Reminder: NCI Requests Cancer Targets for Monoclonal Antibody Production and Characterization | Office of Cancer Clinical Proteomics Research

Cancer.gov

In an effort to improve rigor and reproducibility, the National Cancer Institute (NCI) Antibody Characterization Program requests cancer-related protein targets for monoclonal antibody production and distribution to the scientific community. The program from The Office of Cancer Clinical Proteomics Research provides well-characterized

Sustainable Monitoring and Surveillance Systems to Improve HIV Programs: Review.

PubMed

Low-Beer, Daniel; Mahy, Mary; Renaud, Francoise; Calleja, Txema

2018-04-24

HIV programs have provided a major impetus for investments in surveillance data, with 5-10% of HIV program budgets recommended to support data. However there are questions concerning the sustainability of these investments. The Sustainable Development Goals have consolidated health into one goal and communicable diseases into one target (Target 3.3). Sustainable Development Goals now introduce targets focused specifically on data (Targets 17.18 and 17.19). Data are seen as one of the three systemic issues (in Goal 17) for implementing Sustainable Development Goals, alongside policies and partnerships. This paper reviews the surveillance priorities in the context of the Sustainable Development Goals and highlights the shift from periodic measurement towards sustainable disaggregated, real-time, case, and patient data, which are used routinely to improve programs. Finally, the key directions in developing person-centered monitoring systems are assessed with country examples. The directions contribute to the Sustainable Development Goal focus on people-centered development applied to data. ©Daniel Low-Beer, Mary Mahy, Francoise Renaud, Txema Calleja. Originally published in JMIR Public Health and Surveillance (http://publichealth.jmir.org), 24.04.2018.

Building capacity for water, sanitation, and hygiene programming: Training evaluation theory applied to CLTS management training in Kenya.

PubMed

Crocker, Jonny; Shields, Katherine F; Venkataramanan, Vidya; Saywell, Darren; Bartram, Jamie

2016-10-01

Training and capacity building are long established critical components of global water, sanitation, and hygiene (WaSH) policies, strategies, and programs. Expanding capacity building support for WaSH in developing countries is one of the targets of the Sustainable Development Goals. There are many training evaluation methods and tools available. However, training evaluations in WaSH have been infrequent, have often not utilized these methods and tools, and have lacked rigor. We developed a conceptual framework for evaluating training in WaSH by reviewing and adapting concepts from literature. Our framework includes three target outcomes: learning, individual performance, and improved programming; and two sets of influences: trainee and context factors. We applied the framework to evaluate a seven-month community-led total sanitation (CLTS) management training program delivered to 42 government officials in Kenya from September 2013 to May 2014. Trainees were given a pre-training questionnaire and were interviewed at two weeks and seven months after initial training. We qualitatively analyzed the data using our conceptual framework. The training program resulted in trainees learning the CLTS process and new skills, and improving their individual performance through application of advocacy, partnership, and supervision soft skills. The link from trainees' performance to improved programming was constrained by resource limitations and pre-existing rigidity of trainees' organizations. Training-over-time enhanced outcomes and enabled trainees to overcome constraints in their work. Training in soft skills is relevant to managing public health programs beyond WaSH. We make recommendations on how training programs can be targeted and adapted to improve outcomes. Our conceptual framework can be used as a tool both for planning and evaluating training programs in WaSH. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

Improving workplace productivity--it isn't just about reducing absence.

PubMed

Harte, Kathy; Mahieu, Kathleen; Mallett, David; Norville, Julie; VanderWerf, Sander

2011-01-01

Employers must get more aggressive in their health and productivity strategies. A comprehensive strategy includes data analytics across health and lost-time programs, absence policies that meet today's needs for both employer and employee, health and wellness programs targeting modifiable health behaviors, and absence program administration that is aligned to operational goals. This article targets key aspects of a comprehensive long-term health and productivity strategic vision. An organization can use these aspects independently to address immediate tactical issues while it develops its broader strategy. The target areas include a view from the perspective of data management, absence program design and management, employee health and wellness, and behavioral health.

A Program Manager's Guide for Program Improvement in Ongoing Psychological Health and Traumatic Brain Injury Programs.

PubMed

Ryan, Gery W; Farmer, Carrie M; Adamson, David M; Weinick, Robin M

2014-01-01

Between 2001 and 2011, the U.S. Department of Defense has implemented numerous programs to support service members and their families in coping with the stressors from a decade of the longstanding conflicts in Iraq and Afghanistan. These programs, which address both psychological health and traumatic brain injury (TBI), number in the hundreds and vary in their size, scope, and target population. To ensure that resources are wisely invested and maximize the benefits of such programs, RAND developed a tool to help assess program performance, consider options for improvement, implement solutions, then assess whether the changes worked, with the intention of helping those responsible for managing or implementing programs to conduct assessments of how well the program is performing and to implement solutions for improving performance. Specifically, the tool is intended to provide practical guidance in program improvement and continuous quality improvement for all programs.

Candidate Socioemotional Remediation Program for Individuals with Intellectual Disability

ERIC Educational Resources Information Center

Glaser, Bronwyn; Lothe, Amelie; Chabloz, Melanie; Dukes, Daniel; Pasca, Catherine; Redoute, Jerome; Eliez, Stephan

2012-01-01

The authors developed a computerized program, Vis-a-Vis (VAV), to improve socioemotional functioning and working memory in children with developmental disabilities. The authors subsequently tested whether participants showed signs of improving the targeted skills. VAV is composed of three modules: Focus on the Eyes, Emotion Recognition and…

Achieving Hand Hygiene Success With a Partnership Between Graduate Medical Education, Hospital Leadership, and Physicians.

PubMed

Rosenbluth, Glenn; Garritson, Susan; Green, Adrienne L; Milev, Dimiter; Vidyarthi, Arpana R; Auerbach, Andrew D; Baron, Robert B

2016-11-01

Engaging physicians in hand hygiene programs is a challenge faced by many academic medical centers. Partnerships between education and academic leaders present opportunities for effective collaboration and improvement. The authors developed a robust hand hygiene quality improvement program, with attention to rapid-cycle improvements, including all levels of staff and health care providers. The program included a defined governance structure, clear data collection process, educational interventions, rapid-cycle improvements, and financial incentive for staff and physicians (including residents and fellows). Outcomes were measured on patients in all clinical areas. Run charts were used to document compliance in aggregate and by subgroups throughout the project duration. Institutional targets were achieved and then exceeded, with sustained hand hygiene compliance >90%. Physician compliance lagged behind aggregate compliance but ultimately was sustained at a level exceeding the target. Successfully achieving the institutional goal required collaboration among all stakeholders. Physician-specific data and physician champions were essential to drive improvement. © The Author(s) 2015.

Design choices made by target users for a pay-for-performance program in primary care: an action research approach.

PubMed

Kirschner, Kirsten; Braspenning, Jozé; Jacobs, J E Annelies; Grol, Richard

2012-03-27

International interest in pay-for-performance (P4P) initiatives to improve quality of health care is growing. Current programs vary in the methods of performance measurement, appraisal and reimbursement. One may assume that involvement of health care professionals in the goal setting and methods of quality measurement and subsequent payment schemes may enhance their commitment to and motivation for P4P programs and therefore the impact of these programs. We developed a P4P program in which the target users were involved in decisions about the P4P methods. For the development of the P4P program a framework was used which distinguished three main components: performance measurement, appraisal and reimbursement. Based on this framework design choices were discussed in two panels of target users using an adapted Delphi procedure. The target users were 65 general practices and two health insurance companies in the South of the Netherlands. Performance measurement was linked to the Dutch accreditation program based on three domains (clinical care, practice management and patient experience). The general practice was chosen as unit of assessment. Relative standards were set at the 25th percentile of group performance. The incentive for clinical care was set twice as high as the one for practice management and patient experience. Quality scores were to be calculated separately for all three domains, and for both the quality level and the improvement of performance. The incentive for quality level was set thrice as high as the one for the improvement of performance. For reimbursement, quality scores were divided into seven levels. A practice with a quality score in the lowest group was not supposed to receive a bonus. The additional payment grew proportionally for each extra group. The bonus aimed at was on average 5% to 10% of the practice income. Designing a P4P program for primary care with involvement of the target users gave us an insight into their motives, which can help others who need to discuss similar programs. The resulting program is in line with target users' views and assessments of relevance and applicability. This may enhance their commitment to the program as was indicated by the growing number of voluntary participants after a successfully performed field test during the procedure. The elements of our framework can be very helpful for others who are developing or evaluating a P4P program.

Medicare's chronic care improvement pilot program: what is its potential?

PubMed

Super, Nora

2004-05-10

This paper describes the voluntary chronic care improvement program under traditional fee-for-service Medicare as authorized by the Medicare Prescription Drug, Improvement, and Modernization Act (MMA) of 2003 (Public Law 108-173; section 721). This brief analyzes the emerging issues raised by this new program, including which chronic conditions and regional areas will be targeted, the types of entities that may participate, the physician's role in care management, and the adoption and use of health information technology and evidence-based clinical guidelines.

Bridging evidence-practice gaps: improving use of medicines in elderly Australian veterans.

PubMed

Roughead, Elizabeth E; Kalisch Ellett, Lisa M; Ramsay, Emmae N; Pratt, Nicole L; Barratt, John D; LeBlanc, Vanessa T; Ryan, Philip; Peck, Robert; Killer, Graeme; Gilbert, Andrew L

2013-12-12

The Australian Government Department of Veterans' Affairs (DVA) funds an ongoing health promotion based program to improve use of medicines and related health services, which implements interventions that include audit and feedback in the form of patient-specific feedback generated from administrative claims records. We aimed to determine changes in medicine use as a result of the program. The program provides targeted patient-specific feedback to medical practitioners. The feedback is supported with educational material developed by a clinical panel, subject to peer review and overseen by a national editorial committee. Veterans who meet target criteria also receive educational brochures. The program is supported by a national call centre and ongoing national consultation. Segmented regression analyses (interrupted time series) were undertaken to assess changes in medication use in targeted veterans pre and post each intervention. 12 interventions were included; three to increase medicine use, seven which aimed to reduce use, and two which had combination of messages to change use. All programs that aimed to increase medicine use were effective, with relative effect sizes at the time of the intervention ranging from 1% to 8%. Mixed results were seen with programs aiming to reduce inappropriate medicine use. Highly specific programs were effective, with relative effect sizes at the time of the intervention of 10% decline in use of NSAIDs in high risk groups and 14% decline in use of antipsychotics in dementia. Interventions targeting combinations of medicines, including medicine interactions and potentially inappropriate medicines in the elderly did not change practice significantly. Interventions with combinations of messages targeting multiple components of practice had an impact on one component, but not all components targeted. The Veterans' MATES program showed positive practice change over time, with interventions increasing use of appropriate medicines where under-use was evident and reduced use of inappropriate medicines when single medicines were targeted. Combinations of messages were less effective, suggesting specific messages focusing on single medicines are required to maximise effect. The program provides a model that could be replicated in other settings.

Needs Assessment of Parents of Typical Children Ages 4 to 5 Years Old

ERIC Educational Resources Information Center

Brady, Deon LaMount

2010-01-01

Parent education programs have been very successful in meeting the pre-established goals and expectations of their program without the input of parent participants prior to program implementation. Although programs continue to improve, it is important that programs begin to consider the specific needs of their target population. One parent…

Toward high-efficiency and detailed Monte Carlo simulation study of the granular flow spallation target

NASA Astrophysics Data System (ADS)

Cai, Han-Jie; Zhang, Zhi-Lei; Fu, Fen; Li, Jian-Yang; Zhang, Xun-Chao; Zhang, Ya-Ling; Yan, Xue-Song; Lin, Ping; Xv, Jian-Ya; Yang, Lei

2018-02-01

The dense granular flow spallation target is a new target concept chosen for the Accelerator-Driven Subcritical (ADS) project in China. For the R&D of this kind of target concept, a dedicated Monte Carlo (MC) program named GMT was developed to perform the simulation study of the beam-target interaction. Owing to the complexities of the target geometry, the computational cost of the MC simulation of particle tracks is highly expensive. Thus, improvement of computational efficiency will be essential for the detailed MC simulation studies of the dense granular target. Here we present the special design of the GMT program and its high efficiency performance. In addition, the speedup potential of the GPU-accelerated spallation models is discussed.

Measuring sustainment of prevention programs and initiatives: a study protocol.

PubMed

Palinkas, Lawrence A; Spear, Suzanne E; Mendon, Sapna J; Villamar, Juan; Valente, Thomas; Chou, Chi-Ping; Landsverk, John; Kellam, Shepperd G; Brown, C Hendricks

2016-07-16

Sustaining prevention efforts directed at substance use and mental health problems is one of the greatest, yet least understood, challenges in the field of implementation science. A large knowledge gap exists regarding the meaning of the term "sustainment" and what factors predict or even measure sustainability of effective prevention programs and support systems. The U.S. Substance Abuse and Mental Health Services Administration (SAMHSA) supports a diverse portfolio of prevention and treatment grant programs that aim to improve population and individual level behavioral health. This study focuses on four SAMHSA prevention grant programs, two of which target substance abuse prevention at the state or single community level, one targets suicide prevention, and one targets prevention of aggressive/disruptive behavior in elementary schools. An examination of all four grant programs simultaneously provides an opportunity to determine what is meant by the term sustainment and identify and support both the unique requirements for improving sustainability for each program as well as for developing a generalizable framework comprised of core components of sustainment across diverse prevention approaches. Based on an analysis of qualitative and quantitative data of 10 grantees supported by these four programs, we will develop a flexible measurement system, with both general and specific components, that can bring precision to monitoring sustainment of infrastructure, activities, and outcomes for each prevention approach. We will then transform this system for use in evaluating and improving the likelihood of achieving prevention effort sustainment. To achieve these goals, we will (1) identify core components of sustainment of prevention programs and their support infrastructures; (2) design a measurement system for monitoring and providing feedback regarding sustainment within the four SAMHSA's prevention-related grant programs; and (3) pilot test the predictability of this multilevel measurement system across these programs and the feasibility and acceptability of a measurement system to evaluate and improve the likelihood of sustainment. This project is intended to improve sustainment of the supporting prevention infrastructure, activities, and outcomes that are funded by federal, state, community, and foundation sources.

Improving Struggling Readers' Early Literacy Skills through a Tier 2 Professional Development Program for Rural Classroom Teachers: The Targeted Reading Intervention

ERIC Educational Resources Information Center

Vernon-Feagans, Lynne; Bratsch-Hines, Mary; Varghese, Cheryl; Cutrer, Elizabeth A.; Garwood, Justin D.

2018-01-01

This article reports the results of a randomized controlled trial that replicated and extended research on the Targeted Reading Intervention (TRI), a professional development program for kindergarten and first-grade teachers in low-wealth rural schools that helps enhance literacy skills of struggling readers. In weekly webcam coaching sessions,…

Critical Care Statistics

MedlinePlus

... A, Huang SA, Murthy P, et.al. Quality improvement and cost savings after implementation of the Leapfrog ... Campaign: results of an international guideline-based performance improvement program targeting severe sepsis. Intensive Care Med . 2010 ...

Application of automatic threshold in dynamic target recognition with low contrast

NASA Astrophysics Data System (ADS)

Miao, Hua; Guo, Xiaoming; Chen, Yu

2014-11-01

Hybrid photoelectric joint transform correlator can realize automatic real-time recognition with high precision through the combination of optical devices and electronic devices. When recognizing targets with low contrast using photoelectric joint transform correlator, because of the difference of attitude, brightness and grayscale between target and template, only four to five frames of dynamic targets can be recognized without any processing. CCD camera is used to capture the dynamic target images and the capturing speed of CCD is 25 frames per second. Automatic threshold has many advantages like fast processing speed, effectively shielding noise interference, enhancing diffraction energy of useful information and better reserving outline of target and template, so this method plays a very important role in target recognition with optical correlation method. However, the automatic obtained threshold by program can not achieve the best recognition results for dynamic targets. The reason is that outline information is broken to some extent. Optimal threshold is obtained by manual intervention in most cases. Aiming at the characteristics of dynamic targets, the processing program of improved automatic threshold is finished by multiplying OTSU threshold of target and template by scale coefficient of the processed image, and combining with mathematical morphology. The optimal threshold can be achieved automatically by improved automatic threshold processing for dynamic low contrast target images. The recognition rate of dynamic targets is improved through decreased background noise effect and increased correlation information. A series of dynamic tank images with the speed about 70 km/h are adapted as target images. The 1st frame of this series of tanks can correlate only with the 3rd frame without any processing. Through OTSU threshold, the 80th frame can be recognized. By automatic threshold processing of the joint images, this number can be increased to 89 frames. Experimental results show that the improved automatic threshold processing has special application value for the recognition of dynamic target with low contrast.

Enhancing the Programming Experience for First-Year Engineering Students through Hands-On Integrated Computer Experiences

ERIC Educational Resources Information Center

Canfield, Stephen L.; Ghafoor, Sheikh; Abdelrahman, Mohamed

2012-01-01

This paper describes the redesign and implementation of the course, "Introduction to Programming for Engineers" using microcontroller (MCU) hardware as the programming target. The objective of this effort is to improve the programming competency for engineering students by more closely relating the initial programming experience to the student's…

At-a-Glance B3 Resource Guide for Supporting Academic Achievement for Students with Disabilities

ERIC Educational Resources Information Center

Regional Resource Center Program, 2011

2011-01-01

This results improvement resource guide includes a listing of TA&D programs and centers that provide technical assistance related to academic achievement results improvement for students with disabilities. The website URL, target audience(s), and purpose are provided for each center/program. In addition, a brief example describing the…

Improving Deficient Listening Skills in the Language Arts Program at the Middle Grades.

ERIC Educational Resources Information Center

Alonso, Laura

A project developed a program for improving deficient student-to-student listening skills. The targeted population consisted of 18 seventh-grade middle school students in a culturally diverse, lower middle class community in a near-western suburb of Chicago. The problem of deficient listening skills was evident through teacher observation and…

The Integration of a Family Systems Approach for Understanding Youth Obesity, Physical Activity, and Dietary Programs

PubMed Central

Wilson, Dawn K.; St. George, Sara M.; Lawman, Hannah; Segal, Michelle; Fairchild, Amanda

2012-01-01

Rates of overweight in youth have reached epidemic proportions and are associated with adverse health outcomes. Family-based programs have been widely used to treat overweight in youth. However, few programs incorporate a theoretical framework for studying a family systems approach in relation to youth health behavior change. Therefore, this review provides a family systems theory framework for evaluating family-level variables in weight loss, physical activity, and dietary approaches in youth. Studies were reviewed and effect sizes were calculated for interventions that manipulated the family system, including components that targeted parenting styles, parenting skills, or family functioning, or which had novel approaches for including the family. Twenty-one weight loss interventions were identified, and 25 interventions related to physical activity and/or diet were identified. Overall, family-based treatment programs that incorporated training for authoritative parenting styles, parenting skills, or child management, and family functioning had positive effects on youth weight loss. Programs to improve physical activity and dietary behaviors that targeted the family system also demonstrated improvements in youth health behaviors; however, direct effects of parent-targeted programming is not clear. Both treatment and prevention programs would benefit from evaluating family functioning and parenting styles as possible mediators of intervention outcomes. Recommendations are provided to guide the development of future family-based obesity prevention and treatment programs for youth. PMID:20689989

Improving Outcomes for New York City's Disconnected Youth: Lessons from the Implementation of the Young Adult Literacy Program

ERIC Educational Resources Information Center

Hossain, Farhana; Terwelp, Emily

2015-01-01

In 2008, New York City's Center for Economic Opportunity (CEO) launched the Young Adult Literacy (YAL) program to improve the academic and work-readiness skills of youth who are not in school, do not have a job, and have very low literacy skills. The YAL program targets 16- to 24-year-old young adults who read at the fourth-through eighth-grade…

Impact of 'stretch' targets for cardiovascular disease management within a local pay-for-performance programme.

PubMed

Pape, Utz J; Huckvale, Kit; Car, Josip; Majeed, Azeem; Millett, Christopher

2015-01-01

Pay-for-performance programs are often aimed to improve the management of chronic diseases. We evaluate the impact of a local pay for performance programme (QOF+), which rewarded financially more ambitious quality targets ('stretch targets') than those used nationally in the Quality and Outcomes Framework (QOF). We focus on targets for intermediate outcomes in patients with cardiovascular disease and diabetes. A difference-in-difference approach is used to compare practice level achievements before and after the introduction of the local pay for performance program. In addition, we analysed patient-level data on exception reporting and intermediate outcomes utilizing an interrupted time series analysis. The local pay for performance program led to significantly higher target achievements (hypertension: p-value <0.001, coronary heart disease: p-values <0.001, diabetes: p-values <0.061, stroke: p-values <0.003). However, the increase was driven by higher rates of exception reporting (hypertension: p-value <0.001, coronary heart disease: p-values <0.03, diabetes: p-values <0.05) in patients with all conditions except for stroke. Exception reporting allows practitioners to exclude patients from target calculations if certain criteria are met, e.g. informed dissent of the patient for treatment. There were no statistically significant improvements in mean blood pressure, cholesterol or HbA1c levels. Thus, achievement of higher payment thresholds in the local pay for performance scheme was mainly attributed to increased exception reporting by practices with no discernable improvements in overall clinical quality. Hence, active monitoring of exception reporting should be considered when setting more ambitious quality targets. More generally, the study suggests a trade-off between additional incentive for better care and monitoring costs.

Evaluating Intervention Programs Targeting Parents to Manage Childhood Overweight and Obesity: A Systematic Review Using the RE-AIM Framework.

PubMed

Jang, Myoungock; Chao, Ariana; Whittemore, Robin

2015-01-01

Intervention programs targeting parents to manage childhood overweight and obesity have emerged based on parents influence on the health behaviors of their children. The purpose of this review was to systematically evaluate intervention programs targeting parents to manage childhood overweight and obesity using the Reach, Efficacy, Adopt, Implementation, and Maintenance (RE-AIM) framework. There was a moderate risk of bias across all studies. The overall proportion of studies (n=7) reporting on each dimension of the RE-AIM framework ranged from 78.6% (reach) to 23.8% (maintenance). The majority of intervention programs demonstrated improvement in child BMI. However intervention programs did not reach families of diverse race/ethnicity, were provided by highly trained professionals, and demonstrated high attrition, thus limiting generalizability. Copyright © 2015 Elsevier Inc. All rights reserved.

Survival After Ventricular Fibrillation Cardiac Arrest in the Sao Paulo Metropolitan Subway System: First Successful Targeted Automated External Defibrillator (AED) Program in Latin America.

PubMed

Gianotto-Oliveira, Renan; Gonzalez, Maria Margarita; Vianna, Caio Brito; Monteiro Alves, Maurício; Timerman, Sergio; Kalil Filho, Roberto; Kern, Karl B

2015-10-09

Targeted automated external defibrillator (AED) programs have improved survival rates among patients who have an out-of-hospital cardiac arrest (OHCA) in US airports, as well as European and Japanese railways. The Sao Paulo (Brazil) Metro subway carries 4.5 million people per day. A targeted AED program was begun in the Sao Paulo Metro with the objective to improve survival from cardiac arrest. A prospective, longitudinal, observational study of all cardiac arrests in the Sao Paulo Metro was performed from September 2006 through November 2012. This study focused on cardiac arrest by ventricular arrhythmias, and the primary endpoint was survival to hospital discharge with minimal neurological impairment. A total of 62 patients had an initial cardiac rhythm of ventricular fibrillation. Because no data on cardiac arrest treatment or outcomes existed before beginning this project, the first 16 months of the implementation was used as the initial experience and compared with the subsequent 5 years of full operation. Return of spontaneous circulation was not different between the initial 16 months and the subsequent 5 years (6 of 8 [75%] vs. 39 of 54 [72%]; P=0.88). However, survival to discharge was significantly different once the full program was instituted (0 of 8 vs. 23 of 54 [43%]; P=0.001). Implementation of a targeted AED program in the Sao Paulo Metro subway system saved lives. A short interval between arrest and defibrillation was key for good long-term, neurologically intact survival. These results support strategic expansion of targeted AED programs in other large Latin American cities. © 2015 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

Involving Communities in the Targeting of Cash Transfer Programs for Vulnerable Children: Opportunities and Challenges☆

PubMed Central

Robertson, Laura; Mushati, Phyllis; Skovdal, Morten; Eaton, Jeffrey W.; Makoni, Jeremiah C.; Crea, Tom; Mavise, Gideon; Dumba, Lovemore; Schumacher, Christina; Sherr, Lorraine; Nyamukapa, Constance; Gregson, Simon

2014-01-01

Summary We used baseline data, collected in July–September 2009, from a randomized controlled trial of a cash transfer program for vulnerable children in eastern Zimbabwe to investigate the effectiveness, coverage, and efficiency of census- and community-based targeting methods for reaching vulnerable children. Focus group discussions and in-depth interviews with beneficiaries and other stakeholders were used to explore community perspectives on targeting. Community members reported that their participation improved ownership and reduced conflict and jealousy. However, all the methods failed to target a large proportion of vulnerable children and there was poor agreement between the community- and census-based methods. PMID:24748713

Development of a hospital-based program focused on improving healthcare value.

PubMed

Moriates, Christopher; Mourad, Michelle; Novelero, Maria; Wachter, Robert M

2014-10-01

Frontline physicians face increasing pressure to improve the quality of care they deliver while simultaneously decreasing healthcare costs. Although hospitals and physicians are beginning to implement initiatives targeting this new goal of healthcare value, few of them have a well-developed infrastructure to support this work. In March 2012, we launched a high-value care (HVC) program within the Division of Hospital Medicine at the University of California, San Francisco. The HVC program is co-led by a physician and the division's administrator, and includes other hospitalists, resident physicians, pharmacists, and administrators. The program aims to (1) use financial and clinical data to identify areas with clear evidence of waste in the hospital, (2) promote evidence-based interventions that improve both quality of care and value, and (3) pair interventions with evidence-based cost awareness education to drive culture change. We identified 6 ongoing projects during our first year. Preliminary data for our inaugural projects are encouraging. One initiative, which targeted decreasing nebulizer use on a high-acuity medical floor (often using metered-dose inhalers instead) led to a decrease in rates of more than 50%. The HVC program is proving to be a successful mechanism to promote improved healthcare value and clinician engagement. © 2014 Society of Hospital Medicine.

Building Parental Capacity to Improve Child Development: Impact Evaluation of an Early Childhood Stimulation Program in Bangladesh

ERIC Educational Resources Information Center

Chinen, Marjorie; Bos, Hans; Murray, Matthew; Hamadani, Jena; Hossain, Najmul; Mahmud, Minhaj

2015-01-01

Globally, at least 200 million children younger than five years old are falling short of their potential for development and growth. There is some evidence that improvements to children's health, nutrition, and development outcomes can be made through programs that provide direct learning experiences to children and families; are targeted toward…

Improving Reading Skills in ESL Students through an Intensive Vocabulary Building Program.

ERIC Educational Resources Information Center

Gaudio, Vince

This report describes a program for improving the reading skills of English-as-a-Second-Language (ESL) students. The targeted population consists of 19 ESL students, ranging in age from 7-10 years, in a western suburb of a large metropolitan city in Illinois. The problem of poor reading ability was documented through low reading scores on the STAR…

Improving Students' Word Analysis Skills by Implementing "Working with Words" from the Four Blocks of Literacy Program.

ERIC Educational Resources Information Center

Velasco, Kelly; Zizak, Amanda

This report describes a program for improving word analysis skills in order to increase sight reading, reading accuracy, and fluency. The targeted population consisted of second and third graders in a suburban area close to a large metropolitan city in a Midwestern state. The problems of low word analysis skills were documented through Qualitative…

Pyramids' Reading Program Project Directors' Report, 1971-72.

ERIC Educational Resources Information Center

Brown, Alberta; And Others

The Pyramids' Reading Program, with the Instructional Materials Center (IMC) and the Combine Component, operates in Minneapolis public and parochial Target Area elementary schools to help improve the reading skills of educationally disadvantaged children. The IMC writes, produces, and distributes the reading material used in the program, and the…

An Inexpensive School/Home Intervention Program To Raise Student Achievement.

ERIC Educational Resources Information Center

Evans, Thomas; And Others

A comprehensive strategy targeted to raise student achievement is arguably one of the most important components of any school's vision for improvement. This paper describes a comprehensive intervention program at The San Alejo American School, Honduras (student enrollment: <100). This program was aimed toward raising students' achievement…

Effectiveness of a Culturally Adapted Strengthening Families Program 12-16-Years for High-Risk Irish Families

ERIC Educational Resources Information Center

Kumpfer, Karol L.; Xie, Jing; O'Driscoll, Robert

2012-01-01

Background: Evidence-based programs (EBPs) targeting effective family skills are the most cost effective for improving adolescent behavioural health. Cochrane Reviews have found the "Strengthening Families Program" (SFP) to be the most effective substance abuse prevention intervention. Standardized cultural adaptation processes resulted…

Practice Facilitators' and Leaders' Perspectives on a Facilitated Quality Improvement Program.

PubMed

McHugh, Megan; Brown, Tiffany; Liss, David T; Walunas, Theresa L; Persell, Stephen D

2018-04-01

Practice facilitation is a promising approach to helping practices implement quality improvements. Our purpose was to describe practice facilitators' and practice leaders' perspectives on implementation of a practice facilitator-supported quality improvement program and describe where their perspectives aligned and diverged. We conducted interviews with practice leaders and practice facilitators who participated in a program that included 35 improvement strategies aimed at the ABCS of heart health (aspirin use in high-risk individuals, blood pressure control, cholesterol management, and smoking cessation). Rapid qualitative analysis was used to collect, organize, and analyze the data. We interviewed 17 of the 33 eligible practice leaders, and the 10 practice facilitators assigned to those practices. Practice leaders and practice facilitators both reported value in the program's ability to bring needed, high-quality resources to practices. Practice leaders appreciated being able to set the schedule for facilitation and select among the 35 interventions. According to practice facilitators, however, relying on practice leaders to set the pace of the intervention resulted in a lower level of program intensity than intended. Practice leaders preferred targeted assistance, particularly electronic health record documentation guidance and linkages to state smoking cessation programs. Practice facilitators reported that the easiest interventions were those that did not alter care practices. The dual perspectives of practice leaders and practice facilitators provide a more holistic picture of enablers and barriers to program implementation. There may be greater opportunities to assist small practices through simple, targeted practice facilitator-supported efforts rather than larger, comprehensive quality improvement projects. © 2018 Annals of Family Medicine, Inc.

Early Childhood Language-Centered Intervention Program. O.E.E. Evaluation Report, 1980-1981.

ERIC Educational Resources Information Center

Tobias, Robert; Lavin, Claire

This report evaluates the Early Childhood Language-Centered Intervention Program in New York City Public Schools. The program was designed to promote the development of preschool handicapped students in a variety of areas. The program objective proposed that the target students would show statistically significant improvement at the .05 level in…

Adolescent Sexual Health Education: Parents Benefit Too!

PubMed

Dinaj-Koci, Veronica; Deveaux, Lynette; Wang, Bo; Lunn, Sonya; Marshall, Sharon; Li, Xiaoming; Stanton, Bonita

2015-10-01

The inclusion of parents in adolescent-targeted interventions is intended to benefit the adolescent. Limited research has explored whether parents participating in these programs also benefit directly. We examined the impact of Caribbean Informed Parents and Children Together, the parenting portion of an adolescent-targeted HIV prevention intervention, on parent-reported measures. Bahamian parent-youth dyads (N = 1,833) participating in the randomized control trial were assigned to receive one of four conditions. Parents were assessed longitudinally at baseline and 6 and 12 months later. Through 12 months follow-up, parents exposed to Caribbean Informed Parents and Children Together showed higher knowledge of condom use skills, perceptions of improved condom use competence on the part of their youth, and perceived improved parent-child communication about sex-related information. Although youth were the targeted beneficiary, parents also benefited directly from the sexual risk reduction parenting program. Parents demonstrated improved perceptions and knowledge that would enable them to more effectively guide their child and also protect themselves from sexual risk. © 2015 Society for Public Health Education.

Program interruptions and short-stay transfers represent potential targets for inpatient rehabilitation care-improvement efforts

PubMed Central

Middleton, Addie; Graham, James E.; Krishnan, Shilpa; Ottenbacher, Kenneth J.

2016-01-01

Objective To present comprehensive descriptive summaries of program interruptions and short-stay transfers among Medicare fee-for-service beneficiaries receiving inpatient rehabilitation following stroke, traumatic brain injury (TBI), and traumatic spinal cord injury (SCI). Design Retrospective cohort study of Medicare beneficiaries with any of the three conditions of interest who were admitted to inpatient rehabilitation directly from an acute hospital between July 1, 2012 and November 15, 2013. Results In the final sample (stroke: n=71 769; TBI: n=7109; SCI: n=659), program interruption rates were 0.9% (stroke), 0.8% (TBI), and 1.4% (SCI). Short-stay transfer rates were 22.3% (stroke), 21.8% (TBI), and 31.6% (SCI). 14.7% of short-stay transfers and 12.3% of interruptions resulting in a return to acute care were identified as potentially preventable among those with stroke, 10.2% of transfers and 11.7% of interruptions among those with TBI, and 3.8% of transfers and 11.1% of interruptions among those with SCI. Conclusions Broad healthcare policies aimed at improving quality and reducing costs are currently being implemented. Reducing program interruptions and short-stay transfers during inpatient rehabilitative care represents a potential target for care-improvement efforts. Future research focused on identifying modifiable risk factors for potentially undesirable outcomes will allow for targeted preventative interventions. PMID:27631389

Program Interruptions and Short-Stay Transfers Represent Potential Targets for Inpatient Rehabilitation Care-Improvement Efforts.

PubMed

Middleton, Addie; Graham, James E; Krishnan, Shilpa; Ottenbacher, Kenneth J

2016-11-01

The objective of this work was to present comprehensive descriptive summaries of program interruptions and short-stay transfers among Medicare fee-for-service beneficiaries receiving inpatient rehabilitation after stroke, traumatic brain injury (TBI), and traumatic spinal cord injury (SCI). Retrospective cohort study of Medicare beneficiaries with any of the 3 conditions of interest who were admitted to inpatient rehabilitation directly from an acute hospital between July 1, 2012, and November 15, 2013. In the final sample (stroke, n = 71 769; TBI, n = 7109; SCI, n = 659), program interruption rates were 0.9% (stroke), 0.8% (TBI), and 1.4% (SCI). Short-stay transfer rates were 22.3% (stroke), 21.8% (TBI), and 31.6% (SCI); 14.7% of short-stay transfers and 12.3% of interruptions resulting in a return to acute care were identified as potentially preventable among those with stroke; 10.2% of transfers and 11.7% of interruptions among those with TBI, and 3.8% of transfers and 11.1% of interruptions among those with SCI. Broad health care policies aimed at improving quality and reducing costs are currently being implemented. Reducing program interruptions and short-stay transfers during inpatient rehabilitative care represents a potential target for care-improvement efforts. Future research focused on identifying modifiable risk factors for potentially undesirable outcomes will allow for targeted preventative interventions.

3D flexible alignment using 2D maximum common substructure: dependence of prediction accuracy on target-reference chemical similarity.

PubMed

Kawabata, Takeshi; Nakamura, Haruki

2014-07-28

A protein-bound conformation of a target molecule can be predicted by aligning the target molecule on the reference molecule obtained from the 3D structure of the compound-protein complex. This strategy is called "similarity-based docking". For this purpose, we develop the flexible alignment program fkcombu, which aligns the target molecule based on atomic correspondences with the reference molecule. The correspondences are obtained by the maximum common substructure (MCS) of 2D chemical structures, using our program kcombu. The prediction performance was evaluated using many target-reference pairs of superimposed ligand 3D structures on the same protein in the PDB, with different ranges of chemical similarity. The details of atomic correspondence largely affected the prediction success. We found that topologically constrained disconnected MCS (TD-MCS) with the simple element-based atomic classification provides the best prediction. The crashing potential energy with the receptor protein improved the performance. We also found that the RMSD between the predicted and correct target conformations significantly correlates with the chemical similarities between target-reference molecules. Generally speaking, if the reference and target compounds have more than 70% chemical similarity, then the average RMSD of 3D conformations is <2.0 Å. We compared the performance with a rigid-body molecular alignment program based on volume-overlap scores (ShaEP). Our MCS-based flexible alignment program performed better than the rigid-body alignment program, especially when the target and reference molecules were sufficiently similar.

A centrally generated primary care physician audit report does not improve colonoscopy uptake after a positive result on a fecal occult blood test in Ontario's ColonCancerCheck program.

PubMed

Stock, D; Rabeneck, L; Baxter, N N; Paszat, L F; Sutradhar, R; Yun, L; Tinmouth, J

2017-02-01

Timely follow-up of fecal occult blood screening with colonoscopy is essential for achieving colorectal cancer mortality reduction. In the present study, we evaluated the effectiveness of centrally generated, physician-targeted audit and feedback to improve colonoscopy uptake after a positive fecal occult blood test (fobt) result within Ontario's population-wide ColonCancerCheck Program. This prospective cohort study used data sets from Ontario's ColonCancerCheck Program (2008-2011) that were linked to provincial administrative health databases. Cox proportional hazards regression was used to estimate the effect of centralized, physician-targeted audit and feedback on colonoscopy uptake in an Ontario-wide fobt-positive cohort. A mailed physician audit and feedback report identifying individuals outstanding for colonoscopy for 3 or more months after a positive fobt result did not increase the likelihood of colonoscopy uptake (hazard ratio: 0.95; 95% confidence interval: 0.79 to 1.13). Duration of positive fobt status was strongly inversely associated with the hazard of follow-up colonoscopy ( p for linear trend: <0.001). In a large population-wide setting, centralized tracking in the form of physician-targeted mailed audit and feedback reports does not improve colonoscopy uptake for screening participants with a positive fobt result outstanding for 3 or more months. Mailed physician-targeted screening audit and feedback reports alone are unlikely to improve compliance with follow-up colonoscopy in Ontario. Other interventions such as physician audits or automatic referrals, demonstrated to be effective in other jurisdictions, might be warranted.

AsthmaWise - a field of dreams? The results of an online education program targeting older adults with asthma.

PubMed

Burns, Pippa; Jones, Sandra C; Iverson, Don; Caputi, Peter

2013-09-01

The aim of this study was to establish the feasibility and acceptability of an online asthma self-management program developed for older Australians with asthma. AsthmaWise, an internet education self-management program, was piloted for a 3-month period at the beginning of 2012. Participants were recruited using both online and offline strategies and were required to complete surveys, both pre- and post-intervention, in a repeated measures design. Matched data were collected from 51 participants; the results showed AsthmaWise to be a feasible and acceptable method of delivering asthma education to the target population. Self-reported measures showed an increase in participants' asthma knowledge, asthma control and quality of life. Results from the Perceived Health Web Site Usability Questionnaire (PHWSUQ) showed improvements between usability testing and implementation. The need for asthma self-management education will continue to increase as the population ages and a greater number of older adults are living with asthma. This small pilot study indicates that an online asthma self-management education program can result in improved outcome measures in a target group not normally considered technologically literate.

Improving Healthy Living Youth Development Program Outreach in Extension: Lessons Learned from the 4-H Health Rocks! Program

ERIC Educational Resources Information Center

Kumaran, Muthusami; Fogarty, Kate; Fung, Whitney M.; Terminello, Amanda

2015-01-01

This article discusses a qualitative evaluation of the Florida 4-H Health Rocks! program aimed at youth alcohol, tobacco, and other drug use prevention. A questionnaire was distributed to Extension professionals across Florida to gain insight into the strengths and barriers they faced with programming. Programmatic strengths included targeting a…

Effects of a food supplementation program on the nutritional status of pregnant women in Bangladesh.

PubMed

Khan, M Mahmud; Ahmed, Shakil; Protik, Ali Ehsan; Dhar, Badal Chandra; Roy, S K

2005-12-01

The Government of Bangladesh implemented a comprehensive nutrition intervention in 1997 to reduce the rates of malnutrition among women and children. The pilot program, the Bangladesh Integrated Nutrition Program (BINP), adopted a multisectoral approach targeting women and children through food supplementation, home gardening, and health and nutrition education. This paper estimates the effectiveness of BINP's food supplementation and nutrition education on the nutritional status of pregnant women. Methods. Three effectiveness measures were considered: target efficiency, improvements in the nutritional status of beneficiaries, and the persistence of nutritional effects. To isolate the effects of the intervention, the nutritional status of participants and nonparticipants was compared after controlling for various demographic and socioeconomic characteristics. Data were collected in 2000 from a random sample of 3262 households in a BINP intervention area. Thirty-nine percent of pregnant women were correctly targeted by the program's food supplementation activities. The nutrition program reduced the prevalence of thinness among participant pregnant women by about 3 percentage points per month of enrollment. The prevalence of thinness among program graduates was 62%, which was much higher than that of the matched (nonparticipant) group (35%). This finding is perplexing but it may simply imply that those who enrolled at the initial phase of the project were severely underweight and they fell back to their original status within a short period of time. The nutrition program was intended to improve the nutritional status of women in the longer run through the provision of nutrition education during the food supplementation phase. The prevalence of thinness or severe underweight in women who exited the program after completion of the enrollment period was found to be much higher than in women of similar age and socioeconomic status in the community. This apparent lack of persistence of program benefits requires careful re-evaluation of alternative mechanisms for improving the long-term nutritional status of women.

Targeted interventions for improved equity in maternal and child health in low- and middle-income settings: a systematic review and meta-analysis.

PubMed

Målqvist, Mats; Yuan, Beibei; Trygg, Nadja; Selling, Katarina; Thomsen, Sarah

2013-01-01

Targeted interventions to improve maternal and child health is suggested as a feasible and sometimes even necessary strategy to reduce inequity. The objective of this systematic review was to gather the evidence of the effectiveness of targeted interventions to improve equity in MDG 4 and 5 outcomes. We identified primary studies in all languages by searching nine health and social databases, including grey literature and dissertations. Studies evaluating the effect of an intervention tailored to address a structural determinant of inequity in maternal and child health were included. Thus general interventions targeting disadvantaged populations were excluded. Outcome measures were limited to indicators proposed for Millennium Development Goals 4 and 5. We identified 18 articles, whereof 15 evaluated various incentive programs, two evaluated a targeted policy intervention, and only one study evaluated an intervention addressing a cultural custom. Meta-analyses of the effectiveness of incentives programs showed a pooled effect size of RR 1.66 (95% CI 1.43-1.93) for antenatal care attendance (four studies with 2,476 participants) and RR 2.37 (95% CI 1.38-4.07) for health facility delivery (five studies with 25,625 participants). Meta-analyses were not performed for any of the other outcomes due to scarcity of studies. The targeted interventions aiming to improve maternal and child health are mainly limited to addressing economic disparities through various incentive schemes like conditional cash transfers and voucher schemes. This is a feasible strategy to reduce inequity based on income. More innovative action-oriented research is needed to speed up progress in maternal and child survival among the most disadvantaged populations through interventions targeting the underlying structural determinants of inequity.

Keys to Improving Writing in the Primary Grades.

ERIC Educational Resources Information Center

Bassett, Diane; DeVine, Denise; Perry, Nancy; Rueth, Catherine

This action research describes a program for improving writing skills. The targeted population consisted of first and third graders in two middle class communities in the southern suburbs of Chicago. The need for improvement in writing skills was documented through observation checklists, writing samples, and surveys. Data revealed a need for…

Health insurers promoting employee wellness: strategies, program components and results.

PubMed

Murphy, Brigid M; Schoenman, Julie A; Pirani, Hafiza

2010-01-01

To examine health insurance companies' role in employee wellness. Case studies of eight insurers. Wellness activities in work, clinical, online, and telephonic settings. Senior executives and wellness program leaders from Blue Cross Blue Shield health insurers and from one wellness organization. Telephone interviews with 20 informants. Health insurers were engaged in wellness as part of their mission to promote health and reduce health care costs. Program components included the following: education, health risk assessments, incentives, coaching, environmental consultation, targeted programming, onsite biometric screening, professional support, and full-time wellness staff. Programs relied almost exclusively on positive incentives to encourage participation. Results included participation rates as high as 90%, return on investment ranging from $1.09 to $1.65, and improved health outcomes. Health insurers have expertise in developing, implementing, and marketing health programs and have wide access to employers and their employees' health data. These capabilities make health insurers particularly well equipped to expand the reach of wellness programming to improve the health of many Americans. By coupling members' medical data with wellness-program data, health insurers can better understand an individual's health status to develop and deliver targeted interventions. Through program evaluation, health insurers can also contribute to the limited but growing evidence base on employee wellness programs.

Penalty dynamic programming algorithm for dim targets detection in sensor systems.

PubMed

Huang, Dayu; Xue, Anke; Guo, Yunfei

2012-01-01

In order to detect and track multiple maneuvering dim targets in sensor systems, an improved dynamic programming track-before-detect algorithm (DP-TBD) called penalty DP-TBD (PDP-TBD) is proposed. The performances of tracking techniques are used as a feedback to the detection part. The feedback is constructed by a penalty term in the merit function, and the penalty term is a function of the possible target state estimation, which can be obtained by the tracking methods. With this feedback, the algorithm combines traditional tracking techniques with DP-TBD and it can be applied to simultaneously detect and track maneuvering dim targets. Meanwhile, a reasonable constraint that a sensor measurement can originate from one target or clutter is proposed to minimize track separation. Thus, the algorithm can be used in the multi-target situation with unknown target numbers. The efficiency and advantages of PDP-TBD compared with two existing methods are demonstrated by several simulations.

Improving Narrative Writing Skills, Composition Skills, and Related Attitudes among Second Grade Students by Integrating Word Processing, Graphic Organizers, and Art into a Process Approach to Writing.

ERIC Educational Resources Information Center

Gallick-Jackson, Sheryl A.

A practicum program was developed and implemented to improve narrative writing skills, composition skills, and related attitudes among the targeted second grade students. Objectives for the program were for: 75% of the students to increase their narrative writing skills by at least one proficiency level; 75% of the students to increase their…

Targeting latent function: Encouraging effective encoding for successful memory training and transfer

PubMed Central

Lustig, Cindy; Flegal, Kristin E.

2009-01-01

Cognitive training programs for older adults often result in improvements at the group level. However, there are typically large age and individual differences in the size of training benefits. These differences may be related to the degree to which participants implement the processes targeted by the training program. To test this possibility, we tested older adults in a memory-training procedure either under specific strategy instructions designed to encourage semantic, integrative encoding, or in a condition that encouraged time and attention to encoding but allowed participants to choose their own strategy. Both conditions improved the performance of old-old adults relative to an earlier study (Bissig & Lustig, 2007) and reduced self-reports of everyday memory errors. Performance in the strategy-instruction group was related to pre-existing ability, performance in the strategy-choice group was not. The strategy-choice group performed better on a laboratory transfer test of recognition memory, and training performance was correlated with reduced everyday memory errors. Training programs that target latent but inefficiently-used abilities while allowing flexibility in bringing those abilities to bear may best promote effective training and transfer. PMID:19140647

Fortification of Foods with Vitamin D in India

PubMed Central

G, Ritu; Gupta, Ajay

2014-01-01

Vitamin D deficiency is widely prevalent in India, despite abundant sunshine. Fortification of staple foods with vitamin D is a viable strategy to target an entire population. Vitamin D fortification programs implemented in the United States and Canada have improved the vitamin D status in these countries, but a significant proportion of the population is still vitamin D deficient. Before fortification programs are designed and implemented in India, it is necessary to study the efficacy of the American and Canadian vitamin D fortification programs and then improve upon them to suit the Indian scenario. This review explores potential strategies that could be used for the fortification of foods in the Indian context. These strategies have been proposed considering the diverse dietary practices necessitated by social, economic, cultural and religious practices and the diverse climatic conditions in India. Fortification of staple foods, such as chapati flour, maida, rice flour and rice, may be more viable strategies. Targeted fortification strategies to meet the special nutritional needs of children in India are discussed separately in a review entitled, “Fortification of foods with vitamin D in India: Strategies targeted at children”. PMID:25221975

Fidelity of After-School Program Implementation Targeting Adolescent Youth: Identifying Successful Curricular and Programmatic Characteristics

ERIC Educational Resources Information Center

Rajan, Sonali; Basch, Charles E.

2012-01-01

Background: This study consisted of a formative evaluation of an after-school health education program designed for adolescent females, entitled Girls on Track. Evidence-based after-school programs have potential to supplement the traditional school day, encourage social and emotional skill development, improve the quality of student health, and…

34 CFR 200.88 - Exclusion of supplemental State and local funds from supplement, not supplant and comparability...

Code of Federal Regulations, 2011 CFR

2011-07-01

... EDUCATION TITLE I-IMPROVING THE ACADEMIC ACHIEVEMENT OF THE DISADVANTAGED Migrant Education Program § 200.88... migratory children, as defined in section 1309 of the ESEA. (2) The program is based on performance targets... these requirements. (4) The grantee monitors program performance to ensure that these requirements are...

Improving Target Detection in Visual Search Through the Augmenting Multi-Sensory Cues

DTIC Science & Technology

2013-01-01

target detection, visual search James Merlo, Joseph E. Mercado , Jan B.F. Van Erp, Peter A. Hancock University of Central Florida 12201 Research Parkway...were controlled by a purpose-created, LabView- based software computer program that synchronised the respective displays and recorded response times and

Improving Emotional Intelligence through Personality Development: The Effect of the Smart Phone Application based Dharma Life Program on Emotional Intelligence

PubMed Central

Poonamallee, Latha; Harrington, Alex M.; Nagpal, Manisha; Musial, Alec

2018-01-01

Emotional intelligence is established to predict success in leadership effectiveness in various contexts and has been linked to personality factors. This paper introduces Dharma Life Program, a novel approach to improving emotional intelligence by targeting maladaptive personality traits and triggering neuroplasticity through the use of a smart-phone application and mentoring. The program uses neuroplasticity to enable users to create a more adaptive application of their maladaptive traits, thus improving their emotional intelligence. In this study 26 participants underwent the Dharma Life Program in a leadership development setting. We assessed their emotional and social intelligence before and after the Dharma Life Program intervention using the Emotional and Social Competency Inventory (ESCI). The study found a significant improvement in the lowest three competencies and a significant improvement in almost all domains for the entire sample. Our findings suggest that the completion of the Dharma Life Program has a significant positive effect on Emotional and Social Competency scores and offers a new avenue for improving emotional intelligence competencies. PMID:29527182

Improving Emotional Intelligence through Personality Development: The Effect of the Smart Phone Application based Dharma Life Program on Emotional Intelligence.

PubMed

Poonamallee, Latha; Harrington, Alex M; Nagpal, Manisha; Musial, Alec

2018-01-01

Emotional intelligence is established to predict success in leadership effectiveness in various contexts and has been linked to personality factors. This paper introduces Dharma Life Program, a novel approach to improving emotional intelligence by targeting maladaptive personality traits and triggering neuroplasticity through the use of a smart-phone application and mentoring. The program uses neuroplasticity to enable users to create a more adaptive application of their maladaptive traits, thus improving their emotional intelligence. In this study 26 participants underwent the Dharma Life Program in a leadership development setting. We assessed their emotional and social intelligence before and after the Dharma Life Program intervention using the Emotional and Social Competency Inventory (ESCI). The study found a significant improvement in the lowest three competencies and a significant improvement in almost all domains for the entire sample. Our findings suggest that the completion of the Dharma Life Program has a significant positive effect on Emotional and Social Competency scores and offers a new avenue for improving emotional intelligence competencies.

Speech recognition-based and automaticity programs to help students with severe reading and spelling problems.

PubMed

Higgins, Eleanor L; Raskind, Marshall H

2004-12-01

This study was conducted to assess the effectiveness of two programs developed by the Frostig Center Research Department to improve the reading and spelling of students with learning disabilities (LD): a computer Speech Recognition-based Program (SRBP) and a computer and text-based Automaticity Program (AP). Twenty-eight LD students with reading and spelling difficulties (aged 8 to 18) received each program for 17 weeks and were compared with 16 students in a contrast group who did not receive either program. After adjusting for age and IQ, both the SRBP and AP groups showed significant differences over the contrast group in improving word recognition and reading comprehension. Neither program showed significant differences over contrasts in spelling. The SRBP also improved the performance of the target group when compared with the contrast group on phonological elision and nonword reading efficiency tasks. The AP showed significant differences in all process and reading efficiency measures.

HUD PowerSaver Pilot Loan Program

DOE Office of Scientific and Technical Information (OSTI.GOV)

Zimring, Mark; Hoffman, Ian

2010-12-10

The U.S. Department of Housing and Urban Development (HUD) recently announced the creation of a pilot loan program for home energy improvements. The PowerSaver loan program is a new, energy-focused variant of the Title I Property Improvement Loan Insurance Program (Title I Program) and is planned for introduction in early 2011. The PowerSaver pilot will provide lender insurance for secured and unsecured loans up to $25,000 to single family homeowners. These loans will specifically target residential energy efficiency and renewable energy improvements. HUD estimates the two-year pilot will fund approximately 24,000 loans worth up to $300 million; the program ismore » not capped. The Federal Housing Administration (FHA), HUD's mortgage insurance unit, will provide up to $25 million in grants as incentives to participating lenders. FHA is seeking lenders in communities with existing programs for promoting residential energy upgrades.« less

Spatial analysis of ecosystem service relationships to improve targeting of payments for hydrological services

PubMed Central

Manson, Robert H.; Ricketts, Taylor H.; Geissert, Daniel

2018-01-01

Payment for hydrological services (PHS) are popular tools for conserving ecosystems and their water-related services. However, improving the spatial targeting and impacts of PHS, as well as their ability to foster synergies with other ecosystem services (ES), remain challenging. We aimed at using spatial analyses to evaluate the targeting performance of México’s National PHS program in central Veracruz. We quantified the effectiveness of areas targeted for PHS in actually covering areas of high HS provision and social priority during 2003–2013. First, we quantified provisioning and spatial distributions of two target (water yield and soil retention), and one non-target ES (carbon storage) using InVEST. Subsequently, pairwise relationships among ES were quantified by using spatial correlation and overlap analyses. Finally, we evaluated targeting by: (i) prioritizing areas of individual and overlapping ES; (ii) quantifying spatial co-occurrences of these priority areas with those targeted by PHS; (iii) evaluating the extent to which PHS directly contribute to HS delivery; and (iv), testing if PHS targeted areas disproportionately covered areas with high ecological and social priority. We found that modelled priority areas exhibited non-random distributions and distinct spatial patterns. Our results show significant pairwise correlations between all ES suggesting synergistic relationships. However, our analysis showed a significantly lower overlap than expected and thus significant mismatches between PHS targeted areas and all types of priority areas. These findings suggest that the targeting of areas with high HS provisioning and social priority by Mexico’s PHS program could be improved significantly. This study underscores: (1) the importance of using maps of HS provisioning as main targeting criteria in PHS design to channel payments towards areas that require future conservation, and (2) the need for future research that helps balance ecological and socioeconomic targeting criteria. PMID:29462205

Improving Robotic Assembly of Planar High Energy Density Targets

NASA Astrophysics Data System (ADS)

Dudt, D.; Carlson, L.; Alexander, N.; Boehm, K.

2016-10-01

Increased quantities of planar assemblies for high energy density targets are needed with higher shot rates being implemented at facilities such as the National Ignition Facility and the Matter in Extreme Conditions station of the Linac Coherent Light Source. To meet this growing demand, robotics are used to reduce assembly time. This project studies how machine vision and force feedback systems can be used to improve the quantity and quality of planar target assemblies. Vision-guided robotics can identify and locate parts, reducing laborious manual loading of parts into precision pallets and associated teaching of locations. On-board automated inspection can measure part pickup offsets to correct part drop-off placement into target assemblies. Force feedback systems can detect pickup locations and apply consistent force to produce more uniform glue bond thickness, thus improving the performance of the targets. System designs and performance evaluations will be presented. Work supported in part by the US DOE under the Science Undergraduate Laboratory Internships Program (SULI) and ICF Target Fabrication DE-NA0001808.

Exploring the speed and performance of molecular replacement with AMPLE using QUARK ab initio protein models.

PubMed

Keegan, Ronan M; Bibby, Jaclyn; Thomas, Jens; Xu, Dong; Zhang, Yang; Mayans, Olga; Winn, Martyn D; Rigden, Daniel J

2015-02-01

AMPLE clusters and truncates ab initio protein structure predictions, producing search models for molecular replacement. Here, an interesting degree of complementarity is shown between targets solved using the different ab initio modelling programs QUARK and ROSETTA. Search models derived from either program collectively solve almost all of the all-helical targets in the test set. Initial solutions produced by Phaser after only 5 min perform surprisingly well, improving the prospects for in situ structure solution by AMPLE during synchrotron visits. Taken together, the results show the potential for AMPLE to run more quickly and successfully solve more targets than previously suspected.

BEHAVIOR ANALYSTS IN THE WAR ON POVERTY: A REVIEW OF THE USE OF FINANCIAL INCENTIVES TO PROMOTE EDUCATION AND EMPLOYMENT

PubMed Central

Holtyn, August F.; Jarvis, Brantley P.; Silverman, Kenneth

2017-01-01

Poverty is a pervasive risk factor underlying poor health. Many interventions that have sought to reduce health disparities associated with poverty have focused on improving health-related behaviors of low-income adults. Poverty itself could be targeted to improve health, but this approach would require programs that can consistently move poor individuals out of poverty. Governments and other organizations in the United States have tested a diverse range of antipoverty programs, generally on a large scale and in conjunction with welfare reform initiatives. This paper reviews antipoverty programs that used financial incentives to promote education and employment among welfare recipients and other low-income adults. The incentive-based, antipoverty programs had small or no effects on the target behaviors; they were implemented on large scales from the outset, without systematic development and evaluation of their components; and they did not apply principles of operant conditioning that have been shown to determine the effectiveness of incentive or reinforcement interventions. By applying basic principles of operant conditioning, behavior analysts could help address poverty and improve health through development of effective antipoverty programs. This paper describes a potential framework for a behavior-analytic antipoverty program, with the goal of illustrating that behavior analysts could be uniquely suited to make substantial contributions to the war on poverty. PMID:28078664

Behavior analysts in the war on poverty: A review of the use of financial incentives to promote education and employment.

PubMed

Holtyn, August F; Jarvis, Brantley P; Silverman, Kenneth

2017-01-01

Poverty is a pervasive risk factor underlying poor health. Many interventions that have sought to reduce health disparities associated with poverty have focused on improving health-related behaviors of low-income adults. Poverty itself could be targeted to improve health, but this approach would require programs that can consistently move poor individuals out of poverty. Governments and other organizations in the United States have tested a diverse range of antipoverty programs, generally on a large scale and in conjunction with welfare reform initiatives. This paper reviews antipoverty programs that used financial incentives to promote education and employment among welfare recipients and other low-income adults. The incentive-based, antipoverty programs had small or no effects on the target behaviors; they were implemented on large scales from the outset, without systematic development and evaluation of their components; and they did not apply principles of operant conditioning that have been shown to determine the effectiveness of incentive or reinforcement interventions. By applying basic principles of operant conditioning, behavior analysts could help address poverty and improve health through development of effective antipoverty programs. This paper describes a potential framework for a behavior-analytic antipoverty program, with the goal of illustrating that behavior analysts could be uniquely suited to make substantial contributions to the war on poverty. © 2017 Society for the Experimental Analysis of Behavior.

Designing Effective School Improvement Strategies. Newsletter

ERIC Educational Resources Information Center

Center for Comprehensive School Reform and Improvement, 2009

2009-01-01

Across the country, educators in schools that have not met their targets for improved student learning are considering next steps. As a first step, a school improvement plan that is grounded in data and based on a comprehensive needs assessment can provide a framework for effecting change for a school's programming, student support systems, and…

Improving Student Academic Success through the Promotion of Listening Skills.

ERIC Educational Resources Information Center

Owca, Sally; Pawlak, Emmie; Pronobis, Melanie

This action research project implemented and evaluated a program for improving listening skills in order to improve academic achievement. The targeted population consisted of sixth- and eighth-grade students of three upper/middle class communities located near a large Midwestern city. The problem of poor listening skills was observed when students…

Women, Infants & Children

Science.gov Websites

; Children Page Content WIC is the Special Supplemental Nutrition Program for Women, Infants and Children . This public health program is designed to improve health outcomes and influence lifetime nutrition and health behaviors in targeted, at-risk populations. Nutrition education is the cornerstone of the WIC

Evaluating the effectiveness of a post-license education program for young novice drivers in Belgium.

PubMed

Brijs, Kris; Cuenen, Ariane; Brijs, Tom; Ruiter, Robert A C; Wets, Geert

2014-05-01

The disproportionately large number of traffic accidents of young novice drivers highlights the need for an effective driver education program. The Goals for Driving Education (GDE) matrix shows that driver education must target both lower and higher levels of driver competences. Research has indicated that current education programs do not emphasize enough the higher levels, for example awareness and insight. This has raised the importance of insight programs. On the Road (OtR), a Flemish post-license driver education program, is such an insight program that aims to target these higher levels. The program focus is on risky driving behavior like speeding and drink driving. In addition, the program addresses risk detection and risk-related knowledge. The goal of the study was to do an effect evaluation of this insight program at immediate post-test and 2 months follow-up. In addition, the study aimed to generalize the results of this program to comparable programs in order to make usable policy recommendations. A questionnaire based on the Theory of Planned Behavior (TPB) was used in order to measure participants' safety consciousness of speeding and drink driving. Moreover, we focused on risk detection and risk-related knowledge. Participants (N=366) were randomly assigned to a baseline-follow-up group or a post-test-follow-up group. Regarding speeding and driving, we found OtR to have little effect on the TPB variables. Regarding risk detection, we found no significant effect, even though participants clearly needed substantial improvement when stepping into the program. Regarding risk-related knowledge, the program did result in a significant improvement at post-test and follow-up. It is concluded that the current program format is a good starting point, but that it requires further attention to enhance high level driving skills. Program developers are encouraged to work in a more evidence-based manner when they select target variables and methods to influence these variables. Copyright © 2014 Elsevier Ltd. All rights reserved.

Integrated cockpit design for the Army helicopter improvement program

NASA Technical Reports Server (NTRS)

Drennen, T.; Bowen, B.

1984-01-01

The main Army Helicopter Improvement Program (AHIP) mission is to navigate precisely, locate targets accurately, communicate their position to other battlefield elements, and to designate them for laser guided weapons. The onboard navigation and mast-mounted sight (MMS) avionics enable accurate tracking of current aircraft position and subsequent target location. The AHIP crewstation development was based on extensive mission/task analysis, function allocation, total system design, and test and verification. The avionics requirements to meet the mission was limited by the existing aircraft structural and performance characteristics and resultant space, weight, and power restrictions. These limitations and night operations requirement led to the use of night vision goggles. The combination of these requirements and limitations dictated an integrated control/display approach using multifunction displays and controls.

Nurse managed prenatal programs affect outcomes for corporations.

PubMed

Thompson, P E; Bitowski, B E; Bell, P L

1997-09-01

Faced with higher medical costs and increased insurance premiums, corporations are focusing on health promotion and wellness. With increasing numbers of women in the workforce, corporations have identified the need for prenatal programs. By developing, initiating, and evaluating outcome-based prenatal programs nurses can target the health care needs of this select population. One such program documented several outcomes including improved employee health and an 86% reduction in maternal/newborn costs.

Goals, Data Use, and Instruction: The Effect of a Teacher Professional Development Program on Reading Achievement

ERIC Educational Resources Information Center

van Kuijk, Mechteld F.; Deunk, Marjolein I.; Bosker, Roel J.; Ritzema, Evelien S.

2016-01-01

In this paper, we investigated whether student reading comprehension could be improved with help of a teacher Professional Development (PD) program targeting goals, data use, and instruction. The effect of this PD program on 2nd- and 3rd-grade student achievement was examined using a pretest-posttest control group design. Applying propensity score…

Korean Affairs Report

DTIC Science & Technology

1986-03-13

for the national budget austerity policy, for example, improved administrative efficiency, a public manpower management program, etc. 21 Minister of...targets of employee training programs, but now top executives are found among trainees . Active movement of those institutions providing employee...and equals the budget of the Samsung Business Group. The budget is divided into 9.5 billion won for domestic training programs and 7.5 billion won

Intervention, Treatment, and Prevention of Sexual Abuse and Assault: A Training Program for Racial Minority Service Providers. Final Report.

ERIC Educational Resources Information Center

Specktor, Peggy; Stafford, Rick, Ed.

The Minnesota Program for Victims of Sexual Assault conducted a 9-month training program for racial minority human service professionals from September 1983 through May 1984. The objectives of the project were to improve the identification, intervention, and treatment of sexual assault victims and their families. The project targeted Blacks,…

Use of a hand-held computer observational tool to improve communication for care planning and psychosocial well-being

PubMed Central

Corazzini, Kirsten; Rapp, Carla Gene; McConnell, Eleanor S.; Anderson, Ruth A.

2013-01-01

Staff development nurses in long-term care are challenged to implement training programs that foster quality unlicensed assistive personnel (UAP) care and improve the transfer of their observations to licensed nursing staff for care planning. This study describes the outcomes of a program where UAP recorded behavioral problems of residents to inform care. Findings suggest staff development nurses who aim to improve UAP reporting without simultaneously targeting licensed nursing staff behaviors may worsen nursing staff relationships. PMID:19182546

[Preparation and effect of a behavioral science-based education program for sleep improvement among medical students].

PubMed

Ueda, Masumi; Adachi, Yoshiko; Hayama, Junko; Yamagami, Toshiko

2008-01-01

The present study aimed to investigate a simple education program that is effective for sleep improvement among medical students who will be medical doctors in the future. The education program applied in the present study was developed for sleep improvement based on behavioral science and changes in knowledge and sleeping habits were observed. Subjects were 6th-year medical students of 2002 and 2003. Students of 2002 attended a program including a 90-minute lecture and a 2-week practice learning session, and students of 2003 attended only the lecture. In the lecture, behavior therapy for chronic insomnia was explained using a booklet. In the practice learning session, students set a target behavior for improvement and conducted self-monitoring of their sleep and the targeted behavior. Changes in knowledge about sleep, attitude toward the therapy, sleep, and sleep-related habits were observed and compared between the 2 groups of subjects immediately and 2-weeks after the lecture. It was found that after both programs subjects had more knowledge about sleep than before. In the program including practice learning session, subjects' attitude for managing patients changed from before the lecture to after the lecture, and after the practice learning session. It was found that more than half of the students thought that they could provide sleep guidance based on the behavior therapy. Regarding the subjects' sleep, significant improvements were observed for "having nightmares upon falling asleep," "sleepiness during daytime," "sense of getting a sound sleep," and "mood upon waking up." Regarding sleep-related habits, significant improvements were observed for "taking a nap," "dozing off," and "eating breakfast." On the other hand, only the lecture subjects improved irregularity of bedtime and sleeping time. Although an increase in knowledge and improvement of sleep were observed among students who attended only the lecture, a further increase in knowledge and improvement of sleeping habits were observed among students who also attended the practice learning session. The results described herein suggest developing and providing a simple and convenient education program for sleep improvement was effective for increasing students' knowledge about sleep, developing improved coping methods regarding sleep, and improving sleep. It is also suggested that behavioral scientific instructive methods, including practice learning, are effective for medical education.

Effectiveness of a Class-Wide Peer-Mediated Elementary Math Differentiation Strategy

ERIC Educational Resources Information Center

Lloyd, Jason D.

2017-01-01

Approximately 60% of classroom students have insufficient math skills. Within a Multi-Tiered Systems of Support (MTSS) framework, teachers can implement core differentiation strategies targeted at improving math skills of an entire class of students. Differentiation programs are developed in order to target academic skills of groups of students…

Improving Secondary School Students' Achievement using Intrinsic Motivation

ERIC Educational Resources Information Center

Albrecht, Erik; Haapanen, Rebecca; Hall, Erin; Mantonya, Michelle

2009-01-01

This report describes a program for increasing students' intrinsic motivation in an effort to increase academic achievement. The targeted population consisted of secondary level students in a middle to upper-middle class suburban area. The students of the targeted secondary level classes appeared to be disengaged from learning due to a lack of…

Improving DHH Students' Grammar through an Individualized Software Program

ERIC Educational Resources Information Center

Cannon, Joanna E.; Easterbrooks, Susan R.; Gagne, Phill; Beal-Alvarez, Jennifer

2011-01-01

The purpose of this study was to determine if the frequent use of a targeted, computer software grammar instruction program, used as an individualized classroom activity, would influence the comprehension of morphosyntax structures (determiners, tense, and complementizers) in deaf/hard-of-hearing (DHH) participants who use American Sign Language…

Sugar Free with Justin T.: Diabetes Education through Community Partnerships

ERIC Educational Resources Information Center

Thomas, Justin B.; Donaldson, Joseph L.

2014-01-01

This article describes the design, development, and delivery of an Extension community cable television program, "Sugar Free with Justin T.," in Roane County, Tennessee. The program targets diabetics, pre-diabetics, and those who care for them, with practical information and demonstrations to improve dietary quality. In addition to…

Targeting Obesity through Health Promotion Programs for School Staff

ERIC Educational Resources Information Center

Herbert, Patrick C.; Lohrmann, David K.; Hall, Cougar

2017-01-01

Health promotion programs for school staff are an overlooked and under-utilized resource that can lead to reductions in overweight and obesity among teachers and other staff members if implemented properly. In addition to increasing the overall staff wellness, boosting morale, increasing productivity, improving academic achievement, providing…

The "REST" Program: A New Treatment System for the Oppositional Defiant Adolescent.

ERIC Educational Resources Information Center

Stein, David B.; Smith, Edward D.

1990-01-01

Compared REST (Real Economy System for Teens) program, which combines behavioral treatment and cognitive restructuring, with traditional talk therapy, which uses primarily cognitive restructuring, in treatment of oppositional defiant adolescents. Results showed significantly greater improvement on all target behaviors (room care, personal hygiene,…

Strategies to facilitate implementation and sustainability of large system transformations: a case study of a national program for improving quality of care for elderly people.

PubMed

Nyström, Monica Elisabeth; Strehlenert, Helena; Hansson, Johan; Hasson, Henna

2014-09-18

Large-scale change initiatives stimulating change in several organizational systems in the health and social care sector are challenging both to lead and evaluate. There is a lack of systematic research that can enrich our understanding of strategies to facilitate large system transformations in this sector. The purpose of this study was to examine the characteristics of core activities and strategies to facilitate implementation and change of a national program aimed at improving life for the most ill elderly people in Sweden. The program outcomes were also addressed to assess the impact of these strategies. A longitudinal case study design with multiple data collection methods was applied. Archival data (n = 795), interviews with key stakeholders (n = 11) and non-participant observations (n = 23) were analysed using content analysis. Outcome data was obtained from national quality registries. This study presents an approach for implementing a large national change program that is characterized by initial flexibility and dynamism regarding content and facilitation strategies and a growing complexity over time requiring more structure and coordination. The description of activities and strategies show that the program management team engaged a variety of stakeholders and actor groups and accordingly used a palate of different strategies. The main strategies used to influence change in the target organisations were to use regional improvement coaches, regional strategic management teams, national quality registries, financial incentives and annually revised agreements. Interactive learning sessions, intense communication, monitor and measurements, and active involvement of different experts and stakeholders, including elderly people, complemented these strategies. Program outcomes showed steady progress in most of the five target areas, less so for the target of achieving coordinated care. There is no blue-print on how to approach the challenging task of leading large scale change programs in complex contexts, but our conclusion is that more attention has to be given to the multidimensional strategies that program management need to consider. This multidimensionality comprises different strategies depending on types of actors, system levels, contextual factors, program progress over time, program content, types of learning and change processes, and the conditions for sustainability.

Automatic programming of simulation models

NASA Technical Reports Server (NTRS)

Schroer, Bernard J.; Tseng, Fan T.; Zhang, Shou X.; Dwan, Wen S.

1988-01-01

The objective of automatic programming is to improve the overall environment for describing the program. This improved environment is realized by a reduction in the amount of detail that the programmer needs to know and is exposed to. Furthermore, this improved environment is achieved by a specification language that is more natural to the user's problem domain and to the user's way of thinking and looking at the problem. The goal of this research is to apply the concepts of automatic programming (AP) to modeling discrete event simulation system. Specific emphasis is on the design and development of simulation tools to assist the modeler define or construct a model of the system and to then automatically write the corresponding simulation code in the target simulation language, GPSS/PC. A related goal is to evaluate the feasibility of various languages for constructing automatic programming simulation tools.

Classical Biological Control of Invasive Legacy Crop Pests: New Technologies Offer Opportunities to Revisit Old Pest Problems in Perennial Tree Crops

PubMed Central

Hoddle, Mark S.; Warner, Keith; Steggall, John; Jetter, Karen M.

2014-01-01

Advances in scientific disciplines that support classical biological control have provided “new tools” that could have important applications for biocontrol programs for some long-established invasive arthropod pests. We suggest that these previously unavailable tools should be used in biological control programs targeting “legacy pests”, even if they have been targets of previously unsuccessful biocontrol projects. Examples of “new tools” include molecular analyses to verify species identities and likely geographic area of origin, climate matching and ecological niche modeling, preservation of natural enemy genetic diversity in quarantine, the use of theory from invasion biology to maximize establishment likelihoods for natural enemies, and improved understanding of the interactions between natural enemy and target pest microbiomes. This review suggests that opportunities exist for revisiting old pest problems and funding research programs using “new tools” for developing biological control programs for “legacy pests” could provide permanent suppression of some seemingly intractable pest problems. As a case study, we use citricola scale, Coccus pseudomagnoliarum, an invasive legacy pest of California citrus, to demonstrate the potential of new tools to support a new classical biological control program targeting this insect. PMID:26463063

Overview of Progress on the LANSCE Accelerator and Target Facilities Improvement Program

NASA Astrophysics Data System (ADS)

Macek, R. J.; Brun, T.; Donahue, J. B.; Fitzgerald, D. H.

1997-05-01

Three projects to improve the performance of the accelerator and target facilities for the Los Alamos Neutron Science Center have been initiated since 1994. The LANSCE Reliability Improvement Project was separated into two phases. Phase I, completed in 1995, was targeted at near-term improvements to beam availability that could be completed in a year. Phase II, now underway, consists of two projects: 1) converting the beam injection into the Proton Storage Ring (PSR) from the present two-step process H^- to H^0 to H^+) to direct injection of H^- beam in one step (H^- to H^+), and 2) an upgrade of the spallation neutron production target which will reduce the target change-out time from about a year to about three weeks. The third project, the SPSS Enhancement Project, is aimed at increasing the PSR output beam current from the present 70 μA at 20 Hz to 200 μA at 30 Hz, plus implementing seven new neutron scattering instruments. Objectives, plans, results and progress to date will be summarized.

A Method for Improved Interpretation of "Spot" Biomarker Data ...

EPA Pesticide Factsheets

A Method for Improved Interpretation of "Spot" Biomarker Data The National Exposure Research Laboratory (NERL) Human Exposure and Atmospheric Sciences Division (HEASD) conducts research in support of EPA mission to protect human health and the environment. HEASD research program supports Goal 1 (Clean Air) and Goal 4 (Healthy People) of EPA strategic plan. More specifically, our division conducts research to characterize the movement of pollutants from the source to contact with humans. Our multidisciplinary research program produces Methods, Measurements, and Models to identify relationships between and characterize processes that link source emissions, environmental concentrations, human exposures, and target-tissue dose. The impact of these tools is improved regulatory programs and policies for EPA.

Need for hyperlipidemia management policy reform in China: learning from the global experience.

PubMed

Yu, Wei; Shi, Ruizhi; Li, Jim; Lan, Yong; Li, Qian; Hu, Shanlian

2018-02-01

To evaluate the hyperlipidemia prevention programs and policies in different countries and highlight the need of reforming the hyperlipidemia prevention policies in China to lower the growing cardiovascular disease (CVD) risk. PubMed, Google Scholar and Cochrane were searched for global hyperlipidemia prevention policies. Government-funded policies pertaining to lipid management were considered for this review. Only those studies that evaluated the success of prevention policies on the basis of: (i) achievement of hyperlipidemia targets; (ii) improvement in Cardiovascular (CV) risk reduction; and (iii) outcomes with reduction in hyperlipidemia after implementation of the policy, were included. Several global policies and programs aimed to improve CV health by highlighting lipid profile management. Implementation of the global and national policies led to improvement in cholesterol related outcomes such as availability of diagnostic measures, awareness of the risk factors, decrease in cholesterol levels, achieving healthy lifestyle to prevent CVD and improvement in availability of hypolipidemic medications, etc. Statins have been covered under reimbursement policies in many countries to improve usage and thereby preventing incidence of stroke and CVD. We observed a need for introducing new programs in China as the ongoing hyperlipidemia management policies are inadequate. The World Bank Report 2016 recommended that prevention policies in China be modeled on the US Million Hearts program. New hyperlipidemia prevention policies must set a time-bound target, and need to be patient and clinician centric in terms of applications, and revised periodically for long-term benefits.

Increases in Emotional Intelligence After an Online Training Program Are Associated With Better Decision-Making on the Iowa Gambling Task.

PubMed

Alkozei, Anna; Smith, Ryan; Demers, Lauren A; Weber, Mareen; Berryhill, Sarah M; Killgore, William D S

2018-01-01

Higher levels of emotional intelligence have been associated with better inter and intrapersonal functioning. In the present study, 59 healthy men and women were randomized into either a three-week online training program targeted to improve emotional intelligence ( n = 29), or a placebo control training program targeted to improve awareness of nonemotional aspects of the environment ( n = 30). Compared to placebo, participants in the emotional intelligence training group showed increased performance on the total emotional intelligence score of the Mayer-Salovey-Caruso Emotional Intelligence Test, a performance measure of emotional intelligence, as well as subscales of perceiving emotions and facilitating thought. Moreover, after emotional intelligence training, but not after placebo training, individuals displayed the ability to arrive at optimal performance faster (i.e., they showed a faster learning rate) during an emotion-guided decision-making task (i.e., the Iowa Gambling Task). More specifically, although both groups showed similar performance at the start of the Iowa Gambling Task from pre- to posttraining, the participants in the emotional intelligence training group learned to choose more advantageous than disadvantageous decks than those in the placebo training group by the time they reached the "hunch" period of the task (i.e., the point in the task when implicit task learning is thought to have occurred). Greater total improvements in performance on the Iowa Gambling Task from pre- to posttraining in the emotional intelligence training group were also positively correlated with pre- to posttraining changes in Mayer-Salovey-Caruso Emotional Intelligence Test scores, in particular with changes in the ability to perceive emotions. The present study provides preliminary evidence that emotional intelligence can be trained with the help of an online training program targeted at adults; it also suggests that changes in emotional intelligence, as a result of such a program, can lead to improved emotion-guided decision-making.

Improving Student Writing Skills through the Modeling of the Writing Process.

ERIC Educational Resources Information Center

Kapka, Dawn; Oberman, Dina A.

This study describes a program designed to improve students' writing skills in order to improve academic achievement. The targeted population consists of third and fifth grade elementary students in two separate communities ranging from low to middle class, located in two midwestern suburbs of a large city. Evidence for the existence of the…

Penalty Dynamic Programming Algorithm for Dim Targets Detection in Sensor Systems

PubMed Central

Huang, Dayu; Xue, Anke; Guo, Yunfei

2012-01-01

In order to detect and track multiple maneuvering dim targets in sensor systems, an improved dynamic programming track-before-detect algorithm (DP-TBD) called penalty DP-TBD (PDP-TBD) is proposed. The performances of tracking techniques are used as a feedback to the detection part. The feedback is constructed by a penalty term in the merit function, and the penalty term is a function of the possible target state estimation, which can be obtained by the tracking methods. With this feedback, the algorithm combines traditional tracking techniques with DP-TBD and it can be applied to simultaneously detect and track maneuvering dim targets. Meanwhile, a reasonable constraint that a sensor measurement can originate from one target or clutter is proposed to minimize track separation. Thus, the algorithm can be used in the multi-target situation with unknown target numbers. The efficiency and advantages of PDP-TBD compared with two existing methods are demonstrated by several simulations. PMID:22666074

A target development program for beamhole spallation neutron sources in the megawatt range

DOE Office of Scientific and Technical Information (OSTI.GOV)

Bauer, G.S.; Atchison, F.

1995-10-01

Spallation sources as an alternative to fission neutron sources have been operating successfully up to 160 kW of beam power. With the next generation of these facilities aiming at the medium power range between 0.5 and 5 MW, loads on the targets will be high enough to make present experience of little relevance. With the 0.6 MW continuous facility SINQ under construction, and a 5 MW pulsed facility (ESS) under study in Europe, a research and development program is about to be started which aimes at assessing the limits of stationary and moving solid targets and the feasibility and potentialmore » benefits of flowing liquid metal targets. Apart from theoretical work and examination of existing irradiated material, including used targets from ISIS, it is intended to take advantage of the SINQ solid rod target design to improve the relevant data base by building the target in such a way that individual rods can be equipped as irradiation capsules.« less

Iraqi Police Development Program: Opportunities for Improved Program Accountability and Budget Transparency

DTIC Science & Technology

2011-10-24

makes three recommendations to the Secretary of State, highlighting the need for (1) an adequate current assessment of the Iraqi police forces, (2...with documents obtained from other sources, allowed us to determine that: • DoS does not have a current assessment of Iraqi police forces...capabilities upon which to base its program. Such an assessment is essential for effective program targeting. Further, DoS does not have a sufficiently

High Quantum Efficiency OLED Lighting Systems

DOE Office of Scientific and Technical Information (OSTI.GOV)

Shiang, Joseph

The overall goal of the program was to apply improvements in light outcoupling technology to a practical large area plastic luminaire, and thus enable the product vision of an extremely thin form factor high efficiency large area light source. The target substrate was plastic and the baseline device was operating at 35 LPW at the start of the program. The target LPW of the program was a >2x improvement in the LPW efficacy and the overall amount of light to be delivered was relatively high 900 lumens. Despite the extremely difficult challenges associated with scaling up a wet solution processmore » on plastic substrates, the program was able to make substantial progress. A small molecule wet solution process was successfully implemented on plastic substrates with almost no loss in efficiency in transitioning from the laboratory scale glass to large area plastic substrates. By transitioning to a small molecule based process, the LPW entitlement increased from 35 LPW to 60 LPW. A further 10% improvement in outcoupling efficiency was demonstrated via the use of a highly reflecting cathode, which reduced absorptive loss in the OLED device. The calculated potential improvement in some cases is even larger, ~30%, and thus there is considerable room for optimism in improving the net light coupling efficacy, provided absorptive loss mechanisms are eliminated. Further improvements are possible if scattering schemes such as the silver nanowire based hard coat structure are fully developed. The wet coating processes were successfully scaled to large area plastic substrate and resulted in the construction of a 900 lumens luminaire device.« less

Exploring the speed and performance of molecular replacement with AMPLE using QUARK ab initio protein models

PubMed Central

Keegan, Ronan M.; Bibby, Jaclyn; Thomas, Jens; Xu, Dong; Zhang, Yang; Mayans, Olga; Winn, Martyn D.; Rigden, Daniel J.

2015-01-01

AMPLE clusters and truncates ab initio protein structure predictions, producing search models for molecular replacement. Here, an interesting degree of complementarity is shown between targets solved using the different ab initio modelling programs QUARK and ROSETTA. Search models derived from either program collectively solve almost all of the all-helical targets in the test set. Initial solutions produced by Phaser after only 5 min perform surprisingly well, improving the prospects for in situ structure solution by AMPLE during synchrotron visits. Taken together, the results show the potential for AMPLE to run more quickly and successfully solve more targets than previously suspected. PMID:25664744

Targeting latent function: encouraging effective encoding for successful memory training and transfer.

PubMed

Lustig, Cindy; Flegal, Kristin E

2008-12-01

Cognitive training programs for older adults often result in improvements at the group level. However, there are typically large age and individual differences in the size of training benefits. These differences may be related to the degree to which participants implement the processes targeted by the training program. To test this possibility, we tested older adults in a memory-training procedure either under specific strategy instructions designed to encourage semantic, integrative encoding, or in a condition that encouraged time and attention to encoding but allowed participants to choose their own strategy. Both conditions improved the performance of old-old adults relative to an earlier study (D. Bissig & C. Lustig, 2007) and reduced self-reports of everyday memory errors. Performance in the strategy-instruction group was related to preexisting ability; performance in the strategy?choice group was not. The strategy-choice group performed better on a laboratory transfer test of recognition memory, and training performance was correlated with reduced everyday memory errors. Training programs that target participants' latent but inefficiently used abilities while allowing flexibility in bringing those abilities to bear may best promote effective training and transfer. Copyright (c) 2009 APA, all rights reserved.

Surgical Neuroanatomy and Programming in Deep Brain Stimulation for Obsessive Compulsive Disorder

PubMed Central

Morishita, Takashi; Fayad, Sarah M.; Goodman, Wayne K.; Foote, Kelly D.; Chen, Dennis; Peace, David A.; Rhoton, Albert L.; Okun, Michael S.

2014-01-01

Objectives Deep brain stimulation (DBS) has been established as a safe, effective therapy for movement disorders (Parkinson’s disease, essential tremor, etc.), and its application is expanding to the treatment of other intractable neuropsychiatric disorders including Depression and Obsessive-Compulsive Disorder (OCD). Several published studies have supported the efficacy of DBS for severely debilitating OCD. However, questions remain regarding the optimal anatomical target and the lack of a bedside programming paradigm for OCD DBS. Management of OCD DBS can be highly variable and is typically guided by each center’s individual expertise. In this paper, we review the various approaches to targeting and programming for OCD DBS. We also review the clinical experience for each proposed target, and discuss the relevant neuroanatomy. Methods A PubMed review was performed searching for literature on OCD DBS and included all articles published before March 2012. We included all available studies with a clear description of the anatomical targets, programming details, and the outcomes. Results Six different DBS approaches were identified. High frequency stimulation with high voltage was applied in most cases, and predictive factors for favorable outcomes were discussed in the literature. Conclusion DBS remains an experimental treatment for medication refractory OCD. Target selection and programming paradigms are not yet standardized, though, an improved understanding of the relationship between the DBS lead and the surrounding neuroanatomical structures will aid in the selection of targets and the approach to programming. We propose to form a registry to track OCD DBS cases for future clinical study design. PMID:24345303

Surgical neuroanatomy and programming in deep brain stimulation for obsessive compulsive disorder.

PubMed

Morishita, Takashi; Fayad, Sarah M; Goodman, Wayne K; Foote, Kelly D; Chen, Dennis; Peace, David A; Rhoton, Albert L; Okun, Michael S

2014-06-01

Deep brain stimulation (DBS) has been established as a safe, effective therapy for movement disorders (Parkinson's disease, essential tremor, etc.), and its application is expanding to the treatment of other intractable neuropsychiatric disorders including depression and obsessive-compulsive disorder (OCD). Several published studies have supported the efficacy of DBS for severely debilitating OCD. However, questions remain regarding the optimal anatomic target and the lack of a bedside programming paradigm for OCD DBS. Management of OCD DBS can be highly variable and is typically guided by each center's individual expertise. In this paper, we review the various approaches to targeting and programming for OCD DBS. We also review the clinical experience for each proposed target and discuss the relevant neuroanatomy. A PubMed review was performed searching for literature on OCD DBS and included all articles published before March 2012. We included all available studies with a clear description of the anatomic targets, programming details, and the outcomes. Six different DBS approaches were identified. High-frequency stimulation with high voltage was applied in most cases, and predictive factors for favorable outcomes were discussed in the literature. DBS remains an experimental treatment for medication refractory OCD. Target selection and programming paradigms are not yet standardized, though an improved understanding of the relationship between the DBS lead and the surrounding neuroanatomic structures will aid in the selection of targets and the approach to programming. We propose to form a registry to track OCD DBS cases for future clinical study design. © 2013 International Neuromodulation Society.

Improvements of the target lifetime in the RHIC polarimeter

NASA Astrophysics Data System (ADS)

Steski, D. B.; Huang, H.; Kewisch, J.; Sukhanova, L.; Zelenski, A.

2018-05-01

The Relativistic Heavy Ion Collider (RHIC) at Brookhaven National Laboratory (BNL) is the only collider in the world to collide polarized protons. It is critical to the RHIC experimental program that the polarization of the proton beam is measured. This is accomplished with the Coulomb Nuclear Interference (CNI) polarimeter. The targets used in the RHIC CNI polarimeter are 50 nm thick, 25 mm long and <10 µm wide. As the beam intensity in RHIC has increased and the beam size has decreased, the lifetime of these targets has decreased dramatically. During the 2013 polarized proton experimental run, the targets needed to be replaced twice. This resulted in additional work and lost beam time. Before the 2015 experimental run, metal shields were installed around the ends of the targets which greatly improved the target lifetime. The results from the 2015 experimental run and plans for the 2017 experimental run will be discussed.

RNA Structure Design Improves Activity and Specificity of trans-Splicing-Triggered Cell Death in a Suicide Gene Therapy Approach.

PubMed

Poddar, Sushmita; Loh, Pei She; Ooi, Zi Hao; Osman, Farhana; Eul, Joachim; Patzel, Volker

2018-06-01

Spliceosome-mediated RNA trans-splicing enables correction or labeling of pre-mRNA, but therapeutic applications are hampered by issues related to the activity and target specificity of trans-splicing RNA (tsRNA). We employed computational RNA structure design to improve both on-target activity and specificity of tsRNA in a herpes simplex virus thymidine kinase/ganciclovir suicide gene therapy approach targeting alpha fetoprotein (AFP), a marker of hepatocellular carcinoma (HCC) or human papillomavirus type 16 (HPV-16) pre-mRNA. While unstructured, mismatched target binding domains significantly improved 3' exon replacement (3'ER), 5' exon replacement (5'ER) correlated with the thermodynamic stability of the tsRNA 3' end. Alternative on-target trans-splicing was found to be a prevalent event. The specificity of trans-splicing with the intended target splice site was improved 10-fold by designing tsRNA that harbors secondary target binding domains shielding alternative on-target and blinding off-target splicing events. Such rationally designed suicide RNAs efficiently triggered death of HPV-16-transduced or hepatoblastoma-derived human tissue culture cells without evidence for off-target cell killing. Highest cell death activities were observed with novel dual-targeting tsRNAs programmed for trans-splicing toward AFP and a second HCC pre-mRNA biomarker. Our observations suggest trans-splicing represents a promising approach to suicide gene therapy. Copyright © 2018 The Author(s). Published by Elsevier Inc. All rights reserved.

Training teachers in generalized writing of behavior modification programs for multihandicapped deaf children.

PubMed

Hundert, J

1982-01-01

In contrast to previous studies where teachers were instructed how to implement behavior modification programs designed by an experimenter, teachers in the present experiment were taught how to write as well as implement behavior modification programs. The generalized effects of two training conditions on teacher and pupil behaviors were assessed by a multiple baseline design where, following baseline, two teachers of multi-handicapped deaf children were taught to set objectives and measure pupil performance (measurement training), Later, through a training manual, they learned a general problem-solving approach to writing behavior modification programs (programming training). After both training conditions, experimenter feedback was given for teachers' application of training to a target behavior for one pupil and generalization was measured across target behaviors for the same pupil and across pupils. It was found that measurement training had little general effect on either teacher behavior or pupil behavior. However, after programming training, teachers increased their program writing and correct use of behavior modification procedures and generalized this training across pupils and target behaviors. Along with these effects, there was improvement in pupil behaviors. Possible explanation for generalized effects of teacher training were considered.

Apparatus, Method and Program Storage Device for Determining High-Energy Neutron/Ion Transport to a Target of Interest

NASA Technical Reports Server (NTRS)

Wilson, John W. (Inventor); Tripathi, Ram K. (Inventor); Cucinotta, Francis A. (Inventor); Badavi, Francis F. (Inventor)

2012-01-01

An apparatus, method and program storage device for determining high-energy neutron/ion transport to a target of interest. Boundaries are defined for calculation of a high-energy neutron/ion transport to a target of interest; the high-energy neutron/ion transport to the target of interest is calculated using numerical procedures selected to reduce local truncation error by including higher order terms and to allow absolute control of propagated error by ensuring truncation error is third order in step size, and using scaling procedures for flux coupling terms modified to improve computed results by adding a scaling factor to terms describing production of j-particles from collisions of k-particles; and the calculated high-energy neutron/ion transport is provided to modeling modules to control an effective radiation dose at the target of interest.

2007 Precision Strike Annual Programs Review

DTIC Science & Technology

2007-04-25

Adapting our methods • Remaining a flexible combined-arms force • Enabling a generation of combat- experienced decision-makers by distributing...Sustain Propulsion Network RadioMEMS IMU Flexible Engagement Options Requirements Capabilities Precision Attack Missile (PAM) 67” (with Canister...Aimpoint 6 PAM Seeker Modes PAM’s Multiple Targeting Modes Increase Flexibility , Improve Lethality PAM’s Multiple Targeting Modes Increase Flexibility

Five Years Later: A Look at the EIA Investment.

ERIC Educational Resources Information Center

South Carolina State Dept. of Education, Columbia. Div. of Public Accountability.

A 5-year review of the impact of South Carolina's comprehensive reform legislation, the Education Improvement Act of 1984 (EIA), is presented. Throughout the report, comparisons of EIA program productivity in 1989 with pre-EIA performance are displayed in short program summaries, 33 graphs, and 14 tables. The EIA targeted seven major areas for…

Spillover Effects of Voluntary Environmental Programs on Greenhouse Gas Emissions: Lessons from Mexico

ERIC Educational Resources Information Center

Henriques, Irene; Husted, Bryan W.; Montiel, Ivan

2013-01-01

We compare the environmental performance of voluntary environmental programs (VEPs) with different attributes. Using club theory, we argue that the differential performance of VEPs is due in part to their specific design attributes that will either enhance or diminish their ability to improve both targeted and untargeted environmental impacts. We…

The Army Budget Amended Fiscal Year 1990-91

DTIC Science & Technology

1989-05-01

Station -PERS: Personnel -PGTS: Precision Gunnery Target System -PHIL: Phillipines -PIP: Product Improvement Program -PL: Public Law -PM TRADE : Program...COMANDS 24.174 24.884 27,092 37,280 FOREIGN CURRECY FLUCTUATION 453,848 73,260 0 0 009 BASE INFORMATION MANAGEMENT 72,028 68.967 78,953 80,323 056 BASE

Democratic School Turnarounds: Pursuing Equity and Learning from Evidence

ERIC Educational Resources Information Center

Trujillo, Tina; Renee, Michelle

2012-01-01

In 2009, the Obama Administration announced its intention to rapidly "turn around" 5,000 of the nation's lowest-performing schools. To do so, it relied on the School Improvement Grant program (SIG) to provide targeted funding for states and schools, and to mandate drastic, school-level reforms. While the program channels grants to…

Strategies for Improving Non-Fiction Reading Comprehension.

ERIC Educational Resources Information Center

Bell, Karen; Caspari, Amy

This report describes a program for introducing students to strategies for improving their comprehension of non-fiction materials. The targeted population consisted of students of one third grade class in a small, middle class suburb, northwest of a large, midwestern city. Difficulty reading and comprehending non-fiction material was documented…

Improving Reading Comprehension by Predicting, Monitoring Comprehension, Remediation, and Personal Response Strategies.

ERIC Educational Resources Information Center

Jacobucci, Leanne; Richert, Judy; Ronan, Susan; Tanis, Ariana

This report describes a program for improving inconsistent reading comprehension. The targeted population consisted of first, third, and fifth grade classrooms in a diverse middle class community located in Illinois. The problems of low academic achievement were documented through teacher observation, reading comprehension test scores, and low…

Improving Recreational Reading Habits of Elementary Students.

ERIC Educational Resources Information Center

Krug, Marline; Fordonski, Patricia

A study investigated the effectiveness of a program for improving the recreational reading habits of elementary students through the use of cross-age tutoring in critical reading strategies. The targeted population consisted of a kindergarten and a fourth-grade class in the growing upper-middle-class community of Geneva, Illinois, located…

Improving Behavior through Multiple Intelligences.

ERIC Educational Resources Information Center

Layng, Diana; And Others

This report describes a program to improve inappropriate behavior of targeted fifth and sixth grade classes in an elementary school in northern Illinois. Seventeen percent of the school population is identified as low-income, although the community is experiencing a rapid increase in residential and commercial growth. Time-off task, incomplete…

Improving Transfer of Learning in a Computer Based Classroom.

ERIC Educational Resources Information Center

Davis, Jay Bee

This report describes a program for improving the transfer of the learning of different techniques used in computer applications. The targeted population consisted of sophomores and juniors in a suburban high school in a middle class community. The problem was documented through teacher surveys, student surveys, anecdotal records and behavioral…

Assessment, Improvement, and Cooperation: The Challenge of Reform in Higher Education.

ERIC Educational Resources Information Center

Fincher, Cameron

This monograph contains a collection of six national commission reports that address the nation's need to improve undergraduate education. The reports present findings and recommendations that target policy (public and institutional), programs (college and university), and constructive changes in institutions of higher education, as well as their…

Improving Vocabulary Development Through Balanced Literacy.

ERIC Educational Resources Information Center

Mlakar-Hillig, Mary Ellen; Malvin, Pam; Troy, Leonora

This report describes a program for improving vocabulary development thorough balanced literacy. The targeted population consisted of three elementary classrooms in a community located in a southern suburb of Chicago. A lack of vocabulary knowledge that interfered with student academic success was documented in state and standardized test results,…

Improving Age Appropriate Social Skills To Enhance Interpersonal Relationships.

ERIC Educational Resources Information Center

DuBois, Connie; Endsley, Ammie; West, Dianna

This paper describes a program designed to increase students' social skill development in order to improve positive peer interactions. The target population was elementary school students in one middle-to-upper class, rural community in central Illinois. Evidence for the existence of the problem of inappropriate social behaviors that interfere…

The State and Sustainability of Telepsychiatry Programs.

PubMed

Lauckner, Carolyn; Whitten, Pamela

2016-04-01

Telepsychiatry, or the provision of psychiatric care across a distance using communication technologies, has become widespread and has been used successfully for treating a variety of mental illnesses. Little is known, however, about the sustainability of telepsychiatry programs and their long-term success. The goal of this study was to determine current trends in telepsychiatry by completing an extensive literature review and to follow-up with the authors of telepsychiatry research to examine the current status of their programs and success factors or barriers associated with their experiences. Results indicated that modern telepsychiatry programs often target veteran/military or child populations and that many rely on either federal or internal funding. Interestingly, several researchers indicated that they wished to improve current funding mechanisms, while others wished for improvements in the technology used. Implications of these findings for behavioral health researchers are discussed, along with suggestions for improving future telepsychiatry programs.

City of San Antonio, Texas Better Buildings Program

DOE Office of Scientific and Technical Information (OSTI.GOV)

Meyer, Liza C.; Hammer, Mary C.

2014-06-30

The San Antonio Better Buildings Program is a unified single-point-of-service energy efficiency delivery mechanism targeting residential, commercial, institutional, industrial and public buildings. This comprehensive and replicable energy efficiency program is designed to be an effective demand side management initiative to provide a seamless process for program participants to have turn-key access to expert analysis, support and incentives to improve the performance of their in-place energy using systems, while reducing electrical energy use and demand.

Improving cardiovascular disease management in Australia: NPS MedicineWise.

PubMed

Gadzhanova, Svetla V; Roughead, Elizabeth E; Bartlett, Mark J

2013-08-05

To determine the impact of four NPS MedicineWise programs targeting quality use of medicines in cardiovascular management in primary care. Interrupted time-series analysis using the Department of Veterans' Affairs (DVA) claims dataset from 1 January 2002 to 31 August 2010. We examined the use of antithrombotics in people with atrial fibrillation and in those who had had a stroke, and the use of echocardiography and spironolactone in the population with heart failure. All veterans and their dependants in Australia who had received cardiovascular medicines or health services related to the targeted intervention. NPS MedicineWise national programs to improve cardiovascular management in primary care, which included prescriber feedback, academic detailing, case studies and audits as well as printed educational materials. Changes in medication and health service use before and after the interventions. All national programs were positively associated with significant improvements in related prescribing or test request practice. The interventions to improve the use of antithrombotics resulted in a 1.27% (95% CI, 1.26%-1.28%) and 0.63% (95% CI, 0.62%-0.64%) relative increase in the use of aspirin or warfarin in the population with atrial fibrillation 6 and 12 months after the program, respectively, and in a 1.51% (95% CI, 1.49%-1.53%) relative increase in the use of aspirin as monotherapy for secondary stroke prevention 12 months after the intervention. The heart failure programs resulted in a 3.69% (95% CI, 3.67%-3.71%) relative increase in the use of low-dose spironolactone and a 4.31% (95% CI, 4.27%-4.35%) relative increase in the use of echocardiogram tests 12 months after the intervention. NPS MedicineWise programs were effective in achieving positive changes in medicine and health service use for patients with cardiovascular diseases.

Assessment of the Air Quality Improvement Potentials for Seoul Metropolitan Area using GAINS-Korea

NASA Astrophysics Data System (ADS)

Kim, Y.; Woo, J. H.; Ahn, Y. H.; Kim, J.; Bu, C.; Lee, Y.; Choi, K. C.; Amann, M.; Kim, S. K.

2016-12-01

Urban areas are very important places for climate change and air pollution because they have been emitting a significant amount of Green House Gases (GHGs) and air pollutants. Cause they have massive pollutant emissions and high population density with amount of vehicles. Korea's government has set the 2nd phase capital air quality improvement program called Seoul metropolitan area Air Quality Management Plan(SAQMP), targeting the year 2024. The air quality improvement targets are to achieve annual mean PM10 and pm2.5concentration for SMA Area 30 ug/m3 and 20 ug/m3, respectively. To achieve this target, emissions of PM10, PM2.5 are required to be decreased up to 35%, 45%, respectively, from their future baseline level. In this study, we found the emission level of some pollutants for the year 2030 will be decreased compare with the baseline level but the concentration cannot meet their target even with more stringent control measures. The more in-depth analysis of future PM concentration, estimated from Source-Receptor(S-R) relationship, were conducted for more accurate air quality improvement assessment. As the result, we found that secondary and transboundary pollution have been plying significant role in Seoul Metro air quality. Not only direct/in-region measures, therefore, but indirect measures/international cooperation have to be conducted to achieve target air quality. ** This subject is supported by Korea Ministry of Environment as "Climate Change Correspondence Program". This work was supported by a grant from the National Institute of Environment Research (NIER), funded by the Ministry of Environment (MOE) of the Republic of Korea.

Learning what matters for patients: qualitative evaluation of a health promotion program for those with serious mental illness

PubMed Central

Shiner, Brian; Whitley, Rob; Van Citters, Aricca D.; Pratt, Sarah I.; Bartels, Stephen J.

2008-01-01

Sedentary lifestyle, poor dietary behaviors and metabolic alterations associated with psychiatric medications contribute to poor health and high rates of obesity among individuals with serious mental illness (SMI). Interventions that increase engagement in physical exercise, dietary modifications, lifestyle changes and preventive health care can provide health benefits across the lifespan. These interventions have led to substantial physical improvements in some persons with SMI, while others have not improved or have experienced worsening physical health. We set out to identify characteristics of a health promotion program that persons with SMI associated with physical health improvements. Interviews were conducted with eight participants from the In SHAPE health-promotion program who lost at least 10 pounds or diminished their waist circumference by at least 10 cm. Interviews aimed to determine which aspects of the program were perceived to be most helpful in promoting physical health improvement. Among successful participants, three themes emerged, highlighting the importance of: (i) individualized interventions promoting engagement in the program; (ii) relationships with health-promotion program employees and (iii) self-confidence resulting from program participation. Health-promotion programs that target these areas may have better success in achieving health benefits for persons with SMI. PMID:18552363

Feasibility Study On Missile Launch Detection And Trajectory Tracking

DTIC Science & Technology

2016-09-01

Vehicles ( UAVs ) in military operations, their role in a missile defense operation is not well defined. The simulation program discussed in this thesis ...targeting information to an attacking UAV to reliably intercept the missile. B . FURTHER STUDIES The simulation program can be enhanced to improve the...intercept the threat. This thesis explores the challenges in creating a simulation program to process video footage from an unstable platform and the

Measuring participant rurality in Web-based interventions.

PubMed

Danaher, Brian G; Hart, L Gary; McKay, H Garth; Severson, Herbert H

2007-08-31

Web-based health behavior change programs can reach large groups of disparate participants and thus they provide promise of becoming important public health tools. Data on participant rurality can complement other demographic measures to deepen our understanding of the success of these programs. Specifically, analysis of participant rurality can inform recruitment and social marketing efforts, and facilitate the targeting and tailoring of program content. Rurality analysis can also help evaluate the effectiveness of interventions across population groupings. We describe how the RUCAs (Rural-Urban Commuting Area Codes) methodology can be used to examine results from two Randomized Controlled Trials of Web-based tobacco cessation programs: the ChewFree.com project for smokeless tobacco cessation and the Smokers' Health Improvement Program (SHIP) project for smoking cessation. Using RUCAs methodology helped to highlight the extent to which both Web-based interventions reached a substantial percentage of rural participants. The ChewFree program was found to have more rural participation which is consistent with the greater prevalence of smokeless tobacco use in rural settings as well as ChewFree's multifaceted recruitment program that specifically targeted rural settings. Researchers of Web-based health behavior change programs targeted to the US should routinely include RUCAs as a part of analyzing participant demographics. Researchers in other countries should examine rurality indices germane to their country.

Effectiveness of a web-based education program to improve vaccine storage conditions in primary care (Keep Cool): study protocol for a randomized controlled trial.

PubMed

Thielmann, Anika; Viehmann, Anja; Weltermann, Birgitta M

2015-07-14

Immunization programs are among the most effective public health strategies worldwide. Adequate vaccine storage is a prerequisite to assure the vaccines' effectiveness and safety. In a questionnaire survey among a random sample of German primary care physicians, we discovered vaccine storage deficits: 16% of physicians had experience with cold chain breaches either as an error or near error, 49 % did not keep a temperature log, and 21 % did not use a separate refrigerator for vaccine storage. In a recent feasibility study of 21 practice refrigerators, we showed that these were outside the target range 10.2% of the total time with some single refrigerators being outside the target range as much as 66.3% of the time. These cooling-chain deficits are consistent with the international medical literature, yet an effective, easy to disseminate, practice-centered intervention to improve storage conditions is lacking. This randomized intervention trial will be conducted in a random sample of primary care practices. Based on continuous temperature recordings over 7 days, all practices with readings outside the target range for vaccine storage (+2 °C to +8 °C) will be randomly allocated to a web-based education program or a waiting list control group. The practice physicians and their teams constitute the target population. Participants will be educated about best practices in vaccine storage and will receive a manual including storage checklists and templates for temperature documentation. In all practices, temperatures of the vaccine refrigerators will be monitored continuously using a data logger with a glycol probe as a surrogate for vaccine vial temperature. The effectiveness of the web-based education program will be determined after 6 months in terms of the proportion of refrigerators with vaccine vial temperatures within the target range (+2 °C to +8 °C) during 7-day temperature logging. Secondary outcome parameters include temperature monitoring, no critically low temperatures (≤ -0.5 °C), compliance with storage recommendations, knowledge of good vaccine storage conditions, and assignment of personnel as vaccine storage manager and backup. Keep Cool will develop and evaluate a web-based education program to improve vaccine storage conditions in primary care and thereby ensure immunization safety and effectiveness. DRKS00006561 (date of registration: 20 February 2015).

Can Early Intervention Improve Maternal Well-Being? Evidence from a Randomized Controlled Trial

PubMed Central

Doyle, Orla; Delaney, Liam; O’Farrelly, Christine; Fitzpatrick, Nick; Daly, Michael

2017-01-01

Objective This study estimates the effect of a targeted early childhood intervention program on global and experienced measures of maternal well-being utilizing a randomized controlled trial design. The primary aim of the intervention is to improve children’s school readiness skills by working directly with parents to improve their knowledge of child development and parenting behavior. One potential externality of the program is well-being benefits for parents given its direct focus on improving parental coping, self-efficacy, and problem solving skills, as well as generating an indirect effect on parental well-being by targeting child developmental problems. Methods Participants from a socio-economically disadvantaged community are randomly assigned during pregnancy to an intensive 5-year home visiting parenting program or a control group. We estimate and compare treatment effects on multiple measures of global and experienced well-being using permutation testing to account for small sample size and a stepdown procedure to account for multiple testing. Results The intervention has no impact on global well-being as measured by life satisfaction and parenting stress or experienced negative affect using episodic reports derived from the Day Reconstruction Method (DRM). Treatment effects are observed on measures of experienced positive affect derived from the DRM and a measure of mood yesterday. Conclusion The limited treatment effects suggest that early intervention programs may produce some improvements in experienced positive well-being, but no effects on negative aspects of well-being. Different findings across measures may result as experienced measures of well-being avoid the cognitive biases that impinge upon global assessments. PMID:28095505

A Leadership Intervention to Further the Training of Female Faculty (LIFT-OFF) in Radiology.

PubMed

Spalluto, Lucy B; Spottswood, Stephanie E; Deitte, Lori A; Chern, Alexander; Dewey, Charlene M

2017-06-01

Women are under-represented in the field of radiology, occupy a minority of leadership positions, and, at our institution, have not achieved the same level of academic success as their male counterparts. Consequently, the authors designed, implemented, and evaluated the Leadership Intervention to Further the Training of Female Faculty (LIFT-OFF) program to (1) improve access to opportunities for women's faculty development and advancement, and (2) improve clarification of expectations about the role and path of advancement. LIFT-OFF was developed based on the results of a needs assessment survey. The results generated 14 priority topics, which served as the basis for educational modules conducted by expert speakers. Module effectiveness was assessed with pre- and postsurveys to elicit participant knowledge about the targeted subject matter. A formative program evaluation was performed at the completion of year 1 of 2 to assess outcomes and impacts to date. Seventeen of 55 (31%) educational module post-survey questions demonstrated a statistically significant (P < 0.05) increase in "yes" responses, indicating an improved understanding of targeted information. At year 1, 75% of the participants indicated that the program improved access to faculty development opportunities and 62% reported improved access to career advancement opportunities. Satisfaction with pace of professional advancement increased from 25% to 46% for junior women faculty (P = 0.046). Faculty development programs such as LIFT-OFF can provide career development opportunities and executive skills necessary for women to achieve academic career success and assume leadership positions. Copyright © 2017 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

The Status of Science Education in Illinois Scientific Literacy Target Schools, K-6, 1994. A Study.

ERIC Educational Resources Information Center

Finson, Kevin D.; Beaver, John B.

The Illinois State Board of Education's Scientific Literacy Project provided extra funds to certain schools with the intent of creating demonstration schools useful as models for other schools to improve their science education programs. The study described in this document examined the impact of these funds on the target schools and attempted to…

Improvement of Hungarian Joint Terminal Attack Program

DTIC Science & Technology

2013-06-13

LST Laser Spot Tracker NVG Night Vision Goggle ROMAD Radio Operator Maintainer and Driver ROVER Remotely Operated Video Enhanced Receiver TACP...visual target designation. The other component consists of a laser spot tracker (LST), which identifies targets by tracking laser energy reflecting...capability for every type of night time missions, laser spot tracker for laser spot search missions, remotely operated video enhanced receiver

Adoption and Design of Emerging Dietary Policies to Improve Cardiometabolic Health in the US.

PubMed

Huang, Yue; Pomeranz, Jennifer; Wilde, Parke; Capewell, Simon; Gaziano, Tom; O'Flaherty, Martin; Kersh, Rogan; Whitsel, Laurie; Mozaffarian, Dariush; Micha, Renata

2018-04-14

Suboptimal diet is a leading cause of cardiometabolic disease and economic burdens. Evidence-based dietary policies within 5 domains-food prices, reformulation, marketing, labeling, and government food assistance programs-appear promising at improving cardiometabolic health. Yet, the extent of new dietary policy adoption in the US and key elements crucial to define in designing such policies are not well established. We created an inventory of recent US dietary policy cases aiming to improve cardiometabolic health and assessed the extent of their proposal and adoption at federal, state, local, and tribal levels; and categorized and characterized the key elements in their policy design. Recent federal dietary policies adopted to improve cardiometabolic health include reformulation (trans-fat elimination), marketing (mass-media campaigns to increase fruits and vegetables), labeling (Nutrition Facts Panel updates, menu calorie labeling), and food assistance programs (financial incentives for fruits and vegetables in the Supplemental Nutrition Assistance Program (SNAP) and Women, Infant and Children (WIC) program). Federal voluntary guidelines have been proposed for sodium reformulation and food marketing to children. Recent state proposals included sugar-sweetened beverage (SSB) taxes, marketing restrictions, and SNAP restrictions, but few were enacted. Local efforts varied significantly, with certain localities consistently leading in the proposal or adoption of relevant policies. Across all jurisdictions, most commonly selected dietary targets included fruits and vegetables, SSBs, trans-fat, added sugar, sodium, and calories; other healthy (e.g., nuts) or unhealthy (e.g., processed meats) factors were largely not addressed. Key policy elements to define in designing these policies included those common across domains (e.g., level of government, target population, dietary target, dietary definition, implementation mechanism), and domain-specific (e.g., media channels for food marketing domain) or policy-specific (e.g., earmarking for taxes) elements. Characteristics of certain elements were similarly defined (e.g., fruit and vegetable definition, warning language used in SSB warning labels), while others varied across cases within a policy (e.g., tax base for SSB taxes). Several key elements were not always sufficiently characterized in government documents, and dietary target selections and definitions did not consistently align with the evidence-base. These findings highlight recent action on dietary policies to improve cardiometabolic health in the US; and key elements necessary to design such policies.

An Iceberg Model for Improving Mathematical Understanding and Mindset or Disposition: An Individualized Summer Intervention Program

ERIC Educational Resources Information Center

Westensko, Arla; Moyer-Packenham, Patricia S.; Child, Barbara

2017-01-01

This study describes 3 years of mathematics intervention research examining the effectiveness of a summer individualized tutoring program for rising fourth-, fifth-, and sixth-grade students with low mathematics achievement. Based on an iceberg model of learning, an instructional framework was developed that identified and targeted students'…

Jobs for Florida's Graduates Program Becomes Independent and Its Performance Improves. OPPAGA Status Report.

ERIC Educational Resources Information Center

Allen, Pam; Pardue, Don

The Jobs for Florida's Graduates (JFG) program targets high school students and provides services to help these students graduate and to continue their education or find meaningful employment within one year of graduation. School managers and "job specialists" serve as mentors, identify at-risk high school students, and provide them with…

Challenging States to Improve Quality: A New Federal Proposal

ERIC Educational Resources Information Center

Karolak, Eric

2009-01-01

Everyone knows that "quality" shouldn't be something extra in a child care program. The Obama Administration and leaders in Congress have worked together and this summer proposed an all-new effort to help states prioritize investing in the quality of early childhood learning across all program settings and targeted to the most at-risk children. In…

Improving Student Writing through a Language Rich Environment.

ERIC Educational Resources Information Center

Corona, Cathy; Spangenberger, Sandra; Venet, Iris

A program developed interventions for improving student writing in the areas of technique and creativity. The targeted population consisted of students in the first through fourth grades in three different school sites, all being similar upper-middle class communities, located in the suburbs of a mid-western city. The problems that some students…

Improving Reading Comprehension through Application and Transfer of Reading Strategies

ERIC Educational Resources Information Center

Pesa, Nicole; Somers, Sarah

2007-01-01

This study describes a program designed to improve reading comprehension through the selection, application, and transfer of appropriate reading strategies with both fictional and informational texts. The targeted population consisted of seventh and eighth grade middle school students in a middle-class community in the western suburbs of Chicago,…

Improving Mastery of Basic Mathematics Facts in Elementary School through Various Learning Strategies.

ERIC Educational Resources Information Center

Haught, Laurie; Kunce, Christine; Pratt, Phyllis; Werneske, Roberta; Zemel, Susan

This report describes the intervention programs used to improve student proficiency in learning, recalling, and retaining basic mathematics facts. The targeted population consisted of first, second, third, and fifth grades in four suburban midwestern schools. The problems of recalling basic mathematics facts is documented through teacher surveys,…

Improving Students' Reading Fluency through the Use of Phonics and Word Recognition Strategies.

ERIC Educational Resources Information Center

Ballard, Christine; Jacocks, Kathleen

This study describes a program designed to improve student reading fluency. The targeted population consisted of first and third grade students in a growing urban community in the Midwest. Evidence for the existence of the problem included standardized test scores and independent computer reports that measured academic achievement, phonic…

Improving Spelling of High Frequency Words for Transfer in Written Work

ERIC Educational Resources Information Center

DuBois, Kathleen; Erickson, Kristie; Jacobs, Monica

2007-01-01

This project describes a 12-week program developed to improve student spelling of high frequency words for transfer in written work across the curriculum. The targeted population consists of kindergarten, first, and third graders in two public elementary schools in a community located in central Illinois. Following an extensive literature review,…

Effects of Direct Teaching Using Creative Memorization Strategies To Improve Math Achievement.

ERIC Educational Resources Information Center

Bielsker, Staci; Napoli, Lori; Sandino, Melissa; Waishwell, Lesa

This report describes a program for enhancing direct teaching using creative memorization strategies in order to improve retention and quick retrieval of math facts. The targeted population consisted of first and second grade students in two separate districts in middle class communities. Analysis of probable cause data revealed that students were…

Improving Elementary Students' Spelling Achievement Using High-Frequency Words.

ERIC Educational Resources Information Center

Durnil, Christina; And Others

An action research study detailed a program for improving spelling achievement across the curriculum. The targeted population is composed of second and third grade students from a growing, middle class community located in a suburb of Chicago, Illinois. The problem of misspelled words in the students' writing was documented through students'…

A Culturally Responsive Alternative to "Drill and Kill" Literacy Strategies: Deep Roots, Civil Rights

ERIC Educational Resources Information Center

Peterson, Deborah S.

2014-01-01

This article describes two approaches to improving literacy in a high poverty, diverse urban high school. One curriculum program, "Striving Readers," included a prescribed course of study for students reading below grade level along with schoolwide strategies. This approach did not improve targeted students' reading scores or motivation…

Building Background Knowledge To Improve Reading Comprehension through Use of Technology.

ERIC Educational Resources Information Center

Ferguson, Iyla

This study describes a program designed to increase student background knowledge in order to improve reading comprehension. The targeted first grade class is located in a Midwest, middle class, metropolitan community. More than half of the school's population is identified as low-income. Evidence for the existence of the problem was obtained…

Improved facial affect recognition in schizophrenia following an emotion intervention, but not training attention-to-facial-features or treatment-as-usual.

PubMed

Tsotsi, Stella; Kosmidis, Mary H; Bozikas, Vasilis P

2017-08-01

In schizophrenia, impaired facial affect recognition (FAR) has been associated with patients' overall social functioning. Interventions targeting attention or FAR per se have invariably yielded improved FAR performance in these patients. Here, we compared the effects of two interventions, one targeting FAR and one targeting attention-to-facial-features, with treatment-as-usual on patients' FAR performance. Thirty-nine outpatients with schizophrenia were randomly assigned to one of three groups: FAR intervention (training to recognize emotional information, conveyed by changes in facial features), attention-to-facial-features intervention (training to detect changes in facial features), and treatment-as-usual. Also, 24 healthy controls, matched for age and education, were assigned to one of the two interventions. Two FAR measurements, baseline and post-intervention, were conducted using an original experimental procedure with alternative sets of stimuli. We found improved FAR performance following the intervention targeting FAR in comparison to the other patient groups, which in fact was comparable to the pre-intervention performance of healthy controls in the corresponding intervention group. This improvement was more pronounced in recognizing fear. Our findings suggest that compared to interventions targeting attention, and treatment-as-usual, training programs targeting FAR can be more effective in improving FAR in patients with schizophrenia, particularly assisting them in perceiving threat-related information more accurately. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

Integrating RNA sequencing into neuro-oncology practice.

PubMed

Rogawski, David S; Vitanza, Nicholas A; Gauthier, Angela C; Ramaswamy, Vijay; Koschmann, Carl

2017-11-01

Malignant tumors of the central nervous system (CNS) cause substantial morbidity and mortality, yet efforts to optimize chemo- and radiotherapy have largely failed to improve dismal prognoses. Over the past decade, RNA sequencing (RNA-seq) has emerged as a powerful tool to comprehensively characterize the transcriptome of CNS tumor cells in one high-throughput step, leading to improved understanding of CNS tumor biology and suggesting new routes for targeted therapies. RNA-seq has been instrumental in improving the diagnostic classification of brain tumors, characterizing oncogenic fusion genes, and shedding light on intratumor heterogeneity. Currently, RNA-seq is beginning to be incorporated into regular neuro-oncology practice in the form of precision neuro-oncology programs, which use information from tumor sequencing to guide implementation of personalized targeted therapies. These programs show great promise in improving patient outcomes for tumors where single agent trials have been ineffective. As RNA-seq is a relatively new technique, many further applications yielding new advances in CNS tumor research and management are expected in the coming years. Copyright © 2017 Elsevier Inc. All rights reserved.

Activity-specific aquatic therapy targeting gait for a patient with incomplete spinal cord injury.

PubMed

Wall, Tracy; Falvo, Lisa; Kesten, Adam

2017-04-01

Aquatic therapy can lead to improved mobility and health in individuals with various conditions. This case report looks at an activity-specific aquatic therapy targeting gait for a patient with incomplete spinal cord injury (iSCI). The patient participated in an individualized aquatic therapy program two times a week for 6 weeks. Assessment occurred prior to the intervention. There were two follow-up assessments after the intervention. Follow-up assessment 1 was completed within the same week as the final intervention. Follow-up assessment 2 was completed 4 weeks after the first follow-up to assess for carryover. Improvements that met minimal detectable change and minimal clinically important difference were noted in The Walking for Spinal Cord Injury Index-II, Spinal Cord Injury Functional Ambulation Index gait parameters, and gait speed. An activity-specific aquatic therapy program improved gait in a patient with iSCI. The properties of water create a practical environment for safe practice of skills. Further studies are warranted in large samples.

Quality indicators for family support services and their relationship to organizational social context.

PubMed

Olin, S Serene; Williams, Nate; Pollock, Michele; Armusewicz, Kelsey; Kutash, Krista; Glisson, Charles; Hoagwood, Kimberly E

2014-01-01

Quality measurement is an important component of healthcare reform. The relationship of quality indicators (QIs) for parent-delivered family support services to organizational social contexts known to improve quality is unexamined. This study employs data collected from 21 child mental health programs that deliver team-based family support services. Performance on two levels of QIs-those targeting the program and staff-were significantly associated with organizational social context profiles and dimensions. High quality program policies are associated with positive organizational cultures and engaging climates. Inappropriate staff practices are associated with resistant cultures. Implications for organizational strategies to improve service quality are discussed.

Quality Indicators for Family Support Services and Their Relationship to Organizational Social Context

PubMed Central

Olin, S. Serene; Williams, Nate; Pollock, Michele; Armusewicz, Kelsey; Kutash, Krista; Glisson, Charles; Hoagwood, Kimberly E.

2013-01-01

Quality measurement is an important component of healthcare reform. The relationship of quality indicators (QIs) for parent-delivered family support services to organizational social contexts known to improve quality is unexamined. This study employs data collected from 21 child mental health programs that deliver team-based family support services. Performance on two levels of QIs —those targeting the program and staff -- were significantly associated with organizational social context profiles and dimensions. High quality program policies are associated with positive organizational cultures and engaging climates. Inappropriate staff practices are associated with resistant cultures. Implications for organizational strategies to improve service quality are discussed. PMID:23709286

Difficult relationships--interactions between family members and staff in long-term care.

PubMed

Norris, S

2000-01-01

Staff of long-term care facilities and family members have a common responsibility to ensure the best course of treatment and everyday care for residents who often cannot speak for themselves. Understanding the difference between instrumental and preservative care, and who the proper agent is to provide care in each category will not only improve staff/family interactions, but residential care in general. The Resident Enrichment and Activity Program improves the family/staff relationship obliquely by involving family in social activities; the Family Involvement in Care program, and the Patterns in Caregiving program directly target the relationship and involve the facility's administration to effect policy change.

Evaluation of Pillars4life: a virtual coping skills program for cancer survivors.

PubMed

Smith, Sophia K; O'Donnell, Jonathan D; Abernethy, Amy P; MacDermott, Kristin; Staley, Tina; Samsa, Gregory P

2015-11-01

Pillars4Life is an educational program that teaches coping skills to cancer patients in a virtual group setting; it was recently implemented at 17 hospitals across the USA. The cost-effective, scalable, and assessable Pillars4Life curriculum targets psychosocial resources (e.g., self-efficacy and coping skills) as a means to reduce symptoms (e.g., depression, anxiety, and posttraumatic stress) and enhance quality of life. Cancer patients were recruited from hospitals that received the LIVESTRONG Community Impact Project Award to enroll in a pilot study of Pillars4Life. Consenting participants met with a certified instructor weekly for 10 weeks in a virtual environment; the manualized intervention trained participants in personal coping skills. Longitudinal assessments over 6 months were assessed using validated instruments to determine changes in Pillars4Life targeted resources and outcomes. Multiple linear regression models examined the relationship between changes in targeted resources and changes in outcome from baseline to 3 months post-intervention. Participants (n = 130) had the following characteristics: mean age of 56 ± 11 years, 87% women, 11% non-Caucasian, and 77% with college degree. At 3- and 6-month follow-up, mean scores improved on all key outcome measures such as depression (Patient Health Questionnaire), anxiety (Generalized Anxiety Disorder), posttraumatic stress (Posttraumatic Stress Disorder Checklist), fatigue (Functional Assessment of Chronic Illness Therapy-Fatigue), and well-being (Functional Assessment of Cancer Therapy-General) from baseline (all p < 0.01); results were most pronounced among participants who reported ≥4/10 on the Distress Thermometer at baseline (all p < 0.001). Changes in each targeted resource were associated with 3-month improvements in at least one outcome. Participation in the Pillars4Life program was associated with statistically and clinically significant improvements in scores on pre-specified outcomes and targeted resources. Copyright © 2015 John Wiley & Sons, Ltd.

Using cost and health impacts to prioritize the targeted testing of tuberculosis in the United States.

PubMed

Miller, Thaddeus L; Hilsenrath, Peter; Lykens, Kristine; McNabb, Scott J N; Moonan, Patrick K; Weis, Stephen E

2006-04-01

Evaluation improves efficiency and effectiveness. Current U.S. tuberculosis (TB) control policies emphasize the treatment of latent TB infection (LTBI). However, this policy, if not targeted, may be inefficient. We determined the efficiency of a state-law mandated TB screening program and a non state-law mandated one in terms of cost, morbidity, treatment, and disease averted. We evaluated two publicly funded metropolitan TB prevention and control programs through retrospective analyses and modeling. Main outcomes measured were TB incidence and prevalence, TB cases averted, and cost. A non state-law mandated TB program for homeless persons in Tarrant County screened 4.5 persons to identify one with LTBI and 82 persons to identify one with TB. A state-law mandated TB program for jail inmates screened 109 persons to identify one with LTBI and 3274 persons to identify one with TB. The number of patients with LTBI treated to prevent one TB case was 12.1 and 15.3 for the homeless and jail inmate TB programs, respectively. Treatment of LTBI by the homeless and jail inmate TB screening programs will avert 11.9 and 7.9 TB cases at a cost of 14,350 US dollars and 34,761 US dollars per TB case, respectively. Mandated TB screening programs should be risk-based, not population-based. Non mandated targeted testing for TB in congregate settings for the homeless was more efficient than state-law mandated targeted testing for TB among jailed inmates.

Targeting Parenting in Early Childhood: A Public Health Approach to Improve Outcomes for Children Living in Poverty.

PubMed

Morris, Amanda Sheffield; Robinson, Lara R; Hays-Grudo, Jennifer; Claussen, Angelika H; Hartwig, Sophie A; Treat, Amy E

2017-03-01

In this article, the authors posit that programs promoting nurturing parent-child relationships influence outcomes of parents and young children living in poverty through two primary mechanisms: (a) strengthening parents' social support and (b) increasing positive parent-child interactions. The authors discuss evidence for these mechanisms as catalysts for change and provide examples from selected parenting programs that support the influence of nurturing relationships on child and parenting outcomes. The article focuses on prevention programs targeted at children and families living in poverty and closes with a discussion of the potential for widespread implementation and scalability for public health impact. © 2017 The Authors. Child Development © 2017 Society for Research in Child Development, Inc.

Knowledge of Cervical Cancer Screening among Women across Different Socio-Economic Regions of China.

PubMed

Di, Jiangli; Rutherford, Shannon; Wu, Jiuling; Song, Bo; Ma, Lan; Chen, Jingyi; Chu, Cordia

2015-01-01

China has a high burden of cervical cancer (CC) and wide disparities in CC burden exist among different socio-economic regions. In order to reduce these disparities, China's government launched the National Cervical Cancer Screening Program in Rural Areas (NCCSPRA) in 2009. Understanding the factors associated with underutilization of CC screening among target populations is important to improve the screening participation rate, and a high participation rate is key to achieving the goals of a screening program. However, data on the knowledge of CC among target populations in program areas is lacking in China. This study will investigate the knowledge of CC prevention and control among women in specific project counties to develop a better understanding of factors that might influence CC screening participation in order to improve the implementation of the NCCSPRA. A cross-sectional survey was conducted and face-to-face interview questionnaires were completed by 308 women who received CC screening services in 6 project counties of NCCSPRA across different socio-economic regions of China. ANOVA and Chi-square tests were used to compare the knowledge rates and scores across the different subgroups. Logistic regression was conducted to examine factors associated with knowledge level. The overall CC knowledge rate of the target population was only 19.5%. Regional socio-economic level, advice from doctors, age, and educational status were strong predictors of knowledge level of CC screening. Significantly lower knowledge rates and scores were identified in older women (55-64 years old), less educated women (with primary school or illiterate), women in less developed regions and women who did not receive any advice about screening results from doctors. The knowledge of CC screening among women in the project counties of NCCSPRA was found to be very poor. Given the importance of knowledge in encouraging women to participate in screening is key to reducing CC burden in rural women in China, it is urgent that a targeted health promotion intervention is developed and implemented in project counties, especially targeting older women, women with less education and women in less developed regions, and focus on improving their CC knowledge and encouraging them to communicate with health care providers. The health promotion intervention targeting health care providers is also important to improve their knowledge of CC and provide best advice to women.

Making cognitive decision support work: Facilitating adoption, knowledge and behavior change through QI.

PubMed

Weir, Charlene; Brunker, Cherie; Butler, Jorie; Supiano, Mark A

2017-07-01

This paper evaluates the role of facilitation in the successful implementation of Computerized Decision Support (CDS). Facilitation processes include education, specialized computerized decision support, and work process reengineering. These techniques, as well as modeling and feedback enhance self-efficacy, which we propose is one of the factors that mediate the effectiveness of any CDS. In this study, outpatient clinics implemented quality improvement (QI) projects focused on improving geriatric care. Quality Improvement is the systematic process of improving quality through continuous measurement and targeted actions. The program, entitled "Advancing Geriatric Education through Quality Improvement" (AGE QI), consisted of a 6-month, QI based, intervention: (1) 2h didactic session, (2) 1h QI planning session, (3) computerized decision support design and implementation, (4) QI facilitation activities, (5) outcome feedback, and (6) 20h of CME. Specifically, we examined the impact of the QI based program on clinician's perceived self-efficacy in caring for older adults and the relationship of implementation support and facilitation on perceived success. The intervention was implemented at 3 institutions, 27 community healthcare system clinics, and 134 providers. This study reports the results of pre/post surveys for the forty-nine clinicians who completed the full CME program. Self-efficacy ratings for specific clinical behaviors related to care of older adults were assessed using a Likert based instrument. Self-ratings of efficacy improved across the following domains (depression, falls, end-of-life, functional status and medication management) and specifically in QI targeted domains and were associated with overall clinic improvements. Published by Elsevier Inc.

Implementation of a Worksite Wellness Program Targeting Small Businesses

PubMed Central

Stinson, Kaylan E.; Metcalf, Dianne; Fang, Hai; Brockbank, Claire vS.; Jinnett, Kimberly; Reynolds, Stephen; Trotter, Margo; Witter, Roxana; Tenney, Liliana; Atherly, Adam; Goetzel, Ron Z.

2015-01-01

Objective: To assess small business adoption and need for a worksite wellness program in a longitudinal study of health risks, productivity, workers' compensation rates, and claims costs. Methods: Health risk assessment data from 6507 employees in 260 companies were examined. Employer and employee data are reported as frequencies, with means and standard deviations reported when applicable. Results: Of the 260 companies enrolled in the health risk management program, 71% continued more than 1 year, with 97% reporting that worker wellness improves worker safety. Of 6507 participating employees, 34.3% were overweight and 25.6% obese. Approximately one in five participants reported depression. Potentially modifiable conditions affecting 15% or more of enrollees include chronic fatigue, sleeping problems, headaches, arthritis, hypercholesterolemia, and hypertension. Conclusions: Small businesses are a suitable target for the introduction of health promotion programs. PMID:25563536

Increasing access to program information: a strategy for improving adolescent health.

PubMed

Brindis, Claire D; Hair, Elizabeth C; Cochran, Stephanie; Cleveland, Kevin; Valderrama, L Teresa; Park, M Jane

2007-01-01

To identify existing programs serving 11- to 15-year-olds that aim to improve adolescent health in the areas of Health & Well-being, Fitness, Family & Peer Relationships, School Environment, Smoking, Alcohol Use, and Violence and to assess the utility of readily available resources in providing detailed program information. In Phase 1, publicly available program databases were searched to identify potential programs serving the target population. In Phase 2, an in-depth search of a limited sample of programs meeting the content and age criteria was performed to identify program descriptors. Over 1,000 program names were identified in Phase 1. Information regarding programs is becoming more readily available through the internet; however, the program information that was publicly available only begins to draw the picture. Phase 2 revealed that a broad array of efforts are underway in all seven content areas, but found information on the program descriptors to be limited. Investment in programming is not enough; an upfront investment in communication and information sharing is critical in order to maximize the resources dedicated to the improvement of adolescent health. A well-publicized centralized program repository offered in conjunction with technical assistance would provide an efficient mechanism for this information sharing. We further suggest that the inherent gap between research and practice can be lessened by building a new body of practice knowledge. This would require improved program data collection by programs, the incorporation of program participation information in national surveys and enhanced evaluation efforts.

Research Review: Harnessing the power of individual participant data in a meta-analysis of the benefits and harms of the Incredible Years parenting program.

PubMed

Leijten, Patty; Gardner, Frances; Landau, Sabine; Harris, Victoria; Mann, Joanna; Hutchings, Judy; Beecham, Jennifer; Bonin, Eva-Maria; Scott, Stephen

2018-02-01

Parenting programs aim to reduce children's conduct problems through improvement of family dynamics. To date, research on the precise benefits and possible harms of parenting programs on family well-being has been unsystematic and likely to be subject to selective outcome reporting and publication bias. Better understanding of program benefits and harms requires full disclosure by researchers of all included measures, and large enough numbers of participants to be able to detect small effects and estimate them precisely. We obtained individual participant data for 14 of 15 randomized controlled trials on the Incredible Years parenting program in Europe (total N = 1,799). We used multilevel modeling to estimate program effects on 13 parent-reported outcomes, including parenting practices, children's mental health, and parental mental health. Parental use of praise, corporal punishment, threats, and shouting improved, while parental use of tangible rewards, monitoring, or laxness did not. Children's conduct problems and attention deficit hyperactivity disorder (ADHD) symptoms improved, while emotional problems did not. Parental mental health (depressive symptoms, self-efficacy, and stress) did not improve. There was no evidence of harmful effects. The Incredible Years parenting program improves the aspects of family well-being that it is primarily designed to improve: parenting and children's conduct problems. It also improves parent-reported ADHD symptoms in children. Wider benefits are limited: the program does not improve children's emotional problems or parental mental health. There are no signs of harm on any of the target outcomes. © 2017 Association for Child and Adolescent Mental Health.

Improving resident engagement in quality improvement and patient safety initiatives at the bedside: the Advocate for Clinical Education (ACE).

PubMed

Schleyer, Anneliese M; Best, Jennifer A; McIntyre, Lisa K; Ehrmantraut, Ross; Calver, Patty; Goss, J Richard

2013-01-01

Quality improvement (QI) and patient safety (PS) are essential competencies in residency training; however, the most effective means to engage physicians remains unclear. The authors surveyed all medicine and surgery physicians at their institution to describe QI/PS practices and concurrently implemented the Advocate for Clinical Education (ACE) program to determine if a physician-centered program in the context of educational structures and at the point of care improved performance. The ACE rounded with medicine and surgery teams and provided individual and team-level education and feedback targeting 4 domains: professionalism, infection control, interpreter use, and pain assessment. In a pilot, the ACE observed 2862 physician-patient interactions and 178 physicians. Self-reported compliance often was greater than the behaviors observed. Following ACE implementation, observed professionalism behaviors trended toward improvement; infection control also improved. Physicians were highly satisfied with the program. The ACE initiative is one coaching/feedback model for engaging residents in QI/PS that may warrant further study.

Integrating modelling and phenotyping approaches to identify and screen complex traits - Illustration for transpiration efficiency in cereals.

PubMed

Chenu, K; van Oosterom, E J; McLean, G; Deifel, K S; Fletcher, A; Geetika, G; Tirfessa, A; Mace, E S; Jordan, D R; Sulman, R; Hammer, G L

2018-02-21

Following advances in genetics, genomics, and phenotyping, trait selection in breeding is limited by our ability to understand interactions within the plants and with their environments, and to target traits of most relevance for the target population of environments. We propose an integrated approach that combines insights from crop modelling, physiology, genetics, and breeding to identify traits valuable for yield gain in the target population of environments, develop relevant high-throughput phenotyping platforms, and identify genetic controls and their values in production environments. This paper uses transpiration efficiency (biomass produced per unit of water used) as an example of a complex trait of interest to illustrate how the approach can guide modelling, phenotyping, and selection in a breeding program. We believe that this approach, by integrating insights from diverse disciplines, can increase the resource use efficiency of breeding programs for improving yield gains in target populations of environments.

Promotion of Home-Based Exercise Training as Secondary Prevention of Coronary Heart Disease: A PILOT WEB-BASED INTERVENTION.

PubMed

Torri, Anna; Panzarino, Claudia; Scaglione, Anna; Modica, Maddalena; Bordoni, Bruno; Redaelli, Raffaella; De Maria, Renata; Ferratini, Maurizio

2018-07-01

Although cardiac rehabilitation (CR) is cost- effective in improving the health of patients with coronary heart disease (CHD), less than half of eligible CHD patients attend a CR program. Innovative web-based technologies might improve CR delivery and utilization. We assessed the feasibility and impact on functional capacity and secondary prevention targets of a long-term web-monitored exercise-based CR maintenance program. Low- to moderate-risk CHD patients were recruited at discharge from inpatient CR after a coronary event or revascularization. We developed an interactive web-based platform for secure home individual access control, monitoring, and validation of exercise training. Of 86 eligible patients, 26 consented to participate in the study intervention (IG). Using a quasi-experimental design, we recruited in parallel 27 eligible patients, unavailable for regular web monitoring, who consented to a follow-up visit as usual care (UC). Among IG, active daily data transmission was 100% during month 1, 88% at month 3, and 81% at 6 months, with sustained improvement in self-reported physical activity beginning with the first week after discharge from inpatient CR (2467 [1854-3554] MET-min/wk) to month 3 (3411 [1981-5347] MET-min/wk, P = .019). Both groups showed favorable changes over time in lipid profile, ventricular function, distance walked in 6 min, and quality of life. At 6 mo, IG achieved a significantly higher proportion of cardiovascular risk factor targets than UC (75 ± 20% vs 59 ± 30%, P = .029). Our web-based home CR maintenance program was feasible, well-accepted, and effective in improving physical activity during 6 mo and achieved higher overall adherence to cardiovascular risk targets than UC.

Energy-efficiency program for clothes washers, clothes dryers, and dishwashers

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

1977-11-01

The objectives of this study of dishwashers, clothes washers, and clothes dryers are: to evaluate existing energy efficiency test procedures and recommend the use of specific test procedures for each appliance group and to establish the maximum economically and technologically feasible energy-efficiency improvement goals for each appliance group. Specifically, the program requirements were to determine the energy efficiency of the 1972 models, to evaluate the feasibility improvements that could be implemented by 1980 to maximize energy efficiency, and to calculate the percentage efficiency improvement based on the 1972 baseline and the recommended 1980 targets. The test program was conducted usingmore » 5 dishwashers, 4 top-loading clothes washers, one front-loading clothes washer, 4 electric clothes dryers, and 4 gas clothes dryers. (MCW)« less

Business Case Analysis: Continuous Integrated Logistics Support-Targeted Allowance Technique (CILS-TAT)

DTIC Science & Technology

2013-06-01

In this research, we examine the Naval Sea Logistics Command s Continuous Integrated Logistics Support Targeted Allowancing Technique (CILS TAT) and... the feasibility of program re-implementation. We conduct an analysis of this allowancing method s effectiveness onboard U.S. Navy Ballistic Missile...Defense (BMD) ships, measure the costs associated with performing a CILS TAT, and provide recommendations concerning possible improvements to the

State and Local Implementation of the No Child Left Behind Act. Volume VI--Targeting and Uses of Federal Education Funds

ERIC Educational Resources Information Center

Chambers, Jay G.; Lam, Irene; Mahitivanichcha, Kanya; Esra, Phil; Shambaugh, Larisa; Stullich, Stephanie

2009-01-01

Achieving the goals of federal education legislation depends on how federal funds are distributed and used. Since the enactment of the Elementary and Secondary Education Act (ESEA) in 1965, various federal programs have been created to support educational improvement and target additional resources to meet the educational needs of children who are…

An Analysis of How Building a Collaborative Community of Professional Social Studies Teachers through Targeted Ambient Professional Development Impacts Social Studies Classroom Practices

ERIC Educational Resources Information Center

Thomas-Brown, Karen; Shaffer, LaShorage; Werner, Sharon

2016-01-01

This study examined the impact of a yearlong ambient professional development (PD) program-The Wayne Schools Global Geography Project (WSGG-project)-that focused on improving teacher quality through PD and classroom observations for in-service social studies teachers. The project targeted middle and high school social studies teachers and used…

Evaluation of the Environmental Scoring System in Multiple Child Asthma Intervention Programs in Boston, Massachusetts.

PubMed

Dong, Zhao; Nath, Anjali; Guo, Jing; Bhaumik, Urmi; Chin, May Y; Dong, Sherry; Marshall, Erica; Murphy, Johnna S; Sandel, Megan T; Sommer, Susan J; Ursprung, W W Sanouri; Woods, Elizabeth R; Reid, Margaret; Adamkiewicz, Gary

2018-01-01

To test the applicability of the Environmental Scoring System, a quick and simple approach for quantitatively measuring environmental triggers collected during home visits, and to evaluate its contribution to improving asthma outcomes among various child asthma programs. We pooled and analyzed data from multiple child asthma programs in the Greater Boston Area, Massachusetts, collected in 2011 to 2016, to examine the association of environmental scores (ES) with measures of asthma outcomes and compare the results across programs. Our analysis showed that demographics were important contributors to variability in asthma outcomes and total ES, and largely explained the differences among programs at baseline. Among all programs in general, we found that asthma outcomes were significantly improved and total ES significantly reduced over visits, with the total Asthma Control Test score negatively associated with total ES. Our study demonstrated that the Environmental Scoring System is a useful tool for measuring home asthma triggers and can be applied regardless of program and survey designs, and that demographics of the target population may influence the improvement in asthma outcomes.

Improving health-related fitness in children: the Fit-4-Fun randomized controlled trial study protocol.

PubMed

Eather, Narelle; Morgan, Philip J; Lubans, David R

2011-12-05

Declining levels of physical fitness in children are linked to an increased risk of developing poor physical and mental health. Physical activity programs for children that involve regular high intensity physical activity, along with muscle and bone strengthening activities, have been identified by the World Health Organisation as a key strategy to reduce the escalating burden of ill health caused by non-communicable diseases. This paper reports the rationale and methods for a school-based intervention designed to improve physical fitness and physical activity levels of Grades 5 and 6 primary school children. Fit-4-Fun is an 8-week multi-component school-based health-related fitness education intervention and will be evaluated using a group randomized controlled trial. Primary schools from the Hunter Region in NSW, Australia, will be invited to participate in the program in 2011 with a target sample size of 128 primary schools children (age 10-13). The Fit-4-Fun program is theoretically grounded and will be implemented applying the Health Promoting Schools framework. Students will participate in weekly curriculum-based health and physical education lessons, daily break-time physical activities during recess and lunch, and will complete an 8-week (3 × per week) home activity program with their parents and/or family members. A battery of six health-related fitness assessments, four days of pedometery-assessed physical activity and a questionnaire, will be administered at baseline, immediate post-intervention (2-months) and at 6-months (from baseline) to determine intervention effects. Details of the methodological aspects of recruitment, inclusion criteria, randomization, intervention program, assessments, process evaluation and statistical analyses are described. The Fit-4-Fun program is an innovative school-based intervention targeting fitness improvements in primary school children. The program will involve a range of evidence-based behaviour change strategies to promote and support physical activity of adequate intensity, duration and type, needed to improve health-related fitness. Australia and New Zealand Clinical Trials Register (ANZCTR): ACTRN12611000976987.

West Virginia Safe and Supportive (S3) Schools Project: Year 2 Implementation Evaluation Report

ERIC Educational Resources Information Center

Whisman, Andy

2013-01-01

The 4-year federal Safe and Supportive Schools (S3) program supports targeted interventions to improve and measure conditions for learning at the high school level. For 2011-2012 (Year 2), two evaluation questions were investigated: (EQ1) To what extent do participating schools implement the program with fidelity relative to the WV Model for…

The Efficacy of a Program Promoting Rice Self-Sufficiency in Ghana during a Period of Neoliberalism

ERIC Educational Resources Information Center

Glenna, Leland; Ader, David; Bauchspies, Wenda; Traore, Abou; Agboh-Noameshi, Rita Afiavi

2012-01-01

The number of the world's food insecure rose at the end of the first decade of the twenty-first century. Despite these negative developments, however, a 2010 United Nations report argues that food security could be improved if development efforts are supported by government programs that target smallholder farmers. This report is significant…

Optimal Incentives for Public Sector Workers: The Case of Teacher-Designed Incentive Pay in Texas. Working Paper 2009-05

ERIC Educational Resources Information Center

Taylor, Lori L.; Springer, Matthew G.

2009-01-01

Pay for performance is a popular public education reform, and millions of dollars are currently being targeted for pay for performance programs. These reforms are popular because economic and management theories suggest that well-designed incentive pay programs could improve teacher effectiveness. There is little evidence about the characteristics…

ProjectHeartforGirls.com: Development of a Web-Based HIV/STD Prevention Program for Adolescent Girls Emphasizing Sexual Communication Skills.

PubMed

Widman, Laura; Golin, Carol E; Noar, Seth M; Massey, Joy; Prinstein, Mitchell J

2016-10-01

This article describes the development of ProjectHeartforGirls.com , an interactive web-based program designed to improve sexual communication skills and reduce the risk of HIV/STDs among adolescent girls, a population at heightened risk for negative sexual health outcomes (Centers for Disease Control and Prevention, 2013). Although sexual communication is a critical predictor of safer sex among teens, there are few online interventions that target these skills as a central program component. We developed ProjectHeartforGirls.com to fill this gap. Program development involved (1) identifying the target population (ethnically diverse high school girls), (2) clarifying the theoretical foundation (Reasoned Action Model), (3) conducting formative qualitative research (n = 25 girls), (4) drafting initial program content, (5) receiving ongoing feedback from a teen advisory board (n = 5 girls), (6) programming online content, and (7) conducting usability testing (n = 6 girls). These steps are described along with the final intervention product, which is currently being evaluated in a randomized controlled trial.

ProjectHeartForGirls.com: Development of a web-based HIV/STD prevention program for adolescent girls emphasizing sexual communication skills

PubMed Central

Widman, Laura; Golin, Carol E.; Noar, Seth M.; Massey, Joy; Prinstein, Mitchell J.

2017-01-01

This article describes the development of ProjectHeartforGirls.com, an interactive web-based program designed to improve sexual communication skills and reduce the risk of HIV/STDs among adolescent girls, a population at heightened risk for negative sexual health outcomes (CDC, 2013). Although sexual communication is a critical predictor of safer sex among teens, there are few online interventions that target these skills as a central program component. We developed ProjectHeartforGirls.com to fill this gap. Program development involved 1) identifying the target population (ethnically-diverse high school girls); 2) clarifying the theoretical foundation (Reasoned Action Model); 3) conducting formative qualitative research (n=25 girls); 4) drafting initial program content; 5) receiving ongoing feedback from a teen advisory board (n=5 girls); 6) programming online content; and 7) conducting usability testing (n=6 girls). These steps are described along with the final intervention product, which is currently being evaluated in a randomized controlled trial. PMID:27710087

How to improve the quality of a disease management program for HIV-infected patients using a computerized data system. The Saint-Antoine Orchestra program.

PubMed

Fonquernie, F; Lacombe, K; Vincensini, J P; Boccara, F; Clozel, S; Ayouch Boda, A; Bollens, D; Campa, P; Pacanowski, J; Meynard, J L; Meyohas, M C; Girard, P M

2010-05-01

The emergence of non-AIDS-related events in the HIV-infected population experiencing a longer life expectancy implies the implementation of a comprehensive approach of HIV clinical management through better access to care, prevention, and early diagnosis of co-morbidities. The Orchestra program is a computer-assisted HIV care and support tool implemented since December 2004 in the outpatient clinic of a University Hospital set in Paris, France. The intervention aims at improving access to HIV information care and support specifically targeted five areas of actions: cardiovascular risk factors; gynecological follow-up; anti-hepatitis B virus (HBV) vaccine coverage; sexuality and prevention of sexually transmitted infections; and compliance to antiretrovirals. The impact of this program was examined prospectively on a "before-after" basis after a two-year implementation. In the two-year period, 1717 patients were regularly followed. The level of the database information significantly increased in time (low density lipoprotein (LDL) cholesterol and glycemia were informed in 74% of patients at inclusion versus 95% at two years, and 83% versus 97%, p < 0.001, respectively). The number of targeted interventions was also higher. For eligible women, papanicolaou smears and mammography were prescribed in 52% of cases after intervention, versus 44% at inclusion, p0.04 and 83% versus 50%, p < 0.001, respectively. Indicators of care eventually improved significantly. Initially 72% non-adherent patients declared to be adherent after the intervention ( p < 0.001) and 67% of patients with initial LDL-hypercholesterolemia normalized their LDL level within two years ( p < 0.001). The Orchestra program has provided a unique opportunity to assess and improve prevention and management of co-morbidities in HIV patients.

Enhancing Student Motivation as Evidenced by Improved Academic Growth and Increased Work Completion.

ERIC Educational Resources Information Center

Belcher, Gay; Macari, Nancy

This project evaluated a program for enhancing student motivation as evidenced by improved academic growth and increased work completion. The targeted population consisted of fifth graders in a small school in a medium-sized rural community in the Midwest. The problem of lack of achievement motivation and lack of student concern about academic…

Improving Bilingual Student Learning and Thinking Skills through the Use of the Constructivist Theory.

ERIC Educational Resources Information Center

Thomason, Juliann Elizabeth

This report describes a program for improving bilingual students' learning and thinking skills using the constructivist theory. It targeted bilingual high school students in a middle class, suburban Illinois high school. Students' learning and thinking behaviors were documented using methods that showed when and how they employed new learning and…

Improving Student Interest and Achievement in Social Studies Using a Multiple Intelligence Approach.

ERIC Educational Resources Information Center

Hanley, Chris; Hermiz, Carmen; Lagioia-Peddy, Jennifer; Levine-Albuck, Valerie

This action research paper describes a program initiated by teacher researchers to improve academic achievement and interest in social studies. The targeted group consisted of fifth graders in a lower middle class community in the Midwest. Analysis of the problem-causes data show three main factors: curriculum, attitude, and effect. In regard to…

Chapter 1 in Delaware. Education Consolidation and Improvement Act. Facts and Figures SY 1986-87.

ERIC Educational Resources Information Center

Delaware State Dept. of Public Instruction, Dover.

Over 12 million dollars was allocated to Delaware during the 1986/87 school year to fund compensatory education programs for educationally disadvantaged students under Chapter 1 of the Education Consolidation and Improvement Act. Chapter 1 supplemental services are targeted at low-income children; the children of migrant workers; and handicapped,…

Family Ties to Health Program: A Randomized Intervention to Improve Vegetable Intake in Children

ERIC Educational Resources Information Center

Tabak, Rachel G.; Tate, Deborah F.; Stevens, June; Siega-Riz, Anna Maria; Ward, Dianne S.

2012-01-01

Objective: Evaluate a home-based intervention targeted toward parents to improve vegetable intake in preschool-aged children. Methods: Four-month feasibility study of home-based intervention consisting of 4 tailored newsletters and 2 motivational phone calls compared to control; 4 children's books for the control group; and measured pre and post…

Development of a smoking prevention mass media program using diagnostic and formative research.

PubMed

Worden, J K; Flynn, B S; Geller, B M; Chen, M; Shelton, L G; Secker-Walker, R H; Solomon, D S; Solomon, L J; Couchey, S; Costanza, M C

1988-09-01

The process of developing a mass media campaign to prevent smoking among adolescents is described in detail. This campaign supplements a school smoking prevention program and shares educational objectives with the school program but is otherwise independent. It comprises various television and radio 30- and 60-sec "spot" messages. The campaign development process includes identifying educational objectives and strategies for appealing to young people; conducting diagnostic surveys and focus groups to determine target audience interests and perceptions about smoking and media content; suggesting approaches to producers to create preliminary television and radio messages for testing; conducting formative pretests with target groups to select optimal messages and suggest improvements to those messages; producing final messages for media presentation; and developing a media exposure plan to place messages in local media at optimal times for reception by target audiences. The media campaign is being evaluated in a 5-year project with 5,500 adolescents in four communities to determine the additional effect of mass media over a school program alone in preventing smoking.

Sexual Behavior Among Young Carers in the Context of a Kenyan Empowerment Program Combining Cash-Transfer, Psychosocial Support, and Entrepreneurship.

PubMed

Goodman, Michael L; Selwyn, Beatrice J; Morgan, Robert O; Lloyd, Linda E; Mwongera, Moses; Gitari, Stanley; Keiser, Philip H

2016-01-01

This study examined associations between sexual initiation, unprotected sex, and having multiple sex partners in the past year with participation in a three-year empowerment program targeting orphan and vulnerable children (OVC). The Kenya-based program combines community-conditioned cash transfer, psychosocial empowerment, health education, and microenterprise development. Program participants (n = 1,060) were interviewed in a cross-sectional design. Analyses used gender-stratified hierarchical logit models to assess program participation and other potential predictors. Significant predictors of increased female sexual activity included less program exposure, higher age, younger age at most recent parental death, fewer years of schooling, higher food consumption, higher psychological resilience, and lower general self-efficacy. Significant predictors of increased male sexual activity included more program exposure, higher age, better food consumption, not having a living father, and literacy. Findings support a nuanced view of current cash transfer programs, where female sexual activity may be reduced through improved financial status but male sexual activity may increase. Targeting of OVC sexual risk behaviors would likely benefit from being tailored according to associations found in this study. Data suggest involving fathers in sexual education, targeting women who lost a parent at a younger age, and providing social support for female OVC may decrease risk of human immunodeficiency virus (HIV) transmission.

Are falls prevention programs effective at reducing the risk factors for falls in people with type-2 diabetes mellitus and peripheral neuropathy: A systematic review with narrative synthesis.

PubMed

Gu, Yu; Dennis, Sarah M

2017-02-01

Diabetic peripheral neuropathy (DPN) is a common complication of type-2 diabetes mellitus (T2DM) that predisposes the elderly to a higher falls risk. Falls prevention programs with a component of weight-bearing exercises are effective in decreasing future falls in the elderly. However, weight-bearing exercise was only recently recommended in guidelines for exercise for people with T2DM and DPN. Since then, there have been an increasing number of studies to evaluate the effectiveness of falls prevention programs on this targeted population. A systematic literature review was undertaken to determine the effectiveness of falls prevention programs for people with T2DM and DPN. Nine published studies that investigated the effect of exercise training on falls risk among people with T2DM and DPN were included in the review. Interventions included lower limb strengthening, balance practice, aerobic exercise, walking programs, and Tai Chi. The preliminary evidence presented in this review suggests that people with T2DM and DPN can improve their balance and walking after a targeted multicomponent program without risk of serious adverse events. There is insufficient long-term follow-up data to determine whether the improvements in balance or strength resulted in a decrease falls risk in the community setting. Copyright © 2016 Elsevier Inc. All rights reserved.

Colorado WAM separations standards targets of opportunity and flight test analysis

DOT National Transportation Integrated Search

2009-10-25

The Federal Aviation Administration (FAA) : Surveillance and Broadcast Services (SBS) Program : Office and the Colorado Department of : Transportation are implementing Wide Area : Multilateration (WAM) in Non-Radar Airspace : (NRA) to improve air tra...

Tuning in to Kids: improving emotion socialization practices in parents of preschool children--findings from a community trial.

PubMed

Havighurst, Sophie S; Wilson, Katherine R; Harley, Ann E; Prior, Margot R; Kehoe, Christiane

2010-12-01

This study evaluated a new prevention and early intervention parenting program: Tuning in to Kids. The program aims to improve emotion socialization practices in parents of preschool children and is based on research evidence that parents' responses to, and coaching of, their children's emotions influence emotional and behavioral functioning in children. Two hundred and sixteen primary caregiver parents of children aged 4.0-5.11 years were randomized into an intervention or waitlist control group. Parents in the intervention condition attended a 6-session group parenting program plus two booster sessions. Assessment occurred pre-intervention, post-intervention and at six-month follow-up. Questionnaires assessed parent emotion awareness and regulation, parent beliefs and practices of emotion socialization (emotion dismissing, emotion coaching, empathy) and child behavior (parent and teacher report). Observation of emotion socialization practices and child emotional knowledge was conducted pre-intervention and at follow-up with 161 parent-child dyads. Parents in the intervention condition reported significant improvements in their own emotion awareness and regulation, increases in emotion coaching, and decreases in emotionally dismissive beliefs and behaviors. There were increases in parents' observed use of emotion labels and discussion of causes and consequences of emotions with their children. Child emotional knowledge improved, and reductions in child behavior problems were reported by parents and teachers. This study provides support for the efficacy of a parenting intervention targeting parent emotion socialization practices that lead to improved child emotional knowledge and behavior. This preventative intervention targeting parents' own emotion awareness and regulation, as well as emotional communication in parent-child relationships, is a promising addition to available parenting programs. © 2010 The Authors. Journal of Child Psychology and Psychiatry. © 2010 Association for Child and Adolescent Mental Health.

Expert Consensus on Metrics to Assess the Impact of Patient-Level Antimicrobial Stewardship Interventions in Acute-Care Settings

PubMed Central

Anderson, Deverick J.; Cochran, Ronda L.; Hicks, Lauri A.; Srinivasan, Arjun; Dodds Ashley, Elizabeth S.

2017-01-01

Antimicrobial stewardship programs (ASPs) positively impact patient care, but metrics to assess ASP impact are poorly defined. We used a modified Delphi approach to select relevant metrics for assessing patient-level interventions in acute-care settings for the purposes of internal program decision making. An expert panel rated 90 candidate metrics on a 9-point Likert scale for association with 4 criteria: improved antimicrobial prescribing, improved patient care, utility in targeting stewardship efforts, and feasibility in hospitals with electronic health records. Experts further refined, added, or removed metrics during structured teleconferences and re-rated the retained metrics. Six metrics were rated >6 in all criteria: 2 measures of Clostridium difficile incidence, incidence of drug-resistant pathogens, days of therapy over admissions, days of therapy over patient days, and redundant therapy events. Fourteen metrics rated >6 in all criteria except feasibility were identified as targets for future development. PMID:27927866

Neurocognitive Treatment for a Patient with Alzheimer’s Disease Using a Virtual Reality Navigational Environment

PubMed Central

White, Paul J.F.; Moussavi, Zahra

2016-01-01

In this case study, a man at the onset of Alzheimer’s disease (AD) was enrolled in a cognitive treatment program based upon spatial navigation in a virtual reality (VR) environment. We trained him to navigate to targets in a symmetric, landmark-less virtual building. Our research goals were to determine whether an individual with AD could learn to navigate in a simple VR navigation (VRN) environment and whether that training could also bring real-life cognitive benefits. The results show that our participant learned to perfectly navigate to desired targets in the VRN environment over the course of the training program. Furthermore, subjective feedback from his primary caregiver (his wife) indicated that his skill at navigating while driving improved noticeably and that he enjoyed cognitive improvement in his daily life at home. These results suggest that VRN treatments might benefit other people with AD. PMID:27840579

New graduate nurse transition programs: Relationships with bullying and access to support.

PubMed

Rush, Kathy L; Adamack, Monica; Gordon, Jason; Janke, Robert

2014-01-01

Abstract New graduate nurses are often targets of bullying and horizontal violence. The support offered by new graduate nurse transition programs may moderate the effects of bullying and limit its negative impact on new graduate nurse transition. This study examined the relationships between access to support, workplace bullying and new graduate nurse transition within the context of new graduate transition programs. As part of a mixed methods study, an online survey was administered to new graduates (N = 245) approximately a year from starting employment. Bullied new graduate nurses were less able to access support when needed and had poorer transition experiences than their non-bullied peers. Participation in a formal transition program improved access to support and transition for bullied new graduate nurses. People supports within transition programs positively influenced the new graduate nurse transition experience. Formal transition programs provide support that attenuates the impact of bullying on new graduate nurses and improves transition.

New Graduate Transition Programs: Relationships With Access to Support and Bullying.

PubMed

Rush, Kathy L; Adamack, Monica; Gordon, Jason; Janke, Robert

2014-02-03

Abstract New graduate nurses are often targets of bullying and horizontal violence. The support offered by new graduate nurse transition programs may moderate the effects of bullying and limit its negative impact on new graduate nurse transition. This study examined the relationships between access to support, workplace bullying and new graduate nurse transition within the context of New Graduate Transition programs. As part of a mixed methods study, an online survey was administered to new graduates (n=245) approximately a year from starting employment. Bullied new graduate nurses were less able to access support when needed and had poorer transition experiences than their non-bullied peers. Participation in a formal transition program improved access to support and transition for bullied new graduate nurses. People supports within transition programs positively influenced the new graduate nurse transition experience. Formal transition programs provide support that attenuates the impact of bullying on new graduate nurses and improves transition.

Family-based training program improves brain function, cognition, and behavior in lower socioeconomic status preschoolers

PubMed Central

Neville, Helen J.; Stevens, Courtney; Pakulak, Eric; Bell, Theodore A.; Fanning, Jessica; Klein, Scott; Isbell, Elif

2013-01-01

Using information from research on the neuroplasticity of selective attention and on the central role of successful parenting in child development, we developed and rigorously assessed a family-based training program designed to improve brain systems for selective attention in preschool children. One hundred forty-one lower socioeconomic status preschoolers enrolled in a Head Start program were randomly assigned to the training program, Head Start alone, or an active control group. Electrophysiological measures of children’s brain functions supporting selective attention, standardized measures of cognition, and parent-reported child behaviors all favored children in the treatment program relative to both control groups. Positive changes were also observed in the parents themselves. Effect sizes ranged from one-quarter to half of a standard deviation. These results lend impetus to the further development and broader implementation of evidence-based education programs that target at-risk families. PMID:23818591

Data warehousing in disease management programs.

PubMed

Ramick, D C

2001-01-01

Disease management programs offer the benefits of lower disease occurrence, improved patient care, and lower healthcare costs. In such programs, the key mechanism used to identify individuals at risk for targeted diseases is the data warehouse. This article surveys recent warehousing techniques from HMOs to map out critical issues relating to the preparation, design, and implementation of a successful data warehouse. Discussions of scope, data cleansing, and storage management are included in depicting warehouse preparation and design; data implementation options are contrasted. Examples are provided of data warehouse execution in disease management programs that identify members with preexisting illnesses, as well as those exhibiting high-risk conditions. The proper deployment of successful data warehouses in disease management programs benefits both the organization and the member. Organizations benefit from decreased medical costs; members benefit through an improved quality of life through disease-specific care.

Driving social impact with common global indicators for healthy lifestyle programs: lessons learned.

PubMed

Robinson, Nicole R; Gin, Julia; Kamath-Jha, Shilpa; Infantes, Michel; Hernandez, Ricardo; Alberg-Seberich, Michael; Suri, Devika; Pérez-Escamilla, Rafael

2014-09-01

Partnerships between corporate entities and non-governmental organizations (NGOs) involved in delivering community focused health and well-being programs are becoming increasingly valuable especially in the context of promoting healthy lifestyles around the globe. The Mondelēz International Foundation (MIF) has funded healthy lifestyles community based programs targeting children and youth through partnership with seven global NGOs. To assess collective impact of these programs, it is crucial to identify best practices and common impact indicators that can be measured across programs. MIF therefore organized the Healthy Lifestyles Evaluation Workshop to explore these pertinent questions. Share best practices and identify common impact indicators to measure the success of current and future MIF funded healthy lifestyles programs. Analysis of the Program Impact Pathways (PIPs) and measured output of each of the seven programs. Individual and combined analysis of PIPs of the seven NGO programs led to identification of three critical impact indicators: nutrition knowledge, physical activity, and healthier eating, and also enabled NGOs to identify pathways to improve program delivery among the target population. This workshop enabled MIF and partner NGOs to came together to align on metrics and future engagement approaches for promoting and evaluating community based healthy lifestyles programs.

The Importance of Social Cognition in Improving Functional Outcomes in Schizophrenia

PubMed Central

Javed, Afzal; Charles, Asha

2018-01-01

Social cognition has become recognized as an important driver of functional outcomes and overall recovery in patients with schizophrenia, mediating the relationship between neurocognition and social functioning. Since antipsychotic therapy targeting remission of clinical symptoms has been shown to have a limited impact on social cognition, there has been an increasing drive to develop therapeutic strategies to specifically improve social cognition in schizophrenia. We sought to review current evidence relating to social cognition in schizophrenia and its clinical implications, including interventions designed to target the core domains of social cognition (emotion processing, theory of mind, attributional bias, and social perception) as a means of improving functional outcomes and thereby increasing the likelihood of recovery. Relevant articles were identified by conducting a literature search in PubMed using the search terms “schizophrenia” AND “cognition” AND “social functioning,” limited to Title/Abstract, over a time period of the past 10 years. Current evidence demonstrates that schizophrenia is associated with impairments in all four core domains of social cognition, during the pre-first-episode, first-episode, early, and chronic phases of the disease, and that such impairments are important determinants of functional outcome. Interventions targeting the four core domains of social cognition comprise psychosocial approaches (social cognition training programs) and pharmacological therapies. Social cognition training programs targeting multiple and specific core domains of social cognition have shown promise in improving social cognition skills, which, in some cases, has translated into improvements in functional outcomes. Use of some psychosocial interventions has additionally resulted in improvements in clinical symptoms and/or quality of life. Pharmacological therapies, including oxytocin and certain antipsychotics, have yielded more mixed results, due in part to the confounding impact of factors including variation in receptor genetics, bioavailability, pharmacokinetics, and drug–drug interactions, and inconsistencies between study designs and medication dosages. Additional research is required to advance our understanding of the role of social cognition in schizophrenia, and to further establish the utility of targeted interventions in this setting. PMID:29740360

Take Charge of Pain: evaluating a community-targeted self-management education program for people with musculoskeletal pain.

PubMed

Hoon, Elizabeth; Smith, Karen; Black, Julie; Burnet, Simon; Hill, Catherine; Gill, Tiffany K

2017-03-01

Issue addressed Musculoskeletal conditions are highly prevalent, affecting 28% of the Australian population. Given the persistent nature of many musculoskeletal conditions self-management is recognised as an important aspect of effective disease management. However, participant recruitment and retention for formal self-management programs is a challenge. Methods Arthritis SA (Arthritis Foundation of South Australia, a non-profit community health organisation) redesigned a shorter, community-orientated self-management education program delivered by health professionals. The program utilises aspects of the Stanford model of chronic disease self-management and motivational interviewing as well as principles of adult learning to create an effective learning environment. The program aims to guide participants to learn and practise a range of pain management strategies that are known to be effective in improving quality of life. This study used a pre- and post-test (at 6 weeks) design to determine whether this program achieved benefits in self-reported health outcomes. Outcomes that were measured included pain, fatigue, health distress, self-efficacy and communication. Results A response rate of 47% (n=102) was achieved and small but statistically significant improvements in mean [s.d.] pain scores (6.1 [2.3] to 5.4 [2.4], P=0.001), health distress (2.3 [1.3] to 2.0 [1.3], P=0.002) and self-efficacy (6.2 [2.1] to 6.8 [2.2], P=0.002) were found. Conclusion Community-based participants of this shorter, focused program recorded small but significant improvements in self-reported pain, health distress and self-efficacy. For those who completed the current program, Arthritis SA is currently exploring the potential of developing a booster session to promote sustainable positive health outcomes. So what? Supporting self-management through education is recognised as important but also as a key challenge for effective management of musculoskeletal conditions. Using a pre-post evaluation design, this study demonstrated effectiveness (short-term improvements for self-reported pain, health distress and self-efficacy) for a redesigned and shortened community-targeted program focusing on musculoskeletal pain.

A framework for small infrared target real-time visual enhancement

NASA Astrophysics Data System (ADS)

Sun, Xiaoliang; Long, Gucan; Shang, Yang; Liu, Xiaolin

2015-03-01

This paper proposes a framework for small infrared target real-time visual enhancement. The framework is consisted of three parts: energy accumulation for small infrared target enhancement, noise suppression and weighted fusion. Dynamic programming based track-before-detection algorithm is adopted in the energy accumulation to detect the target accurately and enhance the target's intensity notably. In the noise suppression, the target region is weighted by a Gaussian mask according to the target's Gaussian shape. In order to fuse the processed target region and unprocessed background smoothly, the intensity in the target region is treated as weight in the fusion. Experiments on real small infrared target images indicate that the framework proposed in this paper can enhances the small infrared target markedly and improves the image's visual quality notably. The proposed framework outperforms tradition algorithms in enhancing the small infrared target, especially for image in which the target is hardly visible.

Promoting heart health in women: a workplace intervention to improve knowledge and perceptions of susceptibility to heart disease.

PubMed

Jones, Deborah E; Weaver, Michael T; Friedmann, Erika

2007-07-01

The purpose of this study was to evaluate the effectiveness of a 5-week, 1 hour per week heart disease prevention program for sedentary female municipal workers with known heart disease risk factors. The program was designed to improve participants' knowledge and perceptions of their personal susceptibility to heart disease. In targeting an ethnically diverse, lower income working population, the researchers also sought to contribute to one of the goals of Healthy People 2010, the elimination of health disparities, specifically the reduction of health disparities in heart disease by 25% by the year 2010. A one-group, repeated measures, quasi-experimental design was employed. Forty-eight women 25 to 66 years old responded to the solicitation and participated in the program. Seventy-five percent were African American, 23% were White, and 2% were Latino. Participants completed a 33-item heart disease knowledge questionnaire, demographic questions, and a single visual analog scale statement to assess perceived susceptibility. Fifty-eight percent of the participants improved their knowledge of heart disease and 50% of the participants increased their perception of susceptibility to heart disease from pre- to post-intervention. The greatest improvement in knowledge and awareness of susceptibility occurred for those with limited knowledge and low perceptions of susceptibility. The gains from this workplace health education project for largely minority female municipal workers were modest, but notable. A workplace health education program for women targeted at increasing their knowledge of heart disease may also increase their perceptions of susceptibility to heart disease.

How much does it cost to achieve coverage targets for primary healthcare services? A costing model from Aceh, Indonesia.

PubMed

Abdullah, Asnawi; Hort, Krishna; Abidin, Azwar Zaenal; Amin, Fadilah M

2012-01-01

Despite significant investment in improving service infrastructure and training of staff, public primary healthcare services in low-income and middle-income countries tend to perform poorly in reaching coverage targets. One of the factors identified in Aceh, Indonesia was the lack of operational funds for service provision. The objective of this study was to develop a simple and transparent costing tool that enables health planners to calculate the unit costs of providing basic health services to estimate additional budgets required to deliver services in accordance with national targets. The tool was developed using a standard economic approach that linked the input activities to achieving six national priority programs at primary healthcare level: health promotion, sanitation and environment health, maternal and child health and family planning, nutrition, immunization and communicable diseases control, and treatment of common illness. Costing was focused on costs of delivery of the programs that need to be funded by local government budgets. The costing tool consisting of 16 linked Microsoft Excel worksheets was developed and tested in several districts enabled the calculation of the unit costs of delivering of the six national priority programs per coverage target of each program (such as unit costs of delivering of maternal and child health program per pregnant mother). This costing tool can be used by health planners to estimate additional money required to achieve a certain level of coverage of programs, and it can be adjusted for different costs and program delivery parameters in different settings. Copyright © 2012 John Wiley & Sons, Ltd.

Designing text-messaging (SMS) in HIV programs: ethics-framed recommendations from the field

PubMed Central

Pérez, Guillermo Martínez; Hwang, Bella; Bygrave, Helen; Venables, Emilie

2015-01-01

Text messages (SMS) are being increasingly integrated into HIV programs across Southern Africa to improve patient adherence, linkage to care and provide psycho-social support. Careful attention needs to be paid to the design of SMS-based interventions for clients of HIV-care services to ensure that any potential harm, such as unwanted disclosure of HIV status, is minimized. In this article we propose a set of best practice recommendations to ensure that any SMS-based intervention considers ethical principles to safeguard safety, autonomy and confidentiality of its targeted HIV-positive beneficiaries. This analysis draws from our operational experience in Southern Africa in the design and conduct of mHealth interventions in the frame of HIV projects. The recommendations, framed in the context of the Belmont Report's three ethical pillars, may contribute to more safely operationalize any SMS service integrated into an HIV program if adopted by mHealth planners and implementers. We encourage actors to report on the ethical and methodological pathways followed when conducting SMS-based innovations to improve the wellbeing and quality provision of HIV-care for their targeted clients. PMID:26421096

Translation of an Effective Tai Chi Intervention Into a Community-Based Falls-Prevention Program

PubMed Central

Li, Fuzhong; Harmer, Peter; Glasgow, Russell; Mack, Karin A.; Sleet, David; Fisher, K. John; Kohn, Melvin A.; Millet, Lisa M.; Mead, Jennifer; Xu, Junheng; Lin, Mei-Li; Yang, Tingzhong; Sutton, Beth; Tompkins, Yvaughn

2008-01-01

Tai Chi—Moving for Better Balance, a falls-prevention program developed from a randomized controlled trial for community-based use, was evaluated with the RE-AIM framework in 6 community centers. The program had a 100% adoption rate and 87% reach into the target older adult population. All centers implemented the intervention with good fidelity, and participants showed significant improvements in health-related outcome measures. This evidence-based tai chi program is practical to disseminate and can be effectively implemented and maintained in community settings. PMID:18511723

Business Case Analysis: Continuous Integrated Logistics Support-Targeted Allowance Technique (CILS-TAT)

DTIC Science & Technology

2013-05-30

In this research, we examine the Naval Sea Logistics Command’s Continuous Integrated Logistics Support-Targeted Allowancing Technique (CILS-TAT) and... the feasibility of program re-implementation. We conduct an analysis of this allowancing method’s effectiveness onboard U.S. Navy Ballistic Missile...Defense (BMD) ships, measure the costs associated with performing a CILS-TAT, and provide recommendations concerning possible improvements to the

Technological advances in the surgical treatment of movement disorders.

PubMed

Gross, Robert E; McDougal, Margaret E

2013-08-01

Technological innovations have driven the advancement of the surgical treatment of movement disorders, from the invention of the stereotactic frame to the adaptation of deep brain stimulation (DBS). Along these lines, this review will describe recent advances in inserting neuromodulation modalities, including DBS, to the target, and in the delivery of therapy at the target. Recent radiological advances are altering the way that DBS leads are targeted and inserted, by refining the ability to visualize the subcortical targets using high-field strength magnetic resonance imaging and other innovations, such as diffusion tensor imaging, and the development of novel targeting devices enabling purely anatomical implantations without the need for neurophysiological monitoring. New portable computed tomography scanners also are facilitating lead implantation without monitoring, as well as improving radiological verification of DBS lead location. Advances in neurophysiological mapping include efforts to develop automatic target verification algorithms, and probabilistic maps to guide target selection. The delivery of therapy at the target is being improved by the development of the next generation of internal pulse generators (IPGs). These include constant current devices that mitigate the variability introduced by impedance changes of the stimulated tissue and, in the near future, devices that deliver novel stimulation patterns with improved efficiency. Closed-loop adaptive IPGs are being tested, which may tailor stimulation to ongoing changes in the nervous system, reflected in biomarkers continuously recorded by the devices. Finer-grained DBS leads, in conjunction with new IPGs and advanced programming tools, may offer improved outcomes via current steering algorithms. Finally, even thermocoagulation-essentially replaced by DBS-is being advanced by new minimally-invasive approaches that may improve this therapy for selected patients in whom it may be preferred. Functional neurosurgery has a history of being driven by technological innovation, a tradition that continues into its future.

Resilience Training for Work-related Stress Among Health Care Workers: Results of a Randomized Clinical Trial Comparing In-person and Smartphone-delivered Interventions.

PubMed

Mistretta, Erin G; Davis, Mary C; Temkit, M'hamed; Lorenz, Christopher; Darby, Betty; Stonnington, Cynthia M

2018-01-24

The aim of this study was to assess whether an in-person mindfulness-based resilience training (MBRT) program or a smartphone-delivered resiliency-based intervention improved stress, well-being, and burnout in employees at a major tertiary health care institution. Sixty participants were randomized to a 6-week MBRT, a resiliency-based smartphone intervention, or an active control group. Stress, well-being, and burnout were assessed at baseline, at program completion, and 3 months postintervention. Both the MBRT and the smartphone groups showed improvements in well-being, whereas only the MBRT group showed improvements in stress and emotional burnout over time. The control group did not demonstrate sustained improvement on any outcome. Findings suggest that brief, targeted interventions improve psychological outcomes and point to the need for larger scale studies comparing the individual and combined treatments that can inform development of tailored, effective, and low-cost programs for health care workers.

Food subsidy programs and the health and nutritional status of disadvantaged families in high income countries: a systematic review

PubMed Central

2012-01-01

Background Less healthy diets are common in high income countries, although proportionally higher in those of low socio-economic status. Food subsidy programs are one strategy to promote healthy nutrition and to reduce socio-economic inequalities in health. This review summarises the evidence for the health and nutritional impacts of food subsidy programs among disadvantaged families from high income countries. Methods Relevant studies reporting dietary intake or health outcomes were identified through systematic searching of electronic databases. Cochrane Public Health Group guidelines informed study selection and interpretation. A narrative synthesis was undertaken due to the limited number of studies and heterogeneity of study design and outcomes. Results Fourteen studies were included, with most reporting on the Special Supplemental Nutrition Program for Women, Infants and Children in the USA. Food subsidy program participants, mostly pregnant or postnatal women, were shown to have 10–20% increased intake of targeted foods or nutrients. Evidence for the effectiveness of these programs for men or children was lacking. The main health outcome observed was a small but clinically relevant increase in mean birthweight (23–29g) in the two higher quality WIC studies. Conclusions Limited high quality evidence of the impacts of food subsidy programs on the health and nutrition of adults and children in high income countries was identified. The improved intake of targeted nutrients and foods, such as fruit and vegetables, could potentially reduce the rate of non-communicable diseases in adults, if the changes in diet are sustained. Associated improvements in perinatal outcomes were limited and most evident in women who smoked during pregnancy. Thus, food subsidy programs for pregnant women and children should aim to focus on improving nutritional status in the longer term. Further prospective studies and economic analyses are needed to confirm the health benefits and justify the investment in food subsidy programs. PMID:23256601

Food subsidy programs and the health and nutritional status of disadvantaged families in high income countries: a systematic review.

PubMed

Black, Andrew P; Brimblecombe, Julie; Eyles, Helen; Morris, Peter; Vally, Hassan; O Dea, Kerin

2012-12-21

Less healthy diets are common in high income countries, although proportionally higher in those of low socio-economic status. Food subsidy programs are one strategy to promote healthy nutrition and to reduce socio-economic inequalities in health. This review summarises the evidence for the health and nutritional impacts of food subsidy programs among disadvantaged families from high income countries. Relevant studies reporting dietary intake or health outcomes were identified through systematic searching of electronic databases. Cochrane Public Health Group guidelines informed study selection and interpretation. A narrative synthesis was undertaken due to the limited number of studies and heterogeneity of study design and outcomes. Fourteen studies were included, with most reporting on the Special Supplemental Nutrition Program for Women, Infants and Children in the USA. Food subsidy program participants, mostly pregnant or postnatal women, were shown to have 10-20% increased intake of targeted foods or nutrients. Evidence for the effectiveness of these programs for men or children was lacking. The main health outcome observed was a small but clinically relevant increase in mean birthweight (23-29g) in the two higher quality WIC studies. Limited high quality evidence of the impacts of food subsidy programs on the health and nutrition of adults and children in high income countries was identified. The improved intake of targeted nutrients and foods, such as fruit and vegetables, could potentially reduce the rate of non-communicable diseases in adults, if the changes in diet are sustained. Associated improvements in perinatal outcomes were limited and most evident in women who smoked during pregnancy. Thus, food subsidy programs for pregnant women and children should aim to focus on improving nutritional status in the longer term. Further prospective studies and economic analyses are needed to confirm the health benefits and justify the investment in food subsidy programs.

Top-Down Computerized Cognitive Remediation in Schizophrenia: A Case Study of an Individual with Impairment in Verbal Fluency

PubMed Central

Masson, Marjolaine; Wykes, Til; Maziade, Michel; Reeder, Clare; Gariépy, Marie-Anne; Roy, Marc-André; Ivers, Hans; Cellard, Caroline

2015-01-01

The objective of this case study was to assess the specific effect of cognitive remediation for schizophrenia on the pattern of cognitive impairments. Case A is a 33-year-old man with a schizophrenia diagnosis and impairments in visual memory, inhibition, problem solving, and verbal fluency. He was provided with a therapist delivered cognitive remediation program involving practice and strategy which was designed to train attention, memory, executive functioning, visual-perceptual processing, and metacognitive skills. Neuropsychological and clinical assessments were administered at baseline and after three months of treatment. At posttest assessment, Case A had improved significantly on targeted (visual memory and problem solving) and nontargeted (verbal fluency) cognitive processes. The results of the current case study suggest that (1) it is possible to improve specific cognitive processes with targeted exercises, as seen by the improvement in visual memory due to training exercises targeting this cognitive domain; (2) cognitive remediation can produce improvements in cognitive processes not targeted during remediation since verbal fluency was improved while there was no training exercise on this specific cognitive process; and (3) including learning strategies in cognitive remediation increases the value of the approach and enhances participant improvement, possibly because strategies using verbalization can lead to improvement in verbal fluency even if it was not practiced. PMID:25949840

Wellness incentives in the workplace: cost savings through cost shifting to unhealthy workers.

PubMed

Horwitz, Jill R; Kelly, Brenna D; DiNardo, John E

2013-03-01

The Affordable Care Act encourages workplace wellness programs, chiefly by promoting programs that reward employees for changing health-related behavior or improving measurable health outcomes. Recognizing the risk that unhealthy employees might be punished rather than helped by such programs, the act also forbids health-based discrimination. We reviewed results of randomized controlled trials and identified challenges for workplace wellness programs to function as the act intends. For example, research results raise doubts that employees with health risk factors, such as obesity and tobacco use, spend more on medical care than others. Such groups may not be especially promising targets for financial incentives meant to save costs through health improvement. Although there may be other valid reasons, beyond lowering costs, to institute workplace wellness programs, we found little evidence that such programs can easily save costs through health improvement without being discriminatory. Our evidence suggests that savings to employers may come from cost shifting, with the most vulnerable employees--those from lower socioeconomic strata with the most health risks--probably bearing greater costs that in effect subsidize their healthier colleagues.

Perspectives of HIV Clinic Staff on the Implementation of a Client Financial Incentives Program Targeting Viral Suppression.

PubMed

Anderson, Susannah; Jenner, Eric; Lass, Katherine; Burgess, Samuel

We present perspectives of health care providers and clinic staff on the implementation of a financial incentive program for clients living with HIV in three Louisiana clinics. Interviews were conducted in May-June 2015 with 27 clinic staff to assess their perspectives on implementation of the Health Models financial incentive program, which was initiated in September 2013. Many providers and staff welcomed the program, but some were concerned about sustainability and the ethics of a program that paid patients to receive care. Most said they eventually found the program to be helpful for patients and clinic operations in general, by facilitating partnerships between providers and patients, improving appointment keeping, providing opportunities for patient education, engaging patients in care, and helping patients form new prevention habits. The findings can improve understanding of staff and leadership perceptions of incentive programs and can inform planning and implementation of these programs in the future. Copyright © 2017 Association of Nurses in AIDS Care. All rights reserved.

Implementing and evaluating a program to facilitate chronic disease prevention and screening in primary care: a mixed methods program evaluation.

PubMed

Manca, Donna Patricia; Aubrey-Bassler, Kris; Kandola, Kami; Aguilar, Carolina; Campbell-Scherer, Denise; Sopcak, Nicolette; O'Brien, Mary Ann; Meaney, Christopher; Faria, Vee; Baxter, Julia; Moineddin, Rahim; Salvalaggio, Ginetta; Green, Lee; Cave, Andrew; Grunfeld, Eva

2014-10-08

The objectives of this paper are to describe the planned implementation and evaluation of the Building on Existing Tools to Improve Chronic Disease Prevention and Screening in Primary Care (BETTER 2) program which originated from the BETTER trial. The pragmatic trial, informed by the Chronic Care Model, demonstrated the effectiveness of an approach to Chronic Disease Prevention and Screening (CDPS) involving the use of a new role, the prevention practitioner. The desired goals of the program are improved clinical outcomes, reduction in the burden of chronic disease, and improved sustainability of the health-care system through improved CDPS in primary care. The BETTER 2 program aims to expand the implementation of the intervention used in the original BETTER trial into communities across Canada (Alberta, Ontario, Newfoundland and Labrador, the Northwest Territories and Nova Scotia). This proactive approach provides at-risk patients with an intervention from the prevention practitioner, a health-care professional. Using the BETTER toolkit, the prevention practitioner determines which CDPS actions the patient is eligible to receive, and through shared decision-making and motivational interviewing, develops a unique and individualized 'prevention prescription' with the patient. This intervention is 1) personalized; 2) addressing multiple conditions; 3) integrated through linkages to local, regional, or national resources; and 4) longitudinal by assessing patients over time. The BETTER 2 program brings together primary care providers, policy/decision makers and researchers to work towards improving CDPS in primary care. The target patient population is adults aged 40-65. The reach, effectiveness, adoption, implementation, maintain (RE-AIM) framework will inform the evaluation of the program through qualitative and quantitative methods. A composite index will be used to quantitatively assess the effectiveness of the prevention practitioner intervention. The CDPS actions comprising the composite index include the following: process measures, referral/treatment measures, and target/change outcome measures related to cardiovascular disease, diabetes, cancer and associated lifestyle factors. The BETTER 2 program is a collaborative approach grounded in practice and built from existing work (i.e., integration not creation). The program evaluation is designed to provide an understanding of issues impacting the implementation of an effective approach for CDPS within primary care that may be adapted to become sustainable in the non-research setting.

Genomic Tools in Groundnut Breeding Program: Status and Perspectives

PubMed Central

Janila, P.; Variath, Murali T.; Pandey, Manish K.; Desmae, Haile; Motagi, Babu N.; Okori, Patrick; Manohar, Surendra S.; Rathnakumar, A. L.; Radhakrishnan, T.; Liao, Boshou; Varshney, Rajeev K.

2016-01-01

Groundnut, a nutrient-rich food legume, is cultivated world over. It is valued for its good quality cooking oil, energy and protein rich food, and nutrient-rich fodder. Globally, groundnut improvement programs have developed varieties to meet the preferences of farmers, traders, processors, and consumers. Enhanced yield, tolerance to biotic and abiotic stresses and quality parameters have been the target traits. Spurt in genetic information of groundnut was facilitated by development of molecular markers, genetic, and physical maps, generation of expressed sequence tags (EST), discovery of genes, and identification of quantitative trait loci (QTL) for some important biotic and abiotic stresses and quality traits. The first groundnut variety developed using marker assisted breeding (MAB) was registered in 2003. Since then, USA, China, Japan, and India have begun to use genomic tools in routine groundnut improvement programs. Introgression lines that combine foliar fungal disease resistance and early maturity were developed using MAB. Establishment of marker-trait associations (MTA) paved way to integrate genomic tools in groundnut breeding for accelerated genetic gain. Genomic Selection (GS) tools are employed to improve drought tolerance and pod yield, governed by several minor effect QTLs. Draft genome sequence and low cost genotyping tools such as genotyping by sequencing (GBS) are expected to accelerate use of genomic tools to enhance genetic gains for target traits in groundnut. PMID:27014312

The US ICF Ignition Program and the Inertial Fusion Program

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lindl, J D; Hammel, B A; Logan, B G

2003-07-02

There has been rapid progress in inertial fusion in the past few years. This progress spans the construction of ignition facilities, a wide range of target concepts, and the pursuit of integrated programs to develop fusion energy using lasers, ion beams and z-pinches. Two ignition facilities are under construction (NIF in the U.S. and LMJ in France) and both projects are progressing toward an initial experimental capability. The LIL prototype beamline for LMJ and the first 4 beams of NIF will be available for experiments in 2003. The full 192 beam capability of NIF will be available in 2009 andmore » ignition experiments are expected to begin shortly after that time. There is steady progress in the target science and target fabrication in preparation for indirect drive ignition experiments on NIF. Advanced target designs may lead to 5-10 times more yield than initial target designs. There has also been excellent progress on the science of ion beam and z-pinch driven indirect drive targets. Excellent progress on direct-drive targets has been obtained on the Omega laser at the University of Rochester. This includes improved performance of targets with a pulse shape predicted to result in reduced hydrodynamic instability. Rochester has also obtained encouraging results from initial cryogenic implosions. There is widespread interest in the science of fast ignition because of its potential for achieving higher target gain with lower driver energy and relaxed target fabrication requirements. Researchers from Osaka have achieved outstanding implosion and heating results from the Gekko XII Petawatt facility and implosions suitable for fast ignition have been tested on the Omega laser. A broad based program to develop lasers and ions beams for IFE is under way with excellent progress in drivers, chambers, target fabrication and target injection. KrF and Diode Pumped Solid-State lasers (DPSSL) are being developed in conjunction with drywall chambers and direct drive targets. Induction accelerators for heavy ions are being developed in conjunction with thick-liquid protected wall chambers and indirect-drive targets.« less

Youth Opportunity Grants: Lessons Can Be Learned from Program, but Labor Needs to Make Data Available. Report to Congressional Requester. GAO-06-53

ERIC Educational Resources Information Center

Bellis, David D.

2005-01-01

The Youth Opportunity Grant program (YO) represented an innovative approach to improving education and employment opportunities for at-risk youth by targeting resources in high poverty areas and incorporating strategies that experts have identified as effective for serving this population. The Department of Labor (the Department) awarded 36 grants…

Assessing the Value of Workforce Training. A Guide for Small and Mid-sized Companies and the Providers that Serve Them.

ERIC Educational Resources Information Center

Askov, Eunice N.; Hoops, John; Alamprese, Judith

This booklet provides an introduction to evaluating a work force training program, both to assess its impact and to improve its effectiveness. The guide provides instructions for assessing a single training program, rather than a training department in a company or a training provider. It is targeted at small and midsized companies and the…

Research Needs to Improve Hypertension Treatment and Control in African Americans

PubMed Central

Whelton, Paul K.; Einhorn, Paula T.; Muntner, Paul; Appel, Lawrence J.; Cushman, William C.; Diez Roux, Ana V.; Ferdinand, Keith C.; Rahman, Mahboob; Taylor, Herman A.; Ard, Jamy; Arnett, Donna K.; Carter, Barry L.; Davis, Barry R.; Freedman, Barry I.; Cooper, Lisa A.; Cooper, Richard; Desvigne-Nickens, Patrice; Gavini, Nara; Go, Alan S.; Hyman, David J.; Kimmel, Paul L.; Margolis, Karen L.; Miller, Edgar R.; Mills, Katherine T.; Mensah, George A.; Navar, Ann M.; Ogedegbe, Gbenga; Rakotz, Michael K.; Thomas, George; Tobin, Jonathan N.; Wright, Jackson T.; Yoon, Sung Sug (Sarah); Cutler, Jeffrey A.

2016-01-01

Summary Additional targeted research and customized training programs could spearhead strategies for elimination of the disparities in prevalence and control of high BP between African Americans and the remainder of the US general population. PMID:27620388

Results-Based Financing in Mozambique's Central Medical Store: A Review After 1 Year.

PubMed

Spisak, Cary; Morgan, Lindsay; Eichler, Rena; Rosen, James; Serumaga, Brian; Wang, Angela

2016-03-01

Public health commodity supply chains are typically weak in low-income countries, partly because they have many disparate yet interdependent functions and components. Approaches to strengthening supply chains in such settings have often fallen short-they address technical weaknesses, but not the incentives that motivate staff to perform better. We reviewed the first year of a results-based financing (RBF) program in Mozambique, which began in January 2013. The program aimed to improve the performance of the central medical store-Central de Medicamentos e Artigos Medicos (CMAM)-by realigning incentives. We completed in-depth interviews and focus group discussions with 33 key informants, including representatives from CMAM and donor agencies, and collected quantitative data on performance measures and use of funds. The RBF agreement linked CMAM performance payments to quarterly results on 5 performance indicators related to supply planning, distribution planning, and warehouse management. RBF is predicated on the theory that a combination of carrot and stick-i.e., shared financial incentives, plus increased accountability for results-will spur changes in behavior. Important design elements: (1) indicators were measured against quarterly targets, and payments were made only for indicators that met those targets; (2) targets were set based on documented performance, at levels that could be reasonably attained, yet pushed for improvement; (3) payment was shared with and dependent on all staff, encouraging teamwork and collaboration; (4) results were validated by verifiable data sources; and (5) CMAM had discretion over how to use the funds. We found that CMAM's performance continually improved over baseline and that CMAM achieved many of its performance targets, for example, timely submission of quarterly supply and distribution planning reports. Warehouse indicators, such as inventory management and order fulfillment, proved more challenging but were nonetheless positive. By linking payments to periodic verified results, and giving CMAM discretion over how to spend the funds, the RBF agreement motivated the workforce; focused attention on results; strengthened data collection; encouraged teamwork and innovation; and ultimately strengthened the central supply chain. Policy makers and program managers can use performance incentives to catalyze and leverage existing investments. To further strengthen the approach, such incentive programs can shift attention from quantity to quality indicators, improve verification processes, and aim to institutionalize the approach. © Mukuria et al.

Results-Based Financing in Mozambique’s Central Medical Store: A Review After 1 Year

PubMed Central

Spisak, Cary; Morgan, Lindsay; Eichler, Rena; Rosen, James; Serumaga, Brian; Wang, Angela

2016-01-01

ABSTRACT Background: Public health commodity supply chains are typically weak in low-income countries, partly because they have many disparate yet interdependent functions and components. Approaches to strengthening supply chains in such settings have often fallen short—they address technical weaknesses, but not the incentives that motivate staff to perform better. Methods: We reviewed the first year of a results-based financing (RBF) program in Mozambique, which began in January 2013. The program aimed to improve the performance of the central medical store—Central de Medicamentos e Artigos Medicos (CMAM)—by realigning incentives. We completed in-depth interviews and focus group discussions with 33 key informants, including representatives from CMAM and donor agencies, and collected quantitative data on performance measures and use of funds. Implementation: The RBF agreement linked CMAM performance payments to quarterly results on 5 performance indicators related to supply planning, distribution planning, and warehouse management. RBF is predicated on the theory that a combination of carrot and stick—i.e., shared financial incentives, plus increased accountability for results—will spur changes in behavior. Important design elements: (1) indicators were measured against quarterly targets, and payments were made only for indicators that met those targets; (2) targets were set based on documented performance, at levels that could be reasonably attained, yet pushed for improvement; (3) payment was shared with and dependent on all staff, encouraging teamwork and collaboration; (4) results were validated by verifiable data sources; and (5) CMAM had discretion over how to use the funds. Findings: We found that CMAM’s performance continually improved over baseline and that CMAM achieved many of its performance targets, for example, timely submission of quarterly supply and distribution planning reports. Warehouse indicators, such as inventory management and order fulfillment, proved more challenging but were nonetheless positive. By linking payments to periodic verified results, and giving CMAM discretion over how to spend the funds, the RBF agreement motivated the workforce; focused attention on results; strengthened data collection; encouraged teamwork and innovation; and ultimately strengthened the central supply chain. Conclusion: Policy makers and program managers can use performance incentives to catalyze and leverage existing investments. To further strengthen the approach, such incentive programs can shift attention from quantity to quality indicators, improve verification processes, and aim to institutionalize the approach. PMID:27016552

An Evaluation of FrancoForme: A CASE-MANAGED HOME-BASED PRIMARY AND SECONDARY CARDIOVASCULAR DISEASE PREVENTION PROGRAM FOR FRENCH-SPEAKING CANADIANS.

PubMed

Prince, Stephanie A; Laflamme, Marc; Harris, Jennifer; Tulloch, Heather E; de Margerie, Michele

2017-11-01

Cardiovascular disease (CVD) is the leading cause of mortality globally. Telephone-delivered interventions targeting cardiovascular risk factors are gaining popularity. This study is an evaluation of FrancoForme, a cardiovascular risk factor reduction program for the primary and secondary prevention of CVD among French-speaking patients of Eastern Ontario. This study reports on changes in cardiovascular risk factors, weekly exercise levels, and psychosocial characteristics including anxiety, depression, and quality of life upon program completion (3 months) and at 1 year after the start of the program. Repeated-measures analysis of variance was used to compare changes in outcomes between primary prevention risk groups (low, moderate, and high risk for CVD) and the secondary prevention group (ie, cardiac rehabilitation) at baseline, 3 months and 12 months. A total of 762 patients enrolled in FrancoForme between 2008 and 2015. At 3 months, all program completers (n = 507) experienced significant reductions for all cardiovascular risk factors except diastolic blood pressure. Minutes of self-reported exercise increased significantly by an average 90 minutes per week and all psychosocial variables improved. Significant group effects were observed across several risk factors. Among 12-month responders (n = 240), exercise, high-density lipoproteins, triglycerides, cholesterol, and all psychosocial variables were improved over baseline results. FrancoForme is unique in targeting both the primary and secondary prevention of CVD and removes several of the barriers to participating in a conventional CVD prevention program for French-speaking patients. FrancoForme is successful, receiving high satisfaction rates and resulting in significant improvements in cardiovascular risk factors, exercise, anxiety, and depression, as well as quality of life.

Characteristics and effectiveness of diabetes self-management educational programs targeted to racial/ethnic minority groups: a systematic review, meta-analysis and meta-regression.

PubMed

Ricci-Cabello, Ignacio; Ruiz-Pérez, Isabel; Rojas-García, Antonio; Pastor, Guadalupe; Rodríguez-Barranco, Miguel; Gonçalves, Daniela C

2014-07-19

It is not clear to what extent educational programs aimed at promoting diabetes self-management in ethnic minority groups are effective. The aim of this work was to systematically review the effectiveness of educational programs to promote the self-management of racial/ethnic minority groups with type 2 diabetes, and to identify programs' characteristics associated with greater success. We undertook a systematic literature review. Specific searches were designed and implemented for Medline, EMBASE, CINAHL, ISI Web of Knowledge, Scirus, Current Contents and nine additional sources (from inception to October 2012). We included experimental and quasi-experimental studies assessing the impact of educational programs targeted to racial/ethnic minority groups with type 2 diabetes. We only included interventions conducted in countries members of the OECD. Two reviewers independently screened citations. Structured forms were used to extract information on intervention characteristics, effectiveness, and cost-effectiveness. When possible, we conducted random-effects meta-analyses using standardized mean differences to obtain aggregate estimates of effect size with 95% confidence intervals. Two reviewers independently extracted all the information and critically appraised the studies. We identified thirty-seven studies reporting on thirty-nine educational programs. Most of them were conducted in the US, with African American or Latino participants. Most programs obtained some benefits over standard care in improving diabetes knowledge, self-management behaviors and clinical outcomes. A meta-analysis of 20 randomized controlled trials (3,094 patients) indicated that the programs produced a reduction in glycated hemoglobin of -0.31% (95% CI -0.48% to -0.14%). Diabetes knowledge and self-management measures were too heterogeneous to pool. Meta-regressions showed larger reduction in glycated hemoglobin in individual and face to face delivered interventions, as well as in those involving peer educators, including cognitive reframing techniques, and a lower number of teaching methods. The long-term effects remain unknown and cost-effectiveness was rarely estimated. Diabetes self-management educational programs targeted to racial/ethnic minority groups can produce a positive effect on diabetes knowledge and on self-management behavior, ultimately improving glycemic control. Future programs should take into account the key characteristics identified in this review.

Head-and-Neck Target Delineation Among Radiation Oncology Residents After a Teaching Intervention: A Prospective, Blinded Pilot Study

DOE Office of Scientific and Technical Information (OSTI.GOV)

Bekelman, Justin E.; Wolden, Suzanne; Lee, Nancy

Purpose: We conducted this study to determine the feasibility of incorporating a teaching intervention on target delineation into the educational curriculum of a radiation oncology residency program and to assess the short-term effects on resident skills. Methods and Materials: The study schema consisted of a baseline evaluation, the teaching intervention, and a follow-up evaluation. At the baseline evaluation, the participants contoured three clinical tumor volumes (CTVs) (70 Gy, 59.4 Gy, and 54 Gy) on six contrast-enhanced axial computed tomography images of a de-identified patient with Stage T2N2bM0 squamous cell carcinoma of the right base of the tongue. The participants attendedmore » a series of head-and-neck oncology and anatomy seminars. The teaching intervention consisted of a didactic lecture and an interactive hands-on practical session designed to improve the knowledge and skills for target delineation in the head and neck. At the follow-up evaluation, the residents again contoured the CTVs. Results: Of the 14 eligible residents, 11 (79%) actually participated in the study. For all participants, but especially for those who had not had previous experience with head-and-neck target delineation, the teaching intervention was associated with improvement in the delineation of the node-negative neck (CTV 54 Gy contour). Regardless of clinical experience, participants had difficulty determining what should be included in the CTV 59.4 Gy contour to ensure adequate coverage of potential microscopic disease. Conclusion: Incorporating a teaching intervention into the education curriculum of a radiation oncology residency program is feasible and was associated with short-term improvements in target delineation skills. Subsequent interventions will require content refinement, additional validation, longer term follow-up, and multi-institutional collaboration.« less

Financial incentives: only one piece of the workplace wellness puzzle comment on "corporate wellness programs: implementation challenges in the modern american workplace".

PubMed

Busum, Kristin Van; Mattke, Soeren

2013-11-01

In this commentary, we argue that financial incentives are only one of many key components that employers should consider when designing and implementing a workplace wellness program. Strategies such as social encouragement and providing token rewards may also be effective in improving awareness and engagement. Should employers choose to utilize financial incentives, they should tailor them to the goals for the program as well as the targeted behaviors and health outcomes.

Tuning in to Kids: an effectiveness trial of a parenting program targeting emotion socialization of preschoolers.

PubMed

Wilson, Katherine R; Havighurst, Sophie S; Harley, Ann E

2012-02-01

This article reports on an effectiveness trial of the Tuning in to Kids (TIK) parenting program. TIK aims to improve emotion socialization practices in parents of preschool children; it is a universal prevention program that teaches parents the skills of emotion coaching and also targets parents' own emotion awareness and regulation. The present study followed a 2 × 2 (Treatment Condition × Time) design. One hundred twenty-eight parents of children ages 4.0-5.11 years were recruited from preschools and randomized into intervention and waitlist conditions. Parents in the intervention condition (n = 62) attended a six-session group parenting program delivered by community practitioners who followed intervention fidelity protocols. Parents and preschool teachers completed questionnaires twice during the preschool year: at preintervention and at follow-up (approximately 7 months later). Parents reported on their emotion socialization beliefs and practices, other parenting practices, and on child behavior. Teachers reported on child behavior (Social Competence and Anger-Aggression). Data were analyzed using multilevel modeling. At follow-up, compared to the control group, intervention parents were significantly less emotionally dismissive in their beliefs, less dismissive and more coaching in their practices in response to children's negative emotions, and more positively involved. Although there were improvements in both conditions over time for parent-reported child behavior and teacher-reported social competence, compared to the waitlist group, intervention parents reported a significantly greater reduction in number of behavior problems. This trial demonstrates the potential for community agencies and practitioners in real-world settings to deliver a new parenting program that targets emotional communication in parent-child relationships.

Strategies to improve treatment coverage in community-based public health programs: A systematic review of the literature.

PubMed

Deardorff, Katrina V; Rubin Means, Arianna; Ásbjörnsdóttir, Kristjana H; Walson, Judd

2018-02-01

Community-based public health campaigns, such as those used in mass deworming, vitamin A supplementation and child immunization programs, provide key healthcare interventions to targeted populations at scale. However, these programs often fall short of established coverage targets. The purpose of this systematic review was to evaluate the impact of strategies used to increase treatment coverage in community-based public health campaigns. We systematically searched CAB Direct, Embase, and PubMed archives for studies utilizing specific interventions to increase coverage of community-based distribution of drugs, vaccines, or other public health services. We identified 5,637 articles, from which 79 full texts were evaluated according to pre-defined inclusion and exclusion criteria. Twenty-eight articles met inclusion criteria and data were abstracted regarding strategy-specific changes in coverage from these sources. Strategies used to increase coverage included community-directed treatment (n = 6, pooled percent change in coverage: +26.2%), distributor incentives (n = 2, +25.3%), distribution along kinship networks (n = 1, +24.5%), intensified information, education, and communication activities (n = 8, +21.6%), fixed-point delivery (n = 1, +21.4%), door-to-door delivery (n = 1, +14.0%), integrated service distribution (n = 9, +12.7%), conversion from school- to community-based delivery (n = 3, +11.9%), and management by a non-governmental organization (n = 1, +5.8%). Strategies that target improving community member ownership of distribution appear to have a large impact on increasing treatment coverage. However, all strategies used to increase coverage successfully did so. These results may be useful to National Ministries, programs, and implementing partners in optimizing treatment coverage in community-based public health programs.

Strategies to improve treatment coverage in community-based public health programs: A systematic review of the literature

PubMed Central

2018-01-01

Background Community-based public health campaigns, such as those used in mass deworming, vitamin A supplementation and child immunization programs, provide key healthcare interventions to targeted populations at scale. However, these programs often fall short of established coverage targets. The purpose of this systematic review was to evaluate the impact of strategies used to increase treatment coverage in community-based public health campaigns. Methodology/ principal findings We systematically searched CAB Direct, Embase, and PubMed archives for studies utilizing specific interventions to increase coverage of community-based distribution of drugs, vaccines, or other public health services. We identified 5,637 articles, from which 79 full texts were evaluated according to pre-defined inclusion and exclusion criteria. Twenty-eight articles met inclusion criteria and data were abstracted regarding strategy-specific changes in coverage from these sources. Strategies used to increase coverage included community-directed treatment (n = 6, pooled percent change in coverage: +26.2%), distributor incentives (n = 2, +25.3%), distribution along kinship networks (n = 1, +24.5%), intensified information, education, and communication activities (n = 8, +21.6%), fixed-point delivery (n = 1, +21.4%), door-to-door delivery (n = 1, +14.0%), integrated service distribution (n = 9, +12.7%), conversion from school- to community-based delivery (n = 3, +11.9%), and management by a non-governmental organization (n = 1, +5.8%). Conclusions/significance Strategies that target improving community member ownership of distribution appear to have a large impact on increasing treatment coverage. However, all strategies used to increase coverage successfully did so. These results may be useful to National Ministries, programs, and implementing partners in optimizing treatment coverage in community-based public health programs. PMID:29420534

The Effects of Pay-for-Performance Programs on Health, Health Care Use, and Processes of Care: A Systematic Review.

PubMed

Mendelson, Aaron; Kondo, Karli; Damberg, Cheryl; Low, Allison; Motúapuaka, Makalapua; Freeman, Michele; O'Neil, Maya; Relevo, Rose; Kansagara, Devan

2017-03-07

The benefits of pay-for-performance (P4P) programs are uncertain. To update and expand a prior review examining the effects of P4P programs targeted at the physician, group, managerial, or institutional level on process-of-care and patient outcomes in ambulatory and inpatient settings. PubMed from June 2007 to October 2016; MEDLINE, PsycINFO, CINAHL, Business Economics and Theory, Business Source Elite, Scopus, Faculty of 1000, and Gartner Research from June 2007 to February 2016. Trials and observational studies in ambulatory and inpatient settings reporting process-of-care, health, or utilization outcomes. Two investigators extracted data, assessed study quality, and graded the strength of the evidence. Among 69 studies, 58 were in ambulatory settings, 52 reported process-of-care outcomes, and 38 reported patient outcomes. Low-strength evidence suggested that P4P programs in ambulatory settings may improve process-of-care outcomes over the short term (2 to 3 years), whereas data on longer-term effects were limited. Many of the positive studies were conducted in the United Kingdom, where incentives were larger than in the United States. The largest improvements were seen in areas where baseline performance was poor. There was no consistent effect of P4P on intermediate health outcomes (low-strength evidence) and insufficient evidence to characterize any effect on patient health outcomes. In the hospital setting, there was low-strength evidence that P4P had little or no effect on patient health outcomes and a positive effect on reducing hospital readmissions. Few methodologically rigorous studies; heterogeneous population and program characteristics and incentive targets. Pay-for-performance programs may be associated with improved processes of care in ambulatory settings, but consistently positive associations with improved health outcomes have not been demonstrated in any setting. U.S. Department of Veterans Affairs.

Participation Rates, Process Monitoring, and Quality Improvement Among Cardiac Rehabilitation Programs in the United States: A NATIONAL SURVEY.

PubMed

Pack, Quinn R; Squires, Ray W; Lopez-Jimenez, Francisco; Lichtman, Steven W; Rodriguez-Escudero, Juan P; Lindenauer, Peter K; Thomas, Randal J

2015-01-01

Although strategies exist for improving cardiac rehabilitation (CR) participation rates, it is unclear how frequently these strategies are used and what efforts are being made by CR programs to improve participation rates. We surveyed all CR program directors in the American Association of Cardiovascular and Pulmonary Rehabilitation's database. Data collection included program characteristics, the use of specific referral and recruitment strategies, and self-reported program participation rates. Between 2007 and 2012, 49% of programs measured referral of inpatients from the hospital, 21% measured outpatient referral from office/clinic, 71% measured program enrollment, and 74% measured program completion rates. Program-reported participation rates (interquartile range) were 68% (32-90) for hospital referral, 35% (15-60) for office/clinic referral, 70% (46-80) for enrollment, and 75% (62-82) for program completion. The majority of programs utilized a hospital-based systematic referral, liaison-facilitated referral, or inpatient CR program referral (64%, 68%, and 60% of the time, respectively). Early appointments (<2 weeks) were utilized by 35%, and consistent phone call appointment reminders were utilized by 50% of programs. Quality improvement (QI) projects were performed by about half of CR programs. Measurement of participation rates was highly correlated with performing QI projects (P < .0001.) : Although programs are aware of participation rate gaps, the monitoring of participation rates is suboptimal, QI initiatives are infrequent, and proven strategies for increasing patient participation are inconsistently utilized. These issues likely contribute to the national CR participation gap and may prove to be useful targets for national QI initiatives.

The StrongWomen-Healthy Hearts program in Pennsylvania: RE-AIM analysis.

PubMed

Folta, Sara C; Lichtenstein, Alice H; Seguin, Rebecca A; Goldberg, Jeanne P; Corbin, Marilyn A; Wiker, Nancy; Gauker, Jodi; Chui, Kenneth; Nelson, Miriam E

2015-03-01

Dissemination of evidence-based programs is needed to reduce CVD risk among midlife and older women. The aim of this study is to examine the public health impact of StrongWomen-Healthy Hearts in Pennsylvania using the RE-AIM framework. Reach, adoption, implementation, and maintenance were assessed using qualitative and quantitative measures; effectiveness was assessed using a pretest-posttest within-participants design. Reach into the target population was 5 in 100,000. Compared to the target population, a greater percentage of participants were white, married, middle-class, and had a graduate degree. Effectiveness was demonstrated (weight loss -2.0 kg, p < 0.001). Adoption among trained leaders was high (83.3 %), as was fidelity in implementation (average score 9.3 of 10). No leaders maintained the program. To increase impact of the StrongWomen-Healthy Hearts Program, it will be important to lower the costs and modify the recruitment and training strategies to better reach low-income and minority women. Such strategies may also improve program maintenance.

Two food-assisted maternal and child health nutrition programs helped mitigate the impact of economic hardship on child stunting in Haiti.

PubMed

Donegan, Shannon; Maluccio, John A; Myers, Caitlin K; Menon, Purnima; Ruel, Marie T; Habicht, Jean-Pierre

2010-06-01

Rigorous evaluations of food-assisted maternal and child health and nutrition programs are stymied by the ethics of randomizing recipients to a control treatment. Using nonexperimental matching methods, we evaluated the effect of 2 such programs on child linear growth in Haiti. The 2 well-implemented programs offered the same services (food assistance, behavior change communication, and preventive health services) to pregnant and lactating women and young children. They differed in that one (the preventive program) used blanket targeting of all children 6-23 mo, whereas the other (the recuperative program) targeted underweight (weight-for-age Z score < -2) children 6-59 mo, as traditionally done. We estimated program effects on height-for-age Z scores (HAZ) and stunting (HAZ < -2) by comparing outcomes of children in program areas with matched children from comparable populations in the Haiti Demographic and Health Survey. Children 12-41 mo in the preventive and recuperative program areas had lower prevalence of stunting than those in the matched control group [16 percentage points (pp) lower in preventive and 11 pp in recuperative]. Children in the 2 program areas also were more likely than those in the matched control group to be breast-fed up to 24 mo (25 pp higher in preventive, 22 in recuperative) and children 12 mo and older were more likely to have received the recommended full schedule of vaccinations (32 pp higher in preventive, 31 in recuperative). Both programs improved targeted behaviors and protected child growth in a time of deteriorating economic circumstances.

Rules and tools that improved vaccines for children vaccine-ordering practices in Oregon: a 2010 pilot project.

PubMed

Hewett, Rafe; VanCuren, Anne; Trocio, Loralee; Beaudrault, Sara; Gund, Anona; Luther, Mimi; Groom, Holly

2013-01-01

This project's objective was to enhance efforts to improve vaccine-ordering efficiencies among targeted clinics using publicly purchased vaccines. Using an assessment of ordering behavior developed by the Centers for Disease Control and Prevention, we selected and trained immunization providers and assessed improvements in ordering behavior by comparing ordering patterns before and after the intervention. A total of 144 Vaccines for Children program providers in Oregon. We assessed 144 providers trained in the Economic Order Quantity process between January and November 2010. INTERVENTION (IF APPLICABLE): Providers were invited to participate in regional trainings. Trainings included assignment of ordering frequency and dissemination of tools to support adherence to the recommended ordering frequency. The percent increase in targeted clinics ordering according to recommended order frequency and the resulting decrease in orders placed, as an outcome of training and ordering tools. Only 35% of targeted providers were ordering according to the recommended ordering frequency before the project began. After completing training, utilizing ordering tools and ordering over a 7-month period, 78% of the targeted clinics were ordering according to the recommended frequency, a 120% increase in the number of clinics ordering with the recommended frequency. At baseline, targeted clinics placed 915 total vaccine orders over a 7-month period. After completing training and participating in the Economic Order Quantity process, only 645 orders were placed, a reduction of 30% . The initiative was successful in reducing the number of orders placed by Vaccines for Children providers in Oregon. A previous effort to reduce ordering, without the use of training or tools, did not achieve the same levels of provider compliance, suggesting that the addition of staff and development of tools were helpful in supporting behavior change and improving providers' ability to adhere to assigned order frequencies. Reducing order frequency results in more efficient vaccine ordering patterns and benefits vaccine distributors, Oregon Immunization Program staff, and provider staff.

Advances of Molecular Targeted Therapy in Gastric Cancer.

PubMed

Cetin, Bulent; Gumusay, Ozge; Cengiz, Mustafa; Ozet, Ahmet

2016-06-01

Gastric cancer is the second most common cause of cancer-related death in the world, and its prognosis remains poor with a median overall survival of 12 months for advanced disease. Advances in the understanding of molecular genetics have led to the development of directed molecular targeted therapy in gastric cancer, leading to improve patient outcomes and quality of life. In the treatment of human epidermal growth factor receptor 2 (HER2)-positive gastric cancer, the addition of trastuzumab significantly improves survival in the first-line setting of therapy. Ramucirumab, an antibody directed against vascular endothelial growth factor receptor 2, significantly improved progression-free and overall survival and has been approved for second-line treatment of gastric cancer. Anti-mesenchymal-epithelial transition (c-MET), mammalian target of rapamycin inhibitors, and polo-like kinase 1 inhibitors are under investigation as a novel therapeutic option for the treatment of gastric cancer. The novel therapies target the key immune checkpoint interaction between a T cell co-inhibitory receptor called programmed death 1 (PD-1) and one of its immunosuppressive ligands, PD-L1. This article reviews molecular targeted therapies in gastric cancer, in light of recent advances.

Telemedicine in the Intensive Care Unit: Improved Access to Care at What Cost?

PubMed

Binder, William J; Cook, Jennifer L; Gramze, Nickalaus; Airhart, Sophia

2018-06-01

Health systems across the United States are adopting intensive care unit telemedicine programs to improve patient outcomes. Research demonstrates the potential for decreased mortality and length of stay for patients of these remotely monitored units. Financial models and studies point to cost-effectiveness and the possibility of cost savings in the face of abundant startup costs. Questions remain as to the true financial implications of these programs and targeted populations that may see the greatest benefit. Despite recent growth, widespread adoption may be limited until these unknowns are answered. Copyright © 2018 Elsevier Inc. All rights reserved.

Implementation of a hospital-based quality assessment program for rectal cancer.

PubMed

Hendren, Samantha; McKeown, Ellen; Morris, Arden M; Wong, Sandra L; Oerline, Mary; Poe, Lyndia; Campbell, Darrell A; Birkmeyer, Nancy J

2014-05-01

Quality improvement programs in Europe have had a markedly beneficial effect on the processes and outcomes of rectal cancer care. The quality of rectal cancer care in the United States is not as well understood, and scalable quality improvement programs have not been developed. The purpose of this article is to describe the implementation of a hospital-based quality assessment program for rectal cancer, targeting both community and academic hospitals. We recruited 10 hospitals from a surgical quality improvement organization. Nurse reviewers were trained to abstract rectal cancer data from hospital medical records, and abstracts were assessed for accuracy. We conducted two surveys to assess the training program and limitations of the data abstraction. We validated data completeness and accuracy by comparing hospital medical record and tumor registry data. Nine of 10 hospitals successfully performed abstractions with ≥ 90% accuracy. Experienced nurse reviewers were challenged by the technical details in operative and pathology reports. Although most variables had less than 10% missing data, outpatient testing information was lacking from some hospitals' inpatient records. This implementation project yielded a final quality assessment program consisting of 20 medical records variables and 11 tumor registry variables. An innovative program linking tumor registry data to quality-improvement data for rectal cancer quality assessment was successfully implemented in 10 hospitals. This data platform and training program can serve as a template for other organizations that are interested in assessing and improving the quality of rectal cancer care. Copyright © 2014 by American Society of Clinical Oncology.

Leadership development programs for physicians: a systematic review.

PubMed

Frich, Jan C; Brewster, Amanda L; Cherlin, Emily J; Bradley, Elizabeth H

2015-05-01

Physician leadership development programs typically aim to strengthen physicians' leadership competencies and improve organizational performance. We conducted a systematic review of medical literature on physician leadership development programs in order to characterize the setting, educational content, teaching methods, and learning outcomes achieved. Articles were identified through a search in Ovid MEDLINE from 1950 through November 2013. We included articles that described programs designed to expose physicians to leadership concepts, outlined teaching methods, and reported evaluation outcomes. A thematic analysis was conducted using a structured data entry form with categories for setting/target group, educational content, format, type of evaluation and outcomes. We identified 45 studies that met eligibility criteria, of which 35 reported on programs exclusively targeting physicians. The majority of programs focused on skills training and technical and conceptual knowledge, while fewer programs focused on personal growth and awareness. Half of the studies used pre/post intervention designs, and four studies used a comparison group. Positive outcomes were reported in all studies, although the majority of studies relied on learner satisfaction scores and self-assessed knowledge or behavioral change. Only six studies documented favorable organizational outcomes, such as improvement in quality indicators for disease management. The leadership programs examined in these studies were characterized by the use of multiple learning methods, including lectures, seminars, group work, and action learning projects in multidisciplinary teams. Physician leadership development programs are associated with increased self-assessed knowledge and expertise; however, few studies have examined outcomes at a system level. Our synthesis of the literature suggests important gaps, including a lack of programs that integrate non-physician and physician professionals, limited use of more interactive learning and feedback to develop greater self-awareness, and an overly narrow focus on individual-level rather than system-level outcomes.

Intensive care unit quality improvement: a "how-to" guide for the interdisciplinary team.

PubMed

Curtis, J Randall; Cook, Deborah J; Wall, Richard J; Angus, Derek C; Bion, Julian; Kacmarek, Robert; Kane-Gill, Sandra L; Kirchhoff, Karin T; Levy, Mitchell; Mitchell, Pamela H; Moreno, Rui; Pronovost, Peter; Puntillo, Kathleen

2006-01-01

Quality improvement is an important activity for all members of the interdisciplinary critical care team. Although an increasing number of resources are available to guide clinicians, quality improvement activities can be overwhelming. Therefore, the Society of Critical Care Medicine charged this Outcomes Task Force with creating a "how-to" guide that focuses on critical care, summarizes key concepts, and outlines a practical approach to the development, implementation, evaluation, and maintenance of an interdisciplinary quality improvement program in the intensive care unit. The task force met in person twice and by conference call twice to write this document. We also conducted a literature search on "quality improvement" and "critical care or intensive care" and searched online for additional resources. DATA SYNTHESIS AND OVERVIEW: We present an overview of quality improvement in the intensive care unit setting and then describe the following steps for initiating or improving an interdisciplinary critical care quality improvement program: a) identify local motivation, support teamwork, and develop strong leadership; b) prioritize potential projects and choose the first target; c) operationalize the measures, build support for the project, and develop a business plan; d) perform an environmental scan to better understand the problem, potential barriers, opportunities, and resources for the project; e) create a data collection system that accurately measures baseline performance and future improvements; f) create a data reporting system that allows clinicians and others to understand the problem; g) introduce effective strategies to change clinician behavior. In addition, we identify four steps for evaluating and maintaining this program: a) determine whether the target is changing with periodic data collection; b) modify behavior change strategies to improve or sustain improvements; c) focus on interdisciplinary collaboration; and d) develop and sustain support from the hospital leadership. We also identify a number of online resources to complement this overview. This Society of Critical Care Medicine Task Force report provides an overview for clinicians interested in developing or improving a quality improvement program using a step-wise approach. Success depends not only on committed interdisciplinary work that is incremental and continuous but also on strong leadership. Further research is needed to refine the methods and identify the most cost-effective means of improving the quality of health care received by critically ill patients and their families.

vSDC: a method to improve early recognition in virtual screening when limited experimental resources are available.

PubMed

Chaput, Ludovic; Martinez-Sanz, Juan; Quiniou, Eric; Rigolet, Pascal; Saettel, Nicolas; Mouawad, Liliane

2016-01-01

In drug design, one may be confronted to the problem of finding hits for targets for which no small inhibiting molecules are known and only low-throughput experiments are available (like ITC or NMR studies), two common difficulties encountered in a typical academic setting. Using a virtual screening strategy like docking can alleviate some of the problems and save a considerable amount of time by selecting only top-ranking molecules, but only if the method is very efficient, i.e. when a good proportion of actives are found in the 1-10 % best ranked molecules. The use of several programs (in our study, Gold, Surflex, FlexX and Glide were considered) shows a divergence of the results, which presents a difficulty in guiding the experiments. To overcome this divergence and increase the yield of the virtual screening, we created the standard deviation consensus (SDC) and variable SDC (vSDC) methods, consisting of the intersection of molecule sets from several virtual screening programs, based on the standard deviations of their ranking distributions. SDC allowed us to find hits for two new protein targets by testing only 9 and 11 small molecules from a chemical library of circa 15,000 compounds. Furthermore, vSDC, when applied to the 102 proteins of the DUD-E benchmarking database, succeeded in finding more hits than any of the four isolated programs for 13-60 % of the targets. In addition, when only 10 molecules of each of the 102 chemical libraries were considered, vSDC performed better in the number of hits found, with an improvement of 6-24 % over the 10 best-ranked molecules given by the individual docking programs.Graphical abstractIn drug design, for a given target and a given chemical library, the results obtained with different virtual screening programs are divergent. So how to rationally guide the experimental tests, especially when only a few number of experiments can be made? The variable Standard Deviation Consensus (vSDC) method was developed to answer this issue. Left panel the vSDC principle consists of intersecting molecule sets, chosen on the basis of the standard deviations of their ranking distributions, obtained from various virtual screening programs. In this study Glide, Gold, FlexX and Surflex were used and tested on the 102 targets of the DUD-E database. Right panel Comparison of the average percentage of hits found with vSDC and each of the four programs, when only 10 molecules from each of the 102 chemical libraries of the DUD-E database were considered. On average, vSDC was capable of finding 38 % of the findable hits, against 34 % for Glide, 32 % for Gold, 16 % for FlexX and 14 % for Surflex, showing that with vSDC, it was possible to overcome the unpredictability of the virtual screening results and to improve them.

Knowledge of Cervical Cancer Screening among Women across Different Socio-Economic Regions of China

PubMed Central

Di, Jiangli; Rutherford, Shannon; Wu, Jiuling; Song, Bo; Ma, Lan; Chen, Jingyi; Chu, Cordia

2015-01-01

Background and Objective China has a high burden of cervical cancer (CC) and wide disparities in CC burden exist among different socio-economic regions. In order to reduce these disparities, China’s government launched the National Cervical Cancer Screening Program in Rural Areas (NCCSPRA) in 2009. Understanding the factors associated with underutilization of CC screening among target populations is important to improve the screening participation rate, and a high participation rate is key to achieving the goals of a screening program. However, data on the knowledge of CC among target populations in program areas is lacking in China. This study will investigate the knowledge of CC prevention and control among women in specific project counties to develop a better understanding of factors that might influence CC screening participation in order to improve the implementation of the NCCSPRA. Materials and Methods A cross-sectional survey was conducted and face-to-face interview questionnaires were completed by 308 women who received CC screening services in 6 project counties of NCCSPRA across different socio-economic regions of China. ANOVA and Chi-square tests were used to compare the knowledge rates and scores across the different subgroups. Logistic regression was conducted to examine factors associated with knowledge level. Results The overall CC knowledge rate of the target population was only 19.5%. Regional socio-economic level, advice from doctors, age, and educational status were strong predictors of knowledge level of CC screening. Significantly lower knowledge rates and scores were identified in older women (55–64 years old), less educated women (with primary school or illiterate), women in less developed regions and women who did not receive any advice about screening results from doctors. Conclusion The knowledge of CC screening among women in the project counties of NCCSPRA was found to be very poor. Given the importance of knowledge in encouraging women to participate in screening is key to reducing CC burden in rural women in China, it is urgent that a targeted health promotion intervention is developed and implemented in project counties, especially targeting older women, women with less education and women in less developed regions, and focus on improving their CC knowledge and encouraging them to communicate with health care providers. The health promotion intervention targeting health care providers is also important to improve their knowledge of CC and provide best advice to women. PMID:26657110

The power of light: socio-economic and environmental implications of a rural electrification program in Brazil

NASA Astrophysics Data System (ADS)

Borges da Silveira Bezerra, Paula; Ludovique Callegari, Camila; Ribas, Aline; Lucena, André F. P.; Portugal-Pereira, Joana; Koberle, Alexandre; Szklo, Alexandre; Schaeffer, Roberto

2017-09-01

Universal access to electricity is deemed critical for improving living standards and indispensable for eradicating poverty and achieving sustainable development. In 2003, the ‘Luz para Todos’ (LpT—Light for All) program was launched aiming to universalize access to electricity in Brazil. The program focused on rural and isolated areas, also targeting to bring development to those regions along with electrification. This paper evaluates the results of the LpT program in improving socio-economic development in the poorest regions of Brazil. After an initial qualitative analysis, an empirical quantitative assessment of the influence of increased electrification rates on the components of the Human Development Index (HDI) is performed. The empirical results of this study showed that electrification had a positive influence on all dimensions of the HDI, with the education component having the strongest effect. Although complementary policies were needed to achieve this, results show that electricity access is a major requirement to improve quality of life.

Disease management: a leap of faith to lower-cost, higher-quality health care.

PubMed

Short, Ashley; Mays, Glen; Mittler, Jessica

2003-10-01

With managed care's promise to reduce costs and improve quality waning, employers and health plans are exploring more targeted ways to control rapidly rising health costs. Disease management programs, which focus on patients with chronic conditions such as asthma and diabetes, are growing in popularity, according to findings from the Center for Studying Health System Change's (HSC) 2002-03 site visits to 12 nationally representative communities. In addition to condition-based disease management programs, some health plans and employers are using intensive case management services to coordinate care for high-risk patients with potentially costly and complex medical conditions. Despite high expectations, evidence of both disease management and case management programs' success in controlling costs and improving quality remains limited.

An electromagnetic induction method for underground target detection and characterization

DOE Office of Scientific and Technical Information (OSTI.GOV)

Bartel, L.C.; Cress, D.H.

1997-01-01

An improved capability for subsurface structure detection is needed to support military and nonproliferation requirements for inspection and for surveillance of activities of threatening nations. As part of the DOE/NN-20 program to apply geophysical methods to detect and characterize underground facilities, Sandia National Laboratories (SNL) initiated an electromagnetic induction (EMI) project to evaluate low frequency electromagnetic (EM) techniques for subsurface structure detection. Low frequency, in this case, extended from kilohertz to hundreds of kilohertz. An EMI survey procedure had already been developed for borehole imaging of coal seams and had successfully been applied in a surface mode to detect amore » drug smuggling tunnel. The SNL project has focused on building upon the success of that procedure and applying it to surface and low altitude airborne platforms. Part of SNL`s work has focused on improving that technology through improved hardware and data processing. The improved hardware development has been performed utilizing Laboratory Directed Research and Development (LDRD) funding. In addition, SNL`s effort focused on: (1) improvements in modeling of the basic geophysics of the illuminating electromagnetic field and its coupling to the underground target (partially funded using LDRD funds) and (2) development of techniques for phase-based and multi-frequency processing and spatial processing to support subsurface target detection and characterization. The products of this project are: (1) an evaluation of an improved EM gradiometer, (2) an improved gradiometer concept for possible future development, (3) an improved modeling capability, (4) demonstration of an EM wave migration method for target recognition, and a demonstration that the technology is capable of detecting targets to depths exceeding 25 meters.« less

Targeting Matrix Metalloproteinases in Cancer: Bringing New Life to Old Ideas.

PubMed

Cathcart, Jillian; Pulkoski-Gross, Ashleigh; Cao, Jian

2015-03-01

Since the identification of matrix metalloproteinases (MMPs), a family of zinc-dependent endopeptidases, as being a driving factor for cancer progression and patient prognosis, MMPs have been studied extensively. Although early programs targeting MMPs were largely unsuccessful in clinical trials, they remain a viable and highly desirable therapeutic target based on preclinical studies and their role in disease progression. As information regarding the structure and function of these proteinases is compiled and biotechnology evolves, tools to develop better inhibitors is within our grasp. Improved methods for high throughput screening and in silico drug design programs have identified compounds which are highly potent, have high binding affinities, and exhibit favorable pharmacokinetic profiles. More recently, advances in drug delivery methods or compounds which bind outside the active site have brought new light to the field. In this review, we highlight the role of MMPs in cancer, clinical trials for MMP inhibitors, and novel approaches to targeting MMPs in cancer.

OPTICAL correlation identification technology applied in underwater laser imaging target identification

NASA Astrophysics Data System (ADS)

Yao, Guang-tao; Zhang, Xiao-hui; Ge, Wei-long

2012-01-01

The underwater laser imaging detection is an effective method of detecting short distance target underwater as an important complement of sonar detection. With the development of underwater laser imaging technology and underwater vehicle technology, the underwater automatic target identification has gotten more and more attention, and is a research difficulty in the area of underwater optical imaging information processing. Today, underwater automatic target identification based on optical imaging is usually realized with the method of digital circuit software programming. The algorithm realization and control of this method is very flexible. However, the optical imaging information is 2D image even 3D image, the amount of imaging processing information is abundant, so the electronic hardware with pure digital algorithm will need long identification time and is hard to meet the demands of real-time identification. If adopt computer parallel processing, the identification speed can be improved, but it will increase complexity, size and power consumption. This paper attempts to apply optical correlation identification technology to realize underwater automatic target identification. The optics correlation identification technology utilizes the Fourier transform characteristic of Fourier lens which can accomplish Fourier transform of image information in the level of nanosecond, and optical space interconnection calculation has the features of parallel, high speed, large capacity and high resolution, combines the flexibility of calculation and control of digital circuit method to realize optoelectronic hybrid identification mode. We reduce theoretical formulation of correlation identification and analyze the principle of optical correlation identification, and write MATLAB simulation program. We adopt single frame image obtained in underwater range gating laser imaging to identify, and through identifying and locating the different positions of target, we can improve the speed and orientation efficiency of target identification effectively, and validate the feasibility of this method primarily.

Joy, exercise, enjoyment, getting out: a qualitative study of older people's experience of cycling in Sydney, Australia.

PubMed

Zander, Alexis; Passmore, Erin; Mason, Chloe; Rissel, Chris

2013-01-01

Cycling can be an enjoyable way to meet physical activity recommendations and is suitable for older people; however cycling participation by older Australians is low. This qualitative study explored motivators, enablers, and barriers to cycling among older people through an age-targeted cycling promotion program. Seventeen adults who aged 50-75 years participated in a 12-week cycling promotion program which included a cycling skills course, mentor, and resource pack. Semistructured interviews at the beginning and end of the program explored motivators, enablers, and barriers to cycling. Fitness and recreation were the primary motivators for cycling. The biggest barrier was fear of cars and traffic, and the cycling skills course was the most important enabler for improving participants' confidence. Reported outcomes from cycling included improved quality of life (better mental health, social benefit, and empowerment) and improved physical health. A simple cycling program increased cycling participation among older people. This work confirms the importance of improving confidence in this age group through a skills course, mentors, and maps and highlights additional strategies for promoting cycling, such as ongoing improvement to infrastructure and advertising.

Joy, Exercise, Enjoyment, Getting out: A Qualitative Study of Older People's Experience of Cycling in Sydney, Australia

PubMed Central

Passmore, Erin; Mason, Chloe; Rissel, Chris

2013-01-01

Introduction. Cycling can be an enjoyable way to meet physical activity recommendations and is suitable for older people; however cycling participation by older Australians is low. This qualitative study explored motivators, enablers, and barriers to cycling among older people through an age-targeted cycling promotion program. Methods. Seventeen adults who aged 50–75 years participated in a 12-week cycling promotion program which included a cycling skills course, mentor, and resource pack. Semistructured interviews at the beginning and end of the program explored motivators, enablers, and barriers to cycling. Results. Fitness and recreation were the primary motivators for cycling. The biggest barrier was fear of cars and traffic, and the cycling skills course was the most important enabler for improving participants' confidence. Reported outcomes from cycling included improved quality of life (better mental health, social benefit, and empowerment) and improved physical health. Conclusions. A simple cycling program increased cycling participation among older people. This work confirms the importance of improving confidence in this age group through a skills course, mentors, and maps and highlights additional strategies for promoting cycling, such as ongoing improvement to infrastructure and advertising. PMID:23864869

Functional improvements following the use of the NVT Vision Rehabilitation program for patients with hemianopia following stroke.

PubMed

Hayes, Allison; Chen, Celia S; Clarke, Gayle; Thompson, Annette

2012-01-01

The incidence of visual deficits following stroke ranges from 20%-68% and has significant impact on activities of daily living. The NVT system is a compensatory visual scanning training program that consists of combined static and mobility training and transfer to activities of daily living. The study aims to evaluate functional changes following the NVT program for people who have homonymous hemianopia (HH) following stroke. Interventional case series of 13 consecutive participants with HH undergoing NVT vision rehabilitation. The primary outcome measure was the number of targets missed on a standardized Mobility Assessment Course (MAC). Other outcome measures included assessment of visual scanning, vision specific Quality of Life questionnaires and reading performance. The average number of targets (sd) missed on the MAC course was 39.6 ± 20.9% before intervention, 27.5 ± 16.3% immediately post intervention and 20.8 ± 15.5% at 3 months post rehabilitation. The study showed a statistically significant trend in improvement in mobility related subscales of National Eye Institute Visual Function Questionnaire-NEI VFQ-25 (p=0.003) and the Veteran Affairs Low Vision Visual Function Questionnaire-VA LVFQ-48 (p=0.036) at 3 months post rehabilitation. The NVT intervention resulted in functional improvements in mobility post rehabilitation. The NVT training showed improvement in vision specific quality of life. There is a need for standardised vision therapy intervention, in conjunction with existing rehabilitation services, for patients with stroke and traumatic brain injury.

Development of a Logic Model for a Physical Activity–Based Employee Wellness Program for Mass Transit Workers

PubMed Central

Petruzzello, Steven J.; Ryan, Katherine E.

2014-01-01

Transportation workers, who constitute a large sector of the workforce, have worksite factors that harm their health. Worksite wellness programs must target this at-risk population. Although physical activity is often a component of worksite wellness logic models, we consider it the cornerstone for improving the health of mass transit employees. Program theory was based on in-person interviews and focus groups of employees. We identified 4 short-term outcome categories, which provided a chain of responses based on the program activities that should lead to the desired end results. This logic model may have significant public health impact, because it can serve as a framework for other US mass transit districts and worksite populations that face similar barriers to wellness, including truck drivers, railroad employees, and pilots. The objective of this article is to discuss the development of a logic model for a physical activity–based mass-transit employee wellness program by describing the target population, program theory, the components of the logic model, and the process of its development. PMID:25032838

Development of a logic model for a physical activity-based employee wellness program for mass transit workers.

PubMed

Das, Bhibha M; Petruzzello, Steven J; Ryan, Katherine E

2014-07-17

Transportation workers, who constitute a large sector of the workforce, have worksite factors that harm their health. Worksite wellness programs must target this at-risk population. Although physical activity is often a component of worksite wellness logic models, we consider it the cornerstone for improving the health of mass transit employees. Program theory was based on in-person interviews and focus groups of employees. We identified 4 short-term outcome categories, which provided a chain of responses based on the program activities that should lead to the desired end results. This logic model may have significant public health impact, because it can serve as a framework for other US mass transit districts and worksite populations that face similar barriers to wellness, including truck drivers, railroad employees, and pilots. The objective of this article is to discuss the development of a logic model for a physical activity-based mass-transit employee wellness program by describing the target population, program theory, the components of the logic model, and the process of its development.

A community perspective on the role of fathers during pregnancy: a qualitative study

PubMed Central

2013-01-01

Background Defining male involvement during pregnancy is essential for the development of future research and appropriate interventions to optimize services aiming to improve birth outcomes. Study Aim: To define male involvement during pregnancy and obtain community-based recommendations for interventions to improve male involvement during pregnancy. Methods We conducted focus groups with mothers and fathers from the National Healthy Start Association program in order to obtain detailed descriptions of male involvement activities, benefits, barriers, and proposed solutions for increasing male involvement during pregnancy. The majority of participants were African American parents. Results The involved “male” was identified as either the biological father, or, the current male partner of the pregnant woman. Both men and women described the ideal, involved father or male partner as present, accessible, available, understanding, willing to learn about the pregnancy process and eager to provide emotional, physical and financial support to the woman carrying the child. Women emphasized a sense of “togetherness” during the pregnancy. Suggestions included creating male-targeted prenatal programs, enhancing current interventions targeting females, and increasing healthcare providers’ awareness of the importance of men’s involvement during pregnancy. Conclusions Individual, family, community, societal and policy factors play a role in barring or diminishing the involvement of fathers during pregnancy. Future research and interventions should target these factors and their interaction in order to increase fathers’ involvement and thereby improve pregnancy outcomes. PMID:23497131

Indigenous Child Health in Brazil: The Evaluation of Impacts as a Human Rights Issue.

PubMed

Coates, Anna R; Del Pino Marchito, Sandra; Vitoy, Bernardino

2016-06-01

Improving the health status of indigenous children is a long-standing challenge. Several United Nations committees have identified the health of indigenous peoples as a human rights concern. Addressing the health of indigenous children cannot be separated from their social, cultural, and historic contexts, and any related health program must offer culturally appropriate services and a community perspective broad enough to address the needs of children and the local worlds in which they live. Evaluations of programs must, therefore, address process as well as impacts. This paper assesses interventions addressing indigenous children's health in Brazil, ranging from those explicitly targeting indigenous children's health, such as the targeted immunization program for indigenous peoples, as well as more generalized programs, including a focus upon indigenous children, such as the Integrated Management of Childhood Illness. The paper discusses the tensions and complexities of ethnically targeted health interventions as well as the conceptual and methodological challenge of measuring the processes employed and their impact. The lessons learned, especially the need for countries to more systematically collect data and evaluate impacts using ethnicity as an analytical category, are drawn out with respect to ensuring human rights for all within health sector responses.

Indigenous Child Health in Brazil

PubMed Central

del Pino Marchito, Sandra; Vitoy, Bernardino

2016-01-01

Abstract Improving the health status of indigenous children is a long-standing challenge. Several United Nations committees have identified the health of indigenous peoples as a human rights concern. Addressing the health of indigenous children cannot be separated from their social, cultural, and historic contexts, and any related health program must offer culturally appropriate services and a community perspective broad enough to address the needs of children and the local worlds in which they live. Evaluations of programs must, therefore, address process as well as impacts. This paper assesses interventions addressing indigenous children’s health in Brazil, ranging from those explicitly targeting indigenous children’s health, such as the targeted immunization program for indigenous peoples, as well as more generalized programs, including a focus upon indigenous children, such as the Integrated Management of Childhood Illness. The paper discusses the tensions and complexities of ethnically targeted health interventions as well as the conceptual and methodological challenge of measuring the processes employed and their impact. The lessons learned, especially the need for countries to more systematically collect data and evaluate impacts using ethnicity as an analytical category, are drawn out with respect to ensuring human rights for all within health sector responses. PMID:27781012

Low-rank regularization for learning gene expression programs.

PubMed

Ye, Guibo; Tang, Mengfan; Cai, Jian-Feng; Nie, Qing; Xie, Xiaohui

2013-01-01

Learning gene expression programs directly from a set of observations is challenging due to the complexity of gene regulation, high noise of experimental measurements, and insufficient number of experimental measurements. Imposing additional constraints with strong and biologically motivated regularizations is critical in developing reliable and effective algorithms for inferring gene expression programs. Here we propose a new form of regulation that constrains the number of independent connectivity patterns between regulators and targets, motivated by the modular design of gene regulatory programs and the belief that the total number of independent regulatory modules should be small. We formulate a multi-target linear regression framework to incorporate this type of regulation, in which the number of independent connectivity patterns is expressed as the rank of the connectivity matrix between regulators and targets. We then generalize the linear framework to nonlinear cases, and prove that the generalized low-rank regularization model is still convex. Efficient algorithms are derived to solve both the linear and nonlinear low-rank regularized problems. Finally, we test the algorithms on three gene expression datasets, and show that the low-rank regularization improves the accuracy of gene expression prediction in these three datasets.

Improving Reading and Language Arts Skills of At-Risk First Graders through Direct Instruction of Print Awareness, Phoneme Awareness, and Phonological Processing.

ERIC Educational Resources Information Center

Bump, Sandra K.; Swedberg, Trina L.; Yates, Carol R.

This report describes a program to improve reading and language arts skills. The targeted population consisted of students in 2 first grade classrooms (average class size 25) from a midwestern elementary school in a predominantly white, middle to upper-middle class neighborhood. Data documenting the problem was obtained from the previous year's…

Development and Evaluation of a Pharmacogenomics Educational Program for Pharmacists

PubMed Central

Formea, Christine M.; Nicholson, Wayne T.; McCullough, Kristen B.; Berg, Kevin D.; Berg, Melody L.; Cunningham, Julie L.; Merten, Julianna A.; Ou, Narith N.; Stollings, Joanna L.

2013-01-01

Objectives. To evaluate hospital and outpatient pharmacists’ pharmacogenomics knowledge before and 2 months after participating in a targeted, case-based pharmacogenomics continuing education program. Design. As part of a continuing education program accredited by the Accreditation Council for Pharmacy Education (ACPE), pharmacists were provided with a fundamental pharmacogenomics education program. Evaluation. An 11-question, multiple-choice, electronic survey instrument was distributed to 272 eligible pharmacists at a single campus of a large, academic healthcare system. Pharmacists improved their pharmacogenomics test scores by 0.7 questions (pretest average 46%; posttest average 53%, p=0.0003). Conclusions. Although pharmacists demonstrated improvement, overall retention of educational goals and objectives was marginal. These results suggest that the complex topic of pharmacogenomics requires a large educational effort in order to increase pharmacists’ knowledge and comfort level with this emerging therapeutic opportunity. PMID:23459098

Social Tools And Rules for Teens (The START Program): Program Description and Preliminary Outcomes of an Experiential Socialization Intervention for Adolescents with Autism Spectrum Disorder.

PubMed

Vernon, Ty W; Miller, Amber R; Ko, Jordan A; Wu, Victoria L

2016-05-01

Experiential learning is an essential process in the development of core social competencies. Unfortunately, adolescents with autism spectrum disorders often do not possess the prerequisite skillset and motivation to sustain the level of social immersion needed to benefit from this learning process. These persisting social vulnerabilities can limit their long-term relational success and associated quality of life, creating a need for comprehensive social programming. This paper describes a multi-component socialization intervention that simultaneously targets motivational, conceptual, and skill deficits using a hybrid experiential/didactic treatment approach. Evidence of social competence improvements was noted in survey and live conversational measures, indicating that the START program may hold promise as a method for improving the social success of participating adolescents with ASD.

Development and evaluation of a pharmacogenomics educational program for pharmacists.

PubMed

Formea, Christine M; Nicholson, Wayne T; McCullough, Kristen B; Berg, Kevin D; Berg, Melody L; Cunningham, Julie L; Merten, Julianna A; Ou, Narith N; Stollings, Joanna L

2013-02-12

Objectives. To evaluate hospital and outpatient pharmacists' pharmacogenomics knowledge before and 2 months after participating in a targeted, case-based pharmacogenomics continuing education program.Design. As part of a continuing education program accredited by the Accreditation Council for Pharmacy Education (ACPE), pharmacists were provided with a fundamental pharmacogenomics education program.Evaluation. An 11-question, multiple-choice, electronic survey instrument was distributed to 272 eligible pharmacists at a single campus of a large, academic healthcare system. Pharmacists improved their pharmacogenomics test scores by 0.7 questions (pretest average 46%; posttest average 53%, p=0.0003).Conclusions. Although pharmacists demonstrated improvement, overall retention of educational goals and objectives was marginal. These results suggest that the complex topic of pharmacogenomics requires a large educational effort in order to increase pharmacists' knowledge and comfort level with this emerging therapeutic opportunity.

A specialist peer mentoring program for university students on the autism spectrum: A pilot study.

PubMed

Siew, Choo Ting; Mazzucchelli, Trevor G; Rooney, Rosanna; Girdler, Sonya

2017-01-01

The provision of peer mentoring may improve tertiary education outcomes of students with autism spectrum disorder (ASD). This study evaluated the pilot year of the Curtin Specialist Mentoring Program (CSMP), a specialised peer mentoring program for university students with ASD aimed at improving self-reported well-being, academic success and retention in university studies. A single group pre-test, post-test design was employed. Quantitative and qualitative evaluations were undertaken with 10 young adults with ASD to explore the effectiveness and acceptability of the CSMP program. Students completed a battery of questionnaires focused on general anxiety, state communication apprehension, perceived communication competence, and communication apprehension both prior to, and five months after commencing enrolment in the CSMP. Information regarding academic success and retention was also obtained. Interviews with participants provided further insight into their experience of the program. Students enrolled in the CSMP showed significant improvement in social support and general communication apprehension assessment scores. Interviews revealed key features of the CSMP that may have contributed to these positive outcomes. The current study provides preliminary evidence that a specialised peer mentoring program can improve the well-being of students with ASD, and highlights the importance of interventions which are individualised, flexible, based on a social model, and target environmental factors such as social support.

The development of a community and home-based chronic care management program for older adults.

PubMed

Cooper, Jennifer; McCarter, Kathryn A

2014-01-01

The objective of this paper was to evaluate a chronic care management program piloted by a visiting nurses association. Desired outcomes were to increase nurses' knowledge of self-management of chronic conditions and improve patient self-efficacy and clinical measures. The program provided educational development for nurses and piloted encounters with patients with chronic conditions targeting community health nurses for a chronic care professional (CCP) certification and invited 300 faith community nurses to an education program on chronic condition(s). Thirteen patients with chronic condition(s) were enrolled. Chronic care professional modules were used to increase nurses' knowledge and were measured by successful completion of a certification exam. Faith community nurses participated in an education program and completed a posttest to measure knowledge of content. Patient improvement in self-management was measured by pre- and postintervention self-efficacy scores and clinical measures. Seventeen nurses successfully completed the exam, and 38 faith community nurses participated in the program and completed the posttest. Three patients showed improvement in self-efficacy scores and eight in clinical measures. The educational development of community nurses prepared them to provide effective encounters to improve self-efficacy and clinical outcomes for older adults with chronic conditions. © 2013 Wiley Periodicals, Inc.

Vulnerability of Rehabilitated Agricultural Production Systems to Invasion by Nontarget Plant Species

NASA Astrophysics Data System (ADS)

Baer, Sara G.; Engle, David M.; Knops, Johannes M. H.; Langeland, Kenneth A.; Maxwell, Bruce D.; Menalled, Fabian D.; Symstad, Amy J.

2009-02-01

Vast areas of arable land have been retired from crop production and “rehabilitated” to improved system states through landowner incentive programs in the United States (e.g., Conservation and Wetland Reserve Programs), as well as Europe (i.e., Agri-Environment Schemes). Our review of studies conducted on invasion of rehabilitated agricultural production systems by nontarget species elucidates several factors that may increase the vulnerability of these systems to invasion. These systems often exist in highly fragmented and agriculturally dominated landscapes, where propagule sources of target species for colonization may be limited, and are established under conditions where legacies of past disturbance persist and prevent target species from persisting. Furthermore, rehabilitation approaches often do not include or successfully attain all target species or historical ecological processes (e.g., hydrology, grazing, and/or fire cycles) key to resisting invasion. Uncertainty surrounds ways in which nontarget species may compromise long term goals of improving biodiversity and ecosystem services through rehabilitation efforts on former agricultural production lands. This review demonstrates that more studies are needed on the extent and ecological impacts of nontarget species as related to the goals of rehabilitation efforts to secure current and future environmental benefits arising from this widespread conservation practice.

The effect of a resilience improvement program for adolescents with complex congenital heart disease.

PubMed

Lee, Sunhee; Lee, Junga; Choi, Jae Young

2017-04-01

Adolescents with congenital heart disease need to increase their resilience in the face of challenges in order to preserve their health and quality of life. This study aimed to develop a resilience improvement program for adolescents with congenital heart disease and also to evaluate any change in resilience and quality of life as a measure of the effectiveness of the resilience improvement programs. A nonequivalent control group pretest-posttest study was designed. Twenty-five adolescents who attended the first resilience improvement program were included in the experimental group, and 31 adolescents who took part in the second program were placed in the control group. Adolescents with congenital heart disease completed a self-report questionnaire on three separate occasions: the pretest, the first posttest and the second posttest. The self-report questionnaire included general characteristics and instruments to measure resilience and quality of life. For the longitudinal analysis, generalized estimating equations were used to evaluate the difference in the estimated average trajectories of resilience and quality of life changes. Independent predictors of resilience improvement in adolescents with congenital heart disease were the experimental group ( p=0.02) and middle and high school students ( p=0.02). Quality of life was not associated with membership in the experimental group. However, males scored higher than females on quality of life measures ( p=0.02). It is essential for healthcare providers to apply various programs, including those targeted at accepting illness, improving autonomy and independently managing disease, to adolescents with congenital heart disease.

Enhancing Cognitive Abilities with Comprehensive Training: A Large, Online, Randomized, Active-Controlled Trial

PubMed Central

Hardy, Joseph L.; Nelson, Rolf A.; Thomason, Moriah E.; Sternberg, Daniel A.; Katovich, Kiefer; Farzin, Faraz; Scanlon, Michael

2015-01-01

Background A variety of studies have demonstrated gains in cognitive ability following cognitive training interventions. However, other studies have not shown such gains, and questions remain regarding the efficacy of specific cognitive training interventions. Cognitive training research often involves programs made up of just one or a few exercises, targeting limited and specific cognitive endpoints. In addition, cognitive training studies typically involve small samples that may be insufficient for reliable measurement of change. Other studies have utilized training periods that were too short to generate reliable gains in cognitive performance. Methods The present study evaluated an online cognitive training program comprised of 49 exercises targeting a variety of cognitive capacities. The cognitive training program was compared to an active control condition in which participants completed crossword puzzles. All participants were recruited, trained, and tested online (N = 4,715 fully evaluable participants). Participants in both groups were instructed to complete one approximately 15-minute session at least 5 days per week for 10 weeks. Results Participants randomly assigned to the treatment group improved significantly more on the primary outcome measure, an aggregate measure of neuropsychological performance, than did the active control group (Cohen’s d effect size = 0.255; 95% confidence interval = [0.198, 0.312]). Treatment participants showed greater improvements than controls on speed of processing, short-term memory, working memory, problem solving, and fluid reasoning assessments. Participants in the treatment group also showed greater improvements on self-reported measures of cognitive functioning, particularly on those items related to concentration compared to the control group (Cohen’s d = 0.249; 95% confidence interval = [0.191, 0.306]). Conclusion Taken together, these results indicate that a varied training program composed of a number of tasks targeted to different cognitive functions can show transfer to a wide range of untrained measures of cognitive performance. Trial Registration ClinicalTrials.gov NCT-02367898 PMID:26333022

Hypertension in Russia: Changes Observed After 4 Years of a Comprehensive Health System Improvement Program in the Yaroslavl Region.

PubMed

Mozheyko, Maria; Eregin, Sergey; Danilenko, Natalia; Vigdorchik, Alexey; Tobe, Sheldon W; Campbell, Norman; McLean, Donna; Baskakova, Zhanna; Klimovskaia, Ilnaz; Ramanathan, Krishnan; Hughes, David

2017-02-01

Rates of cardiovascular mortality and morbidity in Russia have been among the highest in Europe. A comprehensive health system improvement program targeting better diagnosis and control of hypertension was undertaken in the Yaroslavl Region of Russia. This initiative was a joint program between clinicians, the Department of Health and Pharmacy of the Yaroslavl Region, and Novartis Pharma LLC. From 2011 to 2014, the blood pressure control rate improved substantially (94% relative improvement), the percentage of patients with a systolic blood pressure ≥180 mm Hg decreased (from 10% to 5%), and there was a reduction in stroke incidence rate from 4.6 to 3.7 per 1000 population. During this same period, significant changes were made to the way hypertension was diagnosed and treated across all regional government polyclinics, and the use of antihypertensive therapies increased. © 2016 The Authors. The Journal of Clinical Hypertension Published by Wiley Periodicals, Inc.

Overlay accuracy with respect to device scaling

NASA Astrophysics Data System (ADS)

Leray, Philippe; Laidler, David; Cheng, Shaunee

2012-03-01

Overlay metrology performance is usually reported as repeatability, matching between tools or optics aberrations distorting the measurement (Tool induced shift or TIS). Over the last few years, improvement of these metrics by the tool suppliers has been impressive. But, what about accuracy? Using different target types, we have already reported small differences in the mean value as well as fingerprint [1]. These differences make the correctables questionable. Which target is correct and therefore which translation, scaling etc. values should be fed back to the scanner? In this paper we investigate the sources of these differences, using several approaches. First, we measure the response of different targets to offsets programmed in a test vehicle. Second, we check the response of the same overlay targets to overlay errors programmed into the scanner. We compare overlay target designs; what is the contribution of the size of the features that make up the target? We use different overlay measurement techniques; is DBO (Diffraction Based Overlay) more accurate than IBO (Image Based Overlay)? We measure overlay on several stacks; what is the stack contribution to inaccuracy? In conclusion, we offer an explanation for the observed differences and propose a solution to reduce them.

This Ad is for You: Targeting and the Effect of Alcohol Advertising on Youth Drinking.

PubMed

Molloy, Eamon

2016-02-01

Endogenous targeting of alcohol advertisements presents a challenge for empirically identifying a causal effect of advertising on drinking. Drinkers prefer a particular media; firms recognize this and target alcohol advertising at these media. This paper overcomes this challenge by utilizing novel data with detailed individual measures of media viewing and alcohol consumption and three separate empirical techniques, which represent significant improvements over previous methods. First, controls for the average audience characteristics of the media an individual views account for attributes of magazines and television programs alcohol firms may consider when deciding where to target advertising. A second specification directly controls for each television program and magazine a person views. The third method exploits variation in advertising exposure due to a 2003 change in an industry-wide rule that governs where firms may advertise. Although the unconditional correlation between advertising and drinking by youth (ages 18-24) is strong, models that include simple controls for targeting imply, at most, a modest advertising effect. Although the coefficients are estimated less precisely, estimates with models including more rigorous controls for targeting indicate no significant effect of advertising on youth drinking. Copyright © 2015 John Wiley & Sons, Ltd.

Low Emissions Aftertreatment and Diesel Emissions Reduction

DOE Office of Scientific and Technical Information (OSTI.GOV)

None

2005-05-27

Detroit Diesel Corporation (DDC) has successfully completed a five-year Low Emissions Aftertreatment and Diesel Emissions Reduction (LEADER) program under a DOE project entitled: ''Research and Development for Compression-Ignition Direct-Injection Engines (CIDI) and Aftertreatment Sub-Systems''. The objectives of the LEADER Program were to: Demonstrate technologies that will achieve future federal Tier 2 emissions targets; and Demonstrate production-viable technical targets for engine out emissions, efficiency, power density, noise, durability, production cost, aftertreatment volume and weight. These objectives were successfully met during the course of the LEADER program The most noteworthy achievements in this program are listed below: (1) Demonstrated Tier 2 Binmore » 3 emissions target over the FTP75 cycle on a PNGV-mule Neon passenger car, utilizing a CSF + SCR system These aggressive emissions were obtained with no ammonia (NH{sub 3}) slip and a combined fuel economy of 63 miles per gallon, integrating FTP75 and highway fuel economy transient cycle test results. Demonstrated feasibility to achieve Tier 2 Bin 8 emissions levels without active NOx aftertreatment. (2) Demonstrated Tier 2 Bin 3 emissions target over the FTP75 cycle on a light-duty truck utilizing a CSF + SCR system, synergizing efforts with the DOE-DDC DELTA program. This aggressive reduction in tailpipe out emissions was achieved with no ammonia slip and a 41% fuel economy improvement, compared to the equivalent gasoline engine-equipped vehicle. (3) Demonstrated Tier 2 near-Bin 9 emissions compliance on a light-duty truck, without active NOx aftertreatment devices, in synergy with the DOE-DDC DELTA program. (4) Developed and applied advanced combustion technologies such as ''CLEAN Combustion{copyright}'', which yields simultaneous reduction in engine out NOx and PM emissions while also improving engine and aftertreatment integration by providing favorable exhaust species and temperature characteristics. These favorable emissions characteristics were obtained while maintaining performance and fuel economy. These aggressive emissions and performance results were achieved by applying a robust systems technology development methodology. This systems approach benefits substantially from an integrated experimental and analytical approach to technology development, which is one of DDCs core competencies Also, DDC is uniquely positioned to undertake such a systems technology development approach, given its vertically integrated commercial structure within the DaimlerChrysler organization. State-of-the-art analytical tools were developed targeting specific LEADER program objectives and were applied to guide system enhancements and to provide testing directions, resulting in a shortened and efficient development cycle. Application examples include ammonia/NO{sub x} distribution improvement and urea injection controls development, and were key contributors to significantly reduce engine out as well as tailpipe out emissions. Successful cooperation between DDC and Engelhard Corporation, the major subcontractor for the LEADER program and provider of state-of-the-art technologies on various catalysts, was another contributing factor to ensure that both passenger car and LD truck applications achieved Tier 2 Bin 3 emissions levels. Significant technical challenges, which highlight barriers of commercialization of diesel technology for passenger cars and LD truck applications, are presented at the end of this report.« less

Symptoms of internalizing and externalizing problems: modeling recovery curves after the death of a parent.

PubMed

Schmiege, Sarah J; Khoo, Siek Toon; Sandler, Irwin N; Ayers, Tim S; Wolchik, Sharlene A

2006-12-01

The death of a parent is a major family disruption that can place children at risk for later depression and other mental health problems. Theoretically based randomized controlled trial for parentally bereaved children. Two-hundred and forty-four children and adolescents and their caregivers from 156 families were randomly assigned to the Family Bereavement Program (FBP) intervention condition (90 families; 135 children) or to a control condition (66 families; 109 children). Data collection occurred from 1996 to 1998. Children and caregivers in the intervention condition met separately for 12 two-hour weekly sessions. Skills targeted by the program for children included positive coping, stress appraisals, control beliefs, and self-esteem. The caregiver program targeted caregiver mental health, life stressors, and improved discipline in the home. Both child and caregiver programs focused on improved quality of the caregiver-child relationship. Child and caregiver reports of internalizing and externalizing symptoms. Longitudinal growth curve modeling was performed to model symptoms over time from the point of parental death. The rate of recovery for girls in the program condition was significantly different from that of girls in the control condition across all outcomes. Boys in both conditions showed reduced symptoms over time. The methodology offers a conceptually unique way of assessing recovery in terms of reduced mental health problems over time after an event and has contributed to further understanding of FBP intervention effects. The intervention program facilitated recovery among girls, who did not show reduction in behavior problems without the program, while boys demonstrated decreased symptoms even without intervention.

[Study of continuous quality improvement for clinical laboratory processes via the platform of Hospital Group].

PubMed

Song, Wenqi; Shen, Ying; Peng, Xiaoxia; Tian, Jian; Wang, Hui; Xu, Lili; Nie, Xiaolu; Ni, Xin

2015-05-26

The program of continuous quality improvement in clinical laboratory processes for complete blood count (CBC) was launched via the platform of Beijing Children's Hospital Group in order to improve the quality of pediatric clinical laboratories. Fifteen children's hospitals of Beijing Children's Hospital group were investigated using the method of Chinese adapted continuous quality improvement with PDCA (Plan-Do-Check-Action). The questionnaire survey and inter-laboratory comparison was conducted to find the existing problems, to analyze reasons, to set forth quality targets and to put them into practice. Then, targeted training was conducted to 15 children's hospitals and the second questionnaire survey, self examinations by the clinical laboratories was performed. At the same time, the Group's online internal quality control platform was established. Overall effects of the program were evaluated so that lay a foundation for the next stage of PDCA. Both quality of control system documents and CBC internal quality control scheme for all of clinical laboratories were improved through this program. In addition, standardization of performance verification was also improved, especially with the comparable verification rate of precision and internal laboratory results up to 100%. In terms of instrument calibration and mandatory diagnostic rates, only three out of the 15 hospitals (20%) failed to pass muster in 2014 from 46.67% (seven out of the 15 hospitals) in 2013. The abnormal data of intraday precision variance coefficients of the five CBC indicator parameters (WBC, RBC, Hb, Plt and Hct) of all the 15 laboratories accounted for 1.2% (2/165) in 2014, a marked decrease from 9.6% (14/145) in 2013. While the number of the hospitals using only one horizontal quality control object for daily quality control has dropped to three from five. The 15 hospitals organized a total of 263 times of training in 2014 from 101 times in 2013, up 160%. The quality improvement program for the clinical laboratories launched via the Hospital Group platform can promote the joint development of the pediatric clinical laboratory discipline of all the member hospitals with remarkable improvement results, and the experience is recommendable for further rollout.

The impact of patient support programs on adherence, clinical, humanistic, and economic patient outcomes: a targeted systematic review

PubMed Central

Ganguli, Arijit; Clewell, Jerry; Shillington, Alicia C

2016-01-01

Background Patient support programs (PSPs), including medication management and counseling, have the potential to improve care in chronic disease states with complex therapies. Little is known about the program’s effects on improving clinical, adherence, humanistic, and cost outcomes. Purpose To conduct a targeted review describing medical conditions in which PSPs have been implemented; support delivery components (eg, face-to-face, phone, mail, and internet); and outcomes associated with implementation. Data sources MEDLINE – 10 years through March 2015 with supplemental handsearching of reference lists. Study selection English-language trials and observational studies of PSPs providing at minimum, counseling for medication management, measurement of ≥1 clinical outcome, and a 3-month follow-up period during which outcomes were measured. Data extraction Program characteristics and related clinical, adherence, humanistic, and cost outcomes were abstracted. Study quality and the overall strength of evidence were reviewed using standard criteria. Data synthesis Of 2,239 citations, 64 studies met inclusion criteria. All targeted chronic disease processes and the majority (48 [75%]) of programs offered in-clinic, face-to-face support. All but 9 (14.1%) were overseen by allied health care professionals (eg, nurses, pharmacists, paraprofessionals). Forty-one (64.1%) reported at least one significantly positive clinical outcome. The most frequent clinical outcome impacted was adherence, where 27 of 41 (66%) reported a positive outcome. Of 42 studies measuring humanistic outcomes (eg, quality of life, functional status), 27 (64%) reported significantly positive outcomes. Only 15 (23.4%) programs reported cost or utilization-related outcomes, and, of these, 12 reported positive impacts. Conclusion The preponderance of evidence suggests a positive impact of PSPs on adherence, clinical and humanistic outcomes. Although less often measured, health care utilization and costs are also reduced following PSP implementation. Further research is needed to better quantify which support programs, delivery methods, and components offer the greatest value for any particular medical condition. PMID:27175071

Geographical differences in perinatal health and child welfare in the Netherlands: rationale for the healthy pregnancy 4 all-2 program.

PubMed

Waelput, Adja J M; Sijpkens, Meertien K; Lagendijk, Jacqueline; van Minde, Minke R C; Raat, Hein; Ernst-Smelt, Hiske E; de Kroon, Marlou L A; Rosman, Ageeth N; Been, Jasper V; Bertens, Loes C M; Steegers, Eric A P

2017-08-01

Geographical inequalities in perinatal health and child welfare require attention. To improve the identification, and care, of mothers and young children at risk of adverse health outcomes, the HP4All-2 program was developed. The program consists of three studies, focusing on creating a continuum for risk selection and tailored care pathways from preconception and antenatal care towards 1) postpartum care, 2) early childhood care, as well as 3) interconception care. The program has been implemented in ten municipalities in the Netherlands, aiming to target communities with a relatively disadvantageous position with regard to perinatal and child health outcomes. To delineate the position of the ten participating municipalities, we present municipal and regional differences in the prevalence of perinatal mortality, perinatal morbidity, children living in deprived neighbourhoods, and children living in families on welfare. Data on all singleton births in the Netherlands between 2009 and 2014 were analysed for the prevalence of perinatal mortality and morbidity. In addition, national data on children living in deprived neighbourhoods and children living in families on welfare between 2009 and 2012 were analysed. The prevalence of these outcomes were calculated and ranked for 62 geographical areas, the 50 largest municipalities and the 12 provinces, to determine the position of the municipalities that participate in HP4All-2. Considerable geographical differences were present for all four outcomes. The municipalities that participate in HP4All-2 are among the 25 municipalities with the highest prevalence of perinatal mortality, perinatal morbidity, children living in deprived neighbourhoods, or children in families on welfare. This study illustrates geographical differences in perinatal health and/or child welfare outcomes and demonstrates that the HP4All-2 program targets municipalities with a relative unfavourable position. By targeting these municipalities, the program is expected to contribute most to improving the care for young children and their mothers at risk, and hence to reducing their risks and health inequalities.

Improving health-related fitness in children: the fit-4-Fun randomized controlled trial study protocol

PubMed Central

2011-01-01

Background Declining levels of physical fitness in children are linked to an increased risk of developing poor physical and mental health. Physical activity programs for children that involve regular high intensity physical activity, along with muscle and bone strengthening activities, have been identified by the World Health Organisation as a key strategy to reduce the escalating burden of ill health caused by non-communicable diseases. This paper reports the rationale and methods for a school-based intervention designed to improve physical fitness and physical activity levels of Grades 5 and 6 primary school children. Methods/Design Fit-4-Fun is an 8-week multi-component school-based health-related fitness education intervention and will be evaluated using a group randomized controlled trial. Primary schools from the Hunter Region in NSW, Australia, will be invited to participate in the program in 2011 with a target sample size of 128 primary schools children (age 10-13). The Fit-4-Fun program is theoretically grounded and will be implemented applying the Health Promoting Schools framework. Students will participate in weekly curriculum-based health and physical education lessons, daily break-time physical activities during recess and lunch, and will complete an 8-week (3 × per week) home activity program with their parents and/or family members. A battery of six health-related fitness assessments, four days of pedometery-assessed physical activity and a questionnaire, will be administered at baseline, immediate post-intervention (2-months) and at 6-months (from baseline) to determine intervention effects. Details of the methodological aspects of recruitment, inclusion criteria, randomization, intervention program, assessments, process evaluation and statistical analyses are described. Discussion The Fit-4-Fun program is an innovative school-based intervention targeting fitness improvements in primary school children. The program will involve a range of evidence-based behaviour change strategies to promote and support physical activity of adequate intensity, duration and type, needed to improve health-related fitness. Trial Registration No Australia and New Zealand Clinical Trials Register (ANZCTR): ACTRN12611000976987 PMID:22142435

IMPACT: Imaging and Molecular Markers for Patients with Lung Cancer: Approaches with Molecular Targets, Complementary/Innovative Treatments, and Therapeutic Modalities

DTIC Science & Technology

2013-02-01

therapies (surgery, radiation and chemotherapy) have reached a therapeutic ceiling in improving the five- year overall survival rate of non-small cell...poor understanding of the disease and its resistance to the therapy . Lung cancer is a heterogeneous disease, resulting from accumulated genetic... a new promising approach to treatment of lung cancer. The program project IMPACT has proposed to integrate targeted therapy in the lung cancer

U.S. Assistance to Yemen: Actions Needed to Improve Oversight of Emergency Food Aid and Assess Security Assistance

DTIC Science & Technology

2013-03-01

annual targets between fiscal years 2008 and 2011 for the number of individuals in Yemen benefiting from food donations. However, reports to Congress...annual performance targets three times for the number of individuals in Yemen benefiting from food donations, reports to Congress about the program...security to several hundred locally employed staff. However, the embassy has deemed other steps proposed by locally employed staff, including telework and

Strategies For Clinical Implementation: Precision Oncology At Three Distinct Institutions.

PubMed

Nadauld, Lincoln D; Ford, James M; Pritchard, Daryl; Brown, Thomas

2018-05-01

Despite rapid advances in molecular diagnostics and targeted therapeutics, the adoption of precision medicine into clinical oncology workflows has been slow. Questions about clinical utility, inconsistent reimbursement for molecular diagnostics, and limited access to targeted therapies are some of the major hurdles that have hampered clinical adoption. Despite these challenges, providers have invested in precision medicine programs in an ongoing search for innovative care models to deliver improved patient outcomes and achieve economic gains. We describe the precision oncology medicine programs implemented by an integrated delivery system, a community care center, and an academic medical center, to demonstrate the approaches and challenges associated with clinical implementation efforts designed to advance this treatment paradigm. Payer policies that include coverage for broad genomic testing panels would support the broader application of precision medicine, deepen research benefits, and bring targeted therapies to more patients with advanced cancer.

Impact on clinical practice of the implementation of guidelines for the toxicity management of targeted therapies in kidney cancer. The protect-2 study.

PubMed

Lainez, Nuria; García-Donas, Jesús; Esteban, Emilio; Puente, Javier; Sáez, M Isabel; Gallardo, Enrique; Pinto-Marín, Álvaro; Vázquez-Estévez, Sergio; León, Luis; García-Carbonero, Icíar; Suárez-Rodríguez, Cristina; Molins, Carmen; Climent-Duran, Miguel A; Lázaro-Quintela, Martín; González Del Alba, Aranzazu; Méndez-Vidal, María José; Chirivella, Isabel; Afonso, Francisco J; López-Brea, Marta; Sala-González, Nuria; Domenech, Montserrat; Basterretxea, Laura; Santander-Lobera, Carmen; Gil-Arnáiz, Irene; Fernández, Ovidio; Caballero-Díaz, Cristina; Mellado, Begoña; Marrupe, David; García-Sánchez, José; Sánchez-Escribano, Ricardo; Fernández Parra, Eva; Villa Guzmán, José C; Martínez-Ortega, Esther; Belén González, María; Morán, Marina; Suarez-Paniagua, Beatriz; Lecumberri, María J; Castellano, Daniel

2016-02-22

The impact of such recommendations after their implementation of guidelines has not usually been evaluated. Herein, we assessed the impact and compliance with the Spanish Oncology Genitourinary Group (SOGUG) Guidelines for toxicity management of targeted therapies in metastatic renal cell carcinoma (mRCC) in daily clinical practice. Data on 407 mRCC patients who initiated first-line targeted therapy during the year before and the year after publication and implementation of the SOGUG guideline program were available from 34 Spanish Hospitals. Adherence to SOGUG Guidelines was assessed in every cycle. Adverse event (AE) management was consistent with the Guidelines as a whole for 28.7% out of 966 post-implementation cycles compared with 23.1% out of 892 pre-implementation cycles (p = 0.006). Analysis of adherence by AE in non-compliant cycles showed significant changes in appropriate management of hypertension (33% pre-implementation vs. 44.5% post-implementation cycles; p < 0.0001), diarrhea (74.0% vs. 80.5%; p = 0.011) and dyslipemia (25.0% vs. 44.6%; p < 0.001). Slight but significant improvements in AE management were detected following the implementation of SOGUG recommendations. However, room for improvement in the management of AEs due to targeted agents still remains and could be the focus for further programs in this direction.

Cognitive-Behavioral-Based Physical Therapy for Patients With Chronic Pain Undergoing Lumbar Spine Surgery: A Randomized Controlled Trial.

PubMed

Archer, Kristin R; Devin, Clinton J; Vanston, Susan W; Koyama, Tatsuki; Phillips, Sharon E; George, Steven Z; McGirt, Matthew J; Spengler, Dan M; Aaronson, Oran S; Cheng, Joseph S; Wegener, Stephen T

2016-01-01

The purpose of this study was to determine the efficacy of a cognitive-behavioral-based physical therapy (CBPT) program for improving outcomes in patients after lumbar spine surgery. A randomized controlled trial was conducted on 86 adults undergoing a laminectomy with or without arthrodesis for a lumbar degenerative condition. Patients were screened preoperatively for high fear of movement using the Tampa Scale for Kinesiophobia. Randomization to either CBPT or an education program occurred at 6 weeks after surgery. Assessments were completed pretreatment, posttreatment and at 3-month follow-up. The primary outcomes were pain and disability measured by the Brief Pain Inventory and Oswestry Disability Index. Secondary outcomes included general health (SF-12) and performance-based tests (5-Chair Stand, Timed Up and Go, 10-Meter Walk). Multivariable linear regression analyses found that CBPT participants had significantly greater decreases in pain and disability and increases in general health and physical performance compared with the education group at the 3-month follow-up. Results suggest a targeted CBPT program may result in significant and clinically meaningful improvement in postoperative outcomes. CBPT has the potential to be an evidence-based program that clinicians can recommend for patients at risk for poor recovery after spine surgery. This study investigated a targeted cognitive-behavioral-based physical therapy program for patients after lumbar spine surgery. Findings lend support to the hypothesis that incorporating cognitive-behavioral strategies into postoperative physical therapy may address psychosocial risk factors and improve pain, disability, general health, and physical performance outcomes. Copyright © 2016 American Pain Society. Published by Elsevier Inc. All rights reserved.

A Community-Based Sensory Training Program Leads to Improved Experience at a Local Zoo for Children with Sensory Challenges.

PubMed

Kong, Michele; Pritchard, Mallory; Dean, Lara; Talley, Michele; Torbert, Roger; Maha, Julian

2017-01-01

Sensory processing difficulties are common among many special needs children, especially those with autism spectrum disorder (ASD). The sensory sensitivities often result in interference of daily functioning and can lead to social isolation for both the individual and family unit. A quality improvement (QI) project was undertaken within a local zoo to systematically implement a sensory training program targeted at helping special needs individuals with sensory challenges, including those with ASD, Down's syndrome, attention-deficit/hyperactivity disorder, and speech delay. We piloted the program over a 2-year period. The program consisted of staff training, provision of sensory bags and specific social stories, as well as creation of quiet zones. Two hundred family units were surveyed before and after implementation of the sensory training program. In this pilot QI study, families reported increased visitation to the zoo, improved interactions with staff members, and the overall quality of their experience. In conclusion, we are able to demonstrate that a sensory training program within the community zoo is feasible, impactful, and has the potential to decrease social isolation for special needs individuals and their families.

A Community-Based Sensory Training Program Leads to Improved Experience at a Local Zoo for Children with Sensory Challenges

PubMed Central

Kong, Michele; Pritchard, Mallory; Dean, Lara; Talley, Michele; Torbert, Roger; Maha, Julian

2017-01-01

Sensory processing difficulties are common among many special needs children, especially those with autism spectrum disorder (ASD). The sensory sensitivities often result in interference of daily functioning and can lead to social isolation for both the individual and family unit. A quality improvement (QI) project was undertaken within a local zoo to systematically implement a sensory training program targeted at helping special needs individuals with sensory challenges, including those with ASD, Down’s syndrome, attention-deficit/hyperactivity disorder, and speech delay. We piloted the program over a 2-year period. The program consisted of staff training, provision of sensory bags and specific social stories, as well as creation of quiet zones. Two hundred family units were surveyed before and after implementation of the sensory training program. In this pilot QI study, families reported increased visitation to the zoo, improved interactions with staff members, and the overall quality of their experience. In conclusion, we are able to demonstrate that a sensory training program within the community zoo is feasible, impactful, and has the potential to decrease social isolation for special needs individuals and their families. PMID:28966920

Influence of age, sex, technique, and exercise program on movement patterns after an anterior cruciate ligament injury prevention program in youth soccer players.

PubMed

DiStefano, Lindsay J; Padua, Darin A; DiStefano, Michael J; Marshall, Stephen W

2009-03-01

Anterior cruciate ligament (ACL) injury prevention programs show promising results with changing movement; however, little information exists regarding whether a program designed for an individual's movements may be effective or how baseline movements may affect outcomes. A program designed to change specific movements would be more effective than a "one-size-fits-all" program. Greatest improvement would be observed among individuals with the most baseline error. Subjects of different ages and sexes respond similarly. Randomized controlled trial; Level of evidence, 1. One hundred seventy-three youth soccer players from 27 teams were randomly assigned to a generalized or stratified program. Subjects were videotaped during jump-landing trials before and after the program and were assessed using the Landing Error Scoring System (LESS), which is a valid clinical movement analysis tool. A high LESS score indicates more errors. Generalized players performed the same exercises, while the stratified players performed exercises to correct their initial movement errors. Change scores were compared between groups of varying baseline errors, ages, sexes, and programs. Subjects with the highest baseline LESS score improved the most (95% CI, -3.4 to -2.0). High school subjects (95% CI, -1.7 to -0.98) improved their technique more than pre-high school subjects (95% CI, -1.0 to -0.4). There was no difference between the programs or sexes. Players with the greatest amount of movement errors experienced the most improvement. A program's effectiveness may be enhanced if this population is targeted.

Target: Development Action.

ERIC Educational Resources Information Center

American Freedom from Hunger Foundation, Washington, DC. Young World Development.

This handbook, suggestive rather than prescriptive, is written for Young World Development and/or similar groups committed to active involvement in community, national, and world improvement. Emphasis is upon organizing high school, college, and adult courses and action programs in the community which will help sensitize participants and make them…

Get Real 'n' Read.

ERIC Educational Resources Information Center

Ledger, Michelle

1997-01-01

Describes a program called Get Real 'n' Read developed by Perth (Australia) public librarians to offer adolescents a greater incentive to use the library and to improve the image of reading. Topics include demographic characteristics of the area; planning; and advertising, including donations appealing to the target audience. (LRW)

Do training programs help AFDC recipients leave the welfare rolls? An evaluation of New York City's BEGIN (Begin Employment Gain Independence Now) program.

PubMed

Angelo, L; March, J A

1997-01-01

Guided by the Federal Family Support Act of 1988 and the Job Opportunity and Basic Skills Program (JOBS), welfare reform initiatives on state and local levels were designed to foster employability among the public assistance population. Reform has focused on enhancing the supply of labor rather than the demand for labor as a route to labor force participation for the public assistance population. Program reforms assume that, by providing job training, educational services, and training-related expenses, labor market entry of the participating clientele would be facilitated while caseloads and public expenditures would decline. To date, analysis of similar programs in many states indicates that the impact of such programs in reducing public assistance caseloads is marginal. In New York City, despite the large investment of public funds in such programs, prior to this study the outcome of program implementation remained largely unknown. This study evaluates New York City's BEGIN program outcome target defined as the ability of the program to move welfare clients off public assistance and into the labor market. While the results of the study indicate that New York City's BEGIN program does not improve client's odds of leaving welfare, when compared to the odds of a non-participation client, there are several significant findings. The impact of program participation can be distinguished among distinct age groups. While older clients responded positively to BEGIN participation, access to day care was the only factor that significantly improved the probability that clients younger than 36 years of age would leave the welfare rolls within a two-year period. In response to the findings, the researchers suggest that future welfare reform efforts should grant localities broader flexibility to determine their own target population so that resources can be allocated to those groups that are most likely to benefit from specific programs.

Improving Social Cognition in People with Schizophrenia with RC2S: Two Single-Case Studies.

PubMed

Peyroux, Elodie; Franck, Nicolas

2016-01-01

Difficulties in social interactions are a central characteristic of people with schizophrenia, and can be partly explained by impairments of social cognitive processes. New strategies of cognitive remediation have been recently developed to target these deficits. The RC2S therapy is an individualized and partly computerized program through which patients practice social interactions and develop social cognitive abilities with simulation techniques in a realistic environment. Here, we present the results of two case-studies involving two patients with schizophrenia presenting with specific profiles of impaired social cognition. Each patient completed three baseline sessions, 14 treatment sessions, and 3 follow-up sessions at the end of the therapy - and for 1 patient, another 3 sessions 9 months later. We used a multiple baseline design to assess specific components of social cognition according to the patients' profiles. Functioning and symptomatology were also assessed at the end of the treatment and 6 months later. Results highlight significant improvements in the targeted social cognitive processes and positive changes in functioning in the long term. The RC2S program seems, thus, to be a new useful program for social cognitive remediation in schizophrenia.

Effectiveness of a visual attention retraining program on the driving performance of clients with stroke.

PubMed

Mazer, Barbara L; Sofer, Susan; Korner-Bitensky, Nicol; Gelinas, Isabelle; Hanley, James; Wood-Dauphinee, Sharon

2003-04-01

To compare the effectiveness of a visual attention retraining program using the Useful Field of View (UFOV) with a traditional visuoperception treatment program on the driving performance of clients with stroke. Randomized controlled trial. Rehabilitation hospital located in Quebec, Canada. Ninety-seven individuals referred for driving evaluation after a stroke. Participants were randomized to receive 20 sessions of either UFOV training of visual processing speed, divided attention, and selective attention or traditional computerized visuoperception retraining. Subjects were evaluated with an on-road driving evaluation, visuoperception tests, and the Test of Everyday Attention. An occupational therapist unaware of group assignment conducted all evaluations. Eighty-four participants completed the outcome evaluation. There were no significant differences between groups on any of the outcome measures. There was, however, almost a 2-fold increase (52.4% vs 28.6%) in the rate of success on the on-road driving evaluation after UFOV training for subjects with right-sided lesions. Rehabilitation that targets visual attention skills was not significantly more beneficial than traditional perceptual training in improving the outcome of an on-road driving evaluation. However, results suggest a potential improvement for subjects with right-sided lesions, indicating that training must target specific skills.

Improving Social Cognition in People with Schizophrenia with RC2S: Two Single-Case Studies

PubMed Central

Peyroux, Elodie; Franck, Nicolas

2016-01-01

Difficulties in social interactions are a central characteristic of people with schizophrenia, and can be partly explained by impairments of social cognitive processes. New strategies of cognitive remediation have been recently developed to target these deficits. The RC2S therapy is an individualized and partly computerized program through which patients practice social interactions and develop social cognitive abilities with simulation techniques in a realistic environment. Here, we present the results of two case-studies involving two patients with schizophrenia presenting with specific profiles of impaired social cognition. Each patient completed three baseline sessions, 14 treatment sessions, and 3 follow-up sessions at the end of the therapy – and for 1 patient, another 3 sessions 9 months later. We used a multiple baseline design to assess specific components of social cognition according to the patients’ profiles. Functioning and symptomatology were also assessed at the end of the treatment and 6 months later. Results highlight significant improvements in the targeted social cognitive processes and positive changes in functioning in the long term. The RC2S program seems, thus, to be a new useful program for social cognitive remediation in schizophrenia. PMID:27199776

The quest to standardize hemodialysis care.

PubMed

Hegbrant, Jörgen; Gentile, Giorgio; Strippoli, Giovanni F M

2011-01-01

A large global dialysis provider's core activities include providing dialysis care with excellent quality, ensuring a low variability across the clinic network and ensuring strong focus on patient safety. In this article, we summarize the pertinent components of the quality assurance and safety program of the Diaverum Renal Services Group. Concerning medical performance, the key components of a successful quality program are setting treatment targets; implementing evidence-based guidelines and clinical protocols; consistently, regularly, prospectively and accurately collecting data from all clinics in the network; processing collected data to provide feedback to clinics in a timely manner, incorporating information on interclinic and intercountry variations; and revising targets, guidelines and clinical protocols based on sound scientific data. The key activities for ensuring patient safety include a standardized approach to education, i.e. a uniform education program including control of theoretical knowledge and clinical competencies; implementation of clinical policies and procedures in the organization in order to reduce variability and potential defects in clinic practice; and auditing of clinical practice on a regular basis. By applying a standardized and systematic continuous quality improvement approach throughout the entire organization, it has been possible for Diaverum to progressively improve medical performance and ensure patient safety. Copyright © 2011 S. Karger AG, Basel.

Design and feasibility of a memory intervention with focus on self-management for cognitive impairment in epilepsy.

PubMed

Caller, Tracie A; Secore, Karen L; Ferguson, Robert J; Roth, Robert M; Alexandre, Faith P; Henegan, Patricia L; Harrington, Jessica J; Jobst, Barbara C

2015-03-01

The aim of this study was to assess the feasibility of a self-management intervention targeting cognitive dysfunction to improve quality of life and reduce memory-related disability in adults with epilepsy. The intervention incorporates (1) education on cognitive function in epilepsy, (2) self-awareness training, (3) compensatory strategies, and (4) application of these strategies in day-to-day life using problem-solving therapy. In addition to the behavioral modification, formal working memory training was conducted by utilizing a commercially available program in a subgroup of patients. Our findings suggest that a self-management intervention targeting cognitive dysfunction was feasible for delivery to a rural population with epilepsy, with 13 of 16 enrolled participants completing the 8-session program. Qualitative data indicate high satisfaction and subjective improvement in cognitive functioning in day-to-day life. These findings provide support for further evaluation of the efficacy of this intervention through a randomized controlled trial. Copyright © 2015 Elsevier Inc. All rights reserved.

Caring Wisely: A Program to Support Frontline Clinicians and Staff in Improving Healthcare Delivery and Reducing Costs.

PubMed

Gonzales, Ralph; Moriates, Christopher; Lau, Catherine; Valencia, Victoria; Imershein, Sarah; Rajkomar, Alvin; Prasad, Priya; Boscardin, Christy; Grady, Deborah; Johnston, S

2017-08-01

We describe a program called "Caring Wisely"®, developed by the University of California, San Francisco's (UCSF), Center for Healthcare Value, to increase the value of services provided at UCSF Health. The overarching goal of the Caring Wisely® program is to catalyze and advance delivery system redesign and innovations that reduce costs, enhance healthcare quality, and improve health outcomes. The program is designed to engage frontline clinicians and staff-aided by experienced implementation scientists-to develop and implement interventions specifically designed to address overuse, underuse, or misuse of services. Financial savings of the program are intended to cover the program costs. The theoretical underpinnings for the design of the Caring Wisely® program emphasize the importance of stakeholder engagement, behavior change theory, market (target audience) segmentation, and process measurement and feedback. The Caring Wisely® program provides an institutional model for using crowdsourcing to identify "hot spot" areas of low-value care, inefficiency and waste, and for implementing robust interventions to address these areas. © 2017 Society of Hospital Medicine.

DBS Programming: An Evolving Approach for Patients with Parkinson's Disease.

PubMed

Wagle Shukla, Aparna; Zeilman, Pam; Fernandez, Hubert; Bajwa, Jawad A; Mehanna, Raja

2017-01-01

Deep brain stimulation (DBS) surgery is a well-established therapy for control of motor symptoms in Parkinson's disease. Despite an appropriate targeting and an accurate placement of DBS lead, a thorough and efficient programming is critical for a successful clinical outcome. DBS programming is a time consuming and laborious manual process. The current approach involves use of general guidelines involving determination of the lead type, electrode configuration, impedance check, and battery check. However there are no validated and well-established programming protocols. In this review, we will discuss the current practice and the recent advances in DBS programming including the use of interleaving, fractionated current, directional steering of current, and the use of novel DBS pulses. These technological improvements are focused on achieving a more efficient control of clinical symptoms with the least possible side effects. Other promising advances include the introduction of computer guided programming which will likely impact the efficiency of programming for the clinicians and the possibility of remote Internet based programming which will improve access to DBS care for the patients.

DBS Programming: An Evolving Approach for Patients with Parkinson's Disease

PubMed Central

Zeilman, Pam; Fernandez, Hubert; Bajwa, Jawad A.

2017-01-01

Deep brain stimulation (DBS) surgery is a well-established therapy for control of motor symptoms in Parkinson's disease. Despite an appropriate targeting and an accurate placement of DBS lead, a thorough and efficient programming is critical for a successful clinical outcome. DBS programming is a time consuming and laborious manual process. The current approach involves use of general guidelines involving determination of the lead type, electrode configuration, impedance check, and battery check. However there are no validated and well-established programming protocols. In this review, we will discuss the current practice and the recent advances in DBS programming including the use of interleaving, fractionated current, directional steering of current, and the use of novel DBS pulses. These technological improvements are focused on achieving a more efficient control of clinical symptoms with the least possible side effects. Other promising advances include the introduction of computer guided programming which will likely impact the efficiency of programming for the clinicians and the possibility of remote Internet based programming which will improve access to DBS care for the patients. PMID:29147598

Development efforts to improve curved-channel microchannel plates

NASA Technical Reports Server (NTRS)

Corbett, M. B.; Feller, W. B.; Laprade, B. N.; Cochran, R.; Bybee, R.; Danks, A.; Joseph, C.

1993-01-01

Curved-channel microchannel plate (C-plate) improvements resulting from an ongoing NASA STIS microchannel plate (MCP) development program are described. Performance limitations of previous C-plates led to a development program in support of the STIS MAMA UV photon counter, a second generation instrument on the Hubble Space Telescope. C-plate gain, quantum detection efficiency, dark noise, and imaging distortion, which are influenced by channel curvature non-uniformities, have all been improved through use of a new centrifuge fabrication technique. This technique will be described, along with efforts to improve older, more conventional shearing methods. Process optimization methods used to attain targeted C-plate performance goals will be briefly characterized. Newly developed diagnostic measurement techniques to study image distortion, gain uniformity, input bias angle, channel curvature, and ion feedback, will be described. Performance characteristics and initial test results of the improved C-plates will be reported. Future work and applications will also be discussed.

Practical ways to facilitate ergonomics improvements in occupational health practice.

PubMed

Kogi, Kazutaka

2012-12-01

Recent advances in participatory programs for improving workplace conditions are discussed to examine practical ways to facilitate ergonomics improvements. Participatory training programs are gaining importance, particularly in promoting occupational health and safety in small-scale workplaces. These programs have led to many improvements that can reduce work-related risks in varied situations. Recent experiences in participatory action-oriented training programs in small workplaces and agriculture are reviewed.The emphasis of the review is on training steps, types of improvements achieved, and the use of action tools by trainers and training participants. Immediate improvements in multiple technical areas are targeted, including materials handling,workstation design, physical environment, welfare facilities, and work organization. In facilitating ergonomics improvements in each local situation, it is important to focus on (a) building on local good practices; (b) applying practical, simple improvements that apply the basic principles of ergonomics; and (c) developing action-oriented toolkits for direct use by workers and managers. This facilitation process is effective when locally designed action toolkits are used by trainers, including local good examples, action checklists, and illustrated how-to guides. Intervention studies demonstrate the effectiveness of participatory steps that use these toolkits in promoting good practices and reducing work-related risks. In facilitating ergonomics improvements in small-scale workplaces, it is important to focus on practical, low-cost improvements that build on local good practices. The use of action-oriented toolkits reflecting basic ergonomics principles is helpful.The promotion of the intercountry networking of positive experiences in participatory training is suggested.

Improving consensus contact prediction via server correlation reduction.

PubMed

Gao, Xin; Bu, Dongbo; Xu, Jinbo; Li, Ming

2009-05-06

Protein inter-residue contacts play a crucial role in the determination and prediction of protein structures. Previous studies on contact prediction indicate that although template-based consensus methods outperform sequence-based methods on targets with typical templates, such consensus methods perform poorly on new fold targets. However, we find out that even for new fold targets, the models generated by threading programs can contain many true contacts. The challenge is how to identify them. In this paper, we develop an integer linear programming model for consensus contact prediction. In contrast to the simple majority voting method assuming that all the individual servers are equally important and independent, the newly developed method evaluates their correlation by using maximum likelihood estimation and extracts independent latent servers from them by using principal component analysis. An integer linear programming method is then applied to assign a weight to each latent server to maximize the difference between true contacts and false ones. The proposed method is tested on the CASP7 data set. If the top L/5 predicted contacts are evaluated where L is the protein size, the average accuracy is 73%, which is much higher than that of any previously reported study. Moreover, if only the 15 new fold CASP7 targets are considered, our method achieves an average accuracy of 37%, which is much better than that of the majority voting method, SVM-LOMETS, SVM-SEQ, and SAM-T06. These methods demonstrate an average accuracy of 13.0%, 10.8%, 25.8% and 21.2%, respectively. Reducing server correlation and optimally combining independent latent servers show a significant improvement over the traditional consensus methods. This approach can hopefully provide a powerful tool for protein structure refinement and prediction use.

Demand generation activities and modern contraceptive use in urban areas of four countries: a longitudinal evaluation

PubMed Central

Speizer, Ilene S; Corroon, Meghan; Calhoun, Lisa; Lance, Peter; Montana, Livia; Nanda, Priya; Guilkey, David

2014-01-01

ABSTRACT Family planning is crucial for preventing unintended pregnancies and for improving maternal and child health and well-being. In urban areas where there are large inequities in family planning use, particularly among the urban poor, programs are needed to increase access to and use of contraception among those most in need. This paper presents the midterm evaluation findings of the Urban Reproductive Health Initiative (Urban RH Initiative) programs, funded by the Bill & Melinda Gates Foundation, that are being implemented in 4 countries: India (Uttar Pradesh), Kenya, Nigeria, and Senegal. Between 2010 and 2013, the Measurement, Learning & Evaluation (MLE) project collected baseline and 2-year longitudinal follow-up data from women in target study cities to examine the role of demand generation activities undertaken as part of the Urban RH Initiative programs. Evaluation results demonstrate that, in each country where it was measured, outreach by community health or family planning workers as well as local radio programs were significantly associated with increased use of modern contraceptive methods. In addition, in India and Nigeria, television programs had a significant effect on modern contraceptive use, and in Kenya and Nigeria, the program slogans and materials that were blanketed across the cities (eg, leaflets/brochures distributed at health clinics and the program logo placed on all forms of materials, from market umbrellas to health facility signs and television programs) were also significantly associated with modern method use. Our results show that targeted, multilevel demand generation activities can make an important contribution to increasing modern contraceptive use in urban areas and could impact Millennium Development Goals for improved maternal and child health and access to reproductive health for all. PMID:25611476

VA residential substance use disorder treatment program providers' perceptions of facilitators and barriers to performance on pre-admission processes.

PubMed

Ellerbe, Laura S; Manfredi, Luisa; Gupta, Shalini; Phelps, Tyler E; Bowe, Thomas R; Rubinsky, Anna D; Burden, Jennifer L; Harris, Alex H S

2017-04-04

In the U.S. Department of Veterans Affairs (VA), residential treatment programs are an important part of the continuum of care for patients with a substance use disorder (SUD). However, a limited number of program-specific measures to identify quality gaps in SUD residential programs exist. This study aimed to: (1) Develop metrics for two pre-admission processes: Wait Time and Engagement While Waiting, and (2) Interview program management and staff about program structures and processes that may contribute to performance on these metrics. The first aim sought to supplement the VA's existing facility-level performance metrics with SUD program-level metrics in order to identify high-value targets for quality improvement. The second aim recognized that not all key processes are reflected in the administrative data, and even when they are, new insight may be gained from viewing these data in the context of day-to-day clinical practice. VA administrative data from fiscal year 2012 were used to calculate pre-admission metrics for 97 programs (63 SUD Residential Rehabilitation Treatment Programs (SUD RRTPs); 34 Mental Health Residential Rehabilitation Treatment Programs (MH RRTPs) with a SUD track). Interviews were then conducted with management and front-line staff to learn what factors may have contributed to high or low performance, relative to the national average for their program type. We hypothesized that speaking directly to residential program staff may reveal innovative practices, areas for improvement, and factors that may explain system-wide variability in performance. Average wait time for admission was 16 days (SUD RRTPs: 17 days; MH RRTPs with a SUD track: 11 days), with 60% of Veterans waiting longer than 7 days. For these Veterans, engagement while waiting occurred in an average of 54% of the waiting weeks (range 3-100% across programs). Fifty-nine interviews representing 44 programs revealed factors perceived to potentially impact performance in these domains. Efficient screening processes, effective patient flow, and available beds were perceived to facilitate shorter wait times, while lack of beds, poor staffing levels, and lengths of stay of existing patients were thought to lengthen wait times. Accessible outpatient services, strong patient outreach, and strong encouragement of pre-admission outpatient treatment emerged as facilitators of engagement while waiting; poor staffing levels, socioeconomic barriers, and low patient motivation were viewed as barriers. Metrics for pre-admission processes can be helpful for monitoring residential SUD treatment programs. Interviewing program management and staff about drivers of performance metrics can play a complementary role by identifying innovative and other strong practices, as well as high-value targets for quality improvement. Key facilitators of high-performing facilities may offer programs with lower performance useful strategies to improve specific pre-admission processes.

Strategies to improve homing of mesenchymal stem cells for greater efficacy in stem cell therapy.

PubMed

Naderi-Meshkin, Hojjat; Bahrami, Ahmad Reza; Bidkhori, Hamid Reza; Mirahmadi, Mahdi; Ahmadiankia, Naghmeh

2015-01-01

Stem/progenitor cell-based therapeutic approach in clinical practice has been an elusive dream in medical sciences, and improvement of stem cell homing is one of major challenges in cell therapy programs. Stem/progenitor cells have a homing response to injured tissues/organs, mediated by interactions of chemokine receptors expressed on the cells and chemokines secreted by the injured tissue. For improvement of directed homing of the cells, many techniques have been developed either to engineer stem/progenitor cells with higher amount of chemokine receptors (stem cell-based strategies) or to modulate the target tissues to release higher level of the corresponding chemokines (target tissue-based strategies). This review discusses both of these strategies involved in the improvement of stem cell homing focusing on mesenchymal stem cells as most frequent studied model in cellular therapies. © 2014 International Federation for Cell Biology.

A potential role of anti-poverty programs in health promotion

PubMed Central

Silverman, Kenneth; Holtyn, August F.; Jarvis, Brantley

2016-01-01

Poverty is one of the most pervasive risk factors underlying poor health, but is rarely targeted to improve health. Research on the effects of anti-poverty interventions on health has been limited, at least in part because funding for that research has been limited. Anti-poverty programs have been applied on a large scale, frequently by governments, but without systematic development and cumulative programmatic experimental studies. Anti-poverty programs that produce lasting effects on poverty have not been developed. Before evaluating the effect of anti-poverty programs on health, programs must be developed that can reduce poverty consistently. Anti-poverty programs require systematic development and cumulative programmatic scientific evaluation. Research on the therapeutic workplace could provide a model for that research and an adaptation of the therapeutic workplace could serve as a foundation of a comprehensive anti-poverty program. Once effective anti-poverty programs are developed, future research could determine if those programs improve health in addition to increasing income. The potential personal, health and economic benefits of effective anti-poverty programs could be substantial, and could justify the major efforts and expenses that would be required to support systematic research to develop such programs. PMID:27235603

A potential role of anti-poverty programs in health promotion.

PubMed

Silverman, Kenneth; Holtyn, August F; Jarvis, Brantley P

2016-11-01

Poverty is one of the most pervasive risk factors underlying poor health, but is rarely targeted to improve health. Research on the effects of anti-poverty interventions on health has been limited, at least in part because funding for that research has been limited. Anti-poverty programs have been applied on a large scale, frequently by governments, but without systematic development and cumulative programmatic experimental studies. Anti-poverty programs that produce lasting effects on poverty have not been developed. Before evaluating the effect of anti-poverty programs on health, programs must be developed that can reduce poverty consistently. Anti-poverty programs require systematic development and cumulative programmatic scientific evaluation. Research on the therapeutic workplace could provide a model for that research and an adaptation of the therapeutic workplace could serve as a foundation of a comprehensive anti-poverty program. Once effective anti-poverty programs are developed, future research could determine if those programs improve health in addition to increasing income. The potential personal, health and economic benefits of effective anti-poverty programs could be substantial, and could justify the major efforts and expenses that would be required to support systematic research to develop such programs. Copyright © 2016 Elsevier Inc. All rights reserved.

Peer-Assisted Analysis of Resident Feedback Improves Clinical Teaching: A Case Report.

PubMed

Mai, Christine L; Baker, Keith

2017-07-01

Anesthesiologists play an important role in educating future clinicians. Yet few residency programs incorporate teaching skills into faculty development. Consequently, many anesthesiologists have limited training to supervise and educate residents. In turn, these attendings may receive negative feedback and poor evaluations from residents without a means to effectively improve. Peer-assisted teaching between faculty members may serve as a strategy to improve teaching skills. We report a case of peer-assisted analysis of resident feedback to identify specific areas of concern that were targeted for improvement. This approach resulted in improved teaching scores and feedback for the faculty member.

Salt Reduction Initiatives around the World - A Systematic Review of Progress towards the Global Target.

PubMed

Trieu, Kathy; Neal, Bruce; Hawkes, Corinna; Dunford, Elizabeth; Campbell, Norm; Rodriguez-Fernandez, Rodrigo; Legetic, Branka; McLaren, Lindsay; Barberio, Amanda; Webster, Jacqui

2015-01-01

To quantify progress with the initiation of salt reduction strategies around the world in the context of the global target to reduce population salt intake by 30% by 2025. A systematic review of the published and grey literature was supplemented by questionnaires sent to country program leaders. Core characteristics of strategies were extracted and categorised according to a pre-defined framework. A total of 75 countries now have a national salt reduction strategy, more than double the number reported in a similar review done in 2010. The majority of programs are multifaceted and include industry engagement to reformulate products (n = 61), establishment of sodium content targets for foods (39), consumer education (71), front-of-pack labelling schemes (31), taxation on high-salt foods (3) and interventions in public institutions (54). Legislative action related to salt reduction such as mandatory targets, front of pack labelling, food procurement policies and taxation have been implemented in 33 countries. 12 countries have reported reductions in population salt intake, 19 reduced salt content in foods and 6 improvements in consumer knowledge, attitudes or behaviours relating to salt. The large and increasing number of countries with salt reduction strategies in place is encouraging although activity remains limited in low- and middle-income regions. The absence of a consistent approach to implementation highlights uncertainty about the elements most important to success. Rigorous evaluation of ongoing programs and initiation of salt reduction programs, particularly in low- and middle- income countries, will be vital to achieving the targeted 30% reduction in salt intake.

Salt Reduction Initiatives around the World – A Systematic Review of Progress towards the Global Target

PubMed Central

Trieu, Kathy; Neal, Bruce; Hawkes, Corinna; Dunford, Elizabeth; Campbell, Norm; Rodriguez-Fernandez, Rodrigo; Legetic, Branka; McLaren, Lindsay; Barberio, Amanda; Webster, Jacqui

2015-01-01

Objective To quantify progress with the initiation of salt reduction strategies around the world in the context of the global target to reduce population salt intake by 30% by 2025. Methods A systematic review of the published and grey literature was supplemented by questionnaires sent to country program leaders. Core characteristics of strategies were extracted and categorised according to a pre-defined framework. Results A total of 75 countries now have a national salt reduction strategy, more than double the number reported in a similar review done in 2010. The majority of programs are multifaceted and include industry engagement to reformulate products (n = 61), establishment of sodium content targets for foods (39), consumer education (71), front-of-pack labelling schemes (31), taxation on high-salt foods (3) and interventions in public institutions (54). Legislative action related to salt reduction such as mandatory targets, front of pack labelling, food procurement policies and taxation have been implemented in 33 countries. 12 countries have reported reductions in population salt intake, 19 reduced salt content in foods and 6 improvements in consumer knowledge, attitudes or behaviours relating to salt. Conclusion The large and increasing number of countries with salt reduction strategies in place is encouraging although activity remains limited in low- and middle-income regions. The absence of a consistent approach to implementation highlights uncertainty about the elements most important to success. Rigorous evaluation of ongoing programs and initiation of salt reduction programs, particularly in low- and middle- income countries, will be vital to achieving the targeted 30% reduction in salt intake. PMID:26201031

Impact of Family Planning and Business Trainings on Private-Sector Health Care Providers in Nigeria.

PubMed

Ugaz, Jorge; Leegwater, Anthony; Chatterji, Minki; Johnson, Doug; Baruwa, Sikiru; Toriola, Modupe; Kinnan, Cynthia

2017-06-01

Private health care providers are an important source of modern contraceptives in Sub-Saharan Africa, yet they face many challenges that might be addressed through targeted training. This study measures the impact of a package of trainings and supportive supervision activities targeted to private health care providers in Lagos State, Nigeria, on outcomes including range of contraceptive methods offered, providers' knowledge and quality of counseling, recordkeeping practices, access to credit and revenue. A total of 965 health care facilities were randomly assigned to treatment and control groups. Facilities in the treatment group-but not those in the control group-were offered a training package that included a contraceptive technology update and interventions to improve counseling and clinical skills and business practices. Multivariate regression analysis of data collected through facility and mystery client surveys was used to estimate effects. The training program had a positive effect on the range of contraceptive methods offered, with facilities in the treatment group providing more methods than facilities in the control group. The training program also had a positive impact on the quality of counseling services, especially on the range of contraceptive methods discussed by providers, their interpersonal skills and overall knowledge. Facilities in the treatment group were more likely than facilities in the control group to have good recordkeeping practices and to have obtained loans. No effect was found on revenue generation. Targeted training programs can be effective tools to improve the provision of family planning services through private providers.

Modeling the Impact and Costs of Semiannual Mass Drug Administration for Accelerated Elimination of Lymphatic Filariasis

PubMed Central

de Vlas, Sake J.; Fischer, Peter U.; Weil, Gary J.; Goldman, Ann S.

2013-01-01

The Global Program to Eliminate Lymphatic Filariasis (LF) has a target date of 2020. This program is progressing well in many countries. However, progress has been slow in some countries, and others have not yet started their mass drug administration (MDA) programs. Acceleration is needed. We studied how increasing MDA frequency from once to twice per year would affect program duration and costs by using computer simulation modeling and cost projections. We used the LYMFASIM simulation model to estimate how many annual or semiannual MDA rounds would be required to eliminate LF for Indian and West African scenarios with varied pre-control endemicity and coverage levels. Results were used to estimate total program costs assuming a target population of 100,000 eligibles, a 3% discount rate, and not counting the costs of donated drugs. A sensitivity analysis was done to investigate the robustness of these results with varied assumptions for key parameters. Model predictions suggested that semiannual MDA will require the same number of MDA rounds to achieve LF elimination as annual MDA in most scenarios. Thus semiannual MDA programs should achieve this goal in half of the time required for annual programs. Due to efficiency gains, total program costs for semiannual MDA programs are projected to be lower than those for annual MDA programs in most scenarios. A sensitivity analysis showed that this conclusion is robust. Semiannual MDA is likely to shorten the time and lower the cost required for LF elimination in countries where it can be implemented. This strategy may improve prospects for global elimination of LF by the target year 2020. PMID:23301115

Discovery and optimization of potent and selective imidazopyridine and imidazopyridazine mTOR inhibitors.

PubMed

Peterson, Emily A; Boezio, Alessandro A; Andrews, Paul S; Boezio, Christiane M; Bush, Tammy L; Cheng, Alan C; Choquette, Deborah; Coats, James R; Colletti, Adria E; Copeland, Katrina W; DuPont, Michelle; Graceffa, Russell; Grubinska, Barbara; Kim, Joseph L; Lewis, Richard T; Liu, Jingzhou; Mullady, Erin L; Potashman, Michele H; Romero, Karina; Shaffer, Paul L; Stanton, Mary K; Stellwagen, John C; Teffera, Yohannes; Yi, Shuyan; Cai, Ti; La, Daniel S

2012-08-01

mTOR is a critical regulator of cellular signaling downstream of multiple growth factors. The mTOR/PI3K/AKT pathway is frequently mutated in human cancers and is thus an important oncology target. Herein we report the evolution of our program to discover ATP-competitive mTOR inhibitors that demonstrate improved pharmacokinetic properties and selectivity compared to our previous leads. Through targeted SAR and structure-guided design, new imidazopyridine and imidazopyridazine scaffolds were identified that demonstrated superior inhibition of mTOR in cellular assays, selectivity over the closely related PIKK family and improved in vivo clearance over our previously reported benzimidazole series. Copyright © 2012. Published by Elsevier Ltd.

Home-Delivered Meals and Nutrition Status Among Older Adults.

PubMed

Sahyoun, Nadine R; Vaudin, Anna

2014-08-01

The trend among older adults in the United States is to "age in place" instead of opting for institutionalization. To maintain older adults with chronic conditions in their homes and to improve health after hospitalization, comprehensive social, health, and nutrition services are essential. Quality of dietary intake is crucial and yet often underestimated. Calorie needs decrease with age while nutrient needs remain the same, even increasing for some nutrients. This poses difficulties for individuals with functional disabilities who are unable to shop and cook due to physical or mental limitations or on a limited budget. The Older American Act home-delivered meal (HDM) program offers at least 1 healthy meal per day, 5 or more days per week, and targets individuals homebound due to illness, disability, or social isolation and those with greatest economic or social need. This review summarizes the available literature on the relationship between HDM and health outcomes. The HDM program is difficult to evaluate because of the multifactorial effect on health status. However, national surveys and smaller studies show that it is well targeted, efficient, and well liked; provides quality food to needy individuals; and helps individuals remain living independently. Studies show that HDMs improve dietary intake, with greater health benefits when more meals reach the neediest individuals. HDMs also decrease institutionalization of older adults and resulting healthcare expenditures. However, funding has not kept up with increased demand for this program. More studies with improved designs may provide more information supporting the program's impact on nutrition status and decreased health expenditures. © 2014 American Society for Parenteral and Enteral Nutrition.

Osteo-cise: Strong Bones for Life: Protocol for a community-based randomised controlled trial of a multi-modal exercise and osteoporosis education program for older adults at risk of falls and fractures

PubMed Central

2012-01-01

Background Osteoporosis affects over 220 million people worldwide, and currently there is no ‘cure’ for the disease. Thus, there is a need to develop evidence-based, safe and acceptable prevention strategies at the population level that target multiple risk factors for fragility fractures to reduce the health and economic burden of the condition. Methods/design The Osteo-cise: Strong Bones for Life study will investigate the effectiveness and feasibility of a multi-component targeted exercise, osteoporosis education/awareness and behavioural change program for improving bone health and muscle function and reducing falls risk in community-dwelling older adults at an increased risk of fracture. Men and women aged ≥60 years will participate in an 18-month randomised controlled trial comprising a 12-month structured and supervised community-based program and a 6-month ‘research to practise’ translational phase. Participants will be randomly assigned to either the Osteo-cise intervention or a self-management control group. The intervention will comprise a multi-modal exercise program incorporating high velocity progressive resistance training, moderate impact weight-bearing exercise and high challenging balance exercises performed three times weekly at local community-based fitness centres. A behavioural change program will be used to enhance exercise adoption and adherence to the program. Community-based osteoporosis education seminars will be conducted to improve participant knowledge and understanding of the risk factors and preventative measures for osteoporosis, falls and fractures. The primary outcomes measures, to be collected at baseline, 6, 12, and 18 months, will include DXA-derived hip and spine bone mineral density measurements and functional muscle power (timed stair-climb test). Secondary outcomes measures include: MRI-assessed distal femur and proximal tibia trabecular bone micro-architecture, lower limb and back maximal muscle strength, balance and function (four square step test, functional reach test, timed up-and-go test and 30-second sit-to-stand), falls incidence and health-related quality of life. Cost-effectiveness will also be assessed. Discussion The findings from the Osteo-cise: Strong Bones for Life study will provide new information on the efficacy of a targeted multi-modal community-based exercise program incorporating high velocity resistance training, together with an osteoporosis education and behavioural change program for improving multiple risk factors for falls and fracture in older adults at risk of fragility fracture. Trial registration Australian New Zealand Clinical Trials Registry reference ACTRN12609000100291 PMID:22640372

Neurocognitive Treatments for Eating Disorders and Obesity.

PubMed

Eichen, Dawn M; Matheson, Brittany E; Appleton-Knapp, Sara L; Boutelle, Kerri N

2017-09-01

Recent research has highlighted executive function and neurocognitive deficits among individuals with eating and weight disorders, identifying a potential target for treatment. Treatments targeting executive function for eating and weight disorders are emerging. This review aims to summarize the recent literature evaluating neurocognitive/executive function-oriented treatments for eating and weight disorders and highlights additional work needed in this area. Cognitive remediation therapy (CRT) for anorexia nervosa has been the most extensively studied neurocognitive treatment for eating disorders. Results demonstrate that CRT improves executive function and may aid in the reduction of eating disorder symptomatology. Computer training programs targeting modifying attention and increasing inhibition are targeting reduction of binge eating and weight loss with modest success. Neurocognitive treatments are emerging and show initial promise for eating and weight disorders. Further research is necessary to determine whether these treatments can be used as stand-alone treatments or whether they need to be used as an adjunct to or in conjunction with other evidence-based treatments to improve outcomes.

Infection of the Invisible: Impressions of a Tuberculosis Intervention Program for Migrants in Istanbul.

PubMed

Yasin, Yesim; Biehl, Kristen; Erol, Maral

2015-10-01

This paper reviews the experience of the Istanbul Tuberculosis Aid Program, which targeted tuberculosis (TB) disease in the growing irregular migrant populations of Istanbul. This experience illustrated the importance of community-based public health interventions when dealing with an infectious disease like TB among vulnerable groups. Our data is derived primarily from a qualitative study carried out with program stakeholders. We summarize lessons for success of ITAP as: (1) Strengthening impact and outreach of TB intervention among irregular migrant communities through involvement of multiple stakeholders (2) Increasing TB awareness through a community targeted approach (3) Increasing TB contact tracing and treatment success among infected irregular migrants, and, (4) Improving overall health seeking behavior of irregular migrants through empowerment and trust. Given these particularities we list our policy suggestions for revision of regulations regarding TB control and healthcare needs of irregular migrant populations.

Technological Advances In The Surgical Treatment Of Movement Disorders

PubMed Central

Gross, Robert E.; McDougal, Margaret E.

2013-01-01

Technological innovations have driven the advancement of the surgical treatment of movement disorders, from the invention of the stereotactic frame to the adaptation of deep brain stimulation (DBS). Along these lines, this review will describe recent advances in getting neuromodulation modalities, including DBS, to the target; and in the delivery of therapy at the target. Recent radiological advances are altering the way that DBS leads are targeted and inserted, by refining the ability to visualize the subcortical targets using high-field strength MRI and other innovations such as diffusion tensor imaging, and the development of novel targeting devices enabling purely anatomical implantations without the need for neurophysiological monitoring. New portable CT scanners also are facilitating lead implantation without monitoring as well as improving radiological verification of DBS lead location. Advances in neurophysiological mapping include efforts to develop automatic target verification algorithms, and probabilistic maps to guide target selection. The delivery of therapy at the target is being improved by the development of the next generation of internal pulse generators (IPGs). These include constant current devices that mitigate the variability introduced by impedance changes of the stimulated tissue, and in the near future, devices that deliver novel stimulation patterns with improved efficiency. Closed-loop adaptive IPGs are being tested, which may tailor stimulation to ongoing changes in the nervous system reflected in Œbiomarkers1 continuously recorded by the devices. Finer grained DBS leads, in conjunction with new IPGs and advanced programming tools, may offer improved outcomes via Œcurrent steering1 algorithms. Finally, even thermocoagulation - essentially replaced by DBS - is being advanced by new Œminimally-invasive1 approaches that may improve this therapy for selected patients in whom it may be preferred. Functional neurosurgery has a history of being driven by technological innovation, a tradition that continues into its future. PMID:23812894

Oral Argument in Children's Television Proceeding.

ERIC Educational Resources Information Center

Choate, Robert B.

The author advocates the outright ban of commercials from Saturday and Sunday morning television and makes several other recommendations that he believes would improve programing and reduce the hard sell of child targeted advertising. The Federal Communications Commission (FCC) could form a Children's Television Broadcast Center and establish a…

Marriage and Fatherhood Programs

ERIC Educational Resources Information Center

Cowan, Phillip A.; Cowan, Carolyn Pape; Knox, Virginia

2010-01-01

To improve the quality and stability of couple and father-child relationships in fragile families, researchers are beginning to consider how to tailor existing couple-relationship and father-involvement interventions, which are now targeted on married couples, to the specific needs of unwed couples in fragile families. The goal, explain Philip…

Gender Effects in Self-Management Training: Individual versus Cooperative Interventions.

ERIC Educational Resources Information Center

Atkins, Michelle; Rohrbeck, Cynthia A.

1993-01-01

Examined gender differences in individual and cooperative (small-group) self-management training programs targeting mathematics performance. Findings from 33 fifth graders revealed that girls in individual training condition improved significantly less than girls in cooperative condition and boys in individual condition. Boys in cooperative…

DOE Office of Scientific and Technical Information (OSTI.GOV)

Johnson, Gary E.; Diefenderfer, Heida L.

The purpose of this document is to describe research, monitoring, and evaluation (RME) for the Federal Columbia River Estuary Program, hereafter called 'the Estuary Program'. The intent of this RME effort is to provide data and information to evaluate progress toward meeting program goals and objectives and support decision making in the Estuary Program. The goal of the Estuary Program is to understand, conserve, and restore the estuary ecosystem to improve the performance of listed salmonid populations. The Estuary Program has five general objectives, designed to fulfill the program goal, as follows: (1) Understand the primary stressors affecting ecosystem controllingmore » factors, such as ocean conditions and invasive species. (2) Conserve and restore factors controlling ecosystem structures and processes, such as hydrodynamics and water quality. (3) Increase the quantity and quality of ecosystem structures, i.e., habitats, juvenile salmonids use during migration through the estuary. (4) Maintain the food web to benefit salmonid performance. (5) Improve salmonid performance in terms of life history diversity, foraging success, growth, and survival. The goal of estuary RME is to provide pertinent and timely research and monitoring information to planners, implementers, and managers of the Estuary Program. The goal leads to three primary management questions pertaining to the main focus of the Estuary Program: estuary habitat conservation and restoration. (1) Are the estuary habitat actions achieving the expected biological and environmental performance targets? (2) Are the offsite habitat actions in the estuary improving juvenile salmonid performance and which actions are most effective at addressing the limiting factors preventing achievement of habitat, fish, or wildlife performance objectives? (3) What are the limiting factors or threats in the estuary/ocean preventing the achievement of desired habitat or fish performance objectives? Performance measures for the estuary are monitored indicators that reflect the status of habitat conditions and fish performance, e.g., habitat connectivity, survival, and life history diversity. Performance measures also pertain to implementation and compliance. Such measures are part of the monitoring, research, and action plans in this estuary RME document. Performance targets specific to the estuary were not included in the 2007 draft Biological Opinion.« less

Effects of combat training on visuomotor performance in children aged 9 to 12 years - an eye-tracking study.

PubMed

Ju, Yan-Ying; Liu, Yen-Hsiu; Cheng, Chih-Hsiu; Lee, Yu-Lung; Chang, Shih-Tsung; Sun, Chi-Chin; Cheng, Hsin-Yi Kathy

2018-02-07

Data on visuomotor performance in combat training and the effects of combat training on visuomotor performance are limited. This study aimed to investigate the effects of a specially designed combat sports (CS) training program on the visuomotor performance levels of children. A pre-post comparative design was implemented. A total of 26 students aged 9-12 years underwent 40-min CS training sessions twice a week for 8 weeks during their physical education classes. The CS training program was designed by a karate coach and a motor control specialist. The other 30 students continued their regular activities and were considered as a control group. Each student's eye movement was monitored using an eye tracker, whereas the motor performance was measured using a target hitting system with a program-controlled microprocessor. The measurements were taken 8 weeks before (baseline), 1 day before (pretest), and 1 week after (posttest) the designated training program. The task used for evaluating these students was hitting or tracking random illuminated targets as rapidly as possible. A two-way analysis of variance [group(2) × time(3)] with repeated measures of time was performed for statistical analysis. For the children who received combat training, although the eye response improvement was not significant, both the primary and secondary saccade onset latencies were significantly earlier compared to the children without combat training. Both groups of students exhibited improvement in their hit response times during the target hitting tasks. The current finding supported the notion that sports training efforts essentially enhance visuomotor function in children aged 9-12 years, and combat training facilitates an earlier secondary saccade onset.

Effectiveness of comprehensive care programs for patients with multiple chronic conditions or frailty: A systematic literature review.

PubMed

Hopman, Petra; de Bruin, Simone R; Forjaz, Maria João; Rodriguez-Blazquez, Carmen; Tonnara, Giuseppe; Lemmens, Lidwien C; Onder, Graziano; Baan, Caroline A; Rijken, Mieke

2016-07-01

To describe comprehensive care programs targeting multimorbid and/or frail patients and to estimate their effectiveness regarding improvement of patient and caregiver related outcomes, healthcare utilization and costs. Systematic search in six electronic databases for scientific papers published between January 2011 and March 2014, supplemented by reference tracking. Wagner's Chronic Care Model (CCM) was used to operationalize comprehensive care. The quality of the included studies was assessed, and a best-evidence synthesis was applied. Nineteen publications were included describing effects of eighteen comprehensive care programs for multimorbid or frail patients, of which only one was implemented in a European country. Programs varied in target groups, settings, interventions and number of CCM components addressed. Providing comprehensive care might result in more patient satisfaction, less depressive symptoms, a better health-related quality of life or functioning of multimorbid or frail patients, but the evidence is insufficient. There is no evidence that comprehensive care reduces the number of primary care or GP visits or healthcare costs. Regarding the use of inpatient care, the evidence was insufficient. No evidence was found for a beneficial effect of comprehensive care on caregiver-related outcomes. Despite the fact that over the years several (good-quality) studies have been performed to estimate the value of comprehensive care for multimorbid and/or frail patients, evidence for their effectiveness remains insufficient. More good-quality studies and/or studies allowing meta-analysis are needed to determine which specific target groups at what moment will benefit from comprehensive care. Moreover, evaluation studies could improve by using more appropriate outcome measures, e.g. measures that relate to patient-defined (personal) goals of care. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

The American College of Surgeons National Surgical Quality Improvement Program: achieving better and safer surgery.

PubMed

Ko, Clifford Y; Hall, Bruce L; Hart, Amy J; Cohen, Mark E; Hoyt, David B

2015-05-01

The American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP), in operation since late 2004, evaluates surgical quality and safety by feeding back valid, timely, risk-adjusted outcomes, which providers use to improve care. A number of components have been developed and refined in the more than a decade since ACS NSQIP's initiation. These items can be grouped into areas of data collection, case sampling, risk adjustment, feedback reporting, the expansion into procedure-targeted sampling, development of improvement collaboratives, and the development of improvement tools. Although ACS NSQIP was originally designed as a hospital-based program, it now also allows for surgeon-specific reporting that can be used by individual surgeons as a feedback tool to improve their performance. There are more than 600 ACS NSQIP hospitals in 49 of the 50 states of the United States and in 13 other countries. Virtually all surgical (sub)specialties are touched by ACS NSQIP, which contains several million patient records and more than 100 statistically risk-adjusted models. In studies that have used ACS NSQIP clinical data, demonstrable improvement has been reported in local hospitals, in regional collaboratives, and across the program overall. Concomitantly, substantial cost savings for individual hospitals, as well as at regional and national levels, have been reported. ACS NSQIP has not only demonstrated how and why the use of accurate clinical data is crucial, but also how the program, through its risk-adjusted feedback, improvement tools, and hospital collaboratives, helps hospitals and providers to achieve safer surgery and better patient care.

Comparison of aerobic versus resistance exercise training effects on metabolic syndrome (from the Studies of a Targeted Risk Reduction Intervention Through Defined Exercise - STRRIDE-AT/RT).

PubMed

Bateman, Lori A; Slentz, Cris A; Willis, Leslie H; Shields, A Tamlyn; Piner, Lucy W; Bales, Connie W; Houmard, Joseph A; Kraus, William E

2011-09-15

Aerobic training (AT) improves the metabolic syndrome (MS) and its component risk factors; however, to our knowledge, no randomized clinical studies have addressed whether resistance training (RT) improves the MS when performed alone or combined with AT. Sedentary, overweight dyslipidemic men and women, aged 18 to 70 years completed a 4-month inactive run-in period and were randomized to 1 of 3 eight-month exercise programs (n = 196). The exercise programs were (1) RT (3 days/week, 3 sets/day of 8 to 12 repetitions of 8 different exercises targeting all major muscle groups); (2) AT (∼120 minutes/week at 75% of the maximum oxygen uptake), and (3) AT and RT combined (AT/RT) (exact combination of AT and RT). Of the 196 randomized patients, 144 completed 1 of the 3 exercise programs. The 86 participants with complete data for all 5 MS criteria were used in the present analysis, and a continuous MS z score was calculated. Eight months of RT did not change the MS score. AT improved the MS score (p <0.07) and showed a trend toward significance compared to RT (p <0.10). AT/RT significantly decreased the MS score and was significantly different from RT alone. In conclusion, RT was not effective at improving the MS score; however, AT was effective. Combined AT and RT was similarly effective but not different from AT alone. When weighing the time commitment versus health benefit, the data suggest that AT alone was the most efficient mode of exercise for improving cardiometabolic health. Published by Elsevier Inc.

Predictors of improvement in hemoglobin concentration among toddlers enrolled in the Massachusetts WIC Program.

PubMed

Altucher, Kristine; Rasmussen, Kathleen M; Barden, Elizabeth M; Habicht, Jean-Pierre

2005-05-01

Nutrition supplementation programs are generally targeted to those members of the population who are thought to be at risk of an undesirable outcome, but not all who participate in such programs respond to them. We sought to identify determinants of improvement in hemoglobin concentration among young children in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). We conducted an observational study using data from 9,930 children who were enrolled in the Massachusetts WIC program and had data available on their hemoglobin values at both 1 and 2 years of age. Predictors of change in hemoglobin concentration between these ages were studied using multivariate statistical modeling. Overall, hemoglobin concentrations increased from age 1 to 2 years in those who had been breastfed 25 or more weeks (P < .0001) and were female (P < .01), and decreased with increasing weight at 1 year of age (P < .001). The determinants of change in hemoglobin concentration differed from the determinants of hemoglobin concentration at age 1 year. The analytical approach used here could be extended to identify subgroups of WIC participants likely to improve in other outcomes. If current efforts to increase the duration of breastfeeding among WIC participants are successful, the importance of WIC in improving hemoglobin concentration among young children also will increase.

Emergency supply of doctors by the Mais Médicos (More Doctors) Program and the quality of the structure of primary health care facilities.

PubMed

Giovanella, Ligia; Mendonça, Maria Helena Magalhães de; Fausto, Marcia Cristina Rodrigues; Almeida, Patty Fidelis de; Bousquat, Aylene; Lima, Juliana Gagno; Seidl, Helena; Franco, Cassiano Mendes; Fusaro, Edgard Rodrigues; Almeida, Sueli Zeferino Ferreira

2016-09-01

The health policy context in Brazil has featured a series of measures to improve primary health care (PHC), including a national access and quality improvement program (Programa Nacional de Melhoria do Acesso e Qualidade, PMAQ-AB) and the Mais Médicos Program (More Doctors, PMM) and upgrading PHC centers ('Requalifica UBS'). The paper examines the PMM's placement of doctors, by quality of PHC structure, in an endeavor to identify synergies among the three programs. It reports on a transverse study based on secondary data from PMAQ-AB Cycles 1 and 2, the PMM and 'Requalifica UBS'. The PHC facilities inventoried during PMAQ-AB Cycle 1 were classified, on pre-established typology, into five groups ranked from A (best) to E (failed). They were then compared in terms of PMM personnel allocated and Requalifica UBS proposals. The results point to convergences in investments by the three programs. Incentives targeted predominantly PHC facilities of types B and C, indicating a concentration of efforts on PHC facilities with potential for structural quality improvements. In addition to expanding access, the provision of doctors by the PMM, added to infrastructure upgrades and work process improvements, contributes to addressing high turnover and guaranteeing retention of doctors in PHC.

Applying national survey results for strategic planning and program improvement: the National Diabetes Education Program.

PubMed

Griffey, Susan; Piccinino, Linda; Gallivan, Joanne; Lotenberg, Lynne Doner; Tuncer, Diane

2015-02-01

Since the 1970s, the federal government has spearheaded major national education programs to reduce the burden of chronic diseases in the United States. These prevention and disease management programs communicate critical information to the public, those affected by the disease, and health care providers. The National Diabetes Education Program (NDEP), the leading federal program on diabetes sponsored by the National Institutes of Health (NIH) and the Centers for Disease Control and Prevention (CDC), uses primary and secondary quantitative data and qualitative audience research to guide program planning and evaluation. Since 2006, the NDEP has filled the gaps in existing quantitative data sources by conducting its own population-based survey, the NDEP National Diabetes Survey (NNDS). The NNDS is conducted every 2–3 years and tracks changes in knowledge, attitudes and practice indicators in key target audiences. This article describes how the NDEP has used the NNDS as a key component of its evaluation framework and how it applies the survey results for strategic planning and program improvement. The NDEP's use of the NNDS illustrates how a program evaluation framework that includes periodic population-based surveys can serve as an evaluation model for similar national health education programs.

Do Parent Education Programs Promote Healthy Post-Divorce Parenting? Critical Distinctions and a Review of the Evidence

PubMed Central

Sigal, Amanda; Sandler, Irwin; Wolchik, Sharlene; Braver, Sanford

2009-01-01

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

The application of implementation science for pressure ulcer prevention best practices in an inpatient spinal cord injury rehabilitation program.

PubMed

Scovil, Carol Y; Flett, Heather M; McMillan, Lan T; Delparte, Jude J; Leber, Diane J; Brown, Jacquie; Burns, Anthony S

2014-09-01

To implement pressure ulcer (PU) prevention best practices in spinal cord injury (SCI) rehabilitation using implementation science frameworks. Quality improvement. SCI Rehabilitation Center. Inpatients admitted January 2012 to July 2013. Implementation of two PU best practices were targeted: (1) completing a comprehensive PU risk assessment and individualized interprofessional PU prevention plan (PUPP); and (2) providing patient education for PU prevention; as part of the pan-Canadian SCI Knowledge Mobilization Network. At our center, the SCI Pressure Ulcer Scale replaced the Braden risk assessment scale and an interprofessional PUPP form was implemented. Comprehensive educational programing existed, so efforts focused on improving documentation. Implementation science frameworks provided structure for a systematic approach to best practice implementation (BPI): (1) site implementation team, (2) implementation drivers, (3) stages of implementation, and (4) improvement cycles. Strategies were developed to address key implementation drivers (staff competency, organizational supports, and leadership) through the four stages of implementation: exploration, installation, initial implementation, and full implementation. Improvement cycles were used to address BPI challenges. Implementation processes (e.g. staff training) and BPI outcomes (completion rates). Following BPI, risk assessment completion rates improved from 29 to 82%. The PUPP completion rate was 89%. PU education was documented for 45% of patients (vs. 21% pre-implementation). Implementation science provided a framework and effective tools for successful pressure ulcer BPI in SCI rehabilitation. Ongoing improvement cycles will target timeliness of tool completion and documentation of patient education.

Disability Insurance and the Dynamics of the Incentive Insurance Trade-Off.

PubMed

Low, Hamish; Pistaferri, Luigi

2018-10-01

We provide a life-cycle framework for comparing insurance and disincentive effects of disability benefits. The risks that individuals face and the parameters of the Disability Insurance (DI ) program are estimated from consumption, health, disability insurance, and wage data. We characterize the effects of disability insurance and study how policy reforms impact behavior and welfare. DI features high rejection rates of disabled applicants and some acceptance of healthy applicants. Despite worse incentives, welfare increases as programs become less strict or generosity increases. Disability insurance interacts with welfare programs: making unconditional means-tested programs more generous improves disability insurance targeting and increases welfare.

A specialist peer mentoring program for university students on the autism spectrum: A pilot study

PubMed Central

2017-01-01

Introduction The provision of peer mentoring may improve tertiary education outcomes of students with autism spectrum disorder (ASD). This study evaluated the pilot year of the Curtin Specialist Mentoring Program (CSMP), a specialised peer mentoring program for university students with ASD aimed at improving self-reported well-being, academic success and retention in university studies. Methods A single group pre-test, post-test design was employed. Quantitative and qualitative evaluations were undertaken with 10 young adults with ASD to explore the effectiveness and acceptability of the CSMP program. Students completed a battery of questionnaires focused on general anxiety, state communication apprehension, perceived communication competence, and communication apprehension both prior to, and five months after commencing enrolment in the CSMP. Information regarding academic success and retention was also obtained. Interviews with participants provided further insight into their experience of the program. Results Students enrolled in the CSMP showed significant improvement in social support and general communication apprehension assessment scores. Interviews revealed key features of the CSMP that may have contributed to these positive outcomes. Conclusions The current study provides preliminary evidence that a specialised peer mentoring program can improve the well-being of students with ASD, and highlights the importance of interventions which are individualised, flexible, based on a social model, and target environmental factors such as social support. PMID:28704446

Online Attention Training for Older Adults.

PubMed

Wennberg, Alexandra; Kueider, Alexandra; Spira, Adam; Adams, Gregory; Rager, Robert; Rebok, George

Evidence suggests that cognitive training interventions can improve older adults' cognitive performance. Successful training programs are adaptable and train multiple cognitive domains to target individual strengths and weaknesses. Computerized training programs are useful because they allow older adults to easily access training. This pilot study used an online attention training program, ATTENTION WORKOUT™, to enhance three aspects of attention- coordination , allocation , and selective focus -in community-dwelling older adults randomized to either an abbreviated (n=13) or an extended (n=17) practice training program over a 6-week period. Participants in the extended practice group significantly improved on selective focus reading distraction tasks with unrelated words (U=39.5; Z=-2.34; p =.02) and blanks (U=26.5; Z=-3.05; p =.002) as well as a matching attributes task (U=49.5; Z=-2.33; p =.02). The extended practice group significantly improved on three tasks of coordinating attention - radio-tuning (U=30; Z=-2.73; p =.01), circuit-breaker resetting (U=46; Z=-2.24; p =.03), and the combination of the two tasks (U=15; Z=-3.51; p <.0001) - as well as a memory generalization task (U=20; Z=-3.27; p =.001). A post-test satisfaction survey found both groups enjoyed the program, but the abbreviated practice group felt the tasks were more difficult. These findings suggest online attention training programs, like ATTENTION WORKOUT, can improve attention-related skills in community-dwelling older adults.

Deep brain stimulation in uncommon tremor disorders: indications, targets, and programming.

PubMed

Artusi, Carlo Alberto; Farooqi, Ashar; Romagnolo, Alberto; Marsili, Luca; Balestrino, Roberta; Sokol, Leonard L; Wang, Lily L; Zibetti, Maurizio; Duker, Andrew P; Mandybur, George T; Lopiano, Leonardo; Merola, Aristide

2018-03-06

In uncommon tremor disorders, clinical efficacy and optimal anatomical targets for deep brain stimulation (DBS) remain inadequately studied and insufficiently quantified. We performed a systematic review of PubMed.gov and ClinicalTrials.gov. Relevant articles were identified using the following keywords: "tremor", "Holmes tremor", "orthostatic tremor", "multiple sclerosis", "multiple sclerosis tremor", "neuropathy", "neuropathic tremor", "fragile X-associated tremor/ataxia syndrome", and "fragile X." We identified a total of 263 cases treated with DBS for uncommon tremor disorders. Of these, 44 had Holmes tremor (HT), 18 orthostatic tremor (OT), 177 multiple sclerosis (MS)-associated tremor, 14 neuropathy-associated tremor, and 10 fragile X-associated tremor/ataxia syndrome (FXTAS). DBS resulted in favorable, albeit partial, clinical improvements in HT cases receiving Vim-DBS alone or in combination with additional targets. A sustained improvement was reported in OT cases treated with bilateral Vim-DBS, while the two cases treated with unilateral Vim-DBS demonstrated only a transient effect. MS-associated tremor responded to dual-target Vim-/VO-DBS, but the inability to account for the progression of MS-associated disability impeded the assessment of its long-term clinical efficacy. Neuropathy-associated tremor substantially improved with Vim-DBS. In FXTAS patients, while Vim-DBS was effective in improving tremor, equivocal results were observed in those with ataxia. DBS of select targets may represent an effective therapeutic strategy for uncommon tremor disorders, although the level of evidence is currently in its incipient form and based on single cases or limited case series. An international registry is, therefore, warranted to clarify selection criteria, long-term results, and optimal surgical targets.

The Behavior Education Support and Treatment (BEST) school intervention program: pilot project data examining schoolwide, targeted-school, and targeted-home approaches.

PubMed

Waschbusch, Daniel A; Pelham, William E; Massetti, Greta

2005-08-01

As part of a pilot project, four elementary schools were randomly assigned to receive one of four interventions: (a) a schoolwide intervention that incorporated universal and targeted treatment, (b) a targeted-school intervention delivered to individual students in regular and special education classrooms, (c) a targeted-home intervention delivered in home and regular classroom settings, and (d) a control condition that did not receive a designated intervention. Results showed that the behavior of disruptive children in all schools improved during the course of the year, with some evidence that interventions provided complementary effects. These findings support the continued use of behavioral interventions in elementary schools and argue for interventions that combine different methods of delivering interventions.

Continuing medical education, continuing professional development, and knowledge translation: improving care of older patients by practicing physicians.

PubMed

Thomas, David C; Johnston, Bree; Dunn, Kathel; Sullivan, Gail M; Brett, Belle; Matzko, Marilyn; Levine, Sharon A

2006-10-01

Many community-based internists and family physicians lack familiarity with geriatrics knowledge and best practices, but they face overwhelming fiscal and time barriers to expanding their skills and improving their behavior in the care of older people. Traditional lecture-and-slide-show continuing medical education (CME) programs have been shown to be relatively ineffective in changing this target group's practice. The challenge for geriatrics educators, then, is to devise CME programs that are highly accessible to practicing physicians, that will have an immediate and significant effect on practitioners' behavior, and that are financially viable. Studies of CME have shown that the most effective programs for knowledge translation in these circumstances involve what is known as active-mode learning, which relies on interactive, targeted, and multifaceted techniques. A systematic literature review, supplemented by structured interviews, was performed to inventory active-mode learning techniques for geriatrics knowledge and skills in the United States. Thirteen published articles met the criteria, and leaders of 28 active-mode CME programs were interviewed. This systematic review indicates that there is a substantial experience in geriatrics training for community-based physicians, much of which is unpublished and incompletely evaluated. It appears that the most effective methods to change behaviors involved multiple educational efforts such as written materials or toolkits combined with feedback and strong communication channels between instructors and learners.

A gender-specific approach to improving substance abuse treatment for women: The Healthy Steps to Freedom program.

PubMed

Lindsay, Anne R; Warren, Cortney S; Velasquez, Sara C; Lu, Minggen

2012-07-01

Given that women increasingly report using drugs to lose weight, substance abuse treatment programs must include body image, weight, eating pathology, and health knowledge as core intervention targets. This study tested the efficacy of a supplemental health and body image curriculum designed for women in substance abuse treatment who report weight concerns called Healthy Steps to Freedom (HSF). Data from 124 adult women recruited from substance abuse treatment facilities in southern Nevada completed measures of drug use, body dissatisfaction, eating pathology, thin-ideal internalization, and health knowledge/behaviors before and after participation in the 12-week HSF program. Results revealed that thin-ideal internalization, body dissatisfaction, and eating disorder symptoms significantly decreased after HSF program participation, whereas health-related behaviors (e.g., increased healthy food consumption) and knowledge (e.g., understanding of basic nutrition, exercise) increased. These results suggest that the inclusion of the HSF program in substance abuse treatment improves weight-related issues in substance-abusing women. Copyright © 2012 Elsevier Inc. All rights reserved.

Child Health Partnerships: a review of program characteristics, outcomes and their relationship.

PubMed

Jayaratne, Kapila; Kelaher, Margaret; Dunt, David

2010-06-17

Novel approaches are increasingly employed to address the social determinants of health of children world-wide. Such approaches have included complex social programs involving multiple stakeholders from different sectors jointly working together (hereafter Child Health Partnerships). Previous reviews have questioned whether these programs have led to significant improvements in child health and related outcomes. We aim to provide definitive answers to this question as well as identifying the characteristics of successful partnerships. A comprehensive literature search identified 11 major Child Health Partnerships in four comparable developed countries. A critical review is focused on various aspects of these including their target groups, program mechanics and outcomes. There was evidence of success in several major areas from the formation of effective joint operations of partners in different partnership models to improvement in both child wellbeing and parenting. There is emerging evidence that Child Health Partnerships are cost-effective. Population characteristics and local contexts need to be taken into account in the introduction and implementation of these programs.

Budget Impact of a Comprehensive Nutrition-Focused Quality Improvement Program for Malnourished Hospitalized Patients

PubMed Central

Sulo, Suela; Feldstein, Josh; Partridge, Jamie; Schwander, Bjoern; Sriram, Krishnan; Summerfelt, Wm. Thomas

2017-01-01

Background Nutrition interventions can alleviate the burden of malnutrition by improving patient outcomes; however, evidence on the economic impact of medical nutrition intervention remains limited. A previously published nutrition-focused quality improvement program targeting malnourished hospitalized patients showed that screening patients with a validated screening tool at admission, rapidly administering oral nutritional supplements, and educating patients on supplement adherence result in significant reductions in 30-day unplanned readmissions and hospital length of stay. Objectives To assess the potential cost-savings associated with decreased 30-day readmissions and hospital length of stay in malnourished inpatients through a nutrition-focused quality improvement program using a web-based budget impact model, and to demonstrate the clinical and fiscal value of the intervention. Methods The reduction in readmission rate and length of stay for 1269 patients enrolled in the quality improvement program (between October 13, 2014, and April 2, 2015) were compared with the pre–quality improvement program baseline and validation cohorts (4611 patients vs 1319 patients, respectively) to calculate potential cost-savings as well as to inform the design of the budget impact model. Readmission rate and length-of-stay reductions were calculated by determining the change from baseline to post–quality improvement program as well as the difference between the validation cohort and the post–quality improvement program, respectively. Results As a result of improved health outcomes for the treated patients, the nutrition-focused quality improvement program led to a reduction in 30-day hospital readmissions and length of stay. The avoided hospital readmissions and reduced number of days in the hospital for the patients in the quality improvement program resulted in cost-savings of $1,902,933 versus the pre–quality improvement program baseline cohort, and $4,896,758 versus the pre–quality improvement program in the validation cohort. When these costs were assessed across the entire patient population enrolled in the quality improvement program, per-patient net savings of $1499 when using the baseline cohort as the comparator and savings per patient treated of $3858 when using the validated cohort as the comparator were achieved. Conclusion The nutrition-focused quality improvement program reduced the per-patient healthcare costs by avoiding 30-day readmissions and through reduced length of hospital stay. These clinical and economic outcomes provide a rationale for merging patient care and financial modeling to advance the delivery of value-based medicine in a malnourished hospitalized population. The use of a novel web-based budget impact model supports the integration of comparative effectiveness analytics and healthcare resource management in the hospital setting to provide optimal quality of care at a reduced overall cost. PMID:28975010

Budget Impact of a Comprehensive Nutrition-Focused Quality Improvement Program for Malnourished Hospitalized Patients.

PubMed

Sulo, Suela; Feldstein, Josh; Partridge, Jamie; Schwander, Bjoern; Sriram, Krishnan; Summerfelt, Wm Thomas

2017-07-01

Nutrition interventions can alleviate the burden of malnutrition by improving patient outcomes; however, evidence on the economic impact of medical nutrition intervention remains limited. A previously published nutrition-focused quality improvement program targeting malnourished hospitalized patients showed that screening patients with a validated screening tool at admission, rapidly administering oral nutritional supplements, and educating patients on supplement adherence result in significant reductions in 30-day unplanned readmissions and hospital length of stay. To assess the potential cost-savings associated with decreased 30-day readmissions and hospital length of stay in malnourished inpatients through a nutrition-focused quality improvement program using a web-based budget impact model, and to demonstrate the clinical and fiscal value of the intervention. The reduction in readmission rate and length of stay for 1269 patients enrolled in the quality improvement program (between October 13, 2014, and April 2, 2015) were compared with the pre-quality improvement program baseline and validation cohorts (4611 patients vs 1319 patients, respectively) to calculate potential cost-savings as well as to inform the design of the budget impact model. Readmission rate and length-of-stay reductions were calculated by determining the change from baseline to post-quality improvement program as well as the difference between the validation cohort and the post-quality improvement program, respectively. As a result of improved health outcomes for the treated patients, the nutrition-focused quality improvement program led to a reduction in 30-day hospital readmissions and length of stay. The avoided hospital readmissions and reduced number of days in the hospital for the patients in the quality improvement program resulted in cost-savings of $1,902,933 versus the pre-quality improvement program baseline cohort, and $4,896,758 versus the pre-quality improvement program in the validation cohort. When these costs were assessed across the entire patient population enrolled in the quality improvement program, per-patient net savings of $1499 when using the baseline cohort as the comparator and savings per patient treated of $3858 when using the validated cohort as the comparator were achieved. The nutrition-focused quality improvement program reduced the per-patient healthcare costs by avoiding 30-day readmissions and through reduced length of hospital stay. These clinical and economic outcomes provide a rationale for merging patient care and financial modeling to advance the delivery of value-based medicine in a malnourished hospitalized population. The use of a novel web-based budget impact model supports the integration of comparative effectiveness analytics and healthcare resource management in the hospital setting to provide optimal quality of care at a reduced overall cost.

Can older "at risk" adults benefit from psychoeducation targeting healthy brain aging?

PubMed

Norrie, Louisa M; Diamond, Keri; Hickie, Ian B; Rogers, Naomi L; Fearns, Samantha; Naismith, Sharon L

2011-04-01

Multifactorial strategies that prevent or delay the onset or progress of cognitive decline and dementia are needed, and should include education regarding recognized risk factors. The current study sought to investigate whether older adults "at risk" of cognitive decline benefit from psychoeducation targeting healthy brain aging. 65 participants (mean age 64.8 years, SD 9.6) with a lifetime history of major depression; vascular risk as evidenced by at least one vascular risk factor; and/or subjective or objective memory impairment were allocated to weekly psychoeducation sessions or a waitlist control group. The small group sessions were conducted over ten weeks by a team of medical and allied health professionals with expertise in late-life depression and cognition. Sessions focused on modifiable risk factors for cognitive decline including vascular risk, diet, exercise, depression, anxiety and sleep disturbance, as well as providing practical strategies for memory and cognition. Both the psychoeducation and waitlist group completed a 20-item knowledge test at baseline and follow-up. Participants in the psychoeducation group were asked to complete follow-up self-report satisfaction questionnaires. Repeated measures ANOVA showed a significant interaction effect depicting improvements in knowledge associated with psychoeducation, corresponding to an improvement of 15% from baseline. Satisfaction data additionally showed that 92.3% of participants rated the program as "good" to "excellent", and over 90% suggested they would recommend it to others. A group-based psychoeducation program targeting healthy brain aging is effective in improving knowledge. Additionally, it is acceptable and rated highly by participants.

A unique funding opportunity for public health in Texas.

PubMed

Schlenker, Thomas; Huber, Carol A

2015-01-01

In addition to the Affordable Care Act, states are more frequently turning to Medicaid waivers to achieve the "Triple Aim" goals of improving the experience of care, improving population health, and reducing per capita costs. These demonstration waivers provide opportunities to test innovative ways to finance and deliver care. Texas is currently implementing a waiver known as the Transformation and Quality Improvement Program. Its inclusion of public health agencies is a unique approach to a system typically limited to traditional providers. San Antonio Metropolitan Health District is one public health agency taking advantage of this new funding opportunity to implement 6 new or expanded programs targeting health issues of highest priority in this south Texas region. This article discusses the use of Medicaid waivers and the advantages and challenges of public health agency participation.

Application of persuasion and health behavior theories for behavior change counseling: design of the ADAPT (Avoiding Diabetes Thru Action Plan Targeting) program.

PubMed

Lin, Jenny J; Mann, Devin M

2012-09-01

Diabetes incidence is increasing worldwide and providers often do not feel they can effectively counsel about preventive lifestyle changes. The goal of this paper is to describe the development and initial feasibility testing of the Avoiding Diabetes Thru Action Plan Targeting (ADAPT) program to enhance counseling about behavior change for patients with pre-diabetes. Primary care providers and patients were interviewed about their perspectives on lifestyle changes to prevent diabetes. A multidisciplinary design team incorporated this data to translate elements from behavior change theories to create the ADAPT program. The ADAPT program was pilot tested to evaluate feasibility. Leveraging elements from health behavior theories and persuasion literature, the ADAPT program comprises a shared goal-setting module, implementation intentions exercise, and tailored reminders to encourage behavior change. Feasibility data demonstrate that patients were able to use the program to achieve their behavior change goals. Initial findings show that the ADAPT program is feasible for helping improve primary care providers' counseling for behavior change in patients with pre-diabetes. If successful, the ADAPT program may represent an adaptable and scalable behavior change tool for providers to encourage lifestyle changes to prevent diabetes. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Adaptive bi-level programming for optimal gene knockouts for targeted overproduction under phenotypic constraints

PubMed Central

2013-01-01

Background Optimization procedures to identify gene knockouts for targeted biochemical overproduction have been widely in use in modern metabolic engineering. Flux balance analysis (FBA) framework has provided conceptual simplifications for genome-scale dynamic analysis at steady states. Based on FBA, many current optimization methods for targeted bio-productions have been developed under the maximum cell growth assumption. The optimization problem to derive gene knockout strategies recently has been formulated as a bi-level programming problem in OptKnock for maximum targeted bio-productions with maximum growth rates. However, it has been shown that knockout mutants in fact reach the steady states with the minimization of metabolic adjustment (MOMA) from the corresponding wild-type strains instead of having maximal growth rates after genetic or metabolic intervention. In this work, we propose a new bi-level computational framework--MOMAKnock--which can derive robust knockout strategies under the MOMA flux distribution approximation. Methods In this new bi-level optimization framework, we aim to maximize the production of targeted chemicals by identifying candidate knockout genes or reactions under phenotypic constraints approximated by the MOMA assumption. Hence, the targeted chemical production is the primary objective of MOMAKnock while the MOMA assumption is formulated as the inner problem of constraining the knockout metabolic flux to be as close as possible to the steady-state phenotypes of wide-type strains. As this new inner problem becomes a quadratic programming problem, a novel adaptive piecewise linearization algorithm is developed in this paper to obtain the exact optimal solution to this new bi-level integer quadratic programming problem for MOMAKnock. Results Our new MOMAKnock model and the adaptive piecewise linearization solution algorithm are tested with a small E. coli core metabolic network and a large-scale iAF1260 E. coli metabolic network. The derived knockout strategies are compared with those from OptKnock. Our preliminary experimental results show that MOMAKnock can provide improved targeted productions with more robust knockout strategies. PMID:23368729

Adaptive bi-level programming for optimal gene knockouts for targeted overproduction under phenotypic constraints.

PubMed

Ren, Shaogang; Zeng, Bo; Qian, Xiaoning

2013-01-01

Optimization procedures to identify gene knockouts for targeted biochemical overproduction have been widely in use in modern metabolic engineering. Flux balance analysis (FBA) framework has provided conceptual simplifications for genome-scale dynamic analysis at steady states. Based on FBA, many current optimization methods for targeted bio-productions have been developed under the maximum cell growth assumption. The optimization problem to derive gene knockout strategies recently has been formulated as a bi-level programming problem in OptKnock for maximum targeted bio-productions with maximum growth rates. However, it has been shown that knockout mutants in fact reach the steady states with the minimization of metabolic adjustment (MOMA) from the corresponding wild-type strains instead of having maximal growth rates after genetic or metabolic intervention. In this work, we propose a new bi-level computational framework--MOMAKnock--which can derive robust knockout strategies under the MOMA flux distribution approximation. In this new bi-level optimization framework, we aim to maximize the production of targeted chemicals by identifying candidate knockout genes or reactions under phenotypic constraints approximated by the MOMA assumption. Hence, the targeted chemical production is the primary objective of MOMAKnock while the MOMA assumption is formulated as the inner problem of constraining the knockout metabolic flux to be as close as possible to the steady-state phenotypes of wide-type strains. As this new inner problem becomes a quadratic programming problem, a novel adaptive piecewise linearization algorithm is developed in this paper to obtain the exact optimal solution to this new bi-level integer quadratic programming problem for MOMAKnock. Our new MOMAKnock model and the adaptive piecewise linearization solution algorithm are tested with a small E. coli core metabolic network and a large-scale iAF1260 E. coli metabolic network. The derived knockout strategies are compared with those from OptKnock. Our preliminary experimental results show that MOMAKnock can provide improved targeted productions with more robust knockout strategies.

MPH program adaptability in a competitive marketplace: the case for continued assessment.

PubMed

Caron, Rosemary M; Tutko, Holly

2010-06-01

In the last several years, the number of Master of Public Health (MPH) programs has increased rapidly in the US. As such, MPH programs, particularly smaller-sized ones, need to critically examine how their programs are meeting the needs and preferences of local public health practitioners. To assist in this necessity, the University of New Hampshire conducted a comprehensive educational assessment of its effectiveness as a smaller-sized, accredited MPH program. The aim of the assessment was to review the MPH program from the perspective of all stakeholders and then to agree on changes that would contribute to the fulfillment of the program's mission, as well as improve program quality and reach. The program's stakeholders examined the following components: policy development and implementation; target audience; marketing strategies; marketplace position; delivery model; curriculum design; and continuing education. Though assessment activities explored a wide array of program attributes, target audience, curriculum design, and delivery strategy presented significant challenges and opportunities for our smaller MPH Program to remain competitive. The effort put forth into conducting an in-depth assessment of the core components of our program also allowed for a comparison to the increasing number of MPH programs developing regionally. Since public health practice is changing and the education of public health practitioners must be adaptable, we propose that a routine assessment of an institution's MPH program could not only meet this need but also assist with keeping smaller, unbranded MPH programs competitive in a burgeoning marketplace.

An empirical approach to the stopping power of solids and gases for ions from 3Li to 18Ar - Part II

NASA Astrophysics Data System (ADS)

Paul, Helmut; Schinner, Andreas

2002-10-01

This paper is a continuation of the work presented in Nucl. Instr. and Meth. Phys. Res. B 179 (2001) 299. Its aim is to produce a table of stopping powers by fitting empirical stopping values. Our database has been increased and we use a better fit function. As before, we treat solid and gaseous targets separately, but we now obtain results also for H 2 and He targets. Using an improved version of our program MSTAR, we can calculate the stopping power for any ion (3⩽ Z1⩽18) at specific energies from 0.001 to 1000 MeV/nucleon and for any element, mixture or compound contained in ICRU Report 49. MSTAR is available in the internet; it can be used as stand alone or built as a subroutine into other programs. Using a statistical program for comparing our fits with the experimental data, we find that MSTAR represents the data within 2% at high energy and within up to 20% (25% for gases) at the lowest energies. Fitting errors are 40-110% larger than experimental errors given by the authors. For some gas targets, MSTAR describes the data better than Ziegler's program TRIM.

Fostering Leadership Skills in Pre-Service Teachers

ERIC Educational Resources Information Center

Xu, Yuejin; Patmor, George

2012-01-01

Teacher leadership is about empowering teachers to take a more active role in school improvement. Current pathways to teacher leadership, namely the Teacher Leader Master (TLM) degree program and teacher-led professional development, mainly target in-service teachers. Less attention has been paid to teacher leadership training in current teacher…

Multidisciplinary VA Cardiac Rehabilitation: Preliminary Results and Treatment Efficacy.

ERIC Educational Resources Information Center

Daly, Susan S.; And Others

Initial studies have suggested that a cardiac rehabilitation program (CRP) may improve the physical and psychological functioning of participants. However, these studies have generally addressed a relatively young group of employed adult males. Three studies were designed to target an older, generally retired Veterans Administration population for…

Are College Graduates Ready for the 21st Century? Community-Engaged Research Can Help

ERIC Educational Resources Information Center

Carbone, Elena T.; Ware, Susan

2017-01-01

Research is clear: Employers want college graduates who can communicate clearly, think analytically, and interact respectfully. Targeted educational experiences have measurably improved these capacities. To better prepare undergraduates, the University of Massachusetts Amherst developed the Community-Engaged Research Program, a pilot program…

Improving Reading Skills through Parental Involvement.

ERIC Educational Resources Information Center

Clark, Kathryn; Pillion, Jennifer

This report describes a project for increasing parental involvement through the existing reading program. The targeted first and second grade students lived in growing rural, Midwestern, low to middle class communities located in north central Illinois. The problem was noted in literature by researchers who found that parents had a very limited…

Early Interventions: Keys to Successful Readers.

ERIC Educational Resources Information Center

Jeffreys, JoAnn; Spang, Joan

This action research outlines an early reading intervention project for improving students' reading skills and promoting the implementation of early reading intervention programs. The targeted population includes first and second grade students in one school located in the suburbs of a major city in Illinois. The problem of early reading…

Assessing the breeding potential of extra-long staple germplasm in an upland cotton breeding program

USDA-ARS?s Scientific Manuscript database

Fiber quality improvement of upland cotton (Gossypium hirsutum L.) is essential to increase the value and competitiveness of cotton fiber. The closely related allotetraploid species G. barbadense has long been targeted as a source of beneficial fiber quality alleles. Although interspecific hybridiza...

The Nation's Energy Problem. Forum Report.

ERIC Educational Resources Information Center

Business-Higher Education Forum, Washington, DC.

Some of the essential elements now deficient in national energy programs are identified, and recommendations are offered for business, universities, and government regarding actions that may improve energy-related research and training. Five topics that need to be addressed by professionals are: (1) an energy policy that ensures that targets for…

78 FR 16509 - Amendment to Information Collection Activity; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-15

... the labor market and achieve self-sufficiency. The projects will evaluate up to twelve subsidized and... assist ex-offenders and noncustodial parents improve labor market outcomes, reduce criminal recidivism... related program models and target populations. Thus, ACF and ETA have agreed to collaborate on the design...

Funding, Reputation and Targets: The Discursive Logics of High-Stakes Testing

ERIC Educational Resources Information Center

Lewis, Steven; Hardy, Ian

2015-01-01

This paper provides insights into teacher and school-based administrators' responses to policy demands for improved outcomes on high-stakes, standardised literacy and numeracy tests in Australia. Specifically, the research reveals the effects of the National Assessment Program--Literacy and Numeracy (NAPLAN), and associated policies, in the state…

Impact of Supplemental Instruction Participation on College Freshman Retention

ERIC Educational Resources Information Center

Skoglund, Kirk; Wall, Timothy J.; Kiene, David

2018-01-01

Supplemental Instruction (SI), a higher-education academic support program, targets challenging college courses and uses peer-led review sessions to develop academic skills, improve grades, influence persistence, and ultimately increase student retention (Arendale, 2001). The goals of this study were twofold: to determine if differences existed in…

Using Background Music To Enhance Memory and Improve Learning.

ERIC Educational Resources Information Center

Anderson, Scheree; Henke, Jeanette; McLaughlin, Maureen; Ripp, Mary; Tuffs, Patricia

This report describes a program to enhance spelling word retention through the use of background music. The targeted population consisted of elementary students in three middle class communities located in the southwestern suburbs of Chicago. The problems for poor spelling retention were documented through data revealing the number of students…

Adaptation of the Wellness Evaluation of Lifestyle Scale to Turkish

ERIC Educational Resources Information Center

Dogan, Türkan; Yildirim, Ibrahim; Myers, Jane E.

2012-01-01

Problem Statement: Studies show that wellness is closely associated with individual life style. Thus, any efforts toward improving wellness should target aspects of a person's life style. A means of assessing holistic wellness is needed to design programs that increase individuals'/clients' health and wellness and to develop psychological…

Thai health education program for improving TB migrant's compliance.

PubMed

Khortwong, Pornsak; Kaewkungwal, Jaranit

2013-03-01

Investigate the effectiveness of health education programs by using the PRECEDE-PROCEED Model to improve non-Thai migrant TB patient's compliance during treatment. This quasi-intervention study was conducted in three targeted hospitals, between August 2009 and December 2010. The study sample consisted of 100 cases, 50 cases who registered in Samutsakorn Province served as the intervention group and 50 cases who registered in Samutprakarn Province served as the control group. At the end of the health education intervention, the intervention group showedsignificantly improved health-behavior scores in nine domains-health promotion, health education, predisposing, reinforcing, enabling factors, behavior and lifestyle, environment, and health status, which were also significantly higher than the control group (p < 0.001). The percentage of patients achieving successful treatment outcomes was 76% in the intervention group and 62% in the control group. The tuberculosis treatment and care program, and the associated health education interventions enabled migrants to complete the treatment regimen and achieve treatment success. It could also help TB staff develop an appropriate program and clear understanding of TB control among migrants. It is recommended that this type of information and health education program be used in other hospitals and healthcare settings providing TB services for migrants throughout the nation.

Fermilab proton accelerator complex status and improvement plans

DOE Office of Scientific and Technical Information (OSTI.GOV)

Shiltsev, Vladimir

2017-05-30

Fermilab carries out an extensive program of accelerator-based high energy particle physics research at the Intensity Frontier that relies on the operation of 8 GeV and 120 GeV proton beamlines for a n umber of fixed target experiments. Routine operation with a world-record 700kW of average 120 GeV beam power on the neutrino target was achieved in 2017 as the result of the Proton Improvement Plan (PIP) upgrade. There are plans to further increase the power to 900 – 1000 kW. The next major upgrade of the FNAL accelerator complex, called PIP-II, is under development. It aims at 1.2MW beammore » power on target at the start of the LBNF/DUNE experiment in the middle of the next decade and assumes replacement of the existing 40-years old 400 MeV normal-conducting Linac with a modern 800 MeV superconducting RF linear accelerator. There are several concepts to further double the beam power to >2.4MW after replacement of the existing 8 GeV Booster synchrotron. In this article we discuss current performance of the Fermilab proton accelerator complex, the upgrade plans for the next two decades and the accelerator R&D program to address cost and performance risks for these upgrades.« less

Strategies for target identification of antimicrobial natural products.

PubMed

Farha, Maya A; Brown, Eric D

2016-05-04

Covering: 2000 to 2015Despite a pervasive decline in natural product research at many pharmaceutical companies over the last two decades, natural products have undeniably been a prolific and unsurpassed source for new lead antibacterial compounds. Due to their inherent complexity, natural extracts face several hurdles in high-throughout discovery programs, including target identification. Target identification and validation is a crucial process for advancing hits through the discovery pipeline, but has remained a major bottleneck. In the case of natural products, extremely low yields and limited compound supply further impede the process. Here, we review the wealth of target identification strategies that have been proposed and implemented for the characterization of novel antibacterials. Traditionally, these have included genomic and biochemical-based approaches, which, in recent years, have been improved with modern-day technology and better honed for natural product discovery. Further, we discuss the more recent innovative approaches for uncovering the target of new antibacterial natural products, which have resulted from modern advances in chemical biology tools. Finally, we present unique screening platforms implemented to streamline the process of target identification. The different innovative methods to respond to the challenge of characterizing the mode of action for antibacterial natural products have cumulatively built useful frameworks that may advocate a renovated interest in natural product drug discovery programs.

Groundnut improvement: use of genetic and genomic tools

PubMed Central

Janila, Pasupuleti; Nigam, S. N.; Pandey, Manish K.; Nagesh, P.; Varshney, Rajeev K.

2013-01-01

Groundnut (Arachis hypogaea L.), a self-pollinated legume is an important crop cultivated in 24 million ha world over for extraction of edible oil and food uses. The kernels are rich in oil (48–50%) and protein (25–28%), and are source of several vitamins, minerals, antioxidants, biologically active polyphenols, flavonoids, and isoflavones. Improved varieties of groundnut with high yield potential were developed and released for cultivation world over. The improved varieties belong to different maturity durations and possess resistance to diseases, tolerance to drought, enhanced oil content, and improved quality traits for food uses. Conventional breeding procedures along with the tools for phenotyping were largely used in groundnut improvement programs. Mutations were used to induce variability and wide hybridization was attempted to tap variability from wild species. Low genetic variability has been a bottleneck for groundnut improvement. The vast potential of wild species, reservoir of new alleles remains under-utilized. Development of linkage maps of groundnut during the last decade was followed by identification of markers and quantitative trait loci for the target traits. Consequently, the last decade has witnessed the deployment of molecular breeding approaches to complement the ongoing groundnut improvement programs in USA, China, India, and Japan. The other potential advantages of molecular breeding are the feasibility to target multiple traits for improvement and provide tools to tap new alleles from wild species. The first groundnut variety developed through marker-assisted back-crossing is a root-knot nematode-resistant variety, NemaTAM in USA. The uptake of molecular breeding approaches in groundnut improvement programs by NARS partners in India and many African countries is slow or needs to be initiated in part due to inadequate infrastructure, high genotyping costs, and human capacities. Availability of draft genome sequence for diploid (AA and BB) and tetraploid, AABB genome species of Arachis in coming years is expected to bring low-cost genotyping to the groundnut community that will facilitate use of modern genetics and breeding approaches such as genome-wide association studies for trait mapping and genomic selection for crop improvement. PMID:23443056

Foodservice employees benefit from interventions targeting barriers to food safety.

PubMed

York, Valerie K; Brannon, Laura A; Shanklin, Carol W; Roberts, Kevin R; Howells, Amber D; Barrett, Elizabeth B

2009-09-01

The number of foodborne illnesses traced to improper food handling in restaurants indicates a need for research to improve food safety in these establishments. Therefore, this 2-year longitudinal study investigated the effectiveness of traditional ServSafe (National Restaurant Association Educational Foundation, Chicago, IL) food-safety training and a Theory of Planned Behavior intervention program targeting employees' perceived barriers and attitudes toward important food-safety behaviors. The effectiveness of the training and intervention was measured by knowledge scores and observed behavioral compliance rates related to food-safety practices. Employees were observed for handwashing, thermometer usage, and proper handling of work surfaces at baseline, after receiving ServSafe training, and again after exposure to the intervention targeting barriers and negative attitudes about food-safety practices. Repeated-measures analyses of variance indicated training improved handwashing knowledge, but the intervention was necessary to improve overall behavioral compliance and handwashing compliance. Results suggest that registered dietitians; dietetic technicians, registered; and foodservice managers should implement a combination of training and intervention to improve knowledge and compliance with food-safety behaviors, rather than relying on training alone. Challenges encountered while conducting this research are discussed, and recommendations are provided for researchers interested in conducting this type of research in the future.

Total quality in acute care hospitals: guidelines for hospital managers.

PubMed

Holthof, B

1991-08-01

Quality improvement can not focus exclusively on peer review and the scientific evaluation of medical care processes. These essential elements have to be complemented with a focus on individual patient needs and preferences. Only then will hospitals create the competitive advantage needed to survive in an increasingly market-driven hospital industry. Hospital managers can identify these patients' needs by 'living the patient experience' and should then set the hospital's quality objectives according to its target patients and their needs. Excellent quality program design, however, is not sufficient. Successful implementation of a quality improvement program further requires fundamental changes in pivotal jobholders' behavior and mindset and in the supporting organizational design elements.

Education Bill passes

NASA Astrophysics Data System (ADS)

Richman, Barbara T.

On March 2 the U.S. House of Representatives passed a bill authorizing $425 million for science and mathematics education in fiscal 1984; the authorization is $350 million more than President Ronald Reagan requested in his budget proposal (Eos, February 15, 1983, p. 65).H.R. 1310 allocates $295 million to the Department of Education not only to improve precollege instruction in science and math, but to beef up foreign language training to aid in improving international communication among scientists. The bill also allots $130 million to the National Science Foundation for a variety of programs, the lion's share of which aims to upgrade research equipment at colleges and universities. It is hoped that industry will match the $100 million targeted for this program.

The Transgender Women of Color Initiative: Implementing and Evaluating Innovative Interventions to Enhance Engagement and Retention in HIV Care.

PubMed

Rebchook, Gregory; Keatley, JoAnne; Contreras, Robert; Perloff, Judy; Molano, Luis Freddy; Reback, Cathy J; Ducheny, Kelly; Nemoto, Tooru; Lin, Royce; Birnbaum, Jeffrey; Woods, Tiffany; Xavier, Jessica

2017-02-01

To improve health outcomes among transgender women of color living with HIV, the Health Resources and Services Administration's Special Programs of National Significance program funded the Enhancing Engagement and Retention in Quality HIV Care for Transgender Women of Color Initiative in 2012. Nine demonstration projects in four US urban areas implemented innovative, theory-based interventions specifically targeting transgender women of color in their jurisdictions. An evaluation and technical assistance center was funded to evaluate the outcomes of the access to care interventions, and these findings will yield best practices and lessons learned to improve the care and treatment of transgender women of color living with HIV infection.

A Review of Effective Youth Engagement Strategies for Mental Health and Substance Use Interventions.

PubMed

Dunne, Tom; Bishop, Lisa; Avery, Susan; Darcy, Stephen

2017-05-01

The majority of adult mental health and substance use (MH&SU) conditions emerge in adolescence. Prevention, diagnosis, and treatment programs targeting this age group have a unique opportunity to significantly impact the well-being of the future generation of adults. At the same time, youth are reluctant to seek treatment and have high rates of dropout from interventions. An emphasis on youth engagement in prevention and treatment interventions for MH&SU results in better health outcomes for those youth. This literature review was undertaken to evaluate opportunities to improve youth engagement in MH&SU programs. The intent was to determine best practices in the field that combined community-level improvement in clinical outcomes with proven strategies in engagement enhancement to inform program development at a local level. The results discuss 40 studies, reviews, and program reports demonstrating effective youth engagement. These have been grouped into six themes based on the underlying engagement mechanism: youth participation in program development, parental relationships, technology, the health clinic, school, and social marketing. A broad range of tools are discussed that intervention developers can leverage to improve youth engagement in prevention or treatment programs. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

A program evaluation of the Patient CaringTouch System: A pre- and postimplementation assessment.

PubMed

Breckenridge-Sproat, Sara T; Swiger, Pauline A; Belew, Donna L; Raju, Dheeraj; Patrician, Patricia A; Loan, Lori A

The Patient CaringTouch System (PCTS) is an innovative, strategic and patient-centric framework developed by the Army Nurse Corps for nursing care delivery that is designed to reduce nursing care variation and improve patient and nurse outcomes. This manuscript describes a program evaluation of the PCTS. A pre and post design was used to describe changes in patient and nursing measures following PCTS implementation. Overall there was a good uptake of the PCTS; however, concurrent with initiation of the PCTS, declines in staffing levels and increases in patient acuity were noted. Medication administration error rates declined, but fall with injury rates increased. Pain reassessment following pain medication administration improved, as did several aspects of the nursing practice environment. Nurses' job dissatisfaction and intent to leave increased; however, potentially preventable losses decreased. The program evaluation results will be used to target areas for improvement so that the PCTS may be sustained. Published by Elsevier Inc.

Is a decentralized continuing medical education program feasible for Chinese rural health professionals?

PubMed

Hu, Guijie; Yi, Yanhua

2016-01-01

Rural health professionals in township health centers (THCs) tend to have less advanced educational degrees. This study aimed to ascertain the perceived feasibility of a decentralized continuing medical education (CME) program to upgrade their educational levels. A cross-sectional survey of THC health professionals was conducted using a self-administered, structured questionnaire in Guangxi Zhuang Autonomous Region, China. The health professionals in the THCs were overwhelmingly young with low education levels. They had a strong desire to upgrade their educational degrees. The decentralized CME program was perceived as feasible by health workers with positive attitudes about the benefit for license examination, and by those who intended to improve their clinical diagnosis and treatment skills. The target groups of such a program were those who expected to undertake a bachelor's degree and who rated themselves as "partially capable" in clinical competency. They reported that 160-400 USD annually would be an affordable fee for the program. A decentralized CME program was perceived feasible to upgrade rural health workers' education level to a bachelor's degree and improve their clinical competency.

Application of the docking program SOL for CSAR benchmark.

PubMed

Sulimov, Alexey V; Kutov, Danil C; Oferkin, Igor V; Katkova, Ekaterina V; Sulimov, Vladimir B

2013-08-26

This paper is devoted to results obtained by the docking program SOL and the post-processing program DISCORE at the CSAR benchmark. SOL and DISCORE programs are described. SOL is the original docking program developed on the basis of the genetic algorithm, MMFF94 force field, rigid protein, precalculated energy grid including desolvation in the frame of simplified GB model, vdW, and electrostatic interactions and taking into account the ligand internal strain energy. An important SOL feature is the single- or multi-processor performance for up to hundreds of CPUs. DISCORE improves the binding energy scoring by the local energy optimization of the ligand docked pose and a simple linear regression on the base of available experimental data. The docking program SOL has demonstrated a good ability for correct ligand positioning in the active sites of the tested proteins in most cases of CSAR exercises. SOL and DISCORE have not demonstrated very exciting results on the protein-ligand binding free energy estimation. Nevertheless, for some target proteins, SOL and DISCORE were among the first in prediction of inhibition activity. Ways to improve SOL and DISCORE are discussed.

Application of target costing in machining

NASA Astrophysics Data System (ADS)

Gopalakrishnan, Bhaskaran; Kokatnur, Ameet; Gupta, Deepak P.

2004-11-01

In today's intensely competitive and highly volatile business environment, consistent development of low cost and high quality products meeting the functionality requirements is a key to a company's survival. Companies continuously strive to reduce the costs while still producing quality products to stay ahead in the competition. Many companies have turned to target costing to achieve this objective. Target costing is a structured approach to determine the cost at which a proposed product, meeting the quality and functionality requirements, must be produced in order to generate the desired profits. It subtracts the desired profit margin from the company's selling price to establish the manufacturing cost of the product. Extensive literature review revealed that companies in automotive, electronic and process industries have reaped the benefits of target costing. However target costing approach has not been applied in the machining industry, but other techniques based on Geometric Programming, Goal Programming, and Lagrange Multiplier have been proposed for application in this industry. These models follow a forward approach, by first selecting a set of machining parameters, and then determining the machining cost. Hence in this study we have developed an algorithm to apply the concepts of target costing, which is a backward approach that selects the machining parameters based on the required machining costs, and is therefore more suitable for practical applications in process improvement and cost reduction. A target costing model was developed for turning operation and was successfully validated using practical data.

Progress in improving provincial plans for nutrition through targeted technical assistance and local advocacy in Vietnam

PubMed Central

Harris, Jody; Nguyen, Phuong H.; To, Quyen; Frongillo, Edward A.; Menon, Purnima

2016-01-01

Vietnam has been decentralizing nutrition planning to provinces, which could help with local relevance and accountability. Assessment in 2009 found a continuing top-down approach, limited human capacity, and difficulty in integrating multiple sectors. Alive and Thrive (A&T) provided targeted assistance and capacity-building for 15 provincial plans for nutrition (PPNs). We aimed to (i) assess PPN content and quality improvements 2009–2014, and (ii) explain processes through which change occurred. Data consisted of interview-based assessments of provincial planning processes, annual PPN assessments, and tracking of A&T involvement. At endline, some provinces produced higher quality plans. Local planning skills improved, but capacity remained insufficient. Awareness of and support for nutrition improved, but some policy and legal environments were contradictory. Objectives were clearer, but use of data for planning remained inconsistent. Provinces became more proactive and creative, but remained constrained by slow approval processes and insufficient funding. Targeted assistance and local advocacy can improve decentralized planning, with success dependent on policy and programming contexts and ability to overcome constraints around capacity, investment, data use and remnants of centralized planning. We recommend strong engagement with planners at the national level to understand how to unblock major constraints; solutions must take into consideration the particular political, financial and administrative context. PMID:27198978

Expert opinions on good practice in evaluation of health promotion and primary prevention measures related to children and adolescents in Germany.

PubMed

Korber, Katharina; Becker, Christian

2017-10-02

Determining what constitutes "good practice" in the measurement of the costs and effects of health promotion and disease prevention measures is of particular importance. The aim of this paper was to gather expert knowledge on (economic) evaluations of health promotion and prevention measures for children and adolescents, especially on the practical importance, the determinants of project success, meaningful parameters for evaluations, and supporting factors, but also on problems in their implementation. This information is targeted at people responsible for the development of primary prevention or health promotion programs. Partially structured open interviews were conducted by two interviewers and transcribed, paraphrased, and summarized for further use. Eight experts took part in the interviews. The interviewed experts saw evaluation as a useful tool to establish the effects of prevention programs, to inform program improvement and further development, and to provide arguments to decision making. The respondents' thought that determinants of a program's success were effectiveness with evidence of causality, cost benefit relation, target-group reach and sustainability. It was considered important that hard and soft factors were included in an evaluation; costs were mentioned only by one expert. According to the experts, obstacles to evaluation were lacking resources, additional labor requirements, and the evaluators' unfamiliarity with a program's contents. It was recommended to consider evaluation design before a program is launched, to co-operate with people involved in a program and to make use of existing structures. While in in this study only a partial view of expert knowledge is represented, it could show important points to consider when developing evaluations of prevention programs. By considering these points, researchers could further advance towards a more comprehensive approach of evaluation targeting measures in children and adolescents.

Managing bond proceeds improves financial performance.

PubMed

Mates, W J

1989-04-01

Healthcare organizations must actively manage tax-exempt bond proceeds after they are initially invested at the time of financing or refinancing. The Tax Reform Act of 1986 imposes serious penalties on issuers who fail to comply with its complex requirements. An active program of bond proceeds management enables organizations to avoid this pitfall and take advantage of legal investment opportunities. Such a program must start with a set of clear guidelines on permitted investments, target rates of return, acceptable levels of risk, and liquidity requirements.

Helping early career research scientists ascend the professional ladder.

PubMed

King, Laina

2013-08-01

The Keystone Symposia Early Career Investigator Travel Award initiative is a unique successful research mentoring program tailored for 'end of the pipeline' life and biomedical scientists from academia and industry. Using targeted educational, mentoring, and networking activities, the program benefits early career scientists in solving a specific laboratory-based research question that is limiting their evolving research and could increase their ability to obtain new grants and improve their career progression. Copyright © 2013 Elsevier Ltd. All rights reserved.

Comparison of optimization algorithms in intensity-modulated radiation therapy planning

NASA Astrophysics Data System (ADS)

Kendrick, Rachel

Intensity-modulated radiation therapy is used to better conform the radiation dose to the target, which includes avoiding healthy tissue. Planning programs employ optimization methods to search for the best fluence of each photon beam, and therefore to create the best treatment plan. The Computational Environment for Radiotherapy Research (CERR), a program written in MATLAB, was used to examine some commonly-used algorithms for one 5-beam plan. Algorithms include the genetic algorithm, quadratic programming, pattern search, constrained nonlinear optimization, simulated annealing, the optimization method used in Varian EclipseTM, and some hybrids of these. Quadratic programing, simulated annealing, and a quadratic/simulated annealing hybrid were also separately compared using different prescription doses. The results of each dose-volume histogram as well as the visual dose color wash were used to compare the plans. CERR's built-in quadratic programming provided the best overall plan, but avoidance of the organ-at-risk was rivaled by other programs. Hybrids of quadratic programming with some of these algorithms seems to suggest the possibility of better planning programs, as shown by the improved quadratic/simulated annealing plan when compared to the simulated annealing algorithm alone. Further experimentation will be done to improve cost functions and computational time.

A wakeup call to the prevention field: are prevention programs for substance use effective for girls?

PubMed

Kumpfer, Karol L; Smith, Paula; Summerhays, Julia Franklin

2008-07-01

Substance misuse in adolescent girls has increased dramatically since 1992. This article reviews trends in use rates and etiological theories tested by gender that suggest that family protective factors have more influence on girls. Next, a literature review reveals that few prevention programs have published their outcomes by gender or developed gender-specific programs. Nationwide community coalition results found positive effects on boys but increased drug use in young girls. The most effective programs are family focused targeting family bonding, supervision, and communication. Recent gender-specific prevention programs with positive results address stress, depression, social assertiveness, and body image. The authors recommend additional research testing programs by gender and also gender-specific versus generic versions of evidence-based programs to determine how to improve prevention program effectiveness for girls.

The effect of a VR exercise program on falls and depression in the elderly with mild depression in the local community.

PubMed

Yang, Jong-Eun; Lee, Tac-Young; Kim, Jin-Kyung

2017-12-01

[Purpose] The purpose of this study is to explore the effect of a VR exercise program on falls and depression in the elderly with mild depression who reside in the local community. [Subjects and Methods] This study was performed by targeting 15 elderly subjects with mild depression who resided in the local community. The targeted subjects voluntarily selected 3 VR exercise programs (each lasting 10 minutes) among 4 activities, and a resting time of 5 minutes was given for an interval after each activity. The VR exercise program was performed for total 12 weeks (36 times), 3 times a week, 45 minutes per session. [Results] After exercise, scores of static balance test (anteroposterior), Falls Efficacy Scale, and the Activities-specific Balance Confidence Scale in the test subjects were improved and depression and internal stress scores were significantly decreased after the intervention. [Conclusion] It can be concluded that the VR exercise program exerts a positive effect not only on the physical factor but also on the mental factor of the elderly subjects with mild depression who reside in the local community. It is expected that based on the VR exercise program, diversified home programs for the elderly should be developed in the future.

Using Targeting Outcomes of Programs as a Framework to Target Photographic Events in Nonformal Educational Programs

ERIC Educational Resources Information Center

Rockwell, S. Kay; Albrecht, Julie A.; Nugent, Gwen C.; Kunz, Gina M.

2012-01-01

Targeting Outcomes of Programs (TOP) is a seven-step hierarchical programming model in which the program development and performance sides are mirror images of each other. It served as a framework to identify a simple method for targeting photographic events in nonformal education programs, indicating why, when, and how photographs would be useful…

Improving cardiovascular health of underserved populations in the community with Life's Simple 7.

PubMed

Murphy, Marcia Pencak; Coke, Lola; Staffileno, Beth A; Robinson, Janis D; Tillotson, Robin

2015-11-01

The purpose of this nurse practitioner (NP) led initiative was to improve the cardiovascular health of two underserved populations in the community using the American Heart Association (AHA) Life's Simple 7 and My Life Check (MLC) tools. Two inner city community sites were targeted: (a) a senior center servicing African American (AA) older adults, and (b) a residential facility servicing homeless women. Preprogram health data (blood pressure, cholesterol, blood glucose levels, body mass index, and health behaviors) were collected to calculate MLC scores. Postprogram health data were obtained on participants with the lowest MLC scores who completed the program. Eight older adults completed the program with a 37.1% increase in average MLC score (6.2 vs. 8.5). Ten women completed the program with a 9.3% decrease in average MLC score (4.3 vs. 3.9). Favorable benefits were observed in the AA older adults. In contrast, similar benefits were not observed in the women, which may be because of a constellation of social, environmental, biological, and mental health factors. NPs are prepared to target community-based settings to address the health of underserved populations. Engaging key stakeholders in the planning and implementation is essential for success. ©2015 American Association of Nurse Practitioners.

Micronutrient Deficiency Control in Vietnam from Policy and Research to Implementation: Keys for Success, Challenges and Lessons Learned.

PubMed

Tran, Van Khanh; Spohrer, Rebecca; LE, Tuyen Danh; Poonawala, Alia; Monech-Pfanner, Regina

2015-01-01

Micronutrient deficiencies are still a public health problem in Vietnam. The Government of Vietnam has taken several steps to improve the situation through issuing supportive policy documents over the last several decades. Food fortification is an important complementary strategy to help bridge the nutrient gap in the population. Currently technical regulations are in place and food fortification is taking place on a voluntary basis, along with other complementary targeted programs including home fortification of complementary foods with micronutrient powders and a communications campaign to reach adolescent girls. These have been built on innotative partnerships with industries on a voluntary, market basis. Other innovative targeted nutrition programs are also being piloted, including a micronutrient supplement project in four provinces and a campain to reach adolescent girls through sports. High level political commitment and resources is a crucial element to scale up in Vietnam. A micronutrient survey planned in 2015 will help provide the evidence to support a possible mandatory decree on food fortification. Vietnam has built a solid foundation in order to scale up its national food fortification program in the future to reach the majority of the population with improved intakes of iron, vitamin A, zinc, and iodine.

An ARC-Informed Family Centered Care Intervention for Children’s Community Based Mental Health Programs

PubMed Central

Madenwald, Kappy; Hoagwood, Kimberly E.

2017-01-01

The experience of parents in helping their children access and use mental health services is linked to service outcomes. Parent peer support service, based on the principles of family-centered care, is one model to improve parent experience and engagement in services. Yet, little is known about how best to integrate this service into the existing array of mental health services. Integration is challenged by philosophical differences between family-centered services and traditional children’s treatment services, and is influenced by the organizational social contexts in which these services are embedded. We describe an organizational and frontline team intervention that draws on research in behavior change, technology transfer, and organizational social context for youth with serious emotional disturbance. The two-pronged intervention, called FAMILY (FCC and ARC Model to Improve the Lives of Youth) is guided by the evidence-based Availability, Responsiveness, and Continuity (ARC) organizational intervention, targeted primarily at program and upper management leadership and includes a family-centered care (FCC) intervention, targeted at frontline providers. The approach employs multilevel implementation strategies to promote the uptake, implementation and sustainability of new practices. We include examples of exercises and tools, and highlight implementation challenges and lessons learned in facilitating program and staff level changes in family-centered service delivery. PMID:28781510

Marketing Residential Treatment Programs for Eating Disorders: A Call for Transparency.

PubMed

Attia, Evelyn; Blackwood, Kristy L; Guarda, Angela S; Marcus, Marsha D; Rothman, David J

2016-06-01

Residential behavioral treatment is a growing sector of the health care industry and is used by a large proportion of adolescent and adult patients with eating disorders. These programs and the organizations that own them have developed extensive marketing strategies that target clinicians and include promotional gifts, meals, travel reimbursement, and continuing education credit. Legislation and policy changes have limited these types of activities when conducted by the pharmaceutical industry, and awareness of conflicts of interest associated with clinician-targeted advertising of drugs and devices has increased. However, similar practices by the behavioral health care industry have evolved without oversight. The authors urge clinicians to consider how marketing strategies by treatment facilities may influence their referral behaviors and call for improved transparency regarding gifts and payments from treatment facilities.

Individualized home-based exercise programs for older people to reduce falls and improve physical performance: A systematic review and meta-analysis.

PubMed

Hill, Keith D; Hunter, Susan W; Batchelor, Frances A; Cavalheri, Vinicius; Burton, Elissa

2015-09-01

There is considerable diversity in the types of exercise programs investigated to reduce falls in older people. The purpose of this paper was to review the effectiveness of individualized (tailored) home-based exercise programs in reducing falls and improving physical performance among older people living in the community. A systematic review and meta-analysis was conducted of randomized or quasi-randomized trials that utilized an individualized home-based exercise program with at least one falls outcome measure reported. Single intervention exercise studies, and multifactorial interventions where results for an exercise intervention were reported independently were included. Two researchers independently rated the quality of each included study. Of 16,871 papers identified from six databases, 12 met all inclusion criteria (11 randomized trials and a pragmatic trial). Study quality overall was high. Sample sizes ranged from 40 to 981, participants had an average age 80.1 years, and although the majority of studies targeted the general older population, several studies included clinical groups as their target (Parkinson's disease, Alzheimer's disease, and hip fracture). The meta-analysis results for the five studies reporting number of fallers found no significant effect of the intervention (RR [95% CI]=0.93 [0.72-1.21]), although when a sensitivity analysis was performed with one study of participants recently discharged from hospital removed, this result was significant (RR [95% CI] = 0.84 [0.72-0.99]). The meta-analysis also found that intervention led to significant improvements in physical activity, balance, mobility and muscle strength. There were no significant differences for measures of injurious falls or fractures. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Improved genome-scale multi-target virtual screening via a novel collaborative filtering approach to cold-start problem

PubMed Central

Lim, Hansaim; Gray, Paul; Xie, Lei; Poleksic, Aleksandar

2016-01-01

Conventional one-drug-one-gene approach has been of limited success in modern drug discovery. Polypharmacology, which focuses on searching for multi-targeted drugs to perturb disease-causing networks instead of designing selective ligands to target individual proteins, has emerged as a new drug discovery paradigm. Although many methods for single-target virtual screening have been developed to improve the efficiency of drug discovery, few of these algorithms are designed for polypharmacology. Here, we present a novel theoretical framework and a corresponding algorithm for genome-scale multi-target virtual screening based on the one-class collaborative filtering technique. Our method overcomes the sparseness of the protein-chemical interaction data by means of interaction matrix weighting and dual regularization from both chemicals and proteins. While the statistical foundation behind our method is general enough to encompass genome-wide drug off-target prediction, the program is specifically tailored to find protein targets for new chemicals with little to no available interaction data. We extensively evaluate our method using a number of the most widely accepted gene-specific and cross-gene family benchmarks and demonstrate that our method outperforms other state-of-the-art algorithms for predicting the interaction of new chemicals with multiple proteins. Thus, the proposed algorithm may provide a powerful tool for multi-target drug design. PMID:27958331

Improved genome-scale multi-target virtual screening via a novel collaborative filtering approach to cold-start problem.

PubMed

Lim, Hansaim; Gray, Paul; Xie, Lei; Poleksic, Aleksandar

2016-12-13

Conventional one-drug-one-gene approach has been of limited success in modern drug discovery. Polypharmacology, which focuses on searching for multi-targeted drugs to perturb disease-causing networks instead of designing selective ligands to target individual proteins, has emerged as a new drug discovery paradigm. Although many methods for single-target virtual screening have been developed to improve the efficiency of drug discovery, few of these algorithms are designed for polypharmacology. Here, we present a novel theoretical framework and a corresponding algorithm for genome-scale multi-target virtual screening based on the one-class collaborative filtering technique. Our method overcomes the sparseness of the protein-chemical interaction data by means of interaction matrix weighting and dual regularization from both chemicals and proteins. While the statistical foundation behind our method is general enough to encompass genome-wide drug off-target prediction, the program is specifically tailored to find protein targets for new chemicals with little to no available interaction data. We extensively evaluate our method using a number of the most widely accepted gene-specific and cross-gene family benchmarks and demonstrate that our method outperforms other state-of-the-art algorithms for predicting the interaction of new chemicals with multiple proteins. Thus, the proposed algorithm may provide a powerful tool for multi-target drug design.

Effect of the atmosphere on the classification of LANDSAT data. [Identifying sugar canes in Brazil

NASA Technical Reports Server (NTRS)

Dejesusparada, N. (Principal Investigator); Morimoto, T.; Kumar, R.; Molion, L. C. B.

1979-01-01

The author has identified the following significant results. In conjunction with Turner's model for the correction of satellite data for atmospheric interference, the LOWTRAN-3 computer was used to calculate the atmospheric interference. Use of the program improved the contrast between different natural targets in the MSS LANDSAT data of Brasilia, Brazil. The classification accuracy of sugar canes was improved by about 9% in the multispectral data of Ribeirao Preto, Sao Paulo.

Claim More™: Empowering African American Women to Make Healthy Choices.

PubMed

Tkatch, Rifky; Musich, Shirley; Draklellis, Jennifer; Hetzel, Marla; Banks, Jo; Dugan, Jessica; Thompson, Kaylene; Hawkins, Kevin

2018-03-01

Diabetes is a serious issue for African American women. The purpose of this project was to develop and test the feasibility of a culturally appropriate and faith-based healthy eating program for African American women at risk for developing diabetes. At total of 30 women from two churches completed a 12-week, faith-based program using a community-based approach with lay health educators in the church setting. Participants set healthy eating goals, attended weekly education classes, and received daily text messaging reminders related to their goals. Outcomes included high levels of social support, frequent engagement with the program, and improved healthy eating. This program demonstrated the ability to target African American women at risk for diabetes and engage them in a health-related program.

Workplace safety and health programs, practices, and conditions in auto collision repair businesses.

PubMed

Brosseau, L M; Bejan, A; Parker, D L; Skan, M; Xi, M

2014-01-01

This article describes the results of a pre-intervention safety assessment conducted in 49 auto collision repair businesses and owners' commitments to specific improvements. A 92-item standardized audit tool employed interviews, record reviews, and observations to assess safety and health programs, training, and workplace conditions. Owners were asked to improve at least one-third of incorrect, deficient, or missing (not in compliance with regulations or not meeting best practice) items, of which a majority were critical or highly important for ensuring workplace safety. Two-thirds of all items were present, with the highest fraction related to electrical safety, machine safety, and lockout/tagout. One-half of shops did not have written safety programs and had not conducted recent training. Many had deficiencies in respiratory protection programs and practices. Thirteen businesses with a current or past relationship with a safety consultant had a significantly higher fraction of correct items, in particular related to safety programs, up-to-date training, paint booth and mixing room conditions, electrical safety, and respiratory protection. Owners selected an average of 58% of recommended improvements; they were most likely to select items related to employee Right-to-Know training, emergency exits, fire extinguishers, and respiratory protection. They were least likely to say they would improve written safety programs, stop routine spraying outside the booth, or provide adequate fire protection for spray areas outside the booth. These baseline results suggest that it may be possible to bring about workplace improvements using targeted assistance from occupational health and safety professionals.

A Novel Approach to Practice-Based Learning and Improvement Using a Web-Based Audit and Feedback Module.

PubMed

Boggan, Joel C; Cheely, George; Shah, Bimal R; Heffelfinger, Randy; Springall, Deanna; Thomas, Samantha M; Zaas, Aimee; Bae, Jonathan

2014-09-01

Systematically engaging residents in large programs in quality improvement (QI) is challenging. To coordinate a shared QI project in a large residency program using an online tool. A web-based QI tool guided residents through a 2-phase evaluation of performance of foot examinations in patients with diabetes. In phase 1, residents completed reviews of health records with online data entry. Residents were then presented with personal performance data relative to peers and were prompted to develop improvement plans. In phase 2, residents again reviewed personal performance. Rates of performance were compared at the program and clinic levels for each phase, with data presented for residents. Acceptability was measured by the number of residents completing each phase. Feasibility was measured by estimated faculty, programmer, and administrator time and costs. Seventy-nine of 86 eligible residents (92%) completed improvement plans and reviewed 1471 patients in phase 1, whereas 68 residents (79%) reviewed 1054 patient charts in phase 2. Rates of performance of examination increased significantly between phases (from 52% to 73% for complete examination, P < .001). Development of the tool required 130 hours of programmer time. Project analysis and management required 6 hours of administrator and faculty time monthly. An online tool developed and implemented for program-wide QI initiatives successfully engaged residents to participate in QI activities. Residents using this tool demonstrated improvement in a selected quality target. This tool could be adapted by other graduate medical education programs or for faculty development.

Appalachian Regional Commission: 1985 Annual Report.

ERIC Educational Resources Information Center

Appalachian Regional Commission, Washington, DC.

In the third year of its finish-up program, the Appalachian Regional Commission (ARC) used its area development appropriation of $44 million to target three broad areas: (1) creating and retaining jobs in the region; (2) providing basic public facilities in the worst-off Appalachian counties; and (3) improving health care throughout the region.…

The Influence of Conditional Cash Transfers on Eligible Children and Their Siblings

ERIC Educational Resources Information Center

Lincove, Jane Arnold; Parker, Adam

2016-01-01

Conditional cash transfers (CCTs) are used to reduce poverty while incentivizing investments in children. Targeting CCTs to certain groups of children can improve efficiency, but positive effects on eligible children may be offset by reductions in investments for ineligible siblings. Using data from Nicaragua, we estimate program effects on…

Instructional Materials Center Project Director's Report 1970-71.

ERIC Educational Resources Information Center

Minneapolis Public Schools, Minn.

The Instructional Materials Center (IMC) was developed in August, 1969, to support the Title I Pyramids Reading Program (PRP) begun a year earlier. The PRP attempted to improve the reading skills of educationally disadvantaged children by (1) using one basal reading series in all Minneapolis Target Area elementary schools, (2) providing an…

The Behavioral Assessment of Social Interactions in Young Children: An Examination of Convergent and Incremental Validity

ERIC Educational Resources Information Center

Callahan, Emily H.; Gillis, Jennifer M.; Romanczyk, Raymond G.; Mattson, Richard E.

2011-01-01

Many treatment programs for individuals with an autism spectrum disorder (ASD) target social skills, and there is growing attention directed toward the development of specific interventions to improve social skills and social interactions in this population (Hestenes & Carroll, 2000; Strain & Hoyson, 2000). However, there are limited tools…

Testing the Efficacy of Theoretically Derived Improvements in the Treatment of Social Phobia

ERIC Educational Resources Information Center

Rapee, Ronald M.; Gaston, Jonathan E.; Abbott, Maree J.

2009-01-01

Recent theoretical models of social phobia suggest that targeting several specific cognitive factors in treatment should enhance treatment efficacy over that of more traditional skills-based treatment programs. In the current study, 195 people with social phobia were randomly allocated to 1 of 3 treatments: standard cognitive restructuring plus in…

Contextual Factors Influencing Readiness for Dissemination of Obesity Prevention Programs and Policies

ERIC Educational Resources Information Center

Dreisinger, Mariah L.; Boland, Elizabeth M.; Filler, Carl D.; Baker, Elizabeth A.; Hessel, Amy S.; Brownson, Ross C.

2012-01-01

Within the realm of obesity prevention research, there have been many promising interventions to improve physical activity and nutrition among diverse target populations. However, very little information is known about the dissemination and replication of these interventions. In 2007 and 2008 as part of a larger obesity prevention initiative,…

Parenting and Preschoolers' Symptoms as a Function of Child Gender and SES

ERIC Educational Resources Information Center

Kim, Hyun-Jeong; Arnold, David H.; Fisher, Paige H.; Zeljo, Alexandra

2005-01-01

Improving parental discipline practices is a central target of behavioral parent training programs, but little research has examined how discipline varies as a function of gender. Based on the assumption that socialization practices might be related to gender differences in psychopathology, we examined relations between parenting and problem…

Improving Written Language Skills in the Primary Grades.

ERIC Educational Resources Information Center

Benischek, Donna; Vejr, Mary Jean; Wetzel, Susan

This report describes a program for advancing written expression skills in the primary grades. Extensive research over the past years has shown that an emphasis on mechanics and conventions inhibits the process of writing in primary students. The targeted population consisted of first and second grade students in a middle class community, located…

Improving Reading Achievement through the Implementation of a Balanced Literacy Approach.

ERIC Educational Resources Information Center

Arkebauer, Cynthia; MacDonald, Christine; Palmer, Crystal

This report describes a program for increasing students' reading fluency and comprehension by giving them a variety of skills and strategies. The targeted population consisted of two elementary schools in a growing, lower to middle class community, located in central Illinois. The problems of lack of reading strategies were documented through data…

Motivating Students to Write through the Use of Children's Literature

ERIC Educational Resources Information Center

Daly, Laura; Sharko, Susan

2010-01-01

This action research project involved the implementation of a program designed to improve student motivation to write through the use of children's literature. The targeted populations were students in one kindergarten class and one third grade ELL [English Language Learners] class in two elementary schools. Both schools were located in a…

Final Evaluation Report for Minneapolis Health and Nutrition Project.

ERIC Educational Resources Information Center

Guardian Resource Development, Inc., St. Paul, Minn.

The social, mental and physical health of children in target Minneapolis Schools has been carefully studied. The intent of this project was to design and implement a program which would improve health. This report discusses the progress of the project for the first year. The project's activities centered around planning, needs assessment and…

Launching Literacy in After-School Programs: Early Lessons from the CORAL Initiative

ERIC Educational Resources Information Center

Arbreton, Amy J. A.; Goldsmith, Julie; Sheldon, Jessica

2005-01-01

The James Irvine Foundation launched the Communities Organizing Resources to Advance Learning (CORAL) initiative in 1999 with the goal of improving the academic achievement of children in the lowest-performing schools in five California cities. In 2004, CORAL adopted a more targeted approach toward reaching this goal by integrating a regular…

Improving Expository Writing Skills with Explicit and Strategy Instructional Methods in Inclusive Middle School Classrooms

ERIC Educational Resources Information Center

Cihak, David F.; Castle, Kristin

2011-01-01

Forty eighth grade students with and without learning disabilities in an inclusive classroom participated in an adapted Step-Up to Writing (Auman, 2002) intervention program. The intervention targeted expository essays and composing topic, detail, transitional, and concluding sentences. A repeated-measures ANOVA indicated that both students with…

Improving Student Transfer of Spelling Skills across the Curriculum.

ERIC Educational Resources Information Center

Dvorak, Lynda; Ingersol, Judith; Kastle, Marlene; Mullins, Belinda; Rafter, Therese

This project describes a program for increasing student retention and transfer of weekly spelling words across the curriculum. The targeted population consists of first, second, and third grade students in a middle class community located in the Northeast quadrant of Illinois. The problems of adequate transfer of previously taught spelling skills…

Improved method for reliable HMW-GS identification by RP-HPLC and SDS-PAGE in common wheat cultivars

USDA-ARS?s Scientific Manuscript database

The accurate identification of alleles for high-molecular weight glutenins (HMW-GS) is critical for wheat breeding programs targeting end-use quality. RP-HPLC methods were optimized for separation of HMW-GS, resulting in enhanced resolution of 1By and 1Dx subunits. Statistically significant differe...

Developing Positive Attitudes and Strategic Reading Skills in Primary Students.

ERIC Educational Resources Information Center

Foss, Jeanette; Soper, Candice

A project developed a program for improving the attitudes of primary students toward reading and encouraging them to become strategic readers. The targeted population consisted of first-grade students in rural-suburban communities west of a large midwestern city. The problem of poor attitudes toward reading and lack of knowledge of reading…

Enhancing Social Responsibility and Prosocial Leadership to Prevent Aggression, Peer Victimization, and Emotional Problems in Elementary School Children.

PubMed

Leadbeater, Bonnie J; Thompson, Kara; Sukhawathanakul, Paweena

2016-12-01

Testing the theories that form the basis of prevention programs can enhance our understanding of behavioral change and inform the development, coordination, and adaptation of prevention programs. However, theories of change showing the linkages from intervention program components to risk or protective factors to desired outcomes across time are rarely specified or tested. In this 2-year longitudinal study, we test the theory that increases in two protective factors (i.e., children's prosocial leadership and their teachers' expectations of social responsibility) targeted by the WITS Programs (Walk Away, Ignore, Talk it Out, and Seek Help) would be associated with declines in peer victimization, aggression, and emotional problems. Participants included Canadian students, in grades 1-4 at baseline (n = 1329) and their parents and teachers. Consistent with our theory of change, variability in program implementation (adherence and integration) and in children's use of program skills (child responsiveness) are related to increases in both protective factors. Increases in these protective factors are associated with subsequent declines in children's aggression, victimization, and emotional problems. We discuss how enhancement of these protective factors may operate to improve child outcomes and the need for theory-based research to refine and improve the effectiveness of intervention strategies and to improve program scale-up. © Society for Community Research and Action 2016.

NGO-promoted women's credit program, immunization coverage, and child mortality in rural Bangladesh.

PubMed

Amin, R; Li, Y

1997-01-01

A growing number of non-governmental organizations (NGOs) are adopting the collateral-free credit programs by anchoring them with their social development programs aimed at improved program effectiveness and sustainability. Drawing upon a sample of 3,564 targeted poor households covered by five small NGOs in rural Bangladesh, this study finds that the NGO credit-members as well as those who reside in the NGO program area are higher adopters of child immunization than those in the non-program area. Similarly, the study found that infant and child mortality is lower among the NGO credit members than among the non-members and that under five-year deaths of children progressively decline with the increase in the doses of vaccines. Implications of these findings are discussed in the study.

A Unique Funding Opportunity for Public Health in Texas

PubMed Central

Schlenker, Thomas; Huber, Carol A.

2015-01-01

In addition to the Affordable Care Act, states are more frequently turning to Medicaid waivers to achieve the “Triple Aim” goals of improving the experience of care, improving population health, and reducing per capita costs. These demonstration waivers provide opportunities to test innovative ways to finance and deliver care. Texas is currently implementing a waiver known as the Transformation and Quality Improvement Program. Its inclusion of public health agencies is a unique approach to a system typically limited to traditional providers. San Antonio Metropolitan Health District is one public health agency taking advantage of this new funding opportunity to implement 6 new or expanded programs targeting health issues of highest priority in this south Texas region. This article discusses the use of Medicaid waivers and the advantages and challenges of public health agency participation. PMID:25423061

A multilevel health promotion intervention in minority-owned workplaces

PubMed Central

Bowen, Deborah J.; Briant, Katherine J.; Harris, Jeffrey; Hannon, Peggy; Buchwald, Dedra

2015-01-01

Introduction Changing health behaviors and health-related environments is important in reducing chronic disease. Minority workplaces are potential venues to provide regular, effective health promotion opportunities to underserved individuals. The purpose of this study was to test the feasibility of changing workplace policy, programs, and practices in minority-owned workplaces. Methods Four minority Native American-owned businesses were recruited to participate in this study. The intervention was a set of recommended standards and guidelines gleaned from the US Preventive Task Force and The Community Guide relevant to workplaces. Each workplace selected between 4 and 6 target areas to improve over the year-long intervention period. The evaluation tool was a semi-structured survey conducted at baseline and at one-year follow-up, with workplace staff responsible for benefits and services to employees. Feasibility was evaluated by assessing the likelihood that the workplaces implemented health promotion activities in the year-long intervention. Results Several practices and policies changed significantly during the intervention in the four workplaces, including coverage for nicotine replacement therapy (NRT), elimination of out of pocket costs for screening and tobacco cessation, accountability systems for providers, posted stair use, cessation line availability that included NRT, offering weight loss programs, offering physical activity programs, and conducting targeted communication programs about health promotion. Other practices and polices changed in the expected direction, but were not significant. Conclusion Changing workplace programs, practices, and policies is feasible in minority workplaces, with support and tools provided by outside organizations. These findings could drive a full-scale test of the intervention in minority businesses in order to improve the health of disadvantaged workers. PMID:26693135

Theory-driven intervention improves calcium intake, osteoporosis knowledge, and self-efficacy in community-dwelling older Black adults.

PubMed

Babatunde, Oyinlola T; Himburg, Susan P; Newman, Frederick L; Campa, Adriana; Dixon, Zisca

2011-01-01

To assess the effectiveness of an osteoporosis education program to improve calcium intake, knowledge, and self-efficacy in community-dwelling older Black adults. Randomized repeated measures experimental design. Churches and community-based organizations. Men and women (n = 110) 50 years old and older from 3 south Florida counties. Participants randomly assigned to either of 2 groups: Group 1 (experimental group) or Group 2 (wait-list control group). Group 1 participated in 6 weekly education program sessions immediately following baseline assessment, and Group 2 started the program following Group 1's program completion. A tested curriculum was adapted to meet the needs of the target population. Dietary calcium intake, osteoporosis knowledge, health beliefs, and self-efficacy. Descriptive and summary statistics, repeated measures analysis of variance, and regression analysis. Of the total participants, 84.6% completed the study (mean age = 70.2 years). Overall, an educational program developed with a theoretical background was associated with improvement in calcium intake, knowledge, and self-efficacy, with no effect on most health belief subscales. Assigned group was the major predictor of change in calcium intake. A theory-driven approach is valuable in improving behavior to promote bone health in this population. Health professionals should consider using more theory-driven approaches in intervention studies. Copyright © 2011 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

Targeting anxiety to improve quality of life in patients with schizophrenia.

PubMed

Buonocore, M; Bosia, M; Bechi, M; Spangaro, M; Cavedoni, S; Cocchi, F; Bianchi, L; Guglielmino, C; Mastromatteo, A R; Cavallaro, R

2017-09-01

Several studies suggested that anxiety can significantly affect the outcome of schizophrenia. Despite this evidence, non-pharmacological interventions targeting anxiety are still heterogenous. This study aims to test the efficacy of a novel training specifically designed to target anxiety in patients with schizophrenia. Innovatively, this training, beyond psychoeducation and problem solving, also targets Theory of Mind, as it provides coping strategies. Twenty-seven outpatients with schizophrenia received a novel rehabilitative training targeting anxiety (Anxiety Management Group [AMG]) combined with a Computer-Assisted Cognitive Remediation (CACR), and twenty received CACR plus a control intervention (Control Newspaper discussion Group [CNG]). All patients were assessed at baseline and after treatment for quality of life, neurocognition and anxiety. After training, patients treated with AMG+CACR showed significantly greater improvements on anxiety. A significant increase in quality of life was observed only for AMG+CACR group. Moreover, the participants' appraisal showed a significant difference between treatment groups with higher ratings among patients who received the AMG+CACR. This study thus suggests feasibility and efficacy of the proposed intervention, that could be implemented in rehabilitative programs for patients with schizophrenia with potential benefits also on disease course and outcome. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Omen: identifying potential spear-phishing targets before the email is sent.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wendt, Jeremy Daniel.

2013-07-01

We present the results of a two year project focused on a common social engineering attack method called "spear phishing". In a spear phishing attack, the user receives an email with information specifically focused on the user. This email contains either a malware-laced attachment or a link to download the malware that has been disguised as a useful program. Spear phishing attacks have been one of the most effective avenues for attackers to gain initial entry into a target network. This project focused on a proactive approach to spear phishing. To create an effective, user-specific spear phishing email, the attackermore » must research the intended recipient. We believe that much of the information used by the attacker is provided by the target organization's own external website. Thus when researching potential targets, the attacker leaves signs of his research in the webserver's logs. We created tools and visualizations to improve cybersecurity analysts' abilities to quickly understand a visitor's visit patterns and interests. Given these suspicious visitors and log-parsing tools, analysts can more quickly identify truly suspicious visitors, search for potential spear-phishing targeted users, and improve security around those users before the spear phishing email is sent.« less

Analysis, Evaluation and Improvement of Sequential Single-Item Auctions for the Cooperative Real-Time Allocation of Tasks

DTIC Science & Technology

2013-03-30

Abstract: We study multi-robot routing problems (MR- LDR ) where a team of robots has to visit a set of given targets with linear decreasing rewards over...time, such as required for the delivery of goods to rescue sites after disasters. The objective of MR- LDR is to find an assignment of targets to...We develop a mixed integer program that solves MR- LDR optimally with a flow-type formulation and can be solved faster than the standard TSP-type

Opening minds in Canada: targeting change.

PubMed

Stuart, Heather; Chen, Shu-Ping; Christie, Romie; Dobson, Keith; Kirsh, Bonnie; Knaak, Stephanie; Koller, Michelle; Krupa, Terry; Lauria-Horner, Bianca; Luong, Dorothy; Modgill, Geeta; Patten, Scott B; Pietrus, Mike; Szeto, Andrew; Whitley, Rob

2014-10-01

To summarize the ongoing activities of the Opening Minds (OM) Anti-Stigma Initiative of the Mental Health Commission of Canada regarding the 4 groups targeted (youth, health care providers, media, and workplaces), highlight some of the key methodological challenges, and review lessons learned. The approach used by OM is rooted in community development philosophy, with clearly defined target groups, contact-based education as the central organizing element across interventions, and a strong evaluative component so that best practices can be identified, replicated, and disseminated. Contact-based education occurs when people who have experienced a mental illness share their personal story of recovery and hope. Results have been generally positive. Contact-based education has the capacity to reduce prejudicial attitudes and improve social acceptance of people with a mental illness across various target groups and sectors. Variations in program outcomes have contributed to our understanding of active ingredients. Contact-based education has become a cornerstone of the OM approach to stigma reduction. A story of hope and recovery told by someone who has experienced a mental illness is powerful and engaging, and a critical ingredient in the fight against stigma. Building partnerships with existing community programs and promoting systematic evaluation using standardized approaches and instruments have contributed to our understanding of best practices in the field of anti-stigma programming. The next challenge will be to scale these up so that they may have a national impact.

The application of implementation science for pressure ulcer prevention best practices in an inpatient spinal cord injury rehabilitation program

PubMed Central

Scovil, Carol Y.; Flett, Heather M.; McMillan, Lan T.; Delparte, Jude J.; Leber, Diane J.; Brown, Jacquie; Burns, Anthony S.

2014-01-01

Objectives To implement pressure ulcer (PU) prevention best practices in spinal cord injury (SCI) rehabilitation using implementation science frameworks. Design Quality improvement. Setting SCI Rehabilitation Center. Participants Inpatients admitted January 2012 to July 2013. Interventions Implementation of two PU best practices were targeted: (1) completing a comprehensive PU risk assessment and individualized interprofessional PU prevention plan (PUPP); and (2) providing patient education for PU prevention; as part of the pan-Canadian SCI Knowledge Mobilization Network. At our center, the SCI Pressure Ulcer Scale replaced the Braden risk assessment scale and an interprofessional PUPP form was implemented. Comprehensive educational programing existed, so efforts focused on improving documentation. Implementation science frameworks provided structure for a systematic approach to best practice implementation (BPI): (1) site implementation team, (2) implementation drivers, (3) stages of implementation, and (4) improvement cycles. Strategies were developed to address key implementation drivers (staff competency, organizational supports, and leadership) through the four stages of implementation: exploration, installation, initial implementation, and full implementation. Improvement cycles were used to address BPI challenges. Outcome Measures Implementation processes (e.g. staff training) and BPI outcomes (completion rates). Results Following BPI, risk assessment completion rates improved from 29 to 82%. The PUPP completion rate was 89%. PU education was documented for 45% of patients (vs. 21% pre-implementation). Conclusion Implementation science provided a framework and effective tools for successful pressure ulcer BPI in SCI rehabilitation. Ongoing improvement cycles will target timeliness of tool completion and documentation of patient education. PMID:25029674

Fourth COS FUV Lifetime Position: Cross-Dispersion Profiles, Flux, and Flat-Field Calibration

NASA Astrophysics Data System (ADS)

Rafelski, Marc

2016-10-01

Obtain observations of spectrophotometric white dwarf standard stars at all cenwaves (excepting G130M/1055 and G130M/1096) and FP-POS to determine flux calibrations to S/N>30 and concurrently, the 1-D L- and P-flat templates, and 2-D cross-dispersion profiles required for improved extraction, at LP4. This program ties the spectroscopic sensitivity monitoring at LP4 with that at LP3, in case rapid evolution of gain at LP4 is discovered in coordination with program 14854. The main requirements for this program are S/N 50/resel, which is driven by two requirements: (1) for high S/N 2-D spectral profiles which are calculated by scaling Program 12806 profiles and requiring that profile contours can be located such that flux errors are less than 1-2%, and (2) for the flat fielding of pixel-to-pixel variations (p-flats). WD 0308-565 is the primary target for this program due to its status as a flux standard and TDS target. GD 71 is used to more efficiently calibrate Segment A in the G160M modes.

Influencing Nursing Knowledge and Attitudes to Positively Affect Care of Patients with Persistent Pain in the Hospital Setting.

PubMed

Keen, Alyson; McCrate, Brian; McLennon, Susan; Ellis, Alexis; Wall, Donna; Jones, Sarah

2017-06-01

Hospitalized patients with persistent pain are among the most challenging populations to effectively manage because of coexistence with acute pain. Nurses play a vital role in pain management; however, gaps in knowledge and detrimental attitudes exist. The purpose of this study was to evaluate the effectiveness of a targeted evidence-based pain education program to increase nurses' knowledge and attitudes about pain management. One group, paired, pretest/posttest educational intervention. A convenience sample of nurses from three medical and surgical inpatient units were recruited. Participants completed a pretest, the Knowledge and Attitudes Survey Regarding Pain Scale, to assess education needs. Identified gaps were targeted during program design. The program consisted of two 30-minute interactive educational sessions approximately 1 month apart. The first session, delivered by a pharmacist, covered pharmacology and pathophysiology content. The second session, delivered by trained registered nurses, used case studies paired with video scenarios. A total of 51 nurses completed the pretest. The final sample consisted of 24 nurses who completed both the pretest and posttest. The mean age was 30 years; 88% were female, and 92% were baccalaureate prepared. Paired t tests indicated higher posttest total scores (p < .001) after the education program compared with pretest scores. Overall program satisfaction was positive. This study found improvement in persistent pain management knowledge and attitudes among direct care nurses caring for hospitalized patients. A targeted educational program may be an effective and efficient delivery method. Copyright © 2017 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

Cooking for One or Two: Applying Participatory Action Research to improve community-dwelling older adults' health and well-being.

PubMed

Chojenta, Catherine; Mingay, Edwina; Gresham, Ellie; Byles, Julie

2018-04-01

This paper describes the process of the redevelopment and expansion of Cooking for One or Two, a community-based nutrition education program for older adults. This project took place in a large regional city in NSW Australia from September 2011 to September 2013. Previous Cooking for One or Two participants and Hunter Medical Research Institute Research Register members were recruited for focus groups (n = 37), recipe testing (n = 19) and telephone interviews (n = 55) to aid in the development and expansion of the program. Participant's experiences and preferences informed the development of a supplementary cookbook and add-on education modules. Through a variety of methods, the research team sought ongoing feedback on the content and direction of the program. Content experts also reviewed the health promotion information for appropriateness. Utilising the Participatory Action Research process resulted in an expanded set of materials for Cooking for One or Two that can enable older people to engage in peer-to-peer education and to take care of their nutritional and social health. The process is a valuable example of the success of ongoing collaboration between researchers and program developers with the target population. SO WHAT?: While the research team developed evidence-based content for the expanded program, the key to success was the continued engagement with the target population. This engagement fostered a sense of ownership over the program by participants and has led to continued support by the target population. © 2018 Australian Health Promotion Association.

Primary analysis of the Mandarin-speaking sub-study within the Sydney diabetes prevention program.

PubMed

Taing, Cecilia Y; Gibson, Alice A; Colagiuri, Stephen; Vita, Philip; Cardona-Morrell, Magnolia; Bauman, Adrian; Moore, Michael; Williams, Mandy; Milat, Andrew; Hony, Jacky; Lin, Sophia; Gwizd, Melissa; Fiatarone Singh, Maria A

2017-10-01

There is strong and consistent evidence from large scale randomised controlled trials that type 2 diabetes can be prevented or delayed through lifestyle modification which improves diet quality, increases physical activity and achieves weight loss in people at risk. Worldwide, the prevalence of type 2 diabetes is increasing in individuals of Chinese descent. Culturally tailored programs are required to address the risk in the Chinese population. This paper analyses effectiveness of a culturally tailored community-based lifestyle modification program (Sydney Diabetes Prevention Program (SDPP)) targeting Mandarin speakers. The SDPP was a 12 month translational study aiming to promote increased physical activity and dietary changes. Effectiveness was assessed through the improvement of anthropometric, metabolic, physical activity and dietary outcomes and number of goals met. Seventy-eight Mandarin-speaking participants at a high risk (Australian Diabetes Risk, AUSDRISK≥15) of developing diabetes were recruited for this study. In this cohort, waist circumference, total cholesterol and fat intake significantly improved at the 12-month review. In comparison to the English-speaking stream, the Mandarin-speaking stream achieved fewer improvements in outcomes and goals. The SDPP was not effective in reducing the risk factors associated with developing type 2 diabetes in this cohort of high risk Mandarin-speaking individuals living in Sydney. Copyright © 2017 Elsevier B.V. All rights reserved.

Outcomes of a Seven Practice Pilot in a Pay For Performance (P4P)-Based Program in Pennsylvania

PubMed Central

Johnson, Rhonda M.; Johnson, Twyla; Zimmerman, Sarah D.; Marsh, Gary M.; Garcia-Dominic, Oralia

2014-01-01

Objectives To examine how a targeted six-month interventions impacted Best Practice/Patient Outcomes for minority patients receiving primary care in physician practices participating in a pay-for-performance (P4P) program. Methods P4P Practices were invited to participate in a pilot intervention study designed to improve care for minority patients with hypertension, diabetes or pediatric asthma. Patient medical records were reviewed to assess how the interventions impacted (n=7 practices): Body mass index, diet and exercise, smoking, compliance with visits as recommended, blood pressure, sodium intake and weight management counseling, medication reconciliation, HbA1c testing, annual lipid profile, and anti-inflammatory medications. Results Significant improvements in various clinical quality measures were observed in all seven practices. Of the 19 specified interventions, 13 were statistically significant at α=0.05 level and 14 met the target proportion. This suggests that the best practice intervention had a significant impact on some of the health care processes in the physician practices. Conclusions The most impactful interventions were those related to face-to-face educational discussions, patient medical chart documentations rather than those pertaining to medication adherence. Improvements in measuring reporting and recording of data at post-intervention were also observed. PMID:25893158

Establishing a portfolio of quality-improvement projects in pediatric surgery through advanced improvement leadership systems.

PubMed

Gerrein, Betsy T; Williams, Christina E; Von Allmen, Daniel

2013-01-01

Formal quality-improvement (QI) projects require that participants are educated in QI methods to provide them with the capability to carry out successful, meaningful work. However, orchestrating a portfolio of projects that addresses the strategic mission of the institution requires an extension of basic QI training to provide the division or business unit with the capacity to successfully develop and manage the portfolio. Advanced Improvement Leadership Systems is a program to help units create a meaningful portfolio. This program, used by the Division of Pediatric General and Thoracic Surgery at Cincinnati Children's Hospital Medical Center, helped establish a portfolio of targeted QI projects designed to achieve outstanding outcomes at competitive costs in multiple clinical areas aligned with the institution's strategic goals (improve disease-based outcomes, patient safety, flow, and patient and family experience). These objectives are addressed in an institutional strategic plan built around 5 core areas: Safety, Productivity, Care Coordination and Outcomes, Patient and Family Experience, and Value. By combining the portfolio of QI projects with improvements in the divisional infrastructure, effective improvement efforts were realized throughout the division. In the 9 months following the program, divisional capability resulted in a 16.5% increase (5.7% to 22.2%) of formally trained staff working on 10 QI teams. Concurrently, a leadership team, designed to coordinate projects, remove barriers, and provide technical support, provided the capacity to pursue this ongoing effort. The Advanced Improvement Leadership Systems program increased the Division's efficiency and effectiveness in pursing the QI mission that is integral at our hospital.

Establishing a Portfolio of Quality-Improvement Projects in Pediatric Surgery through Advanced Improvement Leadership Systems

PubMed Central

Gerrein, Betsy T; Williams, Christina E; von Allmen, Daniel

2013-01-01

Formal quality-improvement (QI) projects require that participants are educated in QI methods to provide them with the capability to carry out successful, meaningful work. However, orchestrating a portfolio of projects that addresses the strategic mission of the institution requires an extension of basic QI training to provide the division or business unit with the capacity to successfully develop and manage the portfolio. Advanced Improvement Leadership Systems is a program to help units create a meaningful portfolio. This program, used by the Division of Pediatric General and Thoracic Surgery at Cincinnati Children’s Hospital Medical Center, helped establish a portfolio of targeted QI projects designed to achieve outstanding outcomes at competitive costs in multiple clinical areas aligned with the institution’s strategic goals (improve disease-based outcomes, patient safety, flow, and patient and family experience). These objectives are addressed in an institutional strategic plan built around 5 core areas: Safety, Productivity, Care Coordination and Outcomes, Patient and Family Experience, and Value. By combining the portfolio of QI projects with improvements in the divisional infrastructure, effective improvement efforts were realized throughout the division. In the 9 months following the program, divisional capability resulted in a 16.5% increase (5.7% to 22.2%) of formally trained staff working on 10 QI teams. Concurrently, a leadership team, designed to coordinate projects, remove barriers, and provide technical support, provided the capacity to pursue this ongoing effort. The Advanced Improvement Leadership Systems program increased the Division’s efficiency and effectiveness in pursing the QI mission that is integral at our hospital. PMID:24361020

Does the addition of hip strengthening exercises improve outcomes following total knee arthroplasty? A study protocol for a randomized trial.

PubMed

Schache, Margaret B; McClelland, Jodie A; Webster, Kate E

2016-06-13

Total knee arthroplasty (TKA) is effective in reducing pain and improving function for end-stage knee osteoarthritis. However, muscle weakness and functional limitations persist despite assistance from post-operative rehabilitation programs that traditionally focus on quadriceps strengthening and range of movement exercises. Hip abductor muscle weakness is evident in knee osteoarthritis and hip muscle strengthening reduces knee pain in this group. Following TKA, people with weak hip abductor strength perform more poorly on measures of physical function. However, very little is known of the effectiveness of including hip abductor strengthening exercises in post-operative rehabilitation. The aim of this trial is to compare the effects of targeted hip abductor strengthening to those of traditional care in a TKA rehabilitation program on muscle strength, patient reported outcomes and functional performance measures. This protocol describes a single-blinded randomized controlled trial, where 104 participants referred for inpatient rehabilitation following TKA will be recruited. Participants will be randomized using computer-generated numbers to one of two groups: usual care or usual care with additional hip strengthening exercises. Participants will attend physiotherapy daily during their inpatient length of stay, and will then attend between six and eight physiotherapy sessions as an outpatient. Primary outcomes are isometric hip abductor strength and the Knee Injury and Osteoarthritis Outcome Score (KOOS). Secondary outcomes are stair climb test, 6 min walk test, timed up and go, 40 m fast-paced walk test, 30 second chair stand test, isometric quadriceps strength, Lower Extremity Functional Scale (LEFS) and SF-12. Outcome measures will be recorded at baseline (admission to inpatient rehabilitation), and then 3 weeks, 6 weeks and 6 months post admission to rehabilitation. The findings of this study will determine whether the addition of targeted hip strengthening to usual care rehabilitation improves physical performance and patient reported outcomes following TKA when compared to usual care rehabilitation. This will then determine whether targeted hip strengthening exercises should be included in traditional rehabilitation programs to improve the outcomes following total knee arthroplasty. The trial protocol was registered with the Australian Clinical Trial Registry ( ACTRN12615000863538 ) on 18 August 2015.

Development of a Pharmacy Technician-Driven Program to Improve Vaccination Rates at an Academic Medical Center.

PubMed

Hill, John D; Anderegg, Sammuel V; Couldry, Rick J

2017-10-01

Background: Influenza and pneumococcal disease contribute substantially to the burden of preventable disease in the United States. Despite quality measures tied to immunization rates, health systems have struggled to achieve these targets in the inpatient setting. Pharmacy departments have had success through implementation of pharmacist standing order programs (SOP); however, these initiatives are labor-intensive and have not resulted in 100% immunization rates. Objective: The objective of this study was to evaluate a pilot utilizing pharmacy technician interventions, in combination with a nursing SOP, to improve vaccination rates of hospitalized patients for influenza and pneumococcal disease. Methods: A process was developed for pharmacy technicians to identify patients who were not previously screened or immunized during the weekend days on the Cardiovascular Progressive Care unit at the University of Kansas Health-System. Targeted pharmacy technician interventions consisted of phone call reminders and face-to-face discussions with nursing staff. The primary study outcome was the change in immunization compliance rates between the control and intervention groups. Results: Influenza vaccine rates showed a statistically significant increase from 72.2% (52 of 72) of patients during the control group to 92.9% (65 of 70, P = .001) of patients during the intervention group. A pneumococcal vaccination rate of 81.3% (61 of 75) was observed in the control group, compared with 84.3% (59 of 70) of patients in the intervention group ( P = .638). Conclusion: An improvement in inpatient influenza immunization rates can be achieved through targeted follow-up performed by pharmacy technicians, in combination with a nursing-driven SOP.

A survey of light-vehicle driver education curriculum on sharing the road with heavy vehicles.

PubMed

Baker, Stephanie; Schaudt, William A; Freed, J C; Toole, Laura

2012-07-01

Light-vehicle driver education programs that contain content about sharing the road with heavy vehicles may be helpful in reducing future light-vehicle/heavy-vehicle interactions. However, the extent of curricula in the United States including such content is unclear. Researchers developed an online survey targeted at instructors/administrators of state driver education programs to identify curricula addressing heavy vehicles and to determine perceived effectiveness. Ninety-one percent of respondents indicated that the light-vehicle driver education curriculum they teach/administer included a component covering how to safely share the road with heavy vehicles (82% perceived this component to be effective). Although a large proportion of these programs included a component on how to safely share the road with heavy vehicles, participants indicated there may be room for improvement. Participants recommended that future improvements to driver education programs include updated materials and student hands-on experience with heavy vehicles. Copyright © 2012 Elsevier Ltd. All rights reserved.

List randomization for soliciting experience of intimate partner violence: Application to the evaluation of Zambia's unconditional child grant program.

PubMed

Peterman, Amber; Palermo, Tia M; Handa, Sudhanshu; Seidenfeld, David

2018-03-01

Social scientists have increasingly invested in understanding how to improve data quality and measurement of sensitive topics in household surveys. We utilize the technique of list randomization to collect measures of physical intimate partner violence in an experimental impact evaluation of the Government of Zambia's Child Grant Program. The Child Grant Program is an unconditional cash transfer, which targeted female caregivers of children under the age of 5 in rural areas to receive the equivalent of US $24 as a bimonthly stipend. The implementation results show that the list randomization methodology functioned as planned, with approximately 15% of the sample identifying 12-month prevalence of physical intimate partner violence. According to this measure, after 4 years, the program had no measurable effect on partner violence. List randomization is a promising approach to incorporate sensitive measures into multitopic evaluations; however, more research is needed to improve upon methodology for application to measurement of violence. Copyright © 2017 John Wiley & Sons, Ltd.

Family communication coordination: a program to increase organ donation.

PubMed

Linyear, A S; Tartaglia, A

1999-09-01

To improve organ donation performance, the Medical College of Virginia Hospitals implemented a comprehensive family support and communication program, consisting of a standard family communications protocol, a hospital-based team from the Department of Pastoral Care, targeted staff education, and an ongoing quality assurance measuring and monitoring system. The 3 best-demonstrated request practices, private setting, "decoupling," and collaboration in the request between the organ procurement organization and hospital staff, were incorporated into the program. Improvement in the consent and donation rate was evident in the second calendar year of the program; the consent rate was 72% and the donation rate was 50%. During the second year, there was also a positive correlation between "decoupling," appropriate requestor, and the consent rate. Implementation of a hospital-based team and a standard protocol facilitated the clarification of roles and responsibilities toward clearer and more consistent family communication and support. Data suggest that staff experience is a major contributor to a positive donation outcome.

Reaching the Students: A New Approach to Enhancing Science Literacy

NASA Astrophysics Data System (ADS)

McNamara, B. J.; Burnham, C. C.

2002-05-01

Most NSF supported programs directed at improving science literacy among university students who are not majoring in SMET normally target instruction in introductory science or math classes. Unfortunately these efforts seldom reach the vast majority of students at a university because students can fulfil their science requirement by taking several other classes or class sections that are not impacted by the NSF program. Ideally it would be desirable to address the issues of science literacy and science anxiety among non-science majors in a single class that is required of essentially all undergraduates. We describe such a program which is being tested at NMSU. The targeted class is the university's freshman level English class. The idea behind this effort is to provide students with the skills they will need to be successful in their science classes in a less threatening humanities environment. We describe the problems that this approach raises, suggest solutions to these problems, and then discuss the overall status of this effort.

Gastrostomy Tube Weaning and Treatment of Severe Selective Eating in Childhood: Experience in Israel Using an Intensive Three Week Program.

PubMed

Shalem, Tzippora; Fradkin, Akiva; Dunitz-Scheer, Marguerite; Sadeh-Kon, Tal; Goz-Gulik, Tali; Fishler, Yael; Weiss, Batia

2016-06-01

Children dependent on gastrostomy tube feeding and those with extremely selective eating comprise the most challenging groups of early childhood eating disorders. We established, for the first time in Israel, a 3 week intensive weaning and treatment program for these patients based on the "Graz model." To investigate the Graz model for tube weaning and for treating severe selective eating disorders in one center in Israel. Pre-program assessment of patients' suitability to participate was performed 3 months prior to the study, and a treatment goal was set for each patient. The program included a multidisciplinary outpatient or inpatient 3 week treatment course. The major outcome measures were achievement of the target goal of complete or partial tube weaning for those with tube dependency, and expansion of the child's nutritional diversity for those with selective eating. Thirty-four children, 28 with tube dependency and 6 with selective eating, participated in four programs conducted over 24 months. Their mean age was 4.3 ± 0.37 years. Of all patients, 29 (85%) achieved the target goal (24 who were tube-dependent and 5 selective eaters). One patient was excluded due to aspiration pneumonia. After 6 months follow-up, 24 of 26 available patients (92%) maintained their target or improved. This intensive 3 week program was highly effective in weaning children with gastrostomy tube dependency and ameliorating severe selective eating. Preliminary evaluation of the family is necessary for completion of the program and achieving the child's personal goal, as are an experienced multidisciplinary team and the appropriate hospital setup, i.e., inpatient or outpatient.

An educational program for insulin self-adjustment associated with structured self-monitoring of blood glucose significantly improves glycemic control in patients with type 2 diabetes mellitus after 12 weeks: a randomized, controlled pilot study.

PubMed

Silva, Daniel Dutra Romualdo; Bosco, Adriana Aparecida

2015-01-01

Self-monitoring of blood glucose (SMBG) has been recommended as a useful tool for improving glycemic control, but is still an underutilized strategy and most diabetic patients are not aware of the actions that must be taken in response to its results and do not adjust their treatment. The purpose of this study was to evaluate the effectiveness and safety of an educational program for insulin self-adjustment based on SMBG in poorly controlled patients with type 2 diabetes (T2DM). A prospective, randomized, controlled 12-week intervention study was conducted on poorly controlled insulin-requiring patients with T2DM. Twenty-three subjects were randomized to two educational programs: a 2-week basic program with guidance about SMBG and types and techniques of insulin administration (group A, n = 12) and a 6-week program including the basic one and additional instructions about self-titration of insulin doses according to a specific protocol (group B, n = 11). Patients were reviewed after 12 weeks and baseline to endpoint changes in glycated hemoglobin (A1C), insulin doses, body weight and incidence of hypoglycemia were compared by paired and independent Student t-tests. After 12 weeks, there was a significant reduction in A1C only in group B, but group comparison showed no significant difference (p = 0.051). A higher percentage of subjects in group B achieved an A1C near the treatment target (<7.5%) than in group A. Daily insulin dose increased non-significantly in the two groups and there was no significant difference in the incidence of hypoglycemia or body weight changes between groups. Training for self-titrating insulin doses combined with structured SMBG can safely improve glycemic control in poorly controlled insulin-treated T2DM patients. This strategy may facilitate effective insulin therapy in routine medical practice, compensating for any reluctance on the part of physicians to optimize insulin therapy and thus to improve the achievement of recommended targets of diabetes care.

A Novel Collaboration to Reduce the Travel-Related Cost of Residency Interviewing.

PubMed

Shappell, Eric; Fant, Abra; Schnapp, Benjamin; Craig, Jill P; Ahn, James; Babcock, Christine; Gisondi, Michael A

2017-04-01

Interviewing for residency is a complicated and often expensive endeavor. Literature has estimated interview costs of $4,000 to $15,000 per applicant, mostly attributable to travel and lodging. The authors sought to reduce these costs and improve the applicant interview experience by coordinating interview dates between two residency programs in Chicago, Illinois. Two emergency medicine residency programs scheduled contiguous interview dates for the 2015-2016 interview season. We used a survey to assess applicant experiences interviewing in Chicago and attitudes regarding coordinated scheduling. Data on utilization of coordinated dates were obtained from interview scheduling software. The target group for this intervention consisted of applicants from medical schools outside Illinois who completed interviews at both programs. Of the 158 applicants invited to both programs, 84 (53%) responded to the survey. Scheduling data were available for all applicants. The total estimated cost savings for target applicants coordinating interview dates was $13,950. The majority of target applicants reported that this intervention increased the ease of scheduling (84%), made them less likely to cancel the interview (82%), and saved them money (71%). Coordinated scheduling of interview dates was associated with significant estimated cost savings and was reviewed favorably by applicants across all measures of experience. Expanding use of this practice geographically and across specialties may further reduce the cost of interviewing for applicants.

Family welfare programme and population stabilization strategies in India.

PubMed

Zodgekar, A V

1996-03-01

India is currently the second most populous country in the world. Population is likely to reach 1 billion by the turn of the century at the present rate of growth. This article provides an overview of the present and past demographic context, population program strategies, family welfare program achievements and deficits, program approaches, and fertility determinants. The author suggests that it is time for the family welfare program to shift directions. The emphasis of family welfare programs should focus on improving the quality of people's lives rather than on demographic targets or on birth control in a very narrow sense. Quality of life improvements would entail increased literacy, a higher status for women, reduced infant mortality, and reduced poverty. The responsibility for family planning must be placed on individual families and not government effort. In order to achieve almost replacement level fertility by 2010, contraceptive prevalence must increase from the present 44% to at least 70%. Increased contraceptive prevalence will not occur without the adoption of the small family norm and improvement in socioeconomic conditions. Family planning programs and services must be accessible at the village level. Sustained fertility decline is achieved by sustained effort and not short-term drastic actions. This article reviews the basic philosophy of the family welfare program, evaluates the effectiveness of the program in achieving fertility decline, and assesses the role of development and other fertility determinants, such as women's status, in reducing fertility.

Creating a bridge between data collection and program planning: a technical assistance model to maximize the use of HIV/AIDS surveillance and service utilization data for planning purposes.

PubMed

Logan, Jennifer A; Beatty, Maile; Woliver, Renee; Rubinstein, Eric P; Averbach, Abigail R

2005-12-01

Over time, improvements in HIV/AIDS surveillance and service utilization data have increased their usefulness for planning programs, targeting resources, and otherwise informing HIV/AIDS policy. However, community planning groups, service providers, and health department staff often have difficulty in interpreting and applying the wide array of data now available. We describe the development of the Bridging Model, a technical assistance model for overcoming barriers to the use of data for program planning. Through the use of an iterative feedback loop in the model, HIV/AIDS data products constantly are evolving to better inform the decision-making tasks of their multiple users. Implementation of this model has led to improved data quality and data products and to a greater willingness and ability among stakeholders to use the data for planning purposes.

Adolescent human papillomavirus vaccination in the United States: Opportunities for integrating pharmacies into the immunization neighborhood.

PubMed

Fava, Joseph P; Colleran, Jacob; Bignasci, Francesca; Cha, Raymond; Kilgore, Paul E

2017-08-03

Human Papillomavirus (HPV) vaccination faces several barriers, including a social stigma which carries religious and philosophical implications among parents of adolescents as well as young adults. Hundreds of immunization interventions and programs have been developed to address these factors and boost HPV vaccination rates in the United States. We sought to review the existing literature highlighting barriers to HPV immunization, as well as programs targeting increased HPV vaccine uptake in effort to develop novel vaccination initiatives. The most impactful barriers identified were parental stigma and low quality of provider recommendations for the vaccine. Despite the implementation of many HPV initiatives, outcomes of these programs are largely limited to modest improvements in vaccine uptake in small, homogeneous populations. We describe pharmacies as distinctly advantageous but underutilized resources within the immunization neighborhood and propose a novel concept to improve vaccination rates as well as reduce HPV-related disease burden in all demographics.

[Revision of Quality Indicators for the Endoscopy Quality Improvement Program of the National Cancer Screening Program in Korea].

PubMed

Min, Jun Ki; Cha, Jae Myung; Cho, Yu Kyung; Kim, Jie Hyun; Yoon, Soon Man; Im, Jong Pil; Jung, Yunho; Moon, Jeong Seop; Kim, Jin Oh; Jeen, Yoon Tae

2018-05-25

Gastroscopy and colonoscopy are widely used for the early diagnosis of stomach and colorectal cancer. The present revision integrates recent data regarding previous quality indicators and novel indicators suggested for gastroscopy and colonoscopy procedures for the National Cancer Screening Program in Korea. The new indicators, developed by the Quality Improvement Committee of the Korean Society for Gastrointestinal Endoscopy, vary in the level of supporting evidence, and most are based solely on expert opinion. Updated indicators validated by clinical research were prioritized, but were chosen by expert consensus when such studies were absent. The resultant quality indicators were graded according to the levels of consensus and recommendations. The updated indicators will provide a relevant guideline for high-quality endoscopy. The future direction of quality indicator development should include relevant outcome measures and an evidence-based approach to support proposed performance targets.

Online public health preparedness training programs: an evaluation of user experience with the technological environment.

PubMed

Nambisan, Priya

2010-01-01

Several public health education programs and government agencies across the country have started offering virtual or online training programs in emergency preparedness for people who are likely to be involved in managing or responding to different types of emergency situations such as natural disasters, epidemics, bioterrorism, etc. While such online training programs are more convenient and cost-effective than traditional classroom-based programs, their success depends to a great extent on the underlying technological environment. Specifically, in an online technological environment, different types of user experiences come in to play-users' utilitarian or pragmatic experience, their fun or hedonic experience, their social experience, and most importantly, their usability experience-and these different user experiences critically shape the program outcomes, including course completion rates. This study adopts a multi-disciplinary approach and draws on theories in human computer interaction, distance learning theories, usability research, and online consumer behavior to evaluate users' experience with the technological environment of an online emergency preparedness training program and discusses its implications for the design of effective online training programs. . Data was collected using a questionnaire from 377 subjects who had registered for and participated in online public health preparedness training courses offered by a large public university in the Northeast. Analysis of the data indicates that as predicted, participants had higher levels of pragmatic and usability experiences compared to their hedonic and sociability experiences. Results also indicate that people who experienced higher levels of pragmatic, hedonic, sociability and usability experiences were more likely to complete the course(s) they registered for compared to those who reported lower levels. The study findings hold important implications for the design of effective online emergency preparedness training targeted at diverse audiences including the general public, health care and public health professionals, and emergency responders. Strategies for improving participants' pragmatic, hedonic, sociability and usability experiences are outlined. There are ample opportunities to improve the pragmatic, hedonic, sociability and usability experiences of the target audience. This is critical to improve the participants' learning and retention as well as the completion rates for the courses offered. Online emergency preparedness programs are likely to play a crucial role in preparing emergency responders at all levels in the future and their success has critical implications for public health informatics.

Musashi2 sustains the mixed-lineage leukemia–driven stem cell regulatory program

PubMed Central

Park, Sun-Mi; Gönen, Mithat; Vu, Ly; Minuesa, Gerard; Tivnan, Patrick; Barlowe, Trevor S.; Taggart, James; Lu, Yuheng; Deering, Raquel P.; Hacohen, Nir; Figueroa, Maria E.; Paietta, Elisabeth; Fernandez, Hugo F.; Tallman, Martin S.; Melnick, Ari; Levine, Ross; Leslie, Christina; Lengner, Christopher J.; Kharas, Michael G.

2015-01-01

Leukemia stem cells (LSCs) are found in most aggressive myeloid diseases and contribute to therapeutic resistance. Leukemia cells exhibit a dysregulated developmental program as the result of genetic and epigenetic alterations. Overexpression of the RNA-binding protein Musashi2 (MSI2) has been previously shown to predict poor survival in leukemia. Here, we demonstrated that conditional deletion of Msi2 in the hematopoietic compartment results in delayed leukemogenesis, reduced disease burden, and a loss of LSC function in a murine leukemia model. Gene expression profiling of these Msi2-deficient animals revealed a loss of the hematopoietic/leukemic stem cell self-renewal program and an increase in the differentiation program. In acute myeloid leukemia patients, the presence of a gene signature that was similar to that observed in Msi2-deficent murine LSCs correlated with improved survival. We determined that MSI2 directly maintains the mixed-lineage leukemia (MLL) self-renewal program by interacting with and retaining efficient translation of Hoxa9, Myc, and Ikzf2 mRNAs. Moreover, depletion of MLL target Ikzf2 in LSCs reduced colony formation, decreased proliferation, and increased apoptosis. Our data provide evidence that MSI2 controls efficient translation of the oncogenic LSC self-renewal program and suggest MSI2 as a potential therapeutic target for myeloid leukemia. PMID:25664853

Sweet promises: Candy advertising to children and implications for industry self-regulation.

PubMed

Harris, Jennifer L; LoDolce, Megan; Dembek, Cathryn; Schwartz, Marlene B

2015-12-01

Candy advertising illustrates limitations of the Children's Food and Beverage Advertising Initiative (CFBAI) self-regulatory program to improve food marketing to children. Participating companies pledge to not advertise candy in child-directed media. Yet independent analyses show that children viewed 65% more candy ads on U.S. television in 2011 than in 2007, before CFBAI implementation. The present research corroborates these findings, characterizes the increase, and examines how CFBAI-participating and non-participating companies use child-targeted techniques and media placement to advertise candy on U.S. television. Content analysis identified child-targeted messages and techniques in 2011 television candy ads, and Nielsen data (2008-2011) quantified candy advertising viewed on children's and other types of television programming. Differences between brands according to CFBAI status and use of child-targeted techniques in ads are evaluated. Data were obtained and analyzed in 2013. CFBAI-company non-approved brands represented 65% of candy ads viewed by children in 2011, up from 45% in 2008, and 77% of these ads contained child-targeted techniques. Although CFBAI companies only placed ads for approved brands on children's networks, 31% of ads viewed by children for CFBAI non-approved brands appeared on networks with higher-than-average youth audiences. CFBAI non-participating companies placed child-targeted candy ads primarily on children's networks. Despite CFBAI pledges, companies continue to advertise candy during programming with large youth audiences utilizing techniques that appeal to children. Both increased CFBAI participation and a more effective definition of "child-directed advertising" are required to reduce children's exposure to targeted advertising for foods that can harm their health. Copyright © 2015 Elsevier Ltd. All rights reserved.

New Directions and Challenges in Preventing Conduct Problems in Early Childhood.

PubMed

Shaw, Daniel S; Taraban, Lindsay E

2017-06-01

In this article, we review advances in developing and preventing conduct problems in early childhood and identify challenges. Among the topics we address are expanding the targets of prevention programs beyond improving parenting skills, implementing family-based interventions during early childhood for families living in impoverished communities, making greater use of community platforms that serve young children at risk for early conduct problems, and incorporating techniques such as motivational interviewing to improve families' engagement in nontraditional mental health settings.

Breast-feeding Coparenting Framework: A New Framework to Improve Breast-feeding Duration and Exclusivity.

PubMed

Abbass-Dick, Jennifer; Dennis, Cindy-Lee

Targeting mothers and fathers in breast-feeding promotion programs is recommended as research has found that father's support positively impacts breast-feeding duration and exclusivity. Breast-feeding coparenting refers to the manner in which parents work together to achieve their breast-feeding goals. The Breast-feeding Coparenting Framework was developed on the basis of diverse coparenting models and research related to father's involvement with breast-feeding. This framework consists of 5 components: joint breast-feeding goal setting, shared breast-feeding responsibility, proactive breast-feeding support, father's/partner's parental-child interactions, and productive communication and problem solving. This framework may be of value to policy makers and program providers working to improve breast-feeding outcomes.

Formative evaluation of a multimedia self-administered computerized hearing loss prevention program.

PubMed

Saunders, Gabrielle H; Vachhani, Jay J; Galvez, Gino; Griest, Susan E

2015-04-01

To determine which features make a computer-based hearing health education intervention effective, easy to use, and enjoyable. The study examined which features of a multimedia self-administered computerized hearing loss prevention program, developed by the National Center for Rehabilitative Auditory Research (referred to as the NCRAR-HLPP), users liked and disliked, and the reasons why. A formative evaluation was conducted in which participants completed a questionnaire to assess knowledge and attitudes towards hearing and hearing loss prevention, used the NCRAR-HLPP, completed the questionnaire for a second time, and were interviewed to learn their opinions about the NCRAR-HLPP. Twenty-five male and four female Veterans recruited from the Portland VA Medical Center who were aged between 25 and 65 years. Participants reported that using the NCRAR-HLPP was a positive experience. Ease of use, multimedia content, personal relevance, and use of emotion were positive features of the program. The questionnaire showed increased knowledge and improved attitude scores following use of the program. This formative evaluation showed changes designed to target user preferences and improve user instructions will be made in future versions of the program.

A prospective evaluation of an interdisciplinary nutrition–rehabilitation program for patients with advanced cancer

PubMed Central

Gagnon, B.; Murphy, J.; Eades, M.; Lemoignan, J.; Jelowicki, M.; Carney, S.; Amdouni, S.; Di Dio, P.; Chasen, M.; MacDonald, N.

2013-01-01

Background Cancer can affect many dimensions of a patient’s life, and in turn, it should be targeted using a multimodal approach. We tested the extent to which an interdisciplinary nutrition–rehabilitation program can improve the well-being of patients with advanced cancer. Methods Between January 10, 2007, and September 29, 2010, 188 patients with advanced cancer enrolled in the 10–12-week program. Body weight, physical function, symptom severity, fatigue dimensions, distress level, coping ability, and overall quality of life were assessed at the start and end of the program. Results Of the enrolled patients, 70% completed the program. Patients experienced strong improvements in the physical and activity dimensions of fatigue (effect sizes: 0.8–1.1). They also experienced moderate reductions in the severity of weakness, depression, nervousness, shortness of breath, and distress (effect sizes: 0.5–0.7), and moderate improvements in Six Minute Walk Test distance, maximal gait speed, coping ability, and quality of life (effect sizes: 0.5–0.7) Furthermore, 77% of patients either maintained or increased their body weight. Conclusions Interdisciplinary nutrition–rehabilitation can be advantageous for patients with advanced cancer and should be considered an integrated part of standard palliative care. PMID:24311946

Patient Navigation to Improve Cancer Screening in Underserved Populations: Reported Experiences, Opportunities, and Challenges.

PubMed

Neal, Chrishanae D; Weaver, Davis T; Raphel, Tiana J; Lietz, Anna P; Flores, Efren J; Percac-Lima, Sanja; Knudsen, Amy B; Pandharipande, Pari V

2018-04-20

Our goal is to define patient navigation for an imaging audience, present a focused selection of published experiences with navigation programs for breast and colorectal cancer screening, and expose principal barriers to the success of such programs. Despite numerous advances in the early detection of cancers, many patients still present with advanced disease. A disproportionate number are low-income minority patients who experience worse health outcomes than their white or more financially stable counterparts. Patient navigation, which aims to assist the medically underserved by overcoming specific barriers to care, may represent one solution to narrowing disparities. Related research suggests that in general, patient navigation programs that have addressed breast or colorectal cancer screening have been successful in improving screening rates and timeliness of follow-up care. However, although beneficial, navigation is expensive and may present an unmanageable financial burden for many health care centers. To overcome this challenge, navigation efforts will likely need to target those patients that are most likely to benefit. Further research to identify such patients will be critically important for improving the sustainability of navigation programs, and, in turn, for realizing the benefits of such programs in reducing cancer disparities. Copyright © 2018. Published by Elsevier Inc.

Environmental exposures and health impacts of PFAS ...

EPA Pesticide Factsheets

Environmental exposures and health impacts of PFAS The National Exposure Research Laboratory (NERL) Human Exposure and Atmospheric Sciences Division (HEASD) conducts research in support of EPA mission to protect human health and the environment. HEASD research program supports Goal 1 (Clean Air) and Goal 4 (Healthy People) of EPA strategic plan. More specifically, our division conducts research to characterize the movement of pollutants from the source to contact with humans. Our multidisciplinary research program produces Methods, Measurements, and Models to identify relationships between and characterize processes that link source emissions, environmental concentrations, human exposures, and target-tissue dose. The impact of these tools is improved regulatory programs and policies for EPA.

Real-time monitoring through the use of technology to enhance performances throughout HIV cascades.

PubMed

Avery, Matthew; Mills, Stephen J; Stephan, Eric

2017-09-01

Controlling the HIV epidemic requires strong linkages across a 'cascade' of prevention, testing, and treatment services. Information and communications technology (ICT) offers the potential to monitor and improve the performance of this HIV cascade in real time. We assessed recent (<18 months) peer-reviewed publications regarding uses of ICT to improve performance through expanded and targeted reach, improved clinical service delivery, and reduced loss to follow-up. Research on ICT has tended to focus on a specific 'silo' of the HIV cascade rather than on tracking individuals or program performance across the cascade. Numerous innovations have been described, including use of social media to expand reach and improve programmatic targeting; technology in healthcare settings to strengthen coordination, guide clinical decision-making and improve clinical interactions; and telephone-based follow-up to improve treatment retention and adherence. With exceptions, publications have tended to be descriptive rather than evaluative, and the evidence-base for the effectiveness of ICT-driven interventions remains mixed. There is widespread recognition of the potential for ICT to improve HIV cascade performance, but with significant challenges. Successful implementation of real-time cascade monitoring will depend upon stakeholder engagement, compatibility with existing workflows, appropriate resource allocation, and managing expectations.

Delivery of Health Coaching by Medical Assistants in Primary Care

PubMed Central

Djuric, Zora; Segar, Michelle; Orizondo, Carissa; Mann, Jeffrey; Faison, Maya; Peddireddy, Nithin; Paletta, Matthew; Locke, Amy

2017-01-01

Background Health coaching is potentially a practical method to assist patients in achieving and maintaining healthy lifestyles. In health coaching, the coach partners with the patient, helping patients discover their own strengths, challenges, and solutions. Methods Two medical assistants were provided with brief training. The 12-week program consisted of telephone coaching with in-person visits at the beginning and end of the program. Coaching targeted improvements in diet, physical activity, and/or sleep habits using a self-care planning form. Results A total of 82 subjects enrolled in the program, 72% completed 8 weeks and 49% completed 12 weeks. Subjects who completed assessments at 12 weeks had significant weight loss despite the fact that weight loss was not a study goal. There also were improvements in diet and physical activity. Subject who completed the study were highly satisfied with the program and felt that health coaching should be available in all family medicine clinics. The main barrier providers voiced was remembering to refer patients. The medical providers indicated high satisfaction with the study and valued having coaching available for their patients. Conclusions Medical assistants can be trained to assist patients with lifestyle changes that are associated with improved health and weight control. PMID:28484068

Scaling Up a Water, Sanitation, and Hygiene Program in Rural Bangladesh: The Role of Program Implementation.

PubMed

Benjamin-Chung, Jade; Sultana, Sonia; Halder, Amal K; Ahsan, Mohammed Ali; Arnold, Benjamin F; Hubbard, Alan E; Unicomb, Leanne; Luby, Stephen P; Colford, John M

2017-05-01

To evaluate whether the quality of implementation of a water, sanitation, and hygiene program called SHEWA-B and delivered by UNICEF to 20 million people in rural Bangladesh was associated with health behaviors and sanitation infrastructure access. We surveyed 33 027 households targeted by SHEWA-B and 1110 SHEWA-B hygiene promoters in 2011 and 2012. We developed an implementation quality index and compared the probability of health behaviors and sanitation infrastructure access in counterfactual scenarios over the range of implementation quality. Forty-seven percent of households (n = 14 622) had met a SHEWA-B hygiene promoter, and 47% of hygiene promoters (n = 527) could recall all key program messages. The frequency of hygiene promoter visits was not associated with improved outcomes. Higher implementation quality was not associated with better health behaviors or infrastructure access. Outcomes differed by only 1% to 3% in scenarios in which all clusters received low versus high implementation quality. SHEWA-B did not meet UNICEF's ideal implementation quality in any area. Improved implementation quality would have resulted in marginal changes in health behaviors or infrastructure access. This suggests that SHEWA-B's design was suboptimal for improving these outcomes.

Pheromone-assisted techniques to improve the efficacy of insecticide sprays against Linepithema humile (Hymenoptera: Formicidae).

PubMed

Choe, Dong-Hwan; Tsai, Kasumi; Lopez, Carlos M; Campbell, Kathleen

2014-02-01

Outdoor residual sprays are among the most common methods for targeting pestiferous ants in urban pest management programs. If impervious surfaces such as concrete are treated with these insecticides, the active ingredients can be washed from the surface by rain or irrigation. As a result, residual sprays with fipronil and pyrethroids are found in urban waterways and aquatic sediments. Given the amount of insecticides applied to urban settings for ant control and their possible impact on urban waterways, the development of alternative strategies is critical to decrease the overall amounts of insecticides applied, while still achieving effective control of target ant species. Herein we report a "pheromone-assisted technique" as an economically viable approach to maximize the efficacy of conventional sprays targeting the Argentine ant. By applying insecticide sprays supplemented with an attractive pheromone compound, (Z)-9-hexadecenal, Argentine ants were diverted from nearby trails and nest entrances and subsequently exposed to insecticide residues. Laboratory experiments with fipronil and bifenthrin sprays indicated that the overall kill of the insecticides on Argentine ant colonies was significantly improved (57-142% increase) by incorporating (Z)-9-hexadecenal in the insecticide sprays. This technique, once it is successfully implemented in practical pest management programs, has the potential of providing maximum control efficacy with reduced amount of insecticides applied in the environment.

A randomized controlled trial of the impact of a teacher classroom management program on the classroom behavior of children with and without behavior problems.

PubMed

Hutchings, Judy; Martin-Forbes, Pam; Daley, David; Williams, Margiad Elen

2013-10-01

This randomized controlled trial (RCT) evaluated the efficacy of the Incredible Years (IY) Teacher Classroom Management (TCM; Webster-Stratton & Reid, 2002) program to assess whether training teachers in IY-TCM principles improve teacher behavior, whether any observed improvements impact pupil behavior classroom-wide, and whether these effects can be demonstrated with children at risk of developing conduct problems. Six intervention and six control classrooms comprising 12 teachers and 107 children (aged 3 to 7years) were recruited. Children were screened for high or low behavior problems using the cut-off points of the teacher-rated Strengths and Difficulties Questionnaire (Goodman, 1997). The primary outcome measure was independent classroom observations using the Teacher-Pupil Observation Tool (Martin et al., 2010). Multilevel modeling analyses were conducted to examine the effect of the intervention on teacher, classroom, and child behavior. Results showed a significant reduction in classroom off-task behavior (d=0.53), teacher negatives to target children (d=0.36), target child negatives towards the teacher (d=0.42), and target child off-task behavior (d=0.48). These preliminary results demonstrate the potential impact of IY-TCM on both teacher and child behavior. Copyright © 2013 Society for the Study of School Psychology. Published by Elsevier Ltd. All rights reserved.

A social marketing theory-based diet-education program for women ages 54 to 83 years improved dietary status.

PubMed

Francis, Sarah L; Taylor, Martha L

2009-12-01

Social Marketing Theory is a comprehensive approach of program development encompassing the needs and preferences of the intended audience. It was hypothesized a Social Marketing Theory-based, registered dietitian-led, in-home, cardiovascular disease-targeted diet-education program would improve the dietary status of community-residing older women. Using a randomized control group design, this 90-day program in two North Carolina counties included 58 women (30 control; 28 intervention) ages 54 to 83 years. Data were collected using the Mini Nutritional Assessment, three 3-day food records, and program evaluations. The intervention group received two individual registered dietitian-led in-home education sessions and the control group received education material mailings (Visits 2 and 3). Pretested education materials were used. Visits/mailings were scheduled 28 to 30 days apart. Variables measured included cardiovascular disease-related dietary practices and dietary status (Mini Nutritional Assessment). Data were analyzed using descriptive statistics, paired sample t tests, multivariant analyses, and independent t tests. Intervention and control Mini Nutritional Assessment scores improved (P=0.0001). Intervention subjects consumed more fiber than control (P=0.013) and reduced sodium intake (P=0.02). Controls reduced energy (P=0.01) and cholesterol intakes (P=0.029), likely because of the decreased food intake. The majority (n=51, 87.9%) rated the program as good to excellent and almost all (n=55, 94.8%) would recommend the program to a friend. The most popular features of the program were the individualized sessions (n=20, 34.5%) and diet analyses (n=11, 19%). These results suggest that cardiovascular disease diet-education materials utilizing Social Marketing Theory principles can lead to improved dietary status among community-residing older women.

Improving glycemic control with the adjunct use of a data management software program.

PubMed

Reed, Charles C; Richa, Jacqueline M; Berndt, Andrea E; Beadle, Randy D; Gerhardt, Susan D; Stewart, Ronald; Corneille, Michael

2012-01-01

Published studies have supported the implementation of tight glucose control (TGC) programs to improve patient outcomes and reduce mortality rates. However, measuring a program's efficiency is challenging, because of a lack of systems that capture data, allow access to data, and support analysis and interpretation in a near prospective time frame. We hypothesized that providing clinicians access to real-time blood glucose (BG) results reports could improve the efficacy of our TGC program. We performed a retrospective review of BG data during a 12-month period in a surgical trauma intensive care unit at a level I trauma center. A unit-specific insulin algorithm was used throughout the study. We compared BG values before and after the implementation of a data management software program that allowed clinicians access to real-time BG results reports. Reports were run daily and weekly to monitor the unit's TGC program. A total of 70 616 BG values from 1044 patients were analyzed. An overall decrease was observed in the BG level mean, from 121 mg/dL to 112 mg/dL (P < .001), as well as a decrease in the aggregated mean across patients, from 132 mg/dL to 119 mg/dL (P < .001), after implementation of the software. The percentage of values within the target range of 80 to 110 mg/dL increased from 38.9% to 50.4% (P < .001). The percentage of BG values less than 70 increased from 2.7% to 3.4% (P < .001). However, the percentage of severe hypoglyce-mic episodes (≤ 40 mg/dL) remained unchanged. Access to real-time aggregated BG data reports through the use of a data management software program improved the efficacy of our TGC program.

Should the Centers for Disease Control and Prevention's childhood lead poisoning intervention level be lowered?

PubMed

Bernard, Susan M

2003-08-01

The US Centers for Disease Control and Prevention (CDC) in 1991 chose 10 micro g/dL as an initial screening level for lead in children's blood. Current data on health risks and intervention options do not support generally lowering that level, but federal lead poisoning prevention efforts can be improved by revising the follow-up testing schedule for infants aged 1 year or less with blood lead levels of 5 micro g/dL or higher; universal education about lead exposure risks; universal administration of improved, locally validated risk-screening questionnaires; enhanced compliance with targeted screening recommendations and federal health program requirements; and development by regulatory agencies of primary prevention criteria that do not use the CDC's intervention level as a target "safe" lead exposure.

A SYSTEMATIC REVIEW OF INTERVENTIONS TARGETING PATERNAL MENTAL HEALTH IN THE PERINATAL PERIOD.

PubMed

Rominov, Holly; Pilkington, Pamela D; Giallo, Rebecca; Whelan, Thomas A

2016-05-01

Interventions targeting parents' mental health in the perinatal period are critical due to potential consequences of perinatal mental illness for the parent, the infant, and their family. To date, most programs have targeted mothers. This systematic review explores the current status and evidence for intervention programs aiming to prevent or treat paternal mental illness in the perinatal period. Electronic databases were systematically searched to identify peer-reviewed studies that described an intervention targeting fathers' mental health in the perinatal period. Mental health outcomes included depression, anxiety, and stress as well as more general measures of psychological functioning. Eleven studies were identified. Three of five psychosocial interventions and three massage-technique interventions reported significant effects. None of the couple-based interventions reported significant effects. A number of methodological limitations were identified, including inadequate reporting of study designs, and issues with the timing of interventions. The variability in outcomes measures across the studies made it difficult to evaluate the overall effectiveness of the interventions. Father-focused interventions aimed at preventing perinatal mood problems will be improved if future studies utilize more rigorous research strategies. © 2016 Michigan Association for Infant Mental Health.

Erythrocyte membrane-coated NIR-triggered biomimetic nanovectors with programmed delivery for photodynamic therapy of cancer.

PubMed

Ding, Hui; Lv, Yanlin; Ni, Dezhi; Wang, Jie; Tian, Zhiyuan; Wei, Wei; Ma, Guanghui

2015-06-07

A new type of photodynamic therapy (PDT) agents using upconversion nanoparticles (UCNPs) with incorporated photosensitizers as the inner core and an erythrocyte membrane (RM) decorated with dual targeting moieties as the cloak is developed. Owing to the endogenous nature of RM, the RM-coating endows the PDT agents with perfect biocompatibility and stealth ability to escape from the entrapment by the reticulo-endothelial system (RES). More importantly, owing to the unique nature of erythrocyte as an oxygen carrier in the blood, the RM outer layer of the agents unequivocally facilitates the permeation of ground-state molecular oxygen ((3)O2) and the singlet oxygen ((1)O2) as compared to the previously developed PDT agents with other types of coating. Another salient feature of the as-prepared PDT platform is the decoration of RM with dual targeting moieties for selective recognition of cancer cells and mitochondrial targeting, respectively. The synergistic effect of RM coating and dual-targeting of such feature-packed agents are investigated in tumor-bearing mice and the improved PDT therapeutic efficacy is confirmed, which is the first paradigm where RM-coated NIR-triggered nanovectors with programmed delivery ability is applied in PDT of tumor in vivo.

Instrumenting free-swimming dolphins echolocating in open water.

PubMed

Martin, Stephen W; Phillips, Michael; Bauer, Eric J; Moore, Patrick W; Houser, Dorian S

2005-04-01

Dolphins within the Navy Marine Mammal Program use echolocation to effectively locate underwater mines. They currently outperform manmade systems at similar tasks, particularly in cluttered environments and on buried targets. In hopes of improving manmade mine-hunting sonar systems, two instrumentation packages were developed to monitor free-swimming dolphin motion and echolocation during open-water target detection tasks. The biosonar measurement tool (BMT) is carried by a dolphin and monitors underwater position and attitude while simultaneously recording echolocation clicks and returning echoes through high-gain binaural receivers. The instrumented mine simulator (IMS) is a modified bottom target that monitors echolocation signals arriving at the target during ensonification. Dolphin subjects were trained to carry the BMT in open-bay bottom-object target searches in which the IMS could serve as a bottom object. The instrumentation provides detailed data that reveal hereto-unavailable information on the search strategies of free-swimming dolphins conducting open-water, bottom-object search tasks with echolocation.

Instrumenting free-swimming dolphins echolocating in open water

NASA Astrophysics Data System (ADS)

Martin, Stephen W.; Phillips, Michael; Bauer, Eric J.; Moore, Patrick W.; Houser, Dorian S.

2005-04-01

Dolphins within the Navy Marine Mammal Program use echolocation to effectively locate underwater mines. They currently outperform manmade systems at similar tasks, particularly in cluttered environments and on buried targets. In hopes of improving manmade mine-hunting sonar systems, two instrumentation packages were developed to monitor free-swimming dolphin motion and echolocation during open-water target detection tasks. The biosonar measurement tool (BMT) is carried by a dolphin and monitors underwater position and attitude while simultaneously recording echolocation clicks and returning echoes through high-gain binaural receivers. The instrumented mine simulator (IMS) is a modified bottom target that monitors echolocation signals arriving at the target during ensonification. Dolphin subjects were trained to carry the BMT in open-bay bottom-object target searches in which the IMS could serve as a bottom object. The instrumentation provides detailed data that reveal hereto-unavailable information on the search strategies of free-swimming dolphins conducting open-water, bottom-object search tasks with echolocation. .

Using Instructional and Motivational Techniques in the Art Classroom To Increase Memory Retention.

ERIC Educational Resources Information Center

Calverley, Ann; Grafer, Bonnie; Hauser, Michelle

This report describes a program for improving memory retention through instructional and motivational techniques in elementary art. Targeted population consisted of third grade students at three sites in a middle class suburb of a large midwestern city. The problems of memory retention were documented through teacher pre-surveys and art memory…

Improving Reading through the Use of Multiple Intelligences.

ERIC Educational Resources Information Center

Albero, Paula; Brown, Ann; Eliason, Susan; Wind, Jeanne

This report describes a program for increasing reading test scores. The targeted population consisted of one second-grade, one third-grade, and two fourth-grade classrooms in a growing middle class community located in a far western suburb of Chicago, Illinois. The problem of low reading test scores was documented though the 1995 IGAP scores on…

American River College Beacon Project: Student Catalyst Program - Peer Assisted Learning. First Semester Summary Report.

ERIC Educational Resources Information Center

American River Coll., Sacramento, CA.

The Peer Assisted Learning (PAL) Project at American River College (ARC) in Sacramento, California, was developed to improve retention rates among underrepresented students in math and science classes with high dropout rates. The project involved a group of 24 paid student Learning Assistants (LA's) who successfully completed the targeted courses…

Improving Low-Income Parents' Fruit and Vegetable Intake and Their Potential to Impact Children's Nutrition

ERIC Educational Resources Information Center

Prelip, Michael; Thai, Chan Le; Erausquin, Jennifer Toller; Slusser, Wendy

2011-01-01

Purpose: The purpose of this research is to test a comprehensive nutrition program developed specifically to target low-income parents of young school-aged children and determine whether the programme-resulted in changes in parents' knowledge, attitude, self-confidence, and behaviours related to both their and their child's nutrition in relation…

Improving Communication Skills among High School Assistant Principals To Increase Administrative Team Effectiveness.

ERIC Educational Resources Information Center

Hosack, Mary Browne

This paper describes a practicum program that was developed to increase the effectiveness of the administrative team at one high school. A lack of communication skills had prevented the target group from working together as a team. Strategies included role-play activities, workshops, and communication skill-development meetings. A series of…

Falling through the Social Safety Net: Food Stamp Use and Nonuse among Older Impoverished Americans

ERIC Educational Resources Information Center

Fuller-Thomson, Esme; Redmond, Melissa

2008-01-01

Purpose: Older adults are less likely than any other age group to use the federal Food Stamp Program. The personal and social costs of elderly diet insufficiency include disease exacerbation, depression, and increased hospitalization. In order to improve targeting and outreach efforts, this study identifies the characteristics of eligible older…

Improving Language Skills To Incorporate Detail in Student's Writing.

ERIC Educational Resources Information Center

McAvinney, Angie

This report describes a program for enriching language use in writing. The targeted population consisted of one classroom of fourth grade students in a public elementary school. This school is in the small rural community near a large city in the Midwest. The problem of lack of language skills in writing was documented with teacher and student…

Impact of the Teacher Study Group Professional Development Program on Student Vocabulary and Observed Teaching Practice: A Replication in First Grade Classrooms

ERIC Educational Resources Information Center

Gersten, Russell; Dimino, Joseph; Jayanthi, Madhavi; Newman-Gonchar, Rebecca; Taylor, Mary Jo

2013-01-01

The ESEA Blueprint for Reform states that teachers need "effective, ongoing, job-embedded, professional development that is targeted to student and school needs… [and] aligned with evidence of improvements in student learning." Unfortunately, the professional development approaches advocated, though sensible and compelling in theory,…

The Influence of a Career Pathways Model and Career Counseling on Students' Career and Academic Self-Efficacy

ERIC Educational Resources Information Center

Stipanovic, Natalie; Stringfield, Sam; Witherell, Eric

2017-01-01

This qualitative study examines the effects of career pathways programming and targeted career counseling services on 71 high school seniors across seven schools engaged in school reforms funded through South Carolina's Education and Economic Development Act (EEDA). EEDA is a statewide, multipronged effort to improve academic achievement,…

Feed Forward Programming of Car Drivers’ Eye Movement Behavior: A System Theoretical Approach. Volume 2

DTIC Science & Technology

1980-03-01

a driver and emphasizes the potential applied value of this theoretical approach in improving driving safety . From a pragmatic point of view, it is...distance, there is less spare time to react after an essential target has been recognized. Because driving safety is of crucial importance under all con

Increasing Student Motivation through the Use of Multiple Intelligences and Cooperative Learning Techniques.

ERIC Educational Resources Information Center

Charbonneau, Nancy L.; Ribar, Linda L.

This action research project implemented and evaluated a program for increasing student motivation and interest in school to improve academic growth. The targeted population consisted of 37 high school students in a rural central Illinois community. Twenty-five students were in art classes and 12 were in child care classes. Anecdotal records,…

A Framework for Developing and Testing Financial Capability Education Programs Targeted to Elementary Schools

ERIC Educational Resources Information Center

Collins, J. Michael; Odders-White, Elizabeth

2015-01-01

Concerns about consumers' ability to manage their finances have triggered a range of proposals, including interventions aimed at elementary school students. The goal of these approaches is to improve lifelong economic decision making, but the evidence supporting their efficacy is thin. In this article, the authors discuss the trend toward…

To Be or Not to Be Dramatic! The Effects of Drama on Reading Ability.

ERIC Educational Resources Information Center

Krueger, Amy; Ranalli, Katherine

This report describes a program for improving literacy skills, such as expression, fluency, and comprehension through the use of drama in the reading curriculum. The targeted population consisted of kindergarten and first grade students, both in middle class communities, located in two northern suburbs of Chicago. The problems of reading ability…

Perceptual Units Training for Improving Word Analysis Skills. Technical Report No. 1.

ERIC Educational Resources Information Center

Weaver, Phyllis A.; And Others

A training program was devised to develop automaticity of one subcomponent of reading--locating and disembedding multiletter units within words. The system involved the use of a training task that was implemented in a microcomputer-based game that required students to detect whether a target unit was presented within words that were shown in rapid…

Improving Student Oral and Written Communication Skills through the Use of Higher Level Thinking.

ERIC Educational Resources Information Center

Kovacevich, Karen; Price, Barbara; Ronna, Vicki; Xanos, Pamela

This study describes a program designed to increase the communication skills of at-risk students. The targeted population consists of kindergarten through third grade students in two elementary schools in a community in central Illinois. The status of family income ranges from low to high levels. Evidence for the existence of inadequate…

The Building Blocks of Character Education: Respect, Responsibility, Citizenship.

ERIC Educational Resources Information Center

Bowman, Mary Lou; Potts, Annmarie

This action research report describes a program to improve and enhance students' social skills in and out of the classroom. The targeted population consisted of two fourth grade classrooms at two different suburban sites. The need to address this issue seems to have grown due to an increase in school violence and the decline of the traditional…

Strategy-Based Cognitive Training for Improving Executive Functions in Older Adults: a Systematic Review.

PubMed

Mowszowski, L; Lampit, A; Walton, C C; Naismith, S L

2016-09-01

Given projected increases in dementia prevalence, emphasising earlier stages of cognitive impairment in older adults enables targeted early intervention strategies. Strategy-based cognitive training (SCT) is a remedial approach involving guidance and practice in compensatory techniques to improve cognition, including memory and attention. It may also be effective for improving executive functions (EF) integral to everyday tasks. This review systematically evaluates SCT effects on EF in older adults without dementia. Following PRISMA guidelines, we reviewed eligible trials according to pre-defined criteria, differentiating SCT from other cognitive interventions and stipulating total EF-focused intervention time, study design and target population (healthy older adults or mild cognitive decline). We then evaluated trials according to design, methodological quality and outcomes. Unfortunately, with too few studies in mild cognitive impairment, we refocused our review only on healthy older adults. Thirteen studies with 4120 participants in total were included, primarily targeting inductive reasoning. Despite heterogeneous study designs and SCT programs, 11/13 trials reported significant EF improvements, generally of moderate effect size (Hedges' g > 0.3). Four studies reported sustained benefits from one month to 10 years. There was some evidence of far transfer. We conclude that there is promising evidence for SCT as a targeted intervention for EF in healthy older adults and preliminary evidence for maintaining effects over time. Fewer trials have investigated far transfer (e.g. improved everyday functioning) or capacity to delay/prevent dementia, which are most relevant to clinical utility. Limitations include the inability to calculate effect sizes for four studies and absence of statistical meta-analysis.

The Cascading Effects of Multiple Dimensions of Implementation on Program Outcomes: a Test of a Theoretical Model.

PubMed

Berkel, Cady; Mauricio, Anne M; Sandler, Irwin N; Wolchik, Sharlene A; Gallo, Carlos G; Brown, C Hendricks

2017-12-14

This study tests a theoretical cascade model in which multiple dimensions of facilitator delivery predict indicators of participant responsiveness, which in turn lead to improvements in targeted program outcomes. An effectiveness trial of the 10-session New Beginnings Program for divorcing families was implemented in partnership with four county-level family courts. This study included 366 families assigned to the intervention condition who attended at least one session. Independent observers provided ratings of program delivery (i.e., fidelity to the curriculum and process quality). Facilitators reported on parent attendance and parents' competence in home practice of program skills. At pretest and posttest, children reported on parenting and parents reported child mental health. We hypothesized effects of quality on attendance, fidelity and attendance on home practice, and home practice on improvements in parenting and child mental health. Structural Equation Modeling with mediation and moderation analyses were used to test these associations. Results indicated quality was significantly associated with attendance, and attendance moderated the effect of fidelity on home practice. Home practice was a significant mediator of the links between fidelity and improvements in parent-child relationship quality and child externalizing and internalizing problems. Findings provide support for fidelity to the curriculum, process quality, attendance, and home practice as valid predictors of program outcomes for mothers and fathers. Future directions for assessing implementation in community settings are discussed.

Case report: a work simulation program for a manual worker with a fracture injury.

PubMed

Chan, Chi-Chung; Chow, Jonathan H.W.

2000-01-01

Work rehabilitation programs targeting different client groups are available in nearly all major hospital occupational therapy departments in Hong Kong. Clients receiving work rehabilitation are referred from various out-patient clinics and other occupational therapists. Those clients experience limitation in work after their injuries or diseases and plan to return to work after rehabilitation. Program objectives are 1) to assist clients to reach maximum work capacity as rapidly as possible 2) to ensure clients return to work safely 3) to improve clients' work readiness. This case report describes an individualized work simulation program at a general hospital in Hong Kong provided for a typical client who is preparing to return to his worker role. Specific job analysis, goals and program rationale for the client are discussed.

Preparing health care organizations for successful case management programs.

PubMed

Bonvissuto, C A; Kastens, J M; Atwell, S R

1997-01-01

This article reports the results of a study of four hospital-based providers in varying stages of implementing case management programs. Three of the providers had most of the necessary elements in place to ensure success, such as a mix of reimbursement sources, an effective and integrated information management system, a full range of clinical services, and continuous quality improvement programs. The authors make several suggestions for key activities that must be pursued by any health care organization seeking to implement a case management program in an era of managed care, tightening reimbursement, and consumer demand for quality care. These include the need to (a) organize essential case management functions under a centralized structure; (b) set realistic, quantifiable targets, and (c) design a communications plan for the program.

Claim More™: Empowering African American Women to Make Healthy Choices

PubMed Central

Tkatch, Rifky; Musich, Shirley; Draklellis, Jennifer; Hetzel, Marla; Banks, Jo; Dugan, Jessica; Thompson, Kaylene; Hawkins, Kevin

2017-01-01

Diabetes is a serious issue for African American women. The purpose of this project was to develop and test the feasibility of a culturally appropriate and faith-based healthy eating program for African American women at risk for developing diabetes. At total of 30 women from two churches completed a 12-week, faith-based program using a community-based approach with lay health educators in the church setting. Participants set healthy eating goals, attended weekly education classes, and received daily text messaging reminders related to their goals. Outcomes included high levels of social support, frequent engagement with the program, and improved healthy eating. This program demonstrated the ability to target African American women at risk for diabetes and engage them in a health-related program. PMID:29172987

Therapeutic targeting of epithelial plasticity programs – Focus on the epithelial-mesenchymal transition

PubMed Central

Malek, Reem; Wang, Hailun; Taparra, Kekoa; Tran, Phuoc T.

2017-01-01

Mounting data points to epithelial plasticity programs such as the epithelial-mesenchymal transition (EMT) as clinically relevant therapeutic targets for the treatment of malignant tumors. In addition to the widely realized role of EMT in increasing cancer cell invasiveness during cancer metastasis, the EMT has also been implicated in allowing cancer cells to avoid tumor suppressor pathways during early tumorigenesis. In addition, data linking EMT to innate and acquired treatment resistance further points towards the desire to develop pharmacological therapies to target epithelial plasticity in cancer. In this review we organized our discussion on pathways and agents that can be used to target the EMT in cancer into three groups: (1) extracellular inducers of EMT; (2) the transcription factors that orchestrate the EMT transcriptome; and, (3) the downstream effectors of EMT. We highlight only briefly specific canonical pathways known to be involved in EMT such as the signal transduction pathways TGFβ, EFGR and Axl-Gas6. We emphasize in more detail pathways that are we believe are emerging novel pathways and therapeutic targets such as epigenetic therapies, glycosylation pathways and immunotherapy. The heterogeneity of tumors and the dynamic nature of epithelial plasticity in cancer cells make it likely that targeting only one EMT related process will be unsuccessful or only transiently successful. We suggest with greater understanding of epithelial plasticity regulation such as with the EMT, a more systematic targeting of multiple EMT regulatory networks will be the best path forward to improve cancer outcomes. PMID:28214899

Historical context for the creation of the Office of Adolescent Health and the Teen Pregnancy Prevention Program.

PubMed

Kappeler, Evelyn M; Farb, Amy Feldman

2014-03-01

In Fiscal Year 2010, Federal funds were dedicated to support evidence-based approaches to effectively target teen pregnancy prevention and resulted in the establishment of the Office of Adolescent Health (OAH) and the Teen Pregnancy Prevention (TPP) Program. Through the tiered TPP Program, OAH supports replication and evaluation of programs using models whose effectiveness has been demonstrated through rigorous evaluation and the development and testing of promising or innovative pregnancy prevention strategies and approaches. This article documents the creation of OAH and the development of the TPP Program, the identification of a TPP evidence base, current program and evaluation efforts at OAH, and government coordination and partnerships related to reducing teen pregnancy. This article is of interest to those working to improve the health and wellbeing of adolescents. Published by Elsevier Inc.

The impact of medication synchronization on quality care criteria in an independent community pharmacy.

PubMed

Hinson, Jessica L; Garofoli, Gretchen K; Elswick, Betsy M

To determine the impact of a comprehensive medication synchronization program in an independent community pharmacy by (1) evaluating changes in Electronic Quality Improvement Platform for Plans and Pharmacies (EQuIPP) scores and (2) examining the change in monthly prescription volume. Independent community pharmacy in Morgantown, WV. Waterfront Family Pharmacy is a single-location independent community pharmacy located in Morgantown, WV. The pharmacy consists of four full-time pharmacists and is the primary practice site for one community pharmacy PGY-1 resident. The pharmacy provides a variety of clinical services, including vaccine administration, medication therapy management, and diabetes education services. In September 2014, Waterfront Family Pharmacy started a comprehensive medication synchronization program. Change in Electronic Quality Improvement Platform for Plans and Pharmacies (EQuIPP) scores and change in monthly prescription volume. At the end of 6 months there was improvement in all targeted EQuIPP scores. There was a 7% improvement in proportion of days covered (PDC) for cholesterol-reducing agents, a 9.5% improvement in PDC for oral glycemic agents, a 1.2% improvement in PDC for renin-angiotensin system antagonists, and a 1.8% reduction in the use of high-risk medications in the elderly. There was also an average increase in monthly prescription volume of 4.8% over the first 6 months after the implementation of the comprehensive medication synchronization program. The implementation of a comprehensive medication synchronization program in an independent community pharmacy may result in benefits including improved EQuIPP scores and increased prescription volume. Copyright © 2017 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.

Allocative and implementation efficiency in HIV prevention and treatment for people who inject drugs.

PubMed

Benedikt, Clemens; Kelly, Sherrie L; Wilson, David; Wilson, David P

2016-12-01

Estimated global new HIV infections among people who inject drugs (PWID) remained stable over the 2010-2015 period and the target of a 50% reduction over this period was missed. To achieve the 2020 UNAIDS target of reducing adult HIV infections by 75% compared to 2010, accelerated action in scaling up HIV programs for PWID is required. In a context of diminishing external support to HIV programs in countries where most HIV-affected PWID live, it is essential that available resources are allocated and used as efficiently as possible. Allocative and implementation efficiency analysis methods were applied. Optima, a dynamic, population-based HIV model with an integrated program and economic analysis framework was applied in eight countries in Eastern Europe and Central Asia (EECA). Mathematical analyses established optimized allocations of resources. An implementation efficiency analysis focused on examining technical efficiency, unit costs, and heterogeneity of service delivery models and practices. Findings from the latest reported data revealed that countries allocated between 4% (Bulgaria) and 40% (Georgia) of total HIV resources to programs targeting PWID - with a median of 13% for the eight countries. When distributing the same amount of HIV funding optimally, between 9% and 25% of available HIV resources would be allocated to PWID programs with a median allocation of 16% and, in addition, antiretroviral therapy would be scaled up including for PWID. As a result of optimized allocations, new HIV infections are projected to decline by 3-28% and AIDS-related deaths by 7-53% in the eight countries. Implementation efficiencies identified involve potential reductions in drug procurement costs, service delivery models, and practices and scale of service delivery influencing cost and outcome. A high level of implementation efficiency was associated with high volumes of PWID clients accessing a drug harm reduction facility. A combination of optimized allocation of resources, improved implementation efficiency and increased investment of non-HIV resources is required to enhance coverage and improve outcomes of programs for PWID. Increasing efficiency of HIV programs for PWID is a key step towards avoiding implicit rationing and ensuring transparent allocation of resources where and how they would have the largest impact on the health of PWID, and thereby ensuring that funding spent on PWID becomes a global best buy in public health. Copyright © 2016. Published by Elsevier B.V.

The Case for Diabetes Population Health Improvement: Evidence-Based Programming for Population Outcomes in Diabetes.

PubMed

Golden, Sherita Hill; Maruthur, Nisa; Mathioudakis, Nestoras; Spanakis, Elias; Rubin, Daniel; Zilbermint, Mihail; Hill-Briggs, Felicia

2017-07-01

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 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. 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.

Protocole of a controlled before-after evaluation of a national health information technology-based program to improve healthcare coordination and access to information.

PubMed

Saillour-Glénisson, Florence; Duhamel, Sylvie; Fourneyron, Emmanuelle; Huiart, Laetitia; Joseph, Jean Philippe; Langlois, Emmanuel; Pincemail, Stephane; Ramel, Viviane; Renaud, Thomas; Roberts, Tamara; Sibé, Matthieu; Thiessard, Frantz; Wittwer, Jerome; Salmi, Louis Rachid

2017-04-21

Improvement of coordination of all health and social care actors in the patient pathways is an important issue in many countries. Health Information (HI) technology has been considered as a potentially effective answer to this issue. The French Health Ministry first funded the development of five TSN ("Territoire de Soins Numérique"/Digital health territories) projects, aiming at improving healthcare coordination and access to information for healthcare providers, patients and the population, and at improving healthcare professionals work organization. The French Health Ministry then launched a call for grant to fund one research project consisting in evaluating the TSN projects implementation and impact and in developing a model for HI technology evaluation. EvaTSN is mainly based on a controlled before-after study design. Data collection covers three periods: before TSN program implementation, during early TSN program implementation and at late TSN program implementation, in the five TSN projects' territories and in five comparison territories. Three populations will be considered: "TSN-targeted people" (healthcare system users and people having characteristics targeted by the TSN projects), "TSN patient users" (people included in TSN experimentations or using particular services) and "TSN professional users" (healthcare professionals involved in TSN projects). Several samples will be made in each population depending on the objective, axis and stage of the study. Four types of data sources are considered: 1) extractions from the French National Heath Insurance Database (SNIIRAM) and the French Autonomy Personalized Allowance database, 2) Ad hoc surveys collecting information on knowledge of TSN projects, TSN program use, ease of use, satisfaction and understanding, TSN pathway experience and appropriateness of hospital admissions, 3) qualitative analyses using semi-directive interviews and focus groups and document analyses and 4) extractions of TSN implementation indicators from TSN program database. EvaTSN is a challenging French national project for the production of evidenced-based information on HI technologies impact and on the context and conditions of their effectiveness and efficiency. We will be able to support health care management in order to implement HI technologies. We will also be able to produce an evaluation toolkit for HI technology evaluation. ClinicalTrials.gov ID: NCT02837406 , 08/18/2016.

Research and Improvement on Characteristics of Emergency Diesel Generating Set Mechanical Support System in Nuclear Power Plant

NASA Astrophysics Data System (ADS)

Zhe, Yang

2017-06-01

There are often mechanical problems of emergency power generation units in nuclear power plant, which bring a great threat to nuclear safety. Through analyzing the influence factors caused by mechanical failure, the existing defects of the design of mechanical support system are determined, and the design idea has caused the direction misleading in the field of maintenance and transformation. In this paper, research analysis is made on basic support design of diesel generator set, main pipe support design and important components of supercharger support design. And this paper points out the specific design flaws and shortcomings, and proposes targeted improvement program. Through the implementation of improvement programs, vibration level of unit and mechanical failure rate are reduced effectively. At the same time, it also provides guidance for design, maintenance and renovation of diesel generator mechanical support system of nuclear power plants in the future.

Criminal history systems: new technology and new directions

NASA Astrophysics Data System (ADS)

Threatte, James

1997-02-01

Many forces are driving states to improve their current Criminal History and On-Line Criminal Justice Information Systems. The predominate factors compelling this movement are (1) the deterioration and cost of supporting older legacy systems, (2) current generation high performance, low cost hardware and system software, and (3) funding programs, such as the National Criminal History Improvement Program, which are targeted specifically at improving these important systems. In early 1996, SAIC established an Internal Research and Development project devoted to Computerized Criminal History Systems (CCH). This project began with an assessment of current hardware, operating system, and relational database technology. Application software design and development approaches were then reviewed with a focus on object-oriented approaches, three tier client server architectures, and tools that enable the `right sizing' of systems. An operational prototype of a State CCH system was established based on the results of these investigations.

Impact of Safety Training and Interventions on Training-Transfer: Targeting Migrant Construction Workers.

PubMed

Hussain, Rahat; Pedro, Akeem; Lee, Do Yeop; Pham, Hai Chien; Park, Chan Sik

2018-05-01

Despite substantial efforts to improve construction safety training, the accident rate of migrant workers is still high. One of the primary factors contributing to the inefficacy of training includes information delivery gaps during training sessions (knowledge-transfer). In addition, there is insufficient evidence that these training programs alone are effective enough to enable migrant workers to transfer their skills to jobsite (training-transfer). This research attempts to identify and evaluate additional interventions to improve the transfer of acquired knowledge to workplace. For this purpose, this study presents the first known experimental effort to assess the effect of interventions on migrant work groups in a multinational construction project in Qatar. Data analysis reveals that the adoption of training programs with the inclusion of interventions significantly improves training-transfer. Construction safety experts can leverage the findings of this study to enhance training-transfer by increasing worker's safety performance and hazard identification ability.

Progress in improving provincial plans for nutrition through targeted technical assistance and local advocacy in Vietnam.

PubMed

Harris, Jody; Nguyen, Phuong H; To, Quyen; Frongillo, Edward A; Menon, Purnima

2016-12-01

Vietnam has been decentralizing nutrition planning to provinces, which could help with local relevance and accountability. Assessment in 2009 found a continuing top-down approach, limited human capacity, and difficulty in integrating multiple sectors. Alive and Thrive (A&T) provided targeted assistance and capacity-building for 15 provincial plans for nutrition (PPNs). We aimed to (i) assess PPN content and quality improvements 2009-2014, and (ii) explain processes through which change occurred. Data consisted of interview-based assessments of provincial planning processes, annual PPN assessments, and tracking of A&T involvement. At endline, some provinces produced higher quality plans. Local planning skills improved, but capacity remained insufficient. Awareness of and support for nutrition improved, but some policy and legal environments were contradictory. Objectives were clearer, but use of data for planning remained inconsistent. Provinces became more proactive and creative, but remained constrained by slow approval processes and insufficient funding. Targeted assistance and local advocacy can improve decentralized planning, with success dependent on policy and programming contexts and ability to overcome constraints around capacity, investment, data use and remnants of centralized planning. We recommend strong engagement with planners at the national level to understand how to unblock major constraints; solutions must take into consideration the particular political, financial and administrative context. © The Author 2016. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.

Connecticut's Value-Based Insurance Plan Increased The Use Of Targeted Services And Medication Adherence.

PubMed

Hirth, Richard A; Cliff, Elizabeth Q; Gibson, Teresa B; McKellar, M Richard; Fendrick, A Mark

2016-04-01

In 2011 Connecticut implemented the Health Enhancement Program for state employees. This voluntary program followed the principles of value-based insurance design (VBID) by lowering patient costs for certain high-value primary and chronic disease preventive services, coupled with requirements that enrollees receive these services. Nonparticipants in the program, including those removed for noncompliance with its requirements, were assessed a premium surcharge. The program was intended to curb cost growth and improve health through adherence to evidence-based preventive care. To evaluate its efficacy in doing so, we compared changes in service use and spending after implementation of the program to trends among employees of six other states. Compared to employees of other states, Connecticut employees were similar in age and sex but had a slightly higher percentage of enrollees with chronic conditions and substantially higher spending at baseline. During the program's first two years, the use of targeted services and adherence to medications for chronic conditions increased, while emergency department use decreased, relative to the situation in the comparison states. The program's impact on costs was inconclusive and requires a longer follow-up period. This novel combination of VBID principles and participation requirements may be a tool that can help plan sponsors increase the use of evidence-based preventive services. Project HOPE—The People-to-People Health Foundation, Inc.

Developing a framework for assessing responsible conduct of research education programs.

PubMed

Olson, Lynne E

2010-03-01

Education in the responsible conduct of research (RCR) in the United States has evolved over the past decade from targeting trainees to including educational efforts aimed at faculty and staff. In addition RCR education has become more focused as federal agencies have moved to recommend specific content and to mandate education in certain areas. RCR education has therefore become a research-compliance issue necessitating the development of policies and the commitment of resources to develop or expand systems for educating faculty and staff and for assuring compliance. These changes implied the need to develop a program evaluation model that could be applied to institutional RCR education programs, which were expected to differ from traditional academic credit-bearing courses targeting trainees. Information gleaned from the examination of corporate compliance models was analyzed in order to create a program evaluation module that could be used to document and assess educational programs focused on teaching RCR. A programmed series of questions for each of the nine RCR content areas identified by the United States Office of Research Integrity was created based on a performance-monitoring evaluation model. The questions focus on educational goals, resources provided to support the educational efforts, educational content, content delivery, educational outcomes, compliance requirements and feedback. Answers collected in response to the questions could be used to both document and continually improve the quality of RCR educational programs through on-going formative assessment and feedback.

Evaluation of the National Guard Health Promotion Program for Chronic Diseases and Comorbid Conditions Among Military Personnel in Jeddah City, Saudi Arabia, 2016.

PubMed

Aljasir, Badr A; Al-Mugti, Hani Saad; Alosaimi, Majed Naif; Al-Mugati, Amer Saad

2017-11-01

Cardiovascular diseases (CVDs) are the leading cause of death worldwide. Preventive efforts mainly target the reduction of modifiable CVD risk factors through community-based promotion programs. One of these programs is the National Guard Health Promotion Program for Chronic Diseases and Comorbid Conditions among military personnel in Jeddah City, Saudi Arabia. Researchers have asserted that to improve every intervention program, especially those targeting public health issues, regular monitoring and evaluation are needed to determine the strength and weakness of the program. The objective of this study was to assess the effectiveness of National Guard Health Promotion Program for Chronic Diseases and Comorbid Conditions among military personnel in Jeddah City by estimating Framingham risk score, diabetes risk score, and satisfaction level for the participants covered by the program for at least 6 months. Through pre- and poststudy design, a systematic random sample of military personnel who fulfilled the inclusion criteria (n = 267) were enrolled in the study. To assess the program's effectiveness, participants were subjected to clinical and laboratory assessment based mainly on Framingham risk scores before and after involvement in the program; satisfaction was assessed concurrently using a self-administered questionnaire. The Wilcoxon signed rank test was used to compare changes in non-normally distributed quantitative variables. Multiple logistic regression analysis was used to identify independent predictors of risk of CVDs. The subjects were all military men, with mean age of 35.8 ± 6.6 years; 6% officers with the remainder "non-officers" primarily working in the combat services. After at least 6 months of the preventive program, there were statistically significant decreases in body mass index (-0.4 ± 1.5 kg/m 2 ), waist circumference (-0.9 ± 6.2 cm), fasting blood glucose (-12.3 ± 29.6 mg/dL), and total cholesterol (-15.4 ± 40.2 mg/dL). Despite this observed improvement, the overall Framingham risk score showed a modest nonsignificant change (-0.1 ± 2.1 points). Similarly, although specific predictors scores of diabetes mellitus showed significant improvement (decreased blood glucose [-0.4 ± 1.8 points] and increased fruit and vegetable consumption [-0.2 ± 0.6 points]), there was no significant change in the overall diabetes risk score (-0.01 ± 2.5). The majority of the participants (96%) expressed that they were satisfied with the program. The National Guard Health Promotion Program is effective in improving specific risk factors such as body mass index, waist circumference, blood glucose, and intake of fruits and vegetables; in addition, it was perceived as being satisfactory. Nevertheless, it had no statistically significant impact on the overall total risk scores for CVDs and diabetes mellitus. Reprint & Copyright © 2017 Association of Military Surgeons of the U.S.

Promoting household water treatment through women's self help groups in Rural India: assessing impact on drinking water quality and equity.

PubMed

Freeman, Matthew C; Trinies, Victoria; Boisson, Sophie; Mak, Gregory; Clasen, Thomas

2012-01-01

Household water treatment, including boiling, chlorination and filtration, has been shown effective in improving drinking water quality and preventing diarrheal disease among vulnerable populations. We used a case-control study design to evaluate the extent to which the commercial promotion of household water filters through microfinance institutions to women's self-help group (SHG) members improved access to safe drinking water. This pilot program achieved a 9.8% adoption rate among women targeted for adoption. Data from surveys and assays of fecal contamination (thermotolerant coliforms, TTC) of drinking water samples (source and household) were analyzed from 281 filter adopters and 247 non-adopters exposed to the program; 251 non-SHG members were also surveyed. While adopters were more likely than non-adopters to have children under 5 years, they were also more educated, less poor, more likely to have access to improved water supplies, and more likely to have previously used a water filter. Adopters had lower levels of fecal contamination of household drinking water than non-adopters, even among those non-adopters who treated their water by boiling or using traditional ceramic filters. Nevertheless, one-third of water samples from adopter households exceeded 100 TTC/100ml (high risk), and more than a quarter of the filters had no stored treated water available when visited by an investigator, raising concerns about correct, consistent use. In addition, the poorest adopters were less likely to see improvements in their water quality. Comparisons of SHG and non-SHG members suggest similar demographic characteristics, indicating SHG members are an appropriate target group for this promotion campaign. However, in order to increase the potential for health gains, future programs will need to increase uptake, particularly among the poorest households who are most susceptible to disease morbidity and mortality, and focus on strategies to improve the correct, consistent and sustained use of these water treatment products.

Promoting Household Water Treatment through Women's Self Help Groups in Rural India: Assessing Impact on Drinking Water Quality and Equity

PubMed Central

Freeman, Matthew C.; Trinies, Victoria; Boisson, Sophie; Mak, Gregory; Clasen, Thomas

2012-01-01

Household water treatment, including boiling, chlorination and filtration, has been shown effective in improving drinking water quality and preventing diarrheal disease among vulnerable populations. We used a case-control study design to evaluate the extent to which the commercial promotion of household water filters through microfinance institutions to women's self-help group (SHG) members improved access to safe drinking water. This pilot program achieved a 9.8% adoption rate among women targeted for adoption. Data from surveys and assays of fecal contamination (thermotolerant coliforms, TTC) of drinking water samples (source and household) were analyzed from 281 filter adopters and 247 non-adopters exposed to the program; 251 non-SHG members were also surveyed. While adopters were more likely than non-adopters to have children under 5 years, they were also more educated, less poor, more likely to have access to improved water supplies, and more likely to have previously used a water filter. Adopters had lower levels of fecal contamination of household drinking water than non-adopters, even among those non-adopters who treated their water by boiling or using traditional ceramic filters. Nevertheless, one-third of water samples from adopter households exceeded 100 TTC/100ml (high risk), and more than a quarter of the filters had no stored treated water available when visited by an investigator, raising concerns about correct, consistent use. In addition, the poorest adopters were less likely to see improvements in their water quality. Comparisons of SHG and non-SHG members suggest similar demographic characteristics, indicating SHG members are an appropriate target group for this promotion campaign. However, in order to increase the potential for health gains, future programs will need to increase uptake, particularly among the poorest households who are most susceptible to disease morbidity and mortality, and focus on strategies to improve the correct, consistent and sustained use of these water treatment products. PMID:22957043

The Implementation and Evaluation of Health Promotion Services and Programs to Improve Cultural Competency: A Systematic Scoping Review.

PubMed

Jongen, Crystal Sky; McCalman, Janya; Bainbridge, Roxanne Gwendalyn

2017-01-01

Cultural competency is a multifaceted intervention approach, which needs to be implemented at various levels of health-care systems to improve quality of care for culturally and ethnically diverse populations. One level of health care where cultural competency is required is in the provision of health promotion services and programs targeted to diverse patient groups who experience health-care and health inequalities. To inform the implementation and evaluation of health promotion programs and services to improve cultural competency, research must assess both intervention strategies and intervention outcomes. This scoping review was completed as part of a larger systematic literature search conducted on evaluations of cultural competence interventions in health care in Canada, the United States, Australia, and New Zealand. Seventeen peer-reviewed databases, 13 websites and clearinghouses, and 11 literature reviews were searched. Overall, 64 studies on cultural competency interventions were found, with 22 being health promotion programs and services. A process of thematic analysis was utilized to identify key intervention strategies and outcomes reported in the literature. The review identified three overarching strategies utilized in health promotion services and programs to improve cultural competency: community-focused strategies, culturally focused strategies, and language-focused strategies. Studies took different approaches to delivering culturally competent health interventions, with the majority incorporating multiple strategies from each overarching category. There were various intermediate health-care and health outcomes reported across the included studies. Most commonly reported were positive reports of patient satisfaction, patient/participant service access, and program/study retention rates. The health outcome results indicate positive potential of health promotion services and programs to improve cultural competency to impact cardiovascular disease and mental health outcomes. However, due to measurement and study quality issues, it is difficult to determine the extent of the impacts. Examined together, these intervention strategies and outcomes provide a framework that can be used by service providers and researchers in the implementation and evaluation of health promotion services and programs to improve cultural competency. While there is evidence indicating the effectiveness of such health promotion interventions in improving intermediate and health outcomes, further attention is needed to issues of measurement and study quality.

"Risk, respect, responsibility": educational strategies to promote safe medicine use.

PubMed

Rucker, N Lee

2003-12-01

Nearly four billion outpatient prescriptions will be dispensed in the United States by 2005. Many people using these medicines will be targeted for educational programs promoting their safe, appropriate use. Such programs have been, or soon will be, developed by virtually all major health care system stakeholders, including: government agencies, the pharmaceutical industry, non-profit organizations and coalitions. After examining changes in 1) health professionals' communication of patient medicine information, and 2) consumers' roles and attitudes, an overview of recent U.S. and international consumer education programs is presented. Despite the proliferation of these programs, most share a weak link in evaluating success and in affecting behavior change. Finally, suggestions for future initiatives are offered, particularly regarding improving evaluation methods.

Comparison of adolescents' HIV/AIDS knowledge and self-efficacy across two cultures.

PubMed

Mahat, Ganga; Scoloveno, Mary Ann; Ayres, Cynthia

2014-01-01

This study examines the effectiveness of a HIV/AIDS peer education program, Teens for AIDS Prevention (TAP) in two cultures. A convenience sample of 287 (American and Nepalese) 9th grade students participated in the study. It was found that HIV/AIDS knowledge scores were significantly higher among American adolescents than their Nepalese counterparts only at pre-intervention. American adolescents had significantly higher self-efficacy scores than Nepalese adolescents both at pre-intervention and post-intervention. Adolescent peer education programs could be used to improve adolescent HIV/AIDS knowledge and self-efficacy for limiting sexual risk behavior; however for the educational programs to be effective, it is pertinent that the program is culturally appropriate to the target population.

Integrating A Mentorship Component in Programming for Care and Support of AIDS-Orphaned and Vulnerable Children: Lessons from the Suubi and Bridges Programs in Sub-Saharan Africa.

PubMed

Ssewamala, Fred M; Nabunya, Proscovia; Mukasa, N Miriam; Ilic, Vilma; Nattabi, Jennifer

2014-03-01

We examine a mentorship component within a family-based economic empowerment intervention for AIDS-orphaned children in Uganda. Mentorship was guided by a comprehensive 9-session curriculum. We present themes developed from the mentors' field reports and logs. Findings suggest that mentorship offers AIDS-orphaned children opportunities to develop and strengthen future plans. Moreover, the mentorship process was beneficial to both the mentees and their mentors. The program creates a positive life trajectory for a highly vulnerable group of youth. The findings can be used to understand and design mentorship programs targeted at improving the psychosocial wellbeing of children and adolescents.

Mapping educational opportunities for healthcare workers on antimicrobial resistance and stewardship around the world.

PubMed

Rogers Van Katwyk, Susan; Jones, Sara L; Hoffman, Steven J

2018-02-05

Antimicrobial resistance is an important global issue facing society. Healthcare workers need to be engaged in solving this problem, as advocates for rational antimicrobial use, stewards of sustainable effectiveness, and educators of their patients. To fulfill this role, healthcare workers need access to training and educational resources on antimicrobial resistance. To better understand the resources available to healthcare workers, we undertook a global environmental scan of educational programs and resources targeting healthcare workers on the topic of antimicrobial resistance and antimicrobial stewardship. Programs were identified through contact with key experts, web searching, and academic literature searching. We summarized programs in tabular form, including participating organizations, region, and intended audience. We developed a coding system to classify programs by program type and participating organization type, assigning multiple codes as necessary and creating summary charts for program types, organization types, and intended audience to illustrate the breadth of available resources. We identified 94 educational initiatives related to antimicrobial resistance and antimicrobial stewardship, which represent a diverse array of programs including courses, workshops, conferences, guidelines, public outreach materials, and online-resource websites. These resources were developed by a combination of government bodies, professional societies, universities, non-profit and community organizations, hospitals and healthcare centers, and insurance companies and industry. Most programs either targeted healthcare workers collectively or specifically targeted physicians. A smaller number of programs were aimed at other healthcare worker groups including pharmacists, nurses, midwives, and healthcare students. Our environmental scan shows that there are many organizations working to develop and share educational resources for healthcare workers on antimicrobial resistance and antimicrobial stewardship. Governments, hospitals, and professional societies appear to be driving action on this front, sometimes working with other types of organizations. A broad range of resources have been made freely available; however, we have noted several opportunities for action, including increased engagement with students, improvements to pre-service education, recognition of antimicrobial resistance courses as continuing medical education, and better platforms for resource-sharing online.

Targeted Employment Subsidies: Issues of Structure and Design.

ERIC Educational Resources Information Center

Bishop, John; Haveman, Robert

Effects of variations in the structure of targeted employment subsidy programs on the attainment of program objectives are explored in this paper. First, the objectives that underlie targeted subsidy programs are outlined in relation to individual program characteristics and the economics of such programs are discussed. Then the wide range of…

Is a decentralized continuing medical education program feasible for Chinese rural health professionals?

PubMed Central

2016-01-01

Purpose: Rural health professionals in township health centers (THCs) tend to have less advanced educational degrees. This study aimed to ascertain the perceived feasibility of a decentralized continuing medical education (CME) program to upgrade their educational levels. Methods: A cross-sectional survey of THC health professionals was conducted using a self-administered, structured questionnaire in Guangxi Zhuang Autonomous Region, China. Results: The health professionals in the THCs were overwhelmingly young with low education levels. They had a strong desire to upgrade their educational degrees. The decentralized CME program was perceived as feasible by health workers with positive attitudes about the benefit for license examination, and by those who intended to improve their clinical diagnosis and treatment skills. The target groups of such a program were those who expected to undertake a bachelor’s degree and who rated themselves as “partially capable” in clinical competency. They reported that 160-400 USD annually would be an affordable fee for the program. Conclusion: A decentralized CME program was perceived feasible to upgrade rural health workers’ education level to a bachelor’s degree and improve their clinical competency. PMID:27134005

Characteristics and effects of suicide prevention programs: comparison between workplace and other settings.

PubMed

Takada, Misato; Shima, Satoru

2010-01-01

The present study reviews the literature on suicide prevention programs conducted in the workplace and other settings, namely school, the community, medical facilities, jail, and the army, by conducting an electronic literature search of all articles published between 1967 and November 2007. From a total of 256 articles identified, various contents of suicide prevention programs were determined, and in 34 studies, the effect of programs was evaluated. A review of the literature reveals that the common contents of suicide prevention programs in the workplace and other settings are education and training of individuals, development of a support network, cooperation from internal and external resources, as well as education and training of managers and staff. Although the characteristic contents of suicide prevention programs at the workplace aimed at improving personnel management and health care, screening and care for high-risk individuals, as well as improvement of building structures, were not described. Although a reduction in undesirable attitudes and an increase in mental health knowledge and coping skills in the workplace are in agreement with findings in other settings, suicide rate, suicide-associated behavior, and depression, which were assessed in other settings, were not evaluated in the three studies targeting the workplace.

Adaptation of Lean Six Sigma Methodologies for the Evaluation of Veterans Choice Program at 3 Urban Veterans Affairs Medical Centers.

PubMed

Ball, Sherry L; Stevenson, Lauren D; Ladebue, Amy C; McCreight, Marina S; Lawrence, Emily C; Oestreich, Taryn; Lambert-Kerzner, Anne C

2017-07-01

The Veterans Health Administration (VHA) is adapting to meet the changing needs of our Veterans. VHA leaders are promoting quality improvement strategies including Lean Six Sigma (LSS). This study used LSS tools to evaluate the Veterans Choice Program (VCP), a program that aims to improve access to health care services for eligible Veterans by expanding health care options to non-VHA providers. LSS was utilized to assess the current process and efficiency patterns of the VCP at 3 VHA Medical Centers. LSS techniques were used to assess data obtained through semistructured interviews with Veterans, staff, and providers to describe and evaluate the VCP process by identifying wastes and defects. The LSS methodology facilitated the process of targeting priorities for improvement and constructing suggestions to close identified gaps and inefficiencies. Identified key process wastes included inefficient exchange of clinical information between stakeholders in and outside of the VHA; poor dissemination of VCP programmatic information; shortages of VCP-participating providers; duplication of appointments; declines in care coordination; and lack of program adaptability to local processes. Recommendations for improvement were formulated using LSS. This evaluation illustrates how LSS can be utilized to assess a nationally mandated health care program. By focusing on stakeholder, staff, and Veteran perspectives, process defects in the VCP were identified and improvement recommendations were made. However, the current LSS language used is not intuitive in health care and similar applications of LSS may consider using new language and goals adapted specifically for health care.