; age 25-34 years (AOR = 5.1, 95 % CI: 1.5-17.1), male sex (AOR = 2.3, 95 % CI: 1.2-4.4), urban residence (AOR = 2.5, CI: 1.1-5.9) and lack of family support (AOR = 0.5, CI: 0.2-0.9). There was relatively high access to HIV care and treatment services at health facilities for HIV positive clients referred from the Kumi home based HIV counseling and testing program. The factors associated with access to HIV care services include; age group, sex, residence and having a supportive family. Stakeholders involved in providing HIV care and treatment services in similar settings should therefore consider these socio-demographic variables as they formulate interventions to improve access to HIV care services.
Full Text Available BACKGROUND: Using the conceptual framework of shared decision-making and evidence-based practice, a web portal was developed to serve as a generic (non disease-specific tailored intervention to improve the lay public's health literacy skills. OBJECTIVE: To evaluate the effects of the web portal compared to no intervention in a real-life setting. METHODS: A pragmatic randomised controlled parallel trial using simple randomisation of 96 parents who had children aged <4 years. Parents were allocated to receive either access to the portal or no intervention, and assigned three tasks to perform over a three-week period. These included a searching task, a critical appraisal task, and reporting on perceptions about participation. Data were collected from March through June 2011. RESULTS: Use of the web portal was found to improve attitudes towards searching for health information. This variable was identified as the most important predictor of intention to search in both samples. Participants considered the web portal to have good usability, usefulness, and credibility. The intervention group showed slight increases in the use of evidence-based information, critical appraisal skills, and participation compared to the group receiving no intervention, but these differences were not statistically significant. CONCLUSION: Despite the fact that the study was underpowered, we found that the web portal may have a positive effect on attitudes towards searching for health information. Furthermore, participants considered the web portal to be a relevant tool. It is important to continue experimenting with web-based resources in order to increase user participation in health care decision-making. TRIAL REGISTRATION: ClinicalTrials.gov NCT01266798.
Sandman, Lars; Liliemark, Jan
There is a strong patient demand for early access to potentially beneficial cancer drugs. In line with this authorization agencies like the European Medicines Agency are providing drugs with conditional market authorisation based on positive interim analyses. This implies that drugs are used with insecure evidence of efficacy and adverse side-effects. Several authors have pointed to ethical problems with such a system but up to date no indepth ethical analysis of this system is found which is the aim of this article. Drawing of the four generally accepted principles of medical ethics: beneficence, nonmaleficence, respect for autonomy and justice the ethical pros and cons of conditional market authorisation are analysed. From the perspective of beneficence and non-maleficence it is found that the main problem is not risk of adverse side-effects to patients, but rather risk of less beneficial outcomes than what can be expected which could change incentives for patients' choice of treatment. This is also related to the extent to which patients might make an autonomous choice, especially taking into account problematic psychological attitudes and biases in medical decision-making. However, the main problem is related to justice and an equitable distribution of scarce health-care resources given the opportunity cost of drugs treatment. When using resources on cancer treatments which later might be found to be less efficacious than was first expected, other patients (in and outside the cancer field) are deprived of potentially more beneficial treatments even though their needs might be equally or more severe. At the same time, demanding more evidence has an ethical cost to patients in terms of depriving them of potential benefits in terms of reduced mortality and morbidity. In order to handle these ethical conflicts further research and analyses are required and it is suggested that pricing strategies and information requirements are alternatives to be further explored
Full Text Available The main objective of this work is to analyze and extend security model of mobile devices running on Android OS. Provided security extension is a Linux kernel security module that allows the system administrator to restrict program's capabilities with per-program profiles. Profiles can allow capabilities like network access, raw socket access, and the permission to read, write, or execute files on matching paths. Module supplements the traditional Android capability access control model by providing mandatory access control (MAC based on path. This extension increases security of access to system objects in a device and allows creating security sandboxes per application.
Tuot, Delphine S; Lopez, Monica; Miller, Cecily; Karliner, Leah S
Language barriers render interaction with the health care system difficult and lead to health disparities for patients with limited English proficiency (LEP). Despite a long-standing legal obligation for large health care organizations in the United States to try to provide free language access services for patients with LEP, professional interpretation is not always widely accessible, and even when it is, its use is often suboptimal. A dual-handset phone with 24-hour access to professional telephonic interpretation was placed at the bedside of all patients admitted to the general medicine floor of a tertiary care academic hospital. Nurses and physicians were surveyed before and after the easy-access interpretation program's implementation. Distribution of pre- and postimplementation surveys to 127 and 122 nurses, respectively, yielded a total of 163 completed surveys (overall participation rate, 65%). Distribution of surveys to 96 and 78 physicians, respectively, yielded 116 completed surveys (overall participation rate, 67%). After implementation, use of professional telephonic interpreters for communication with LEP patients increased fourfold, without a decrease in use of professional in-person interpreters. There were significant increases in professional interpreter use during brief communications with high error potential, including medication administration (odds ratio [OR] = 1.9, 95% confidence interval [CI] 1.1-3.2) and pre-rounding (OR = 3.4, 95% CI 1.2-9.8). Increasing ease of access to dual-handset interpreter telephones promotes use of professional interpreters in the acute care setting. Future hospital policy should focus on further integrating language services into the hospital environment, accompanied by an educational program to assist in shifting professional norms toward use of professional interpreters.
Gewirtz, Abigail H; DeGarmo, David S; Zamir, Osnat
Despite significant stressors facing military families over the past 15 years of wars in Iraq and Afghanistan, no parenting programs adapted or developed for military families with school-aged children have been rigorously tested. We present outcome data from the first randomized controlled trial of a behavioral parent training program for families with a parent deployed to Iraq or Afghanistan. In the present study, 336 primarily National Guard and Reserve families with 4-12-year-old children were recruited from a Midwestern state. At least one parent in each family had deployed to the recent conflicts: Operations Iraqi or Enduring Freedom, or New Dawn (OIF/OEF/OND). Families were randomized to a group-based parenting program (After Deployment, Adaptive Parenting Tools (ADAPT)) or web and print resources-as-usual. Using a social interaction learning framework, we hypothesized an indirect effects model: that the intervention would improve parenting, which, in turn, would be associated with improvements in child outcomes. Applying intent-to-treat analyses, we examined the program's effect on observed parenting, and children's adjustment at 12-months post baseline. Controlling for demographic (marital status, length, child gender), deployment variables (number of deployments), and baseline values, families randomized to the ADAPT intervention showed significantly improved observed parenting compared to those in the comparison group. Observed parenting, in turn, was associated with significant improvements in child adjustment. These findings present the first evidence for the effectiveness of a parenting program for deployed military families with school-aged children.
The aim of this study was to evaluate the effectiveness of the medium of videoconferencing for the delivery of a course for radiology residents in practice-based learning (PBL), including evidence-based practice, at centers geographically separated from the principal teaching site.
Houmard, Joseph A; Pories, Walter J; Dohm, G Lynis
Severe obesity is increasing at a disproportionate rate compared to milder grade obesity. Our research group has obtained evidence indicative of an “obesity metabolic program” in the skeletal muscle of severely obese individuals which may be genetically or epigenetically determined. We believe this represents a paradigm shift in thinking about metabolic regulation in obesity.
Sanford DeRousie, Rebecca M.; Bierman, Karen L.
This study examined the extent to which an evidence-based preschool curriculum (Head Start REDI) was sustained by 20 teachers during the year following a randomized controlled efficacy trial, when teachers were no longer required by the research project to implement the curriculum. Two quantitative measures of sustainability (teacher ratings, REDI…
Giffen, Carol A; Wagner, Elizabeth L; Adams, John T; Hitchcock, Denise M; Welniak, Lisbeth A; Brennan, Sean P; Carroll, Leslie E
The National Heart, Lung, and Blood Institute (NHLBI), within the United States' National Institutes of Health (NIH), established the Biologic Specimen and Data Repository Information Coordinating Center (BioLINCC) in 2008 to develop the infrastructure needed to link the contents of the NHLBI Biorepository and the NHLBI Data Repository, and to promote the utilization of these scientific resources by the broader research community. Program utilization metrics were developed to measure the impact of BioLINCC on Biorepository access by researchers, including visibility, program efficiency, user characteristics, scientific impact, and research types. Input data elements were defined and are continually populated as requests move through the process of initiation through fulfillment and publication. This paper reviews the elements of the tracking metrics which were developed for BioLINCC and reports the results for the first six on-line years of the program.
Marie Vander Kloet
Full Text Available It is increasingly understood that university education must be accessible to persons with disabilities. The responsibility to make the university accessible is arguably shared by all of us and yet, the extent to which it has become fully accessible is certainly suspect. By undertaking qualitative, discursive analysis of websites, online texts and other materials provided by Ontario’s teaching and learning centres, this paper seeks to do two things. First, it provides a critical overview of the types of training currently available at Ontario universities for teaching assistants on accessibility and teaching. This review will outline initiatives directed towards compliance with Accessibility for Ontarians with Disabilities Act (AODA requirements, those focused on education and advocacy (as well as areas of overlap and broader equity training which encompasses accessibility. Second, this paper, considering the content of the reviewed material and informed by critical disability studies, offers up an articulation of future directions for research, writing, advocacy, and training on teaching assistant development on accessible teaching. Il est de plus en plus accepté que l’éducation universitaire doit être accessible aux personnes handicapées. Certes, la responsabilité de rendre l’université accessible est partagée par tous et pourtant, la mesure dans laquelle celle-ci est devenue totalement accessible est sans nul doute suspecte. Après avoir entrepris des analyses qualitatives et discursives de sites web, de textes en ligne et d’autres documents fournis par des centres d’enseignement et d’apprentissage de l’Ontario, on cherche dans cet article à accomplir deux choses. Tout d’abord, l’article présente un aperçu critique des types de formation disponibles à l’heure actuelle dans les universités de l’Ontario à l’intention des enseignants auxiliaires sur l’accessibilité et l’enseignement. Cet examen va d
Full Text Available Falls in older adults are a significant public health issue and a particularly significant health risk in Minnesota. With accumulating research evidence suggesting that falls can be prevented through exercise, there is an increased public health effort among organizations serving older adults to translate and disseminate evidence-based programs into the community. Such efforts, however, face additional challenges if they are implemented in communities with older adults from different cultural backgrounds and languages. This paper briefly describes a pilot community-based dissemination project, including the initiation, implementation, process, and outcomes, of an evidence-based fall prevention (Tai Ji Quan: Moving for Better Balance formerly known as Tai Chi: Moving for Better Balance through a local Area Agency on Aging in the Minneapolis/St. Paul metropolitan area in Minnesota (USA. Overall, the program was successfully implemented resulting in adoption by local community organizations serving Asian and, to a lesser degree, East African non-English speaking older adults. Bilingual community instructors were trained to lead the classes resulting in broad participation and improved physical performance by the older adults targeted for the intervention. The results from this pilot study indicate that Tai Ji Quan: Moving for Better Balance can be implemented with positive results in non-English speaking community settings using bilingual leaders.
Smith, Matthew Lee; Ory, Marcia G; Larsen, Ross
Older women who are vulnerable to falls and their negative consequences have been shown, in controlled randomized clinical trials, to benefit from fall prevention programs. The purpose of this study was to identify personal characteristics of female participants enrolled in a falls prevention program, the effectiveness of the program for female participants, and whether personal characteristics indicate which women might benefit most from programs delivered in real-world settings. Data were collected from seniors enrolled in A Matter of Balance/Voluntary Lay Leader (AMOB/VLL) program sessions conducted in Texas over the 2-year period from 2007 to 2009. Baseline and postintervention data from 1,101 female participants were drawn from a larger, state-wide dataset and analyzed using structural equation modeling to identify relationships between variables of interest. Analyses revealed that women who attended AMOB/VLL significantly increased falls efficacy from baseline to postintervention (t = 1.680; p < .05; d = 0.143) and reduced the number of times fallen (t = 3.790; p < .01; d = 0.313). Further, participants reported decreases in days of physical (t = 3.810; p < .01; d = 0.323) and mental health (t = 1.850; p < .05; d = 0.156) reported as not good. Findings from this study support the effectiveness of evidence-based programs for reducing falls-related risks in older women. Identifying the characteristics of female participants enrolled in AMOB/VLL can enable public health professionals to better target and meet the health demands of the aging female population. Such translational research can help to guide the dissemination of additional state-wide health promotion programs for older women. Copyright © 2010 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.
Hawkins, Richard E; Weiss, Kevin B
In this issue, Lipner and colleagues describe research supporting the value of the examinations used in the maintenance of certification (MOC) programs of the American Board of Internal Medicine and the American Board of Surgery. The authors of this commentary review the contribution of this research and previous investigations that underscore the value of this component of the American Board of Medical Specialties (ABMS) MOC program. In addition, they point out that the MOC examination is one element of a comprehensive approach to physician lifelong learning, assessment, and quality improvement. The ABMS MOC program requires diplomates of the ABMS member boards to engage in continuous professional development in the six domains of competence and performance previously defined by the ABMS and the Accreditation Council for Graduate Medical Education. Although evidence and a sound rationale exist to support educational and assessment methods that target all six domains, it will be important to continue to build the body of evidence demonstrating the value of MOC to the public and to the profession.
Storer, Heather L; Barkan, Susan E; Sherman, Emma L; Haggerty, Kevin P; Mattos, Leah M
The high needs of youth involved in the child welfare system and the poor long-term outcomes of former foster youth represent a significant systemic challenge. As part of a process to adapt an evidence-based parenting program for a child welfare population, we conducted a series of focus groups with child welfare staff, foster caregivers, and young adults who were involved in the foster system as teens. From these focus groups we learned that, although there is a need for evidence-based parenting programs for families involved in the child welfare setting, one of the significant barriers to program implementation is the lack of meaningful connection between caregivers and youth in their care. We will provide an in-depth discussion on the proposed adaptations to make Staying Connected more relevant for foster families, including the addition of skills training to help overcome some of the barriers to connection. Staying Connected holds the promise of cultivating more supportive home environments that have the capacity to nurture youths' healthy development, including the avoidance of high-risk behaviors.
Moessner, Markus; Minarik, Carla; Özer, Fikret; Bauer, Stephanie
The majorities of individual suffering from eating disorders do not seek or receive adequate professional treatment. Internet-based approaches promise to facilitate access to conventional healthcare by providing an easy-access, low-threshold contact. The current study investigated whether an Internet-based program for the prevention and early intervention for eating disorders (ProYouth) may contribute to the actual and intended uptake of professional care. Characteristics of individuals who seek help are explored as well as barriers to help-seeking. The sample included 453 ProYouth participants who were surveyed three months after registration. Actual help-seeking behavior, intended help-seeking, potential help-seeking, and barriers to help-seeking were assessed. Within three months of participation, 43 individuals (9.5%) took up treatment, 32 (7.8%) intended to start treatment, and 163 (43.1%) of the remaining reported that they would seek professional help in case of need (potential help-seeking). Approximately 50% of (potential) help-seekers stated that participation in ProYouth has changed their attitude towards help-seeking. Mental health literacy and shame/stigma were the most frequently mentioned barriers. This is the first study indicating that an online program for prevention and early intervention may serve as facilitator in accessing conventional healthcare.
Jones, Terry; Cason, Carolyn L.; Mancini, Mary E.
Registered nurses (n=368) participated in a skills recredentialing program in which competencies were assessed by a knowledge test and performance test under simulated conditions and evaluator ratings in actual patient-care situations. No significant differences in results between the simulated and actual conditions support the validity of the…
Cantos - Sánchez, Pedro; Gutiérrez-i-Puigarnau, Eva; Mulalic, Ismir
decision and household expenditures. The results show that the scrappage program increased the probability to buy a new car, but decreased the mean expenditure devoted to the purchase of this new vehicle. We also evaluate the impact of the financial aid on the household welfare, which suggests...
Angrist, Joshua, D.; Lang, Kevin
This paper studies the impact of the Metropolitan Council for Educational Opportunities (METCO), a desegregation program that sends mostly black students out of the Boston public school district to attend schools in more affluent suburban districts. It examines METCO's impact on the test scores of third, fifth, and seventh graders in a large…
IPSY (Information + Psychosocial Competence = Protection) is a universal life skills program aiming at the promotion of generic intra-and interpersonal life skills, substance specific skills (for example, resistance skills), school bonding, knowledge, and the prevention of substance misuse with a focus on alcohol and tobacco in youth. This program…
Ghosh, C.; Giambona, E.; Harding, J.P.; Sezer, O.; Sirmans, C.F.
This article examines the role of stock option programs and executive holdings of stock options in real estate investment trust (REIT) governance. We study the issue by analyzing how the market reaction to a stock repurchase announcement varies as a function of the individual REIT's governance
Di Gropello, Emanuela; Marshall, Jeffery H.
We analyze the effectiveness of the Programa Hondureno de Educacion Comunitaria (PROHECO) community school program in rural Honduras. The data include standardized tests and extensive information on school, teacher, classroom and community features for 120 rural schools drawn from 15 states. Using academic achievement decompositions we find that…
Jung, Jae Yup
This study investigated whether a number of cultural orientation, sociodemographic, academic achievement, and personal/personal experience variables predict attitudes toward the provision of special programs/provisions for gifted students. Surveys completed by 241 Australian preservice teachers were analyzed using confirmatory factor analyses and…
Laugeson, Elizabeth A.; Frankel, Fred; Gantman, Alexander; Dillon, Ashley R.; Mogil, Catherine
The present study examines the efficacy and durability of the PEERS Program, a parent-assisted social skills group intervention for high-functioning adolescents with ASD. Results indicate that teens receiving PEERS significantly improved their social skills knowledge, social responsiveness, and overall social skills in the areas of social…
Mailend, Marja-Liisa; Maas, Edwin
Purpose: Apraxia of speech (AOS) is considered a speech motor programming impairment, but the specific nature of the impairment remains a matter of debate. This study investigated 2 hypotheses about the underlying impairment in AOS framed within the Directions Into Velocities of Articulators (DIVA; Guenther, Ghosh, & Tourville, 2006) model: The…
Kimman, Tjeerd G; Boot, Hein J; Berbers, Guy A M; Vermeer-de Bondt, Patricia E; Wit, G Ardine de; Melker, Hester E de
Among all public health provisions national immunization programs (NIPs) are beyond doubt one of the most effective in reducing mortality, morbidity, and costs associated with major infectious diseases. To maintain their success, NIPs have to modernize in response to many new and old demands
Steele, Jennifer L.; Slater, Robert O.; Zamarro, Gema; Miller, Trey; Li, Jennifer; Burkhauser, Susan; Bacon, Michael
Using data from seven cohorts of language immersion lottery applicants in a large, urban school district, we estimate the causal effects of immersion programs on students' test scores in reading, mathematics, and science and on English learners' (EL) reclassification. We estimate positive intent-to-treat (ITT) effects on reading performance in…
Chazdon, Scott; Meyer, Nathan; Mohr, Caryn; Troschinetz, Alexis
The public value poster session is a new tool for effectively demonstrating and reporting the public value of Extension programming. Akin to the research posters that have long played a critical role in the sharing of findings from academic studies, the public value poster provides a consistent format for conveying the benefits to society of…
Kaiser, Micha; Schiller, Jörg; Schreckenberger, Christopher
In this paper, we analyze how a nationwide population-based skin cancer screening program (SCS) implemented in Germany in 2008 has impacted the number of hospital discharges following malignant skin neoplasm diagnosis and the malignant melanoma mortality rate per 100,000 inhabitants. Our panel data, drawn from the Eurostat database, cover subregions in 22 European countries, measured at the lowest nomenclature of territorial units for statistics (NUTS) level for 2000-2013. Applying fixed effects methods, we find a significantly positive and robust effect of the German SCS on the number of patients diagnosed with malignant skin neoplasm. However, the program does not significantly influence the melanoma mortality rate. This finding conflicts with the decreased melanoma mortality rate found for the pilot SCS program in northern Germany. Our results indicate that Germany's nationwide SCS program is effective in terms of a higher diagnosis rate for malignant skin neoplasms and thus may contribute to an improvement in the early detection of skin cancer.
Frahm, Kathryn A.; Alsac-Seitz, Biray; Mescia, Nadine; Brown, Lisa M.; Hyer, Kathy; Liburd, Desiree; Rogoff, David P.; Troutman, Adewale
This article describes an Online Mentor Program (OMP) designed to support and facilitate mentorships among and between Florida Department of Health (FDOH) employees and USF College of Public Health students using a Web-based portal. The Florida Public Health Training Center (FPHTC) at the University of South Florida (USF) College of Public Health…
D. Rem (Dana); D.R. Gasper (Des)
textabstractSpecial arrangements were made by the European Union for decision-making on the possible accession of Romania and Bulgaria. A regime of extra procedures was added to the arrangements used for the Eastern European countries which joined the Union in 2004. This paper examines how the
Schilling, Elizabeth A; Aseltine, Robert H; James, Amy
This study replicated and extended previous evaluations of the Signs of Suicide (SOS) prevention program in a high school population using a more rigorous pre-test post-test randomized control design than used in previous SOS evaluations in high schools (Aseltine and DeMartino 2004; Aseltine et al. 2007). SOS was presented to an ethnically diverse group of ninth grade students in technical high schools in Connecticut. After controlling for the pre-test reports of suicide behaviors, exposure to the SOS program was associated with significantly fewer self-reported suicide attempts in the 3 months following the program. Ninth grade students in the intervention group were approximately 64% less likely to report a suicide attempt in the past 3 months compared with students in the control group. Similarly, exposure to the SOS program resulted in greater knowledge of depression and suicide and more favorable attitudes toward (1) intervening with friends who may be exhibiting signs of suicidal intent and (2) getting help for themselves if they were depressed or suicidal. In addition, high-risk SOS participants, defined as those with a lifetime history of suicide attempt, were significantly less likely to report planning a suicide in the 3 months following the program compared to lower-risk participants. Differential attrition is the most serious limitation of the study; participants in the intervention group who reported a suicide attempt in the previous 3 months at baseline were more likely to be missing at post-test than their counterparts in the control group.
Moatti, J P; Vlahov, D; Feroni, I; Perrin, V; Obadia, Y
In Marseille, southeastern France, HIV prevention programs for injection drug users (IDUs) simultaneously include access to sterile syringes through needle exchange programs (NEPs), legal pharmacy sales and, since 1996, vending machines that mechanically exchange new syringes for used ones. The purpose of this study was to compare the characteristics of IDUs according to the site where they last obtained new syringes. During 3 days in September 1997, all IDUs who obtained syringes from 32 pharmacies, four NEPs and three vending machines were offered the opportunity to complete a self-administered questionnaire on demographics, drug use characteristics and program utilization. Of 485 individuals approached, the number who completed the questionnaire was 141 in pharmacies, 114 in NEPs and 88 at vending machines (response rate = 70.7%). Compared to NEP users, vending machine users were younger and less likely to be enrolled in a methadone program or to report being HIV infected, but more likely to misuse buprenorphine. They also had lower financial resources and were less likely to be heroin injectors than both pharmacy and NEP users. Our results suggest that vending machines attract a very different group of IDUs than NEPs, and that both programs are useful adjuncts to legal pharmacy sales for covering the needs of IDUs for sterile syringes in a single city. Assessment of the effectiveness and cost-effectiveness of combining such programs for the prevention of HIV and other infectious diseases among IDUs requires further comparative research. Copyright 2001 S. Karger AG, Basel