Psychometric Needs Assessment. Theory and Practice.

ERIC Educational Resources Information Center

Scissons, Edward H.

The Psychometric Needs Assessment (PNA) model was designed to provide a means of describing a target population and various sub-populations contained therein. The specific purpose of such description is to provide a guide to determination of the continuing educational programming needs of professionals. Major attributes of the PNA model are the…

Mortality Reduction, Fertility Decline, and Population Growth: Toward a More Relevant Assessment of the Relationships among Them. World Bank Staff Working Papers No. 686 and Population and Development Series No. 11.

ERIC Educational Resources Information Center

Gwatkin, Davidson

One of a special series on population change and development, this paper focuses primarily on the programs and policies responsible for mortality or fertility change, rather than on the growth impact of a mortality or fertility change per se. The first portion of the document examines three models for assessing the population growth implications…

A Reproductive Management Program for an Urban Population of Eastern Grey Kangaroos (Macropus giganteus).

PubMed

Tribe, Andrew; Hanger, Jon; McDonald, Ian J; Loader, Jo; Nottidge, Ben J; McKee, Jeff J; Phillips, Clive J C

2014-09-15

Traditionally, culling has been the expedient, most common, and in many cases, the only tool used to control free-ranging kangaroo populations. We applied a reproductive control program to a population of eastern grey kangaroos confined to a golf course in South East Queensland. The program aimed to reduce fecundity sufficiently for the population to decrease over time so that overgrazing of the fairways and the frequency of human-animal conflict situations were minimised. In 2003, 92% of the female kangaroos above 5 kg bodyweight were implanted with the GnRH agonist deslorelin after darting with a dissociative anaesthetic. In 2007, 86% of the females above 5 kg were implanted with deslorelin and also 87% of the males above 5 kg were sterilised by either orchidectomy or vasectomy. In 2005, 2008 and 2009, the population was censused to assess the effect of each treatment. The 2003 deslorelin program resulted in effective zero population growth for approximately 2.5 years. The combined deslorelin-surgery program in 2007 reduced the birth rate from 0.3 to 0.06%/year for 16 months, resulting in a 27% population reduction by November 2009. The results were consistent with implants conferring contraception to 100% of implanted females for at least 12 months. The iatrogenic mortality rates for each program were 10.5% and 4.9%, respectively, with 50% of all mortalities due to darting-related injuries, exertional myopathy/hyperthermia or recovery misadventure. The short term sexual and agonistic behaviour of the males was assessed for the 2007 program: no significant changes were seen in adult males given the vasectomy procedure, while sexual behaviours' were decreased in adult males given the orchidectomy procedure. It is concluded that female reproduction was effectively controlled by implantation with deslorrelin and male reproductive behaviour was reduced by orchidectomy, which together achieved population control.

Demonstration of the Military Ecological Risk Assessment Framework (MERAF): Apache Longbow - Hell Missile Test at Yuma Proving Ground

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

Efroymson, R.A.

2002-05-09

This ecological risk assessment for a testing program at Yuma Proving Ground, Arizona, is a demonstration of the Military Ecological Risk Assessment Framework (MERAF; Suter et al. 2001). The demonstration is intended to illustrate how risk assessment guidance concerning-generic military training and testing activities and guidance concerning a specific type of activity (e.g., low-altitude aircraft overflights) may be implemented at a military installation. MERAF was developed with funding from the Strategic Research and Development Program (SERDP) of the Department of Defense. Novel aspects of MERAF include: (1) the assessment of risks from physical stressors using an ecological risk assessment framework,more » (2) the consideration of contingent or indirect effects of stressors (e.g., population-level effects that are derived from habitat or hydrological changes), (3) the integration of risks associated with different component activities or stressors, (4) the emphasis on quantitative risk estimates and estimates of uncertainty, and (5) the modularity of design, permitting components of the framework to be used in various military risk assessments that include similar activities. The particular subject of this report is the assessment of ecological risks associated with a testing program at Cibola Range of Yuma Proving Ground, Arizona. The program involves an Apache Longbow helicopter firing Hellfire missiles at moving targets, i.e., M60-A1 tanks. Thus, the three component activities of the Apache-Hellfire test were: (1) helicopter overflight, (2) missile firing, and (3) tracked vehicle movement. The demonstration was limited, to two ecological endpoint entities (i.e., potentially susceptible and valued populations or communities): woody desert wash communities and mule deer populations. The core assessment area is composed of about 126 km{sup 2} between the Chocolate and Middle Mountains. The core time of the program is a three-week period, including fourteen days of activity in August of 2000.« less

Kit fox population trends at the Naval Petroleum Reserves in California

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

Kato, T.T.; Scrivner, J.H.; Warrick, G.

The San Joaquin kit fox was listed as an endangered subspecies following passage of the Endangered Species Protection Act of 1966, and further classified as rare under the California Endangered Species Act of 1970. The San Joaquin kit fox occurs on the Naval Petroleum Reserves in California administered by the Department of Energy (DOE). A long term kit fox population monitoring program was initiated as part of DOE's mitigation strategy to comply with the Endangered Species Act. In addition to monitoring kit fox populations, the program includes assessments of kit fox prey density and assessments of predator abundance. The objectivesmore » of this study were to: describe the long term changes in the kit fox population on the Reserves and assess the roles of coyotes and lagomorphs in kit fox population dynamics. When the fox population on NPR-1 declined between 1980 and 1984, it appeared to have been negatively impacted by a declining prey base (lagomorphs) and an increasing coyote population. Declining lagomorph densities may have been a more important factor because as coyote numbers declined between 1985 and 1990, the kit fox population remained stable. The fox population on NPR-2 remained at a higher and more stable level than the population on NPR-1. The factors determining the higher densities and greater stability of the fox population on NPR-2 are unknown.« less

The use of propensity scores to assess the generalizability of results from randomized trials

PubMed Central

Stuart, Elizabeth A.; Cole, Stephen R.; Bradshaw, Catherine P.; Leaf, Philip J.

2014-01-01

Randomized trials remain the most accepted design for estimating the effects of interventions, but they do not necessarily answer a question of primary interest: Will the program be effective in a target population in which it may be implemented? In other words, are the results generalizable? There has been very little statistical research on how to assess the generalizability, or “external validity,” of randomized trials. We propose the use of propensity-score-based metrics to quantify the similarity of the participants in a randomized trial and a target population. In this setting the propensity score model predicts participation in the randomized trial, given a set of covariates. The resulting propensity scores are used first to quantify the difference between the trial participants and the target population, and then to match, subclassify, or weight the control group outcomes to the population, assessing how well the propensity score-adjusted outcomes track the outcomes actually observed in the population. These metrics can serve as a first step in assessing the generalizability of results from randomized trials to target populations. This paper lays out these ideas, discusses the assumptions underlying the approach, and illustrates the metrics using data on the evaluation of a schoolwide prevention program called Positive Behavioral Interventions and Supports. PMID:24926156

The role of the case manager in a disease management program.

PubMed

Huston, Carol J

2002-01-01

Disease management programs provide new opportunities and roles for case managers to provide population-based healthcare to the chronically ill. This article identifies common components of disease management programs and examines roles assumed by case managers in disease management programs such as baseline assessment, performing economic analyses of diseases and their respective associated resource utilization, developing and/or implementing care guidelines or algorithms, educational interventions, disease management program implementation, and outcomes assessment. Areas of expertise needed to be an effective case manager in a disease management program are also identified.

The role of the case manager in a disease management program.

PubMed

Huston, C J

2001-01-01

Disease management programs provide new opportunities and roles for case managers to provide population-based healthcare to the chronically ill. This article identifies common components of disease management programs and examines roles assumed by case managers in disease management programs such as baseline assessment, performing economic analyses of diseases and their respective associated resource utilization, developing and/or implementing care guidelines or algorithms, educational interventions, disease management program implementation, and outcomes assessment. Areas of expertise needed to be an effective case manager in a disease management program are also identified.

IEC planning: eight state-of-the-art principles.

PubMed

Middleton, J

1983-12-01

Considerable experience and research has been accumulated in the last 20 years on the ways in which information/education/communication (IEC) programs can be effectively designed, implemented, and evaluated. Possibly more effort has focused on population and family planning IEC than on any other sectoral program of development communication. Several principles have emerged which, taken together, define the state of the art in the field. These principles provide a framework of experience which can guide the development of comprehensive IEC programs. They include: policy and resource assessment; audience analysis; strategy design; message research and pretesting; participation and feedback; management; evaluation; and collaboration. The nature of the national policy base for population and family planning programs will determine the goals and approaches of the IEC program. Strong policies of limitation on popultion growth lead to equally strong and pervasive IEC efforts designed to directly affect contraceptive behavior. Assessment of existing policy is an essential aspect of the design of an effective IEC program. Policies establish the rationale and boundaries for action. Population and family planning programs are concerned with some of the most intimate human behavior. Consequently, structured and sensitive audience analysis has become an integral part of the design of IEC programs. The design of communication strategy requires clearly stated objectives. Principles of human learning are used to structure information appropriately. Message research and pretesting have become integral components of the strategy design process. Small scale research on specific objectives is necessary to establish the basis for message design. Audience participation and feedback in remaining phases of program development and implementation are important. The management of an IEC program requires a specific combination of planning, flexibility, and creativity. Evaluation of program effects--identification of the degree of change toward stated objectives -- is critical to long term assessment of the underlying strategy and the identification both of needed corrections and new directions for the future. Collaboration with and involvement of stakeholders in the design and implementation of a national IEC program significantly raises the probability that support will be forthcoming. Taken together these 8 principles can become the basic building blocks of an effective population/family planning IEC program.

Comparison of harvest scenarios for the cost-effective suppression of Lake Trout in Swan Lake, Montana

USGS Publications Warehouse

Syslo, John M.; Guy, Christopher S.; Cox, Benjamin S.

2013-01-01

Given the large amount of resources required for long-term control or eradication projects, it is important to assess strategies and associated costs and outcomes before a particular plan is implemented. We developed a population model to assess the cost-effectiveness of mechanical removal strategies for suppressing long-term abundance of nonnative Lake Trout Salvelinus namaycush in Swan Lake, Montana. We examined the efficacy of targeting life stages (i.e., juveniles or adults) using temporally pulsed fishing effort for reducing abundance and program cost. Exploitation rates were high (0.80 for juveniles and 0.68 for adults) compared with other lakes in the western USA with Lake Trout suppression programs. Harvesting juveniles every year caused the population to decline, whereas harvesting only adults caused the population to increase above carrying capacity. Simultaneous harvest of juveniles and adults was required to cause the population to collapse (i.e., 95% reduction relative to unharvested abundance) with 95% confidence. The population could collapse within 15 years for a total program cost of US$1,578,480 using the most aggressive scenario. Substantial variation in cost existed among harvest scenarios for a given reduction in abundance; however, total program cost was minimized when collapse was rapid. Our approach provides a useful case study for evaluating long-term mechanical removal options for fish populations that are not likely to be eradicated.

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…

Bangladesh. Population education programme reviewed.

PubMed

1995-01-01

The UNFPA (UN Population Fund)-funded population education program was reviewed last November 1994 in order to identify the emerging needs and requirements as well as chart the future directions of the program. The review was undertaken with the assistance of the CST SAWA Adviser on Population Education, Dr. D.M. de Rebello. Comprehensive literature review, and intensive discussions with government functionaries, educationists, teachers, students, UNFPA country director and staff and concerned officials of the World Bank and other UN agencies involved in the program served as the modalities for the review. The review looked into the current status of the school education sector and assessed the present progress of the population education program vis-a-vis its objectives and achievements. It also analyzed the issues and constraints in relation to institutionalization of the program, capacity building and integration of population education in curriculum and textbooks. Among the many recommendations, the review proposed further building up of national capacities at various levels; development of teaching/learning materials and textbooks for the new sectors; and intensification of good quality teacher education. Institutionalization of population education in the formal school system up to grade 12 and in technical and vocational education as well as the madrasah system and the introduction of population education in the Mass Non-formal Education Program were also proposed. full text

Data-Based Locally Directed Evaluation of Vocational Education Programs. Component 3. Assessing Student Career Interests.

ERIC Educational Resources Information Center

Florida State Univ., Tallahassee. Program of Vocational Education.

Part of a system by which local education agency (LEA) personnel may evaluate secondary and postsecondary vocational education programs, this third of eight components focuses on assessment of student career interests. Procedures covered include determination of the student population to be surveyed, selection of the instrument, and discrepancy…

Estimating site occupancy and detection probabilities for cooper's and sharp-shinned hawks in the Southern Sierra Nevada

Treesearch

Jennifer E. Carlson; Douglas D. Piirto; John J. Keane; Samantha J. Gill

2015-01-01

Long-term monitoring programs that can detect a population change over time can be useful for managers interested in assessing population trends in response to forest management activities for a particular species. Such long-term monitoring programs have been designed for the Northern Goshawk (Accipiter gentilis), but not for the more elusive Sharp...

The Pacific Family and Food Safety: A Food Guide into the 21st Century.

ERIC Educational Resources Information Center

Camacho, Mary Elaine; Aguon, Jane M.

The Food Safety First Program in Guam and the Marianas, sponsored in part by the United States Department of Agriculture, assesses the food safety behavior of the local population, and uses the results to develop educational programs. The thriving of bacteria in the local climate places extra importance on educating the population on the necessity…

Reliability and Validity of the World Health Organization Quality of Life: Brief Version (WHOQOL-BREF) in a Homeless Substance Dependent Veteran Population

ERIC Educational Resources Information Center

Garcia-Rea, Elizabeth A.; LePage, James P.

2010-01-01

With the high number of homeless, there is a critical need for rapid and accurate assessment of quality of life to assess program outcomes. The World Health Organization's WHOQOL-100 has demonstrated promise in accurately assessing quality-of-life in this population. However, its length may make large scale use impractical for working with a…

The power to detect trends in Missouri River fish populations within the Pallid Sturgeon Population Assessment Program

USGS Publications Warehouse

Bryan, Janice L.; Wildhaber, Mark L.; Gladish, Dan; Holan, Scott; Ellerseick, Mark

2010-01-01

As with all large rivers in the United States, the Missouri River has been altered, with approximately 32.5 percent of the main stem length impounded and 32.5 percent channelized. These physical alterations to the environment have had effects on the fisheries, but studies examining the effects of alterations have been localized and for short periods of time. In response to the U.S. Fish and Wildlife Service biological opinion, the U.S. Army Corps of Engineers initiated monitoring of the fish community of the Missouri River in 2003. The goal of the Pallid Sturgeon Population Assessment Program is to provide information to detect changes in populations and habitat preferences with time for pallid sturgeon (Scaphirhynchus albus) and native target species in the Missouri River Basin. To determine statistical power of the Pallid Sturgeon Population Assessment Program, a power analysis was conducted using a normal linear mixed model with variance component estimates based on the first 3 years of data (2003 to 2005). In cases where 3 years of data were unavailable, estimates were obtained using those data. It was determined that at least 20 years of data, sampling 12 bends with 8 subsamples per bend, would be required to detect a 5 percent annual decline in most of the target fish populations. Power varied between Zones. Zone 1 (upstream from Lake Sakakawea) did not have any species/gear type combinations with adequate power, whereas Zone 3 (downstream from Gavins Point Dam) had 19 species/gear type combinations with adequate power. With a slight increase in the sampling effort to 12 subsamples per bend, the Pallid Sturgeon Population Assessment Program has adequate power to detect declines in shovelnose sturgeon (S. platorynchus) throughout the entire Missouri River because of large catch rates. The lowest level of non-occurrence (in other words, zero catches) at the bend level for pallid sturgeon was 0.58 using otter trawls in Zone 1. Consequently, the power of the pallid sturgeon models was not as high as other species at the current level of sampling, but an increase in the sampling effort to 16 subsamples for each of 24 bends for 20 years would generate adequate power for the pallid sturgeon in all Zones. Since gear types are selective in their species efficiency, the strength of the Pallid Sturgeon Population Assessment Program approach is using multiple gears that have statistical power to detect population trends at the same time in different fish species within the Missouri River. As often is the case with monitoring studies involving endangered species, the data used to conduct the analyses exhibit some departures from the parametric model assumptions; however, preliminary simulations indicate that the results of this study are appropriate.

Assessing institutional support for Hispanic nursing student retention: a study to evaluate the psychometric properties of two self-assessment inventories.

PubMed

Bond, Mary Lou; Cason, Carolyn L

2014-01-01

To assess the content validity and internal consistency reliability of the Healthcare Professions Education Program Self-Assessment (PSA) and the Institutional Self-Assessment for Factors Supporting Hispanic Student Retention (ISA). Health disparities among vulnerable populations are among the top priorities demanding attention in the United States. Efforts to recruit and retain Hispanic nursing students are essential. Based on a sample of provosts, deans/directors, and an author of the Model of Institutional Support, participants commented on the perceived validity and usefulness of each item of the PSA and ISA. Internal consistency reliability was calculated by Cronbach's alpha using responses from nursing schools in states with large Hispanic populations. The ISA and PSA were found to be reliable and valid tools for assessing institutional friendliness. The instruments highlight strengths and identify potential areas of improvement at institutional and program levels.

Trauma Training for School Counselors: How Well Do Programs Prepare?

ERIC Educational Resources Information Center

Lokeman, Kimberly Shawnte

2011-01-01

This study investigates the availability and perceived importance of trauma response training in school counseling preparatory programs. Using two population samples, 101 counselor educators of institutions with CACREP-accredited school counseling programs and 803 practicing school counselors, questionnaires assessed the extent to which…

Assessment Study of an Undergraduate Research Training Abroad Program

ERIC Educational Resources Information Center

Nieto-Fernandez, Fernando; Race, Kathryn; Quarless, Duncan A.

2013-01-01

The Old Westbury Neuroscience International Research Program (OWNIP) encourages undergraduate students from health disparities populations and underrepresented minorities to pursue careers in basic science, biomedical, clinical, and behavioral health research fields. To evaluate this program, several measures were used tracked through an online…

Building a Model Program for Substance-Exposed Newborns and Their Families: From Needs Assessment to Intervention, Evaluation, and Consultation

ERIC Educational Resources Information Center

Spielman, Eda; Herriott, Anna; Paris, Ruth; Sommer, Amy R.

2015-01-01

Despite growing concern about substance misuse in pregnancy and infants born substance-exposed, few programs have been developed that address the complex needs of this vulnerable population. This article describes the process of developing Project NESST® (Newborns Exposed to Substances: Support and Therapy), from needs assessment to program…

Culturally Grounded Prevention for Minority Youth Populations: A Systematic Review of the Literature

PubMed Central

Lauricella, Michela; Valdez, Jessica K.; Okamoto, Scott K.; Helm, Susana; Zaremba, Colleen

2016-01-01

Contemporary prevention science has focused on the application of cultural adaptations of evidence-based prevention programs for minority youth populations. Far less is known about culturally grounded methods that are intended to organically develop prevention programs within specific populations and communities. This article systematically reviews recent literature on culturally grounded interventions used to prevent health disparities in ethnic minority youth populations. In this review, we assessed 31 peer-reviewed articles published in 2003 or later that fit inclusionary criteria pertaining to the development and evaluation of culturally grounded prevention programs. The evaluated studies indicated different approaches toward cultural grounding, as well as specific populations, geographic regions, and health issues that have been targeted. Specifically, the findings indicated that most of the studies focused on the development and evaluation of culturally grounded HIV/STI and substance abuse prevention programs for Mexican American, African American, and American Indian/Alaska Native youth residing in the South or Southwestern U.S. These studies largely relied on community-based participatory or qualitative research methods to develop programs from the “ground up.” This review has implications for the development of future culturally grounded and culturally adapted prevention programs targeting underserved minority youth populations and geographic regions. Specifically, it identifies populations and regions where culturally grounded prevention efforts are underdeveloped or non-existent, providing some scientific direction for the future development of these types of programs. PMID:26733384

Culturally Grounded Prevention for Minority Youth Populations: A Systematic Review of the Literature.

PubMed

Lauricella, Michela; Valdez, Jessica K; Okamoto, Scott K; Helm, Susana; Zaremba, Colleen

2016-02-01

Contemporary prevention science has focused on the application of cultural adaptations of evidence-based prevention programs for minority youth populations. Far less is known about culturally grounded methods that are intended to organically develop prevention programs within specific populations and communities. This article systematically reviews recent literature on culturally grounded interventions used to prevent health disparities in ethnic minority youth populations. In this review, we assessed 31 peer-reviewed articles published in 2003 or later that fit inclusionary criteria pertaining to the development and evaluation of culturally grounded prevention programs. The evaluated studies indicated different approaches toward cultural grounding, as well as specific populations, geographic regions, and health issues that have been targeted. Specifically, the findings indicated that most of the studies focused on the development and evaluation of culturally grounded HIV/STI and substance abuse prevention programs for Mexican-American, African American, and American Indian/Alaska Native youth residing in the South or Southwestern US. These studies largely relied on community-based participatory or qualitative research methods to develop programs from the "ground up." This review has implications for the development of future culturally grounded and culturally adapted prevention programs targeting underserved minority youth populations and geographic regions. Specifically, it identifies populations and regions where culturally grounded prevention efforts are underdeveloped or non-existent, providing some scientific direction for the future development of these types of programs.

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.

A health equity impact assessment umbrella program (AAPRISS) to tackle social inequalities in health: program description.

PubMed

Lang, Thierry; Bidault, Elsa; Villeval, Mélanie; Alias, François; Gandouet, Benjamin; Servat, Martine; Theis, Ivan; Breton, Eric; Haschar-Noé, Nadine; Grosclaude, Pascale

2016-09-01

The failure to simultaneously address two objectives (increasing the average health of the population and reducing health inequalities) may have led to what has been observed in France so far: an overall decrease in mortality and increase in inequality. The Apprendre et Agir pour Réduire les Inégalités Sociales de Santé (AAPRISS) methodology is to analyze and modify interventions that are already underway in terms of their potential impact on health inequalities. It relies on partnership between researchers and actors in the health field, as well as policy makers. In this paper, we describe the program and discuss its feasibility and acceptability. This program is not a single intervention, but a process aiming at assessing and reshaping existing health programs, therefore acting as a kind of meta-intervention. The program develops scientific and methodological support stemming from co-construction methods aimed at increasing equity within the programs. Stakeholders from prevention policy-making and the health care system, as well as researchers, collaborate in defining interventions, monitoring their progress, and choosing indicators, methods and evaluation procedures. The target population is mainly the population of the greater Toulouse area. The steps of the process are described: (1) establishment of AAPRISS governance and partnerships; (2) inclusion of projects; and (3) the projects' process. Many partners have rallied around this program, which has been shown to be feasible and acceptable by partners and health actors. A major challenge is understanding each partner's expectations in terms of temporality of interventions, expected outcomes, assessment methods and indicators. Analyzing the projects has been quite feasible, and some modifications have been implemented in them in order to take inequalities in health into account. © The Author(s) 2015.

Costs of the multimicronutrient supplementation program in Chiclayo, Peru.

PubMed

Lechtig, Aarón; Gross, Rainer; Paulini, Javier; de Romaã, Daniel López

2006-01-01

There is little information on the cost parameters of weekly multimicronutrient supplementation programs. To assess the cost parameters and cost-effectiveness of a weekly multimicronutrient supplementation program in an urban population of Peru. Data from the Integrated Food Security Program (Programa Integrado de Seguridad Alimentaria [PISA]), which distributed capsules and foodlets to women and adolescent girls and to children under five, were extrapolated to a population of 100,000 inhabitants. The annual cost per community member was US$1.51. The cost-effectiveness ratio was US$0.12 per 1% of prevented anemia per community member. These costs are in the upper margin of iron supplementation alone. They will decrease notably when weekly multimicronutrient supplementation programs are integrated into health packages and participation by women increases. Focusing on micronutrient deficiencies would prevent these problems, and food-distribution programs would be effectively targeted to food-deficient populations.

[Assessment of results in the early diagnosis of breast cancer program in Asturias Community].

PubMed

Natal, Carmen; Suárez, María Teresa; Serrano, Susana; Díaz, Concepción; González, Cristina; Menéndez, Primitiva; Castañón, Rubén; García, María Luisa; Blázquez, Elena

2012-01-01

To evaluate and disseminate the intermediate results of a breast cancer early detection program in the Asturias Community. We report the results of screening examinations performed between 2005 and 2009, using the indicators proposed in the European Guidelines on Quality Assurance in Mammography Screening. The information sources for breast cancer cases diagnosed were the pathology information system and the information on the characteristics of the tumour from the pathology report. The classification of the diagnostic features of the program was from its own information system. A total of 1,384 breast cancers were diagnosed in the program target population during the study period, of which 49% were diagnosed in the program, 13% were interval cancers, 17% were diagnosed in women who chose not to participate in the program, and 22% in women who for various reasons had not been invited to participate. The most advanced diagnoses were made in the group of interval cancers and the earliest diagnoses were made in the uninvited population. When the healthcare system is directed towards the asymptomatic population to provide a measure of prevention, it must ensure that there is a favourable balance. The results of this evaluation are consistent with accepted standards and with those found in other assessments. Copyright © 2011 SECA. Published by Elsevier Espana. All rights reserved.

Thinking Inside the Box: The Health Cube Paradigm for Health and Wellness Program Evaluation and Design

PubMed Central

Harris, Sharon

2013-01-01

Abstract Appropriately constructed health promotions can improve population health. The authors developed a practical model for designing, evaluating, and improving initiatives to provide optimal value. Three independent model dimensions (impact, engagement, and sustainability) and the resultant three-dimensional paradigm were described using hypothetical case studies, including a walking challenge, a health risk assessment survey, and an individual condition management program. The 3-dimensional model is illustrated and the dimensions are defined. Calculation of a 3-dimensional score for program comparisons, refinements, and measurement is explained. Program 1, the walking challenge, had high engagement and impact, but limited sustainability. Program 2, the health risk assessment survey, had high engagement and sustainability but limited impact. Program 3, the on-site condition management program, had measurable impact and sustainability but limited engagement, because of a lack of program capacity. Each initiative, though successful in 2 dimensions, lacked sufficient evolution along the third axis for optimal value. Calculation of a 3-dimensional score is useful for health promotion program development comparison and refinements, and overall measurement of program success. (Population Health Management 2013;16:291–295) PMID:23869538

Increased natural reproduction and genetic diversity one generation after cessation of a steelhead trout (Oncorhynchus mykiss) conservation hatchery program.

PubMed

Berejikian, Barry A; Van Doornik, Donald M

2018-01-01

Spatial and temporal fluctuations in productivity and abundance confound assessments of captive propagation programs aimed at recovery of Threatened and Endangered populations. We conducted a 17 year before-after-control-impact experiment to determine the effects of a captive rearing program for anadromous steelhead trout (Oncorhynchus mykiss) on a key indicator of natural spawner abundance (naturally produced nests or 'redds'). The supplemented population exhibited a significant (2.6-fold) increase in redd abundance in the generation following supplementation. Four non-supplemented (control) populations monitored over the same 17 year period exhibited stable or decreasing trends in redd abundance. Expected heterozygosity in the supplemented population increased significantly. Allelic richness increased, but to a lesser (non-significant) degree. Estimates of the effective number of breeders increased from a harmonic mean of 24.4 in the generation before supplementation to 38.9 after supplementation. Several non-conventional aspects of the captive rearing program may have contributed to the positive response in the natural population.

Protocols for long-term monitoring of seabird ecology in the Gulf of Alaska

USGS Publications Warehouse

Piatt, John F.; Byrd, G. Vernon; Harding, Ann M.A.; Kettle, Arthur B.; Kitaysky, Sasha; Litzow, Michael A.; Roseneau, David G.; Shultz, Michael T.; van Pelt, Thomas I.

2003-01-01

Seabird populations will need to be monitored for many years to assess both recovery and ecological conditions affecting recovery. Detailed studies of individual seabird colonies and marine ecosystems in the Gulf of Alaska have been conducted by the U.S. Geological Survey and U.S. Fish and Wildlife Service under the auspices of damage assessment and restoration programs of the Trustee Council. Much has been learned about factors influencing seabird populations and their capacity to recover from the spill in the Gulf of Alaska. As the restoration program moves toward long-term monitoring of populations, however, protocols and long-term monitoring strategies that focus on key parameters of interest and that are inexpensive, practical, and applicable over a large geographic area need to be developed.

Factors in the Achievement of Below-Replacement Fertility in Chiang Mai, Thailand. Papers of the East-West Population Institute, Number 96, March 1986.

ERIC Educational Resources Information Center

Pardthaisong, Tieng

The study assesses the impact of family planning programs on the fertility of women in the Chiang Mai province of Thailand, where family planning programs were introduced early in 1963. The study documents and estimates the fertility trend of Chiang Mai's population from existing sources of data. A demographic survey, in which a random sample of…

Financial impact of population health management programs: reevaluating the literature.

PubMed

Grossmeier, Jessica; Terry, Paul E; Anderson, David R; Wright, Steven

2012-06-01

Although many employers offer some components of worksite-based population health management (PHM), most do not yet invest in comprehensive programs. This hesitation to invest in comprehensive programs may be attributed to numerous factors, such as other more pressing business priorities, reluctance to intervene in the personal health choices of employees, or insufficient funds for employee health. Many decision makers also remain skeptical about whether investment in comprehensive programs will produce a financial return on investment (ROI). Most peer-reviewed studies assessing the financial impact of PHM were published before 2000 and include a broad array of program and study designs. Many of these studies have also included indirect productivity savings in their assessment of financial outcomes. In contrast, this review includes only peer-reviewed studies of the direct health care cost impact of comprehensive PHM programs that meet rigorous methodological criteria. A systematic search of health sciences databases identified only 5 studies with program designs and study methods meeting these selection criteria published after 2007. This focused review found that comprehensive PHM programs can yield a positive ROI based on their impact on direct health care costs, but the level of ROI achieved was lower than that reported by literature reviews with less focused and restrictive qualifying criteria. To yield substantial short-term health care cost savings, the longer term financial return that can credibly be associated with a comprehensive, prevention-oriented population health program must be augmented by other financial impact strategies.

Demographic Profile and Needs Assessment of Single Parents and Homemakers in New Jersey Vocational Education Programs 1990-1991.

ERIC Educational Resources Information Center

Montclair State Coll., Upper Montclair, NJ. Life Skills Center.

A 5-year (1986-91) follow-up needs assessment was conducted to evaluate current single parent and displaced homemaker programs in New Jersey. Suggestions were offered to help them continue effectively helping the changing target population attain long-term economic self-sufficiency. Recommendations made in response to specific findings included…

42 CFR 56.503 - Project elements.

Code of Federal Regulations, 2011 CFR

2011-10-01

... SERVICES Grants for Planning and Developing Migrant Health Programs § 56.503 Project elements. A project for the planning and development of a migrant health program supported under this subpart must: (a... an assessment of need of the population proposed to be served by the migrant health program for the...

75 FR 17940 - Draft Programmatic Environmental Assessment for the Evaluation of the Grant Programs Directorate...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-08

... and emergency preparedness grant programs that it administers. These programs provide grant funding to... effects of communication facilities construction or modification subject to review by the Federal... have or are likely to have a measurable negative effect on migratory bird populations. Avian mortality...

Narrative Report of the El Centro de la Causa Library Project, 1973-1975.

ERIC Educational Resources Information Center

Chicago Public Library, IL.

El Centro de la Causa and the Chicago Public Library cooperated in a program to serve Chicago's Spanish speaking population. The project assessed needs and designed programs to meet those needs by establishing a library in El Centro's community center and some outreach programs. An active acquisitions program for Spanish language materials was…

Population genetics of commercial and feral honey bees in Western Australia.

PubMed

Chapman, Nadine C; Lim, Julianne; Oldroyd, Benjamin P

2008-04-01

Due to the introduction of exotic honey bee (Apis mellifera L.) diseases in the eastern states, the borders of the state of Western Australia were closed to the import of bees for breeding and other purposes > 25 yr ago. To provide genetically improved stock for the industry, a closed population breeding program was established that now provides stock for the majority of Western Australian beekeepers. Given concerns that inbreeding may have resulted from the closed population breeding structure, we assessed the genetic diversity within and between the breeding lines by using microsatellite and mitochondrial markers. We found that the breeding population still maintains considerable genetic diversity, despite 25 yr of selective breeding. We also investigated the genetic distance of the closed population breeding program to that of beekeepers outside of the program, and the feral Western Australian honey bee population. The feral population is genetically distinct from the closed population, but not from the genetic stock maintained by beekeepers outside of the program. The honey bees of Western Australia show three mitotypes, originating from two subspecies: Apis mellifera ligustica (mitotypes C1 and M7b) and Apis mellifera iberica (mitotype M6). Only mitotypes C1 and M6 are present in the commercial populations. The feral population contains all three mitotypes.

Population-based programs for increasing colorectal cancer screening in the United States.

PubMed

Verma, Manisha; Sarfaty, Mona; Brooks, Durado; Wender, Richard C

2015-01-01

Answer questions and earn CME/CNE Screening to detect polyps or cancer at an early stage has been shown to produce better outcomes in colorectal cancer (CRC). Programs with a population-based approach can reach a large majority of the eligible population and can offer cost-effective interventions with the potential benefit of maximizing early cancer detection and prevention using a complete follow-up plan. The purpose of this review was to summarize the key features of population-based programs to increase CRC screening in the United States. A search was conducted in the SCOPUS, OvidSP, and PubMed databases. The authors selected published reports of population-based programs that met at least 5 of the 6 International Agency for Research on Cancer (IARC) criteria for cancer prevention and were known to the National Colorectal Cancer Roundtable. Interventions at the level of individual practices were not included in this review. IARC cancer prevention criteria served as a framework to assess the effective processes and elements of a population-based program. Eight programs were included in this review. Half of the programs met all IARC criteria, and all programs led to improvements in screening rates. The rate of colonoscopy after a positive stool test was heterogeneous among programs. Different population-based strategies were used to promote these screening programs, including system-based, provider-based, patient-based, and media-based strategies. Treatment of identified cancer cases was not included explicitly in 4 programs but was offered through routine medical care. Evidence-based methods for promoting CRC screening at a population level can guide the development of future approaches in health care prevention. The key elements of a successful population-based approach include adherence to the 6 IARC criteria and 4 additional elements (an identified external funding source, a structured policy for positive fecal occult blood test results and confirmed cancer cases, outreach activities for recruitment and patient education, and an established rescreening process). © 2015 American Cancer Society.

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.

Loss of genetic diversity in Culex quinquefasciatus targeted by a lymphatic filariasis vector control program in Recife, Brazil.

PubMed

Cartaxo, Marina F S; Ayres, Constância F J; Weetman, David

2011-09-01

Recife is one of the largest cities in north-eastern Brazil and is endemic for lymphatic filariasis transmitted by Culex quinquefasciatus. Since 2003 a control program has targeted mosquito larvae by elimination of breeding sites and bimonthly application of Bacillus sphaericus. To assess the impact of this program on the local vector population we monitored the genetic diversity and differentiation of Cx. quinquefasciatus using microsatellites and a B. sphaericus-resistance associated mutation (cqm1(REC)) over a 3-year period. We detected a significant but gradual decline in allelic diversity, which, coupled with subtle temporal genetic structure, suggests a major impact of the control program on the vector population. Selection on cqm1(REC) does not appear to be involved with loss of neutral diversity from the population, with no temporal trend in resistant allele frequency and no correlation with microsatellite differentiation. The evidence for short-term genetic drift we detected suggests a low ratio of effective population size: census population size for Cx. quinquefasciatus, perhaps coupled with strong geographically-restricted population structure. Spatial definition of populations will be an important step for success of an expanded vector control program. Copyright © 2011 Royal Society of Tropical Medicine and Hygiene. Published by Elsevier Ltd. All rights reserved.

The Philosophical Underpinnings and Key Features of the Dynamic Learning Maps Alternate Assessment

ERIC Educational Resources Information Center

Kingston, Neal M.; Karvonen, Meagan; Bechard, Sue; Erickson, Karen A.

2016-01-01

The Dynamic Learning Maps™ Alternate Assessment is based on a different set of guiding principles than other assessments. In this article we describe characteristics of the alternate assessment population and we look at the history of alternate assessment and the problems that have been faced in implementing useful assessment programs for students…

Use of the SF-8 to assess health-related quality of life for a chronically ill, low-income population participating in the Central Louisiana Medication Access Program (CMAP).

PubMed

Lefante, John J; Harmon, Gary N; Ashby, Keith M; Barnard, David; Webber, Larry S

2005-04-01

The utility of the SF-8 for assessing health-related quality of life (HRQL) is demonstrated. Race and gender differences in physical component (PCS) and mental component (MCS) summary scores among participants in the CENLA Medication Access Program (CMAP), along with comparisons to the United States population are made. Age-adjusted multiple linear regression analyses were used to compare 1687 CMAP participants to the US population. Internal race and gender comparisons, adjusting for age and the number of self reported diagnoses, were also obtained. The paired t-test was used to assess 6-month change in PCS and MCS scores for a subset of 342 participants. CMAP participants have PCS and MCS scores that are significantly 10-12 points lower than the US population, indicating lower self-reported HRQL. Females have significantly higher PCS and significantly lower MCS than males. African-Americans have significantly higher MCS than Caucasians. Significant increases in both PCS and MCS were observed for the subset of participants after 6 months of intervention. The expected lower baseline PCS and MCS measures and the expected associations with age and number of diagnoses indicate that the SF-8 survey is an effective tool for measuring the HRQL of participants in this program. Preliminary results indicate significant increases in both PCS and MCS 6 months after intervention.

National assessment of Tree City USA participation

EPA Pesticide Factsheets

Tree City USA is a national program that recognizes municipal commitment to community forestry. In return for meeting program requirements, Tree City USA participants expect social, economic, and/or environmental benefits. Understanding the geographic distribution and socioeconomic characteristics of Tree City USA communities at the national scale can offer insights into the motivations or barriers to program participation, and provide context for community forestry research at finer scales. In this study, researchers assessed patterns in Tree City USA participation for all U.S. communities with more than 2,500 people according to geography, community population size, and socioeconomic characteristics, such as income, education, and race. Nationally, 23.5% of communities studied were Tree City USA participants, and this accounted for 53.9% of the total population in these communities. Tree City USA participation rates varied substantially by U.S. region, but in each region participation rates were higher in larger communities, and long-term participants tended to be larger communities than more recent enrollees. In logistic regression models, owner occupancy rates were significant negative predictors of Tree City USA participation, education and percent white population were positive predictors in many U.S. regions, and inconsistent patterns were observed for income and population age. The findings indicate that communities with smaller populations, lower educat

Training needs assessment of service providers: targeted intervention for HIV/AIDS in Jharkhand, India.

PubMed

Kumar, Anant; Kumar, Prakash

2013-01-01

Training needs assessments are pivotal for any capacity building program. Building capacity of service providers and staff involved in HIV/AIDS intervention programs is crucial because of the distinct nature of such programs. It requires specific knowledge, skills, and attitudes that are of utmost importance, influencing the reach of the program and its impact in halting and reversing the epidemic. This study was conducted to identify the training needs assessment of personnel involved in targeted intervention for high risk populations vulnerable to HIV infection in Jharkhand, India. Through the study the authors critically examine the existing training needs and gaps and suggest strategies to address them.

An Assessment of the Nature and Extent of Community and Employee Fitness Programs and Levels of Participation. Final Report. Report No. 9.

ERIC Educational Resources Information Center

Bozzo, Robert; And Others

This report presents an assessment and comparison of the nature and extent of general population, employee, and school fitness programs. Chapter I provides an overview of the research effort and the research questions developed as a framework for delineating issues to be examined. Chapter II identifies the generic approach used to examine the…

A Case Study in Citizen Science: The Effectiveness of a Trap-Neuter-Return Program in a Chicago Neighborhood.

PubMed

Spehar, Daniel D; Wolf, Peter J

2018-01-18

The use of trap-neuter-return (TNR) as a method of managing free-roaming cat populations has increased in the United States in recent decades. Historically, TNR has been conducted most often at a grassroots level, which has led to inconsistent data collection and assessment practices. Consequently, a paucity of analyzable data exists. An initiative is underway to standardize TNR program data collection and assessment. However, it could be some time before scientifically sound protocols are implemented on a broad scale. In the interim, sets of data collected by nascent citizen scientists offer valid opportunities to evaluate grassroots TNR programs. The purpose of the present study was to examine the effectiveness of a TNR program conducted by a citizen scientist located in Chicago, Illinois, where a county law permitting TNR was enacted in 2007. Colony populations, when grouped by the number of years enrolled in the program, declined by a mean of 54% from entry and 82% from peak levels. Results from coexistent TNR programs in the Chicago area are consistent with these findings.

A PROJECTION OF URBAN GROWTH IN ATLANTA, GEORGIA

EPA Science Inventory

The U. S. Environmental Protection Agency's Regional Vulnerability Assessment Program(ReVA) is designed to develop and demonstrate approaches to identify the ecosystems at the greatest risk from regional population growth and economic activity. As part of this program, a cellular...

A comparative assessment of major international disasters: the need for exposure assessment, systematic emergency preparedness, and lifetime health care.

PubMed

Lucchini, Roberto G; Hashim, Dana; Acquilla, Sushma; Basanets, Angela; Bertazzi, Pier Alberto; Bushmanov, Andrey; Crane, Michael; Harrison, Denise J; Holden, William; Landrigan, Philip J; Luft, Benjamin J; Mocarelli, Paolo; Mazitova, Nailya; Melius, James; Moline, Jacqueline M; Mori, Koji; Prezant, David; Reibman, Joan; Reissman, Dori B; Stazharau, Alexander; Takahashi, Ken; Udasin, Iris G; Todd, Andrew C

2017-01-07

The disasters at Seveso, Three Mile Island, Bhopal, Chernobyl, the World Trade Center (WTC) and Fukushima had historic health and economic sequelae for large populations of workers, responders and community members. Comparative data from these events were collected to derive indications for future preparedness. Information from the primary sources and a literature review addressed: i) exposure assessment; ii) exposed populations; iii) health surveillance; iv) follow-up and research outputs; v) observed physical and mental health effects; vi) treatment and benefits; and vii) outreach activities. Exposure assessment was conducted in Seveso, Chernobyl and Fukushima, although none benefited from a timely or systematic strategy, yielding immediate and sequential measurements after the disaster. Identification of exposed subjects was overall underestimated. Health surveillance, treatment and follow-up research were implemented in Seveso, Chernobyl, Fukushima, and at the WTC, mostly focusing on the workers and responders, and to a lesser extent on residents. Exposure-related physical and mental health consequences were identified, indicating the need for a long-term health care of the affected populations. Fukushima has generated the largest scientific output so far, followed by the WTCHP and Chernobyl. Benefits programs and active outreach figured prominently in only the WTC Health Program. The analysis of these programs yielded the following lessons: 1) Know who was there; 2) Have public health input to the disaster response; 3) Collect health and needs data rapidly; 4) Take care of the affected; 5) Emergency preparedness; 6) Data driven, needs assessment, advocacy. Given the long-lasting health consequences of natural and man-made disasters, health surveillance and treatment programs are critical for management of health conditions, and emergency preparedness plans are needed to prevent or minimize the impact of future threats.

DEVELOPMENT OF TOOLS TO ASSESS THE EFFECTS OF INDIVIDUAL, POPULATION, AND SPATIAL LEVELS: INTEGRATED ASSESSMENT OF MULTIPLE STRESSORS ON PISCIVOROUS BIRDS

EPA Science Inventory

The goal of the US Environmental Protection Agency's National Health and Environmental Research Laboratory's Wildlife Risk Assessment program is to develop scientifically valid methods to assess risks to wildlife and aquatic organisms from multiple stressors. To this end, the Loo...

Pregnant Employee Protection Program in a Large Chemical Company.

PubMed

Frey, Gunild; Schuster, Michael; Oberlinner, Christoph; Queier-Wahrendorf, Annette; Lang, Stefan; Yong, Mei

2015-09-01

To assess whether a structured employee protection program for pregnant workers at a chemical company has an impact on pregnancy outcomes. Reported pregnancies (n = 1402) between 2003 and 2010 and their outcomes were documented using questionnaires at the time of pregnancy report, end of pregnancy, and 1 year later. Potential maternal exposures were assessed using job histories, workplace inspections, and questionnaires. Participation was 86% overall and was consistently high across subgroups.Pregnancy losses (10.9%), pregnancy complications, and preterm births (8.1%) were in agreement with rates in the general population and were independent of type of work and maternal exposure category. Pregnancy complication rates in this chemical company are not statistically elevated than that in the general population, as suggested in a previous study. The protection program may play a role in preventing complications that may have occurred.

The need for health impact assessment in China: Potential benefits for public health and steps forward

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

Wu Liming, E-mail: lmwu@scdc.sh.c; Center for Environment and Population Health, Griffith University, Nathan 4111; Rutherford, Shannon

2011-07-15

Health impact assessment (HIA) is a useful tool to predict and estimate the potential health impact associated with programs, projects, and policies by comprehensively identifying relevant health determinants and their consequences. China is undergoing massive and rapid socio-economic changes leading to environment and population health challenges such as a large increase in non-communicable diseases, the emergence and re-emergence of infectious diseases, new health risks associated with environmental pollutants and escalating health inequality. These health issues are affected by multiple determinants which can be influenced by planned policies, programs, and projects. This paper discusses the needs for health impact assessment inmore » China in order to minimize the negative health consequences from projects, programs and policies associated with rapid social and economic development. It first describes the scope of China's current impact assessment system and points out its inadequacy in meeting the requirements of population health protection and promotion. It then analyses the potential use of HIA and why China needs to develop and apply HIA as a tool to identify potential health impacts of proposed programs, projects and policies so as to influence decision-making early in the planning process. Thus, the paper recommends the development of HIA as a useful tool in China to enhance decision-making for the protection and promotion of population health. For this to happen, the paper outlines steps necessary for the establishment and successful implementation of HIA in China: beginning with the establishment of a HIA framework, followed by workforce capacity building, methodology design, and intersectoral collaboration and stakeholder engagement.« less

Making better use of the policies and funding we already have.

PubMed

Baxter, Raymond J

2010-09-01

The potential for population health reform could be enhanced by assessing whether we have made the most of policies and resources already available. Opportunities to promote population health independent of major changes in resources or public authority include the following: enforcing laws already in effect; clarifying and updating the application of long-standing policies; leveraging government's and the private sector's purchasing and investment clout; facilitating access to programs by everyone who is eligible for them; evaluating the effectiveness of population health programs, agencies, and policies; and intervening to stop agencies and policies from operating at cross-purposes.

MCE Field Study Project.

ERIC Educational Resources Information Center

Taber, Florence M.

The effectiveness of six microcomputer programs designed for the secondary to adult population to teach concepts associated with daily living skills (vocations, elementary budgeting, money management assessment, banking, and home safety) was studied. These programs were field tested in special education classrooms in three different school…

Population ecology of the sea lamprey (Petromyzon marinus) as an invasive species in the Laurentian Great Lakes and an imperiled species in Europe

USGS Publications Warehouse

Hansen, Michael J.; Madenjian, Charles P.; Slade, Jeffrey W.; Steeves, Todd B.; Almeida, Pedro R.; Quintella, Bernardo R.

2016-01-01

The sea lamprey Petromyzon marinus (Linnaeus) is both an invasive non-native species in the Laurentian Great Lakes of North America and an imperiled species in much of its native range in North America and Europe. To compare and contrast how understanding of population ecology is useful for control programs in the Great Lakes and restoration programs in Europe, we review current understanding of the population ecology of the sea lamprey in its native and introduced range. Some attributes of sea lamprey population ecology are particularly useful for both control programs in the Great Lakes and restoration programs in the native range. First, traps within fish ladders are beneficial for removing sea lampreys in Great Lakes streams and passing sea lampreys in the native range. Second, attractants and repellants are suitable for luring sea lampreys into traps for control in the Great Lakes and guiding sea lamprey passage for conservation in the native range. Third, assessment methods used for targeting sea lamprey control in the Great Lakes are useful for targeting habitat protection in the native range. Last, assessment methods used to quantify numbers of all life stages of sea lampreys would be appropriate for measuring success of control in the Great Lakes and success of conservation in the native range.

Assessing the Impact of Pilot School Snack Programs on Milk and Alternatives Intake in 2 Remote First Nation Communities in Northern Ontario, Canada

ERIC Educational Resources Information Center

Gates, Michelle; Hanning, Rhona M.; Gates, Allison; McCarthy, Daniel D.; Tsuji, Leonard J. S.

2013-01-01

Background: Canadian Aboriginal youth have poorer diet quality and higher rates of overweight and obesity than the general population. This research aimed to assess the impact of simple food provision programs on the intakes of milk and alternatives among youth in Kashechewan and Attawapiskat First Nations (FNs), Ontario, Canada. Methods: A pilot…

Enhancing the role of case managers with specialty populations: development and evaluation of a palliative care education program.

PubMed

Howell, Doris; Prestwich, Catherine; Laughlin, Emmy; Giga, Nasreen

2004-01-01

Palliative home care is an important component of the care system for patients at the end of life and case management is considered an essential element of the Canadian home care system. Case managers play a critical role in allocating resources, thus influencing the costs and the viability of palliative home care. Case management education programs focused on care coordination with specialty palliative care populations are nonexistent. An education program targeted at improving the knowledge and skills of case managers in allocating resources to palliative care populations was developed and pilot-tested in a metropolitan Canadian city home care program. Core curriculum was based on an initial learning needs assessment and used case-based problem solving to enhance case-management skills. An improvement in knowledge was noted on posttests and case managers described increased comfort and confidence in their role as case managers to this patient population. Home care organizations caring for palliative care populations must ensure case managers are prepared for case management roles with specialty populations if the home is to be rendered an appropriate and viable care setting for patients at the end of life.

Impact of a comprehensive population health management program on health care costs.

PubMed

Grossmeier, Jessica; Seaverson, Erin L D; Mangen, David J; Wright, Steven; Dalal, Karl; Phalen, Chris; Gold, Daniel B

2013-06-01

Assess the influence of participation in a population health management (PHM) program on health care costs. A quasi-experimental study relied on logistic and ordinary least squares regression models to compare the costs of program participants with those of nonparticipants, while controlling for differences in health care costs and utilization, demographics, and health status. Propensity score models were developed and analyses were weighted by inverse propensity scores to control for selection bias. Study models yielded an estimated savings of $60.65 per wellness participant per month and $214.66 per disease management participant per month. Program savings were combined to yield an integrated return-on-investment of $3 in savings for every dollar invested. A PHM program yielded a positive return on investment after 2 years of wellness program and 1 year of integrated disease management program launch.

EXAMINING REGIONAL LAND USE CHANGE: THE COMMUNITY GROWTH MODEL (CGM)

EPA Science Inventory

The U. S. Environmental Protection Agency's Regional Vulnerability Assessment
Program (ReV A) is designed to develop and demonstrate approaches to identify the ecosystems at the greatest risk from regional population growth and economic activity.
As part of this program, ...

Assessing the Needs and Resources for North Carolina's Smart Start Population.

ERIC Educational Resources Information Center

North Carolina Child Advocacy Inst., Raleigh.

This report is the inaugural edition of a triennial profile of the condition of North Carolina's youngest population (age birth through 5 years), the target population for the state's "Smart Start" program. Part 1 of the report details the needs of young children in the state by means of state and county-by-county data. Part 2 presents…

The Draw to Florida Community Colleges from Florida's "College-Age" Population by Program Areas.

ERIC Educational Resources Information Center

Baldwin, Anne

This information capsule presents an overview of the enrollments in the 28 Florida community colleges in comparison to the college-age population in the related counties. The purpose of the report is to determine: (1) the degree of market penetration or percent draw of the "college-age" population; (2) assess the effects of Vocational…

Service quality assessment of workers compensation health care delivery programs in New York using SERVQUAL.

PubMed

Arunasalam, Mark; Paulson, Albert; Wallace, William

2003-01-01

Preferred provider organizations (PPOs) provide healthcare services to an expanding proportion of the U.S. population. This paper presents a programmatic assessment of service quality in the workers' compensation environment using two different models: the PPO program model and the fee-for-service (FFS) payor model. The methodology used here will augment currently available research in workers' compensation, which has been lacking in measuring service quality determinants and assessing programmatic success/failure of managed care type programs. Results indicated that the SERVQUAL tool provided a reliable and valid clinical quality assessment tool that ascertained that PPO marketers should focus on promoting physician outreach (to show empathy) and accessibility (to show reliability) for injured workers.

Assessing power of large river fish monitoring programs to detect population changes: the Missouri River sturgeon example

USGS Publications Warehouse

Wildhaber, M.L.; Holan, S.H.; Bryan, J.L.; Gladish, D.W.; Ellersieck, M.

2011-01-01

In 2003, the US Army Corps of Engineers initiated the Pallid Sturgeon Population Assessment Program (PSPAP) to monitor pallid sturgeon and the fish community of the Missouri River. The power analysis of PSPAP presented here was conducted to guide sampling design and effort decisions. The PSPAP sampling design has a nested structure with multiple gear subsamples within a river bend. Power analyses were based on a normal linear mixed model, using a mixed cell means approach, with variance estimates from the original data. It was found that, at current effort levels, at least 20 years for pallid and 10 years for shovelnose sturgeon is needed to detect a 5% annual decline. Modified bootstrap simulations suggest power estimates from the original data are conservative due to excessive zero fish counts. In general, the approach presented is applicable to a wide array of animal monitoring programs.

Progress in NTHMP Hazard Assessment

USGS Publications Warehouse

Gonzalez, F.I.; Titov, V.V.; Mofjeld, H.O.; Venturato, A.J.; Simmons, R.S.; Hansen, R.; Combellick, Rodney; Eisner, R.K.; Hoirup, D.F.; Yanagi, B.S.; Yong, S.; Darienzo, M.; Priest, G.R.; Crawford, G.L.; Walsh, T.J.

2005-01-01

The Hazard Assessment component of the U.S. National Tsunami Hazard Mitigation Program has completed 22 modeling efforts covering 113 coastal communities with an estimated population of 1.2 million residents that are at risk. Twenty-three evacuation maps have also been completed. Important improvements in organizational structure have been made with the addition of two State geotechnical agency representatives to Steering Group membership, and progress has been made on other improvements suggested by program reviewers. ?? Springer 2005.

Design to monitor trend in abundance and presence of American beaver (Castor canadensis) at the national forest scale.

PubMed

Beck, Jeffrey L; Dauwalter, Daniel C; Gerow, Kenneth G; Hayward, Gregory D

2010-05-01

Wildlife conservationists design monitoring programs to assess population dynamics, project future population states, and evaluate the impacts of management actions on populations. Because agency mandates and conservation laws call for monitoring data to elicit management responses, it is imperative to design programs that match the administrative scale for which management decisions are made. We describe a program to monitor population trends in American beaver (Castor canadensis) on the US Department of Agriculture, Black Hills National Forest (BHNF) in southwestern South Dakota and northeastern Wyoming, USA. Beaver have been designated as a management indicator species on the BHNF because of their association with riparian and aquatic habitats and its status as a keystone species. We designed our program to monitor the density of beaver food caches (abundance) within sampling units with beaver and the proportion of sampling units with beavers present at the scale of a national forest. We designated watersheds as sampling units in a stratified random sampling design that we developed based on habitat modeling results. Habitat modeling indicated that the most suitable beaver habitat was near perennial water, near aspen (Populus tremuloides) and willow (Salix spp.), and in low gradient streams at lower elevations. Results from the initial monitoring period in October 2007 allowed us to assess costs and logistical considerations, validate our habitat model, and conduct power analyses to assess whether our sampling design could detect the level of declines in beaver stated in the monitoring objectives. Beaver food caches were located in 20 of 52 sampled watersheds. Monitoring 20 to 25 watersheds with beaver should provide sufficient power to detect 15-40% declines in the beaver food cache index as well as a twofold decline in the odds of beaver being present in watersheds. Indices of abundance, such as the beaver food cache index, provide a practical measure of population status to conduct long-term monitoring across broad landscapes such as national forests.

Teplice Program--The Impact of Air Pollution on Human Health

EPA Science Inventory

The aim of the Teplice Program is to investigate and assess the impact of air pollution on the health of the population in the district of Teplice, Czech Republic. Characterization of the air pollutants demonstrated unusually high concentrations during winter inversions of fine p...

Assessment of programs that encourage students from diverse populations to consider transportation careers.

DOT National Transportation Integrated Search

2010-03-01

The primary purpose of this study was to assess the attitudes, experiences, and awareness level of : students exposed to a specialized transportation curriculum and to track the progress of participants in a : series of summer transportation institut...

Small-scale monitoring - can it be integrated with large-scale programs?

Treesearch

C. M. Downes; J. Bart; B. T. Collins; B. Craig; B. Dale; E. H. Dunn; C. M. Francis; S. Woodley; P. Zorn

2005-01-01

There are dozens of programs and methodologies for monitoring and inventory of bird populations, differing in geographic scope, species focus, field methods and purpose. However, most of the emphasis has been placed on large-scale monitoring programs. People interested in assessing bird numbers and long-term trends in small geographic areas such as a local birding area...

Smoking Behaviors Among Urban and Rural Pregnant Women Enrolled in the Kansas WIC Program.

PubMed

Jacobson, Lisette T; Dong, Frank; Scheuermann, Taneisha S; Redmond, Michelle L; Collins, Tracie C

2015-10-01

Smoking during pregnancy is associated with poor birth outcomes. The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) is a public nutritional assistance program for low-income pregnant women and their children up to age five. This study examined differences in smoking behavior among women enrolled in the Kansas WIC program. A secondary analysis was conducted using the Pregnancy Nutrition Surveillance System dataset of enrolled women between 2005 and 2011. Geographic residency status was obtained through application of the Census tract-based rural-urban commuting area codes. Chi square tests of association were used to assess differences. Multi-variable binary logistic regression was used to assess maternal characteristics and smoking 3 months prior to pregnancy. Total sample size averaged 21,650 women for years 2005 through 2011. Low-income, rural pregnant women smoked at significantly higher rates before, during, and after pregnancy. High smoking rates have remained unchanged since 2008. The following characteristics were associated with reduced odds of smoking 3 months prior to pregnancy: being 17 years old or younger, Hispanic, a high school graduate, urban location, normal body mass index, no live births prior to current pregnancy, and using multi-vitamins. Results from this study indicate that the WIC population in rural areas may have different needs regarding smoking cessation programming than the urban WIC population. Findings help inform WIC program administrators and assist in enhancing current smoking cessation services to the Kansas WIC population.

Domestic violence in the Arab American population: transforming environmental conditions through community education.

PubMed

Kulwicki, A D; Miller, J

1999-01-01

The purpose of this research was to assess and provide community interventions for victims of domestic violence in the Arab American immigrant population in a large midwestern city of the United States. The theoretical framework of critical social theory provided the context for the research. A survey tool for assessing domestic violence was administered in the homes of 202 Arab American immigrants, followed by open discussion with the Arabic data collector. Findings from the research were used to develop and implement specific community education programs and clinic resources for the local immigrant population.

Health and Reproductive Assessment of Selected Puerto Rican Parrots ( Amazona vittata ) in Captivity.

PubMed

Clubb, Susan; Velez, Jafet; Garner, Michael M; Zaias, Julia; Cray, Carolyn

2015-12-01

The Puerto Rican parrot ( Amazona vittata ) has become an iconic and high-profile conservation species. The cornerstone of the recovery plan for this critically endangered species is an active captive breeding program, management of the wild population, and a long-term reintroduction program. In 2002, 40 adult Puerto Rican parrots that had not produced viable offspring were selected for reproductive assessment at 2 aviary populations in Puerto Rico (Iguaca and Río Abajo), which are the only sources of parrots for release. The goal was to enhance reproductive potential and produce productive pairings in an attempt to augment the population growth and provide ample individuals for reintroduction. Seven Hispanolian Amazon parrots ( Amazona ventralis ) that were used as surrogate parents for the Puerto Rican parrots were also included in the study. This assessment included physical examination, endoscopic evaluation, hematologic and plasma biochemical profiles, viral screening, and hormonal assays. Results of general physical examination and hematologic and plasma biochemical testing revealed overall good health and condition of this subset of the population of Puerto Rican parrots; no major infectious diseases were found. Endoscopic examination also revealed overall good health and condition, especially of females. The apparent low fertility of male birds warrants further investigation. The findings helped to define causes of reproductive failure in the selected pairs and individual birds. New pairings resulting from the assessment helped to augment reproduction of this critically endangered species.

A plan for the North American Bat Monitoring Program (NABat)

USGS Publications Warehouse

Loeb, Susan C.; Rodhouse, Thomas J.; Ellison, Laura E.; Lausen, Cori L.; Reichard, Jonathan D.; Irvine, Kathryn M.; Ingersoll, Thomas E.; Coleman, Jeremy; Thogmartin, Wayne E.; Sauer, John R.; Francis, Charles M.; Bayless, Mylea L.; Stanley, Thomas R.; Johnson, Douglas H.

2015-01-01

The purpose of the North American Bat Monitoring Program (NABat) is to create a continent-wide program to monitor bats at local to rangewide scales that will provide reliable data to promote effective conservation decisionmaking and the long-term viability of bat populations across the continent. This is an international, multiagency program. Four approaches will be used to gather monitoring data to assess changes in bat distributions and abundances: winter hibernaculum counts, maternity colony counts, mobile acoustic surveys along road transects, and acoustic surveys at stationary points. These monitoring approaches are described along with methods for identifying species recorded by acoustic detectors. Other chapters describe the sampling design, the database management system (Bat Population Database), and statistical approaches that can be used to analyze data collected through this program.

[Between Puebla and Cairo Plus Five].

PubMed

1998-03-01

The National Forum of Women and Population Policies was held in Puebla, Mexico, in January 1998 to assess achievements and lags in carrying out the Program of Action adopted at the International Conference on Population and Development in Cairo. The forum proposed diagnosing the current situation in order to compare existing realities with proposals contained in Mexico¿s National Population Program, the National Reproductive Health and Family Planning Program, and the Mexican program of the UN Population Fund. The lack of disaggregated information and of research, except for a handful of states with particularly grave demographic and reproductive health problems, were barriers to evaluation. It also appeared indispensable to analyze the situations of the nongovernmental organizations involved, and to define priorities among remaining tasks. Two achievements of the forum in Puebla were to reconstitute a coordinating body for follow-up of the Program of Action with a specific work plan, and to reinforce links and communication with state population councils and health institutions in order to facilitate implementation of the Program of Action. Among the 53 organizations represented at the Puebla Forum, 66% were involved in actions to fight poverty and 90% in actions to increase autonomy of women. 74% had ties to government agencies. The themes receiving most attention were sexuality and family planning, pregnancy and delivery, and HIV and other sexually transmitted diseases.

Study Abroad Program Design, Personal Development and Intercultural Effectiveness

ERIC Educational Resources Information Center

Wiedenhoeft, Margaret Davis

2011-01-01

Research on study abroad focuses on the development of learning outcomes and assessment (Bolen, 2007) or program design, such as level of integration with local student population, housing situation, and level of interaction with host culture (Brecht & Robinson, 1993; Engle & Engle, 2004; Georgetown Consortium Research Project, n.d.;…

The effect of the AED and AED programs on survival of individuals, groups and populations.

PubMed

Stokes, Nathan Allen; Scapigliati, Andrea; Trammell, Antoine R; Parish, David C

2012-10-01

The automated external defibrillator (AED) is a tool that contributes to survival with mixed outcomes. This review assesses the effectiveness of the AED, consistencies and variations among studies, and how varying outcomes can be resolved. A worksheet for the International Liaison Committee on Resuscitation (ILCOR) 2010 science review focused on hospital survival in AED programs was the foundation of the articles reviewed. Articles identified in the search covering a broader range of topics were added. All articles were read by at least two authors; consensus discussions resolved differences. AED use developed sequentially. Use of AEDs by emergency medical technicians (EMTs) compared to manual defibrillators showed equal or superior survival. AED use was extended to trained responders likely to be near victims, such as fire/rescue, police, airline attendants, and casino security guards, with improvement in all venues but not all programs. Broad public access initiatives demonstrated increased survival despite low rates of AED use. Home AED programs have not improved survival; in-hospital trials have had mixed results. Successful programs have placed devices in high-risk sites, maintained the AEDs, recruited a team with a duty to respond, and conducted ongoing assessment of the program. The AED can affect survival among patients with sudden ventricular fibrillation (VF). Components of AED programs that affect outcome include the operator, location, the emergency response system, ongoing maintenance and evaluation. Comparing outcomes is complicated by variations in definitions of populations and variables. The effect of AEDs on individuals can be dramatic, but the effect on populations is limited.

Applying RE-AIM to the evaluation of FUEL Your Life : a worksite translation of DPP.

PubMed

Brace, Andrea M; Padilla, Heather M; DeJoy, David M; Wilson, Mark G; Vandenberg, Robert J; Davis, Marsha

2015-01-01

Weight management programs are becoming increasingly common in workplace settings; however, few target middle-aged men. The purpose of this article is to describe the process evaluation of a worksite translation of the Diabetes Prevention Program in a predominantly middle-aged male population. The translated program, FUEL Your Life, was largely self-directed, with support from peer health coaches and occupational health nurses. The RE-AIM (Reach Effectiveness Adoption Implementation Maintenance) framework was used to examine the factors that influenced program implementation using data from an environmental assessment, participant surveys, peer health coach surveys, and occupational health nurse interviews. An overwhelming majority of the employees who enrolled in the study were overweight or obese (92%). Overall, the program was effective for weight maintenance; those with higher levels of participation and engagement had better weight loss outcomes. The peer health coach and family elements of the intervention were underused. The program was successful in reaching the intended population; however, the program had limited success in engaging this population. Not surprisingly, weight loss was a function of participant engagement and participation. Increasing participant engagement and participation is important to the success of weight management interventions translated to the worksite setting. Garnering buy-in and support from management can serve to increase the perceived importance of weight management in worksites. With management support, weight management protocols could be integrated as a component of the mandatory safety and health assessments already in place, fostering promotion of healthy weight in the workforce. © 2014 Society for Public Health Education.

Challenges and solutions in the evaluation of a low back pain disease management program.

PubMed

Kotsos, Thomas; Muldowney, Kevin; Chapa, Griselda; Martin, J Eric; Linares, Antonio

2009-02-01

This paper examines a novel approach to evaluating a nurse-run telephonic low back pain (LBP) disease management (DM) program offered by a fully-insured commercial health plan population with approximately 150,000 members located in the northeastern United States. Members with at least 6 member months of eligibility were identified to have LBP using administrative claims and eligibility data. The LBP program relies on telephonic nurse management augmented by printed materials, adapting and advocating HEDIS imaging guidelines, and drug utilization review. Outcomes of this LBP DM program were assessed using a pre-post population-based approach as recommended in the DMAA Outcomes Guidelines Report. Baseline year and program year populations were segmented into 5 LBP clinical categories and each was weight adjusted using population size. LBP-related medical service utilization and pharmacy utilization also were evaluated. Individuals under active LBP management exhibited a decrease in LBP-related imaging and surgeries. Overall analgesic use also decreased. These data suggest the LBP DM program is associated with a decrease in imaging, surgeries, and analgesic use. The magnitude of the clinically segmented weight-adjusted return on investment (ROI) was lower than the unadjusted ROI, but was directionally positive indicating program impact. This adjustment is necessary in order to gain insight into and consistency of the results of a comprehensive LBP DM program evaluation.

Students with learning disabilities and hearing impairment: issues for the secondary and postsecondary teacher.

PubMed

Roth, V

1991-01-01

Although the number of students with both learning disability and hearing impairment (LDHI) currently enrolled in secondary and postsecondary programs has not been precisely determined, it is clear that these students are currently receiving inadequate assessment and support in many institutions. The best route for serving these students would seem to be collaborative efforts between deaf educators and learning disabilities specialists, yet serious gaps exist between these two professions in regard to interpretation of laws governing special services, training of professionals, and locations of educational programs. The difficulties of developing collaborative work have been compounded by controversies within each field and the heterogeneity of the populations served by both disciplines. Those interested in creating good LDHI assessments should begin by considering the qualifications needed by those conducting evaluation procedures. The inadequacies of current formal assessment devices for this population need to be recognized; informal procedures, such as teacher observation and curriculum-based assessments, are still some of the best tools available for identification and educational planning.

The development of a fear of falling interdisciplinary intervention program

PubMed Central

Gomez, Fernando; Curcio, Carmen-Lucia

2007-01-01

Objective: To describe the development process of a protocol for a fear of falling interdisciplinary intervention program based on the main factors associated with fear of falling. Design/methods: The process of developing a protocol consisted of defining the target population, selecting the initial assessment components, adapting the intervention program based on findings about fear of falling and restriction of activities in this population. Settings: University-affiliated outpatient vertigo, dizziness and falls clinic in coffee-growers zone of Colombian Andes Mountains. Results: An intervention program was developed based on three main falling conceptual models. A medical intervention, based on a biomedical and pathophysiological model, a physiotherapeutic intervention based on a postural control model and a psychological intervention based on a biological-behavioral model. Conclusion: This interdisciplinary fear of falling intervention program developed is based on particular characteristics of target population, with differences in the inclusion criteria and the program intervention components; with emphasis on medical (recurrent falls and dizziness evaluation and management), psychological (cognitive-behavioral therapy) and physiotherapeutic (balance and transfers training) components. PMID:18225468

Targeted Ovarian Cancer Education for Hispanic Women: A Pilot Program in Arizona.

PubMed

Schlumbrecht, Matthew; Yarian, Ranay; Salmon, Kristine; Niven, Christine; Singh, Diljeet

2016-06-01

In disadvantaged populations, including Hispanics, there is a deficit in understanding of cancer risk factors, symptoms, prevention, and treatment. The objective of this study was to assess ovarian cancer knowledge in a population of Hispanic women in Arizona, identify deficiencies, and to evaluate the utility of an educational program developed specifically for this community's needs. A de novo questionnaire about ovarian cancer was distributed to Hispanic women enrolled in family literacy programs at Mesa Public Schools. Following this assessment, a video educational program was developed, with emphasis on areas of greatest knowledge deficits, and post-intervention assessment administered. Chi square, Wilcoxon rank sum, and Kruskal-Wallis tests were used for analysis. 167 questionnaires were completed in the pretest group and 102 in the post-intervention group. Between groups, there were no differences in age (p = 0.49), education (p = 0.68), or annual income (p = 0.26). In the pretest group, 45 % of questions were answered correctly versus 84 % in the post-test group (p < 0.01). 24.2 % of the initial respondents correctly identified ovarian cancer symptoms versus 85.6 of post-test respondents (p < 0.01). With the program, there was an increase in the number of correct post-test responses for each question and symptom (p < 0.01), except those about hereditary risk of ovarian cancer (p = 0.62) and pelvic anatomy (p = 0.16). Following identification of an ovarian cancer knowledge deficit in this cohort of Hispanic women, an educational tool targeting specific deficiencies successfully increased cancer knowledge and awareness of symptoms. Similar efforts in this and other minority populations should be continued.

Guidelines for Participation and Testing Accommodations for Special Populations in State Assessment Programs

ERIC Educational Resources Information Center

Bergeson, Terry; Heuschel, Mary Alice; Hall, Greg; Willhoft, Joe

2005-01-01

This publication is designed to assist administrators, teachers, parents, and students in making decisions regarding participation and testing accommodations for special populations in statewide testing in Washington. The intent of Washington's Education Reform Act of 1993 is to increase student achievement by developing a public school system…

Influence of limiting and regulating factors on populations of Asian citrus psyllid and the risk of insect and disease outbreaks

USDA-ARS?s Scientific Manuscript database

Data from long term monitoring programs in two Florida citrus groves were used to assess Asian citrus psyllid demography and population ecology, which is needed to implement more effective management strategies for huanglongbing. We describe and interpret seasonal patterns and correlations between A...

RESIDUES AND METABOLITES OF SELECTED PERSISTENT HALOGENATED HYDROCARBONS IN BLOOD SPECIMENS FROM A GENERAL POPULATION SURVEY

EPA Science Inventory

The National Center for Health Statistics collaborated with the National Human Monitoring Program of the U.S. Environmental Protection Agency (EPA) in a four-year study to assess the exposure of the general population to selected pesticides through analysis of blood serum and uri...

HIV/AIDS Prevention among the Male Population: Results of a Peer Education Program for Taxicab and Tricycle Drivers in the Philippines

ERIC Educational Resources Information Center

Morisky, Donald E.; Nguyen, Chrystene; Ang, Alfonso; Tiglao, Teodora V.

2005-01-01

This study assesses the results of a 2-year community-based peer education program aimed at increasing HIV/AIDS knowledge, attitudes toward condoms, and condom use behavior among taxicab and tricycle drivers in the Philippines. Pretest, posttest, and follow-up data were collected throughout the educational intervention program. The results of the…

Analyzing best practices in employee health management: how age, sex, and program components relate to employee engagement and health outcomes.

PubMed

Terry, Paul E; Grossmeier, Jessica; Mangen, David J; Gingerich, Stefan B

2013-04-01

Examine the influence of employee health management (EHM) best practices on registration, participation, and health behavior change in telephone-based coaching programs. Individual health assessment data, EHM program data, and health coaching participation data were analyzed for associations with coaching program enrollment, active participation, and risk reduction. Multivariate analyses occurred at the individual (n = 205,672) and company levels (n = 55). Considerable differences were found in how age and sex impacted typical EHM evaluation metrics. Cash incentives for the health assessment were associated with more risk reduction for men than for women. Providing either a noncash or a benefits-integrated incentive for completing the health assessment, or a noncash incentive for lifestyle management, strengthened the relationship between age and risk reduction. In EHM programs, one size does not fit all. These results can help employers tailor engagement strategies for their specific population.

Evaluation of a Cultural Competence Assessment for Preservice Teachers

ERIC Educational Resources Information Center

Bustamante, Rebecca M.; Skidmore, Susan T.; Nelson, Judith A.; Jones, Brandolyn E.

2016-01-01

Globally, public schools enroll culturally and linguistically diverse student populations and teacher preparation programs must assess the cultural competence of preservice teachers. Yet, few adequately tested measures of teacher cultural competence are available. In this research study, a sample of 396 preservice teachers were surveyed to…

ASSESSING ENDOCRINE-DISRUPTING CHEMICAL EXPOSURE IN INDIGENOUS AQUATIC POPULATIONS IN THE OHIO RIVER

EPA Science Inventory

The NERL has launched a collaborative study with the ORSANCO to determine the degree of ecologically relevant endocrine-disrupting chemical (EDC) exposure in the New Cumberland Pool of the Ohio River under the Environmental Monitoring and Assessment Program - Great Rivers Project...

Interpretation of the Ecological Significance of Atrazine Stream-Water Concentrations Using a Statistically-Designed Monitoring Program

EPA Science Inventory

A risk assessment was conducted by the US Environmental Protection Agency (EPA) as part of the 2003 Interim Registration Eligibility Document (IRED) on atrazine. The assessment indicated potential community- and population-level risk to sensitive aquatic ecosystems at prolonged ...

Inclusion of disability-related content in nurse practitioner curricula.

PubMed

Smeltzer, Suzanne C; Blunt, Elizabeth; Marozsan, Heather; Wetzel-Effinger, Lisa

2015-04-01

To examine the integration of disability-content in a national sample of nurse practitioner curricula. Responses of National Organization of Nurse Practitioner Faculties (NONPF) members to an online 34-item survey designed to assess disability-related content included in nurse practitioner (NP) curricula; populations of people with disabilities addressed; models of disability; and resources used to teach about disability, facilitators and barriers to inclusion of disability, and respondents' assessment of the adequacy of coverage of disability in their programs. A survey used previously to assess integration of disability content in undergraduate nursing programs was modified to make it relevant to NP curricula. Nursing faculty and people with disability validated the survey to ensure its completeness and sensitivity to the disability community. Participating programs represent 111 (33.6%) NP programs. Lack of disability-related content reported by NP faculty in the majority of programs suggests that there is considerable room for improvement in efforts to address this often vulnerable population. Because people with disabilities can be found in any setting where health care is provided, all NPs need to be prepared to care for people with disabilities across the life span. Strategies need to be developed and implemented to increase the awareness of NP faculty about the health issues of people with disabilities and integration of disability-related content without disrupting existing overloaded NP curricula. © 2014 American Association of Nurse Practitioners.

Fall risk and prevention needs assessment in an older adult Latino population: a model community global health partnership.

PubMed

Hanlin, Erin R; Delgado-Rendón, Angélica; Lerner, E Brooke; Hargarten, Stephen; Farías, René

2013-01-01

The impact of falls in older adults presents a significant public health burden. Fall risk is not well-described in Latino populations nor have fall prevention programs considered the needs of this population. The objectives of this study were to develop a needs assessment of falls in older adult Latinos at a community center (CC), determine fall prevention barriers and strengths in this population, determine the level of interest in various fall prevention methods, and provide medical students an opportunity for participation in a culturally diverse community project. A cross-sectional survey was conducted with a convenience sample of older adult program participants. The survey was developed in collaboration with both partners. CC participants were approached by the interviewer and asked to participate. They were read the survey in their preferred language and their answers were recorded. Data were analyzed using descriptive statistics. We conducted 103 interviews. We found that 54% of participants had fallen in the last year, and of those 21% required medical care, 81% were afraid of falling again, and 66% considered themselves at risk for falling again. Of all respondents, 52% had 5 or more of the 10 surveyed risk factors for falling; 4% had no risk factors. Of all respondents, 75% were afraid of falling. Talking with health care providers and participating in an exercise class were the preferred methods of health information delivery (78% and 65%, respectively). Older adult Latinos in this selected population frequently fall and are worried about falling. Risk factors are prevalent. A fall prevention program is warranted and should include exercise classes and a connection with local primary care providers. A partnership between an academic organization and a CC is an ideal collaboration for the future development of prevention program.

Assessing International Evaluations. An Example from USAID's Democracy and Governance Program

ERIC Educational Resources Information Center

Bollen, Kenneth; Paxton, Pamela; Morishima, Rumi

2005-01-01

Each year, hundreds of millions of dollars are spent in international and bilateral aid programs to assist developing countries in expanding democratic governance. Evaluating these efforts' effectiveness is important given the vast needs of the client population. This article reviews a sample of evaluations of the United States Agency for…

United States Geological Survey, programs in Nevada

USGS Publications Warehouse

,

1995-01-01

The U.S. Geological Survey (USGS) has been collecting and interpreting natural-resources data in Nevada for more than 100 years. This long-term commitment enables planners to manage better the resources of a State noted for paradoxes. Although Nevada is one of the most sparsely populated States in the Nation, it has the fastest growing population (fig. 1). Although 90 percent of the land is rural, it is the fourth most urban State. Nevada is the most arid State and relies heavily on water resources. Historically, mining and agriculture have formed the basis of the economy; now tourism and urban development also have become important. The USGS works with more than 40 local, State, and other Federal agencies in Nevada to provide natural-resources information for immediate and long-term decisions.Subjects included in this fact sheet:Low-Level Radioactive-Waste DisposalMining and Water in the Humboldt BasinAquifer Systems in the Great BasinWater Allocation in Truckee and Carson BasinsNational Water-Quality Assessment ProgramMinerals Assessment for Land ManagementIrrigation DrainageGround-Water Movement at Nevada Test SiteOil and Gas ResourcesNational Mapping ProgramDigital Mapping and Aerial PhotographyCollection of Hydrologlc DataGeologic MappingEarthquake HazardsAssessing Mineral Resources of the SubsurfaceEarth Observation DataCooperative Programs

San Joaquin kit fox Vulpes macrotis mutica program, Camp Roberts, California

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

Not Available

Camp Roberts is a California Army National Guard Training Site located in central California. The San Joaquin kit fox, an endangered subspecies of kit fox, has been known to occur at Camp Roberts since 1960. The population of foxes began to increase in the early 1970's when use of rodenticides decreased. In 1987 the California Army National Guard contracted EG G Energy Measurements to conduct a 3-year study to assess the effects of Camp Roberts activities on the kit fox population. The major objective of the Camp Roberts Environmental Studies Program is to prepare a comprehensive Biological Assessment of themore » effects of all NGB-authorized activities (includes military training, anticipated construction projects, repair and maintenance activities, and all NGB-authorized non-military activities such as hunting and fishing programs, grazing leases, etc.) on San Joaquin kit fox. The program also provides NGB with the scientific expertise necessary to insure compliance with the Endangered Species Act. The specific objective of this report is to summarize progress and results of the Environmental Studies Program made during Fiscal Years 1989 and 1990 (FY89/90). 32 refs., 9 figs., 14 tabs.« less

Exploitation of data from breeding programs supports rapid implementation of genomic selection for key agronomic traits in perennial ryegrass.

PubMed

Pembleton, Luke W; Inch, Courtney; Baillie, Rebecca C; Drayton, Michelle C; Thakur, Preeti; Ogaji, Yvonne O; Spangenberg, German C; Forster, John W; Daetwyler, Hans D; Cogan, Noel O I

2018-06-02

Exploitation of data from a ryegrass breeding program has enabled rapid development and implementation of genomic selection for sward-based biomass yield with a twofold-to-threefold increase in genetic gain. Genomic selection, which uses genome-wide sequence polymorphism data and quantitative genetics techniques to predict plant performance, has large potential for the improvement in pasture plants. Major factors influencing the accuracy of genomic selection include the size of reference populations, trait heritability values and the genetic diversity of breeding populations. Global diversity of the important forage species perennial ryegrass is high and so would require a large reference population in order to achieve moderate accuracies of genomic selection. However, diversity of germplasm within a breeding program is likely to be lower. In addition, de novo construction and characterisation of reference populations are a logistically complex process. Consequently, historical phenotypic records for seasonal biomass yield and heading date over a 18-year period within a commercial perennial ryegrass breeding program have been accessed, and target populations have been characterised with a high-density transcriptome-based genotyping-by-sequencing assay. Ability to predict observed phenotypic performance in each successive year was assessed by using all synthetic populations from previous years as a reference population. Moderate and high accuracies were achieved for the two traits, respectively, consistent with broad-sense heritability values. The present study represents the first demonstration and validation of genomic selection for seasonal biomass yield within a diverse commercial breeding program across multiple years. These results, supported by previous simulation studies, demonstrate the ability to predict sward-based phenotypic performance early in the process of individual plant selection, so shortening the breeding cycle, increasing the rate of genetic gain and allowing rapid adoption in ryegrass improvement programs.

Does SCHIP Spell Better Dental Care Access for Children? An Early Look at New Initiatives. Occasional Paper Number 50. Assessing the New Federalism: An Urban Institute Program To Assess Changing Social Policies.

ERIC Educational Resources Information Center

Almeida, Ruth; Hill, Ian; Kenney, Genevieve

Dental disease is one of the most prevalent illnesses facing children in the United States today. Eighty percent of untreated dental disease in permanent teeth is found in roughly 25 percent of 5- to 17-year old children, most of whom come from low-income and other vulnerable populations. The State Children's Health Insurance Program (SCHIP)…

Demographic monitoring of wild muriqui populations: Criteria for defining priority areas and monitoring intensity.

PubMed

Strier, Karen B; Possamai, Carla B; Tabacow, Fernanda P; Pissinatti, Alcides; Lanna, Andre M; Rodrigues de Melo, Fabiano; Moreira, Leandro; Talebi, Maurício; Breves, Paula; Mendes, Sérgio L; Jerusalinsky, Leandro

2017-01-01

Demographic data are essential to assessments of the status of endangered species. However, establishing an integrated monitoring program to obtain useful data on contemporary and future population trends requires both the identification of priority areas and populations and realistic evaluations of the kinds of data that can be obtained under different monitoring regimes. We analyzed all known populations of a critically endangered primate, the muriqui (genus: Brachyteles) using population size, genetic uniqueness, geographic importance (including potential importance in corridor programs) and implementability scores to define monitoring priorities. Our analyses revealed nine priority populations for the northern muriqui (B. hypoxanthus) and nine for the southern muriqui (B. arachnoides). In addition, we employed knowledge of muriqui developmental and life history characteristics to define the minimum monitoring intensity needed to evaluate demographic trends along a continuum ranging from simple descriptive changes in population size to predictions of population changes derived from individual based life histories. Our study, stimulated by the Brazilian government's National Action Plan for the Conservation of Muriquis, is fundamental to meeting the conservation goals for this genus, and also provides a model for defining priorities and methods for the implementation of integrated demographic monitoring programs for other endangered and critically endangered species of primates.

Using National Coastal Assessment Data to Model Estuarine Water Quality at Large Spatial Scales.

EPA Science Inventory

The water quality of the Nation’s estuaries is attracting scrutiny in light of population growth and enhanced nutrient delivery. The USEPA has evaluated water quality in the National Coastal Assessment (NCA) and National Aquatic Resource Surveys (NARS) programs. Here we rep...

Addressing Diversity in Teacher Education Programs

ERIC Educational Resources Information Center

Valentin, Sylvia

2006-01-01

Different aspects of diversity have been explored in order to assess whether preservice teachers are being prepared to meet the needs of their diverse student population. Diversity continues to be examined in a fragmented way by looking at issues separately. It seems necessary that prior to assessing preservice teachers' competence in diversity,…

Beyond Books: Public Libraries As Partners For Population Health.

PubMed

Morgan, Anna U; Dupuis, Roxanne; D'Alonzo, Bernadette; Johnson, Andria; Graves, Amy; Brooks, Kiahana L; McClintock, Autumn; Klusaritz, Heather; Bogner, Hillary; Long, Judith A; Grande, David; Cannuscio, Carolyn C

2016-11-01

Public libraries are not usually included in discussions about improving population health. They are, however, well positioned to be partners in building a culture of health through programming that addresses the social determinants of health. The Healthy Library Initiative, a partnership between the University of Pennsylvania and the Free Library of Philadelphia (the public library system that serves the city), has undertaken such efforts in Philadelphia. In this article we report findings from an assessment of how ten highly subscribed programs address the social determinants of health, as well as results of interviews with community residents and library staff. Of the 5.8 million in-person Free Library visits in 2015, 500,000 included attendance at specialized programs that addressed multiple health determinants, such as housing and literacy. Library staff provided intensive support to vulnerable populations including homeless people, people with mental illness and substance use, recent immigrants, and children and families suffering from trauma. We found that public libraries are trusted institutions that have broad population reach and untapped potential to improve population health. Project HOPE—The People-to-People Health Foundation, Inc.

Ethnicity matters: the experiences of minority groups in public health programs.

PubMed

Pardasani, Manoj; Bandyopadhyay, Subir

2014-01-01

The minority population in the US is expected to overtake the nonHispanic Caucasian population by 2050. Compounding this demographic shift are the significant disparities between Caucasian and non Caucasian groups especially with regard to income, living standards, health and access to healthcare and vital services. Thus, healthcare and social service programs are being charged with identifying barriers and providing effective, culturally competent care to reduce these disparities in health and quality of life. But the issue of poverty and access is global and disparities affect communities worldwide. The purpose of this cross-sectional study is to assess the service concerns of 137 low-income or poor consumers receiving healthcare and social services in publicly funded facilities. Utilizing a modified cultural competence assessment tool, this study evaluates the impact of race/ethnicity on the experiences of receiving vital services and identifies factors that impact the help-seeking decisions made by consumers. Recommendations for practitioners and organizations to help promote effective models of services for a vulnerable, diverse population are provided.

Assessing genetic diversity of wild and hatchery samples of the Chinese sucker (Myxocyprinus asiaticus) by the mitochondrial DNA control region.

PubMed

Wu, Jiayun; Wu, Bo; Hou, Feixia; Chen, Yongbai; Li, Chong; Song, Zhaobin

2016-01-01

To restore the natural populations of Chinese sucker (Myxocyprinus asiaticus), a hatchery release program has been underway for nearly 10 years. Using DNA sequences of the mitochondrial control region, we assessed the genetic diversity and genetic structure among samples collected from three sites of the wild population as well as from three hatcheries. The haplotype diversity of the wild samples (h = 0.899-0.975) was significantly higher than that of the hatchery ones (h = 0.296-0.666), but the nucleotide diversity was almost identical between them (π = 0.0170-0.0280). Relatively high gene flow was detected between the hatchery and wild samples. Analysis of effective population size indicated that M. asiaticus living in the Yangtze River has been expanding following a bottleneck in the recent past. Our results suggest the hatchery release programs for M. asiaticus have not reduced the genetic diversity, but have influenced the genetic structure of the species in the upper Yangtze River.

Assessment of factors influencing retention in the Philippine National Rural Physician Deployment Program

PubMed Central

2012-01-01

Background The ‘Doctors to the Barrios’ (DTTB) Program was launched in 1993 in response to the shortage of doctors in remote communities in the Philippines. While the Program has attracted physicians to work in such areas for the prescribed 2-year period, ongoing monitoring shows that very few chose to remain there for longer and be absorbed by their Local Government Unit (LGU). This assessment was carried out to explore the reasons for the low retention rates and to propose possible strategies to reverse the trend. Methods A mixed methods approach was used comprising a self-administered questionnaire for members of the current cohort of DTTBs, and oral interviews with former DTTBs. Results Among former DTTBs, the wish to serve rural populations was the most widely cited motivation. By comparison, among the current cohort of DTTBs, more than half joined the Program due to return of service obligations; a quarter to help rural populations, and some out of an interest in public health. Those who joined the Program to return service experienced significantly less satisfaction, whilst those who joined out of an interest in public health were significantly more satisfied with their rural work. Those who graduated from medical schools in the National Capital Region were significantly more critical about their compensation and perceived there to be fewer options for leisure in rural areas. With regard to the factors impeding retention, lack of support from the LGU was most frequently mentioned, followed by concerns about changes in compensation upon absorption by the LGU, family issues and career advancement. Conclusions Through improved collaboration with the Department of Health, LGUs need to strengthen the support provided to DTTBs. Priority could be given to those acting out of a desire to help rural populations or having an interest in public health, and those who have trained outside of the National Capital Region. Whether physicians should be able to use the Program to fulfil return service obligations should be critically assessed. PMID:23167701

Serving homeless Veterans in the VA Desert Pacific Healthcare Network: A needs assessment to inform quality improvement endeavors

PubMed Central

Gabrielian, Sonya; Yuan, Anita; Rubenstein, Lisa; Andersen, Ronald M.; Gelberg, Lillian

2016-01-01

This report describes a needs assessment of VA programs for homeless Veterans in Southern California and Nevada, the geographic region with the most homeless Veterans in the nation. The assessment was formulated through key informant interviews. Current service provisions are discussed, along with salient unmet needs for this vulnerable population. PMID:23974403

Serving homeless veterans in the VA Desert Pacific Healthcare Network: a needs assessment to inform quality improvement endeavors.

PubMed

Gabrielian, Sonya; Yuan, Anita; Rubenstein, Lisa; Andersen, Ronald M; Gelberg, Lillian

2013-08-01

This report describes a needs assessment of VA programs for homeless Veterans in Southern California and Nevada, the geographic region with the most homeless Veterans in the nation. The assessment was formulated through key informant interviews. Current service provisions are discussed, along with salient unmet needs for this vulnerable population.

Predicting Performance on the Tennessee Comprehensive Assessment for Third Grade Reading Students Using Reading Curriculum Based Measures

ERIC Educational Resources Information Center

Kirkham, Scott; Lampley, James H.

2014-01-01

The purpose of this study was to investigate the relationship between three predictor variables (Fall R-CBM, Winter R-CBM, and Spring R-CBM) and the Tennessee Comprehensive Assessment Program third grade reading and language arts assessment. The population selected for this study included all third grade students from an East Tennessee school…

An Empirical Investigation of Group Treatment for a Clinical Population of Adult Female Incest Survivors.

ERIC Educational Resources Information Center

Saxe, Brenda J.; Johnson, Susan M.

1999-01-01

Empirically assesses the effectiveness of a group treatment program on intrapersonal symptomatology and interpersonal difficulties in a clinical population of women with a history of incest. Results indicate that a time-limited group, which focuses on the original trauma, is effective in reducing intrapersonal symptomatology for women with a…

Teacher Migration: Extension and Application of the Population Ecology Model to Explore Teacher Transfers in a Reform Environment

ERIC Educational Resources Information Center

Hochbein, Craig; Carpenter, Bradley

2017-01-01

This article assesses the association between the Title I School Improvement Grant (SIG) program's personnel replacement policy and teacher employment patterns within an urban school district. Hannan and Freeman's population ecology model allowed the authors to consider schools within districts as individual organizations nested within a larger…

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.

Evidence, models, conservation programs and limits to management

USGS Publications Warehouse

Nichols, J.D.

2012-01-01

Walsh et al. (2012) emphasized the importance of obtaining evidence to assess the effects of management actions on state variables relevant to objectives of conservation programs. They focused on malleefowl Leipoa ocellata, ground-dwelling Australian megapodes listed as vulnerable. They noted that although fox Vulpes vulpes baiting is the main management action used in malleefowl conservation throughout southern Australia, evidence of the effectiveness of this action is limited and currently debated. Walsh et al. (2012) then used data from 64 sites monitored for malleefowl and foxes over 23 years to assess key functional relationships relevant to fox control as a conservation action for malleefowl. In one set of analyses, Walsh et al. (2012) focused on two relationships: fox baiting investment versus fox presence, and fox presence versus malleefowl population size and rate of population change. Results led to the counterintuitive conclusion that increases in investments in fox control produced slight decreases in malleefowl population size and growth. In a second set of analyses, Walsh et al. (2012) directly assessed the relationship between investment in fox baiting and malleefowl population size and rate of population change. This set of analyses showed no significant relationship between investment in fox population control and malleefowl population growth. Both sets of analyses benefited from the incorporation of key environmental covariates hypothesized to influence these management relationships. Walsh et al. (2012) concluded that "in most situations, malleefowl conservation did not effectively benefit from fox baiting at current levels of investment." In this commentary, I discuss the work of Walsh et al. (2012) using the conceptual framework of structured decision making (SDM). In doing so, I accept their analytic results and associated conclusions as accurate and discuss basic ideas about evidence, conservation and limits to management.

[Fertility change in Mexico and the politics of population].

PubMed

Zavala De Cosio, M E

1993-01-01

This introduction to a detailed study of fertility change in Mexico assesses the available fertility data and describes the sources used, traces the beginning and course of the demographic transition in Mexico, and describes the work. Mexico's demographic transition began around 1930 with the acceleration of mortality decline. The considerable time lag between the mortality decline and the beginning of the fertility decline resulted in a period of very rapid growth. Between 1955 and 1975, the growth rate exceeded 3% annually. The start of the fertility decline dated to about 1970, the time of a major reform of population policy and creation of institutions to reduce growth. But the fertility decline was not solely the result of population programs. An incipient fertility decline could be observed in the metropolitan and more educated population sectors beginning in the early 1960s. The onset of the mortality decline in the 1930s resulted from the sustained social and economic progress made possible after the conclusion of the Mexican Revolution. Between 1930 and 1980, the adult illiteracy rate declined from 61.2% to 17%, while life expectancy increased from 33 years to 63.2 years. In Mexico as in other Latin American countries, the mortality decline, which disturbed the traditional balance between high mortality and high fertility, was the force setting off the demographic transition and the necessary precursor to fertility decline. The first of two main sections of the book focuses on examination of fertility variations in Mexico since around 1900 using cross-sectional and longitudinal methods of analysis. The second part describes the origins, history, and institutions involved in Mexico's population policies and the demographic programs and their principal results. The influence of population policies in demographic change is assessed, especially in the case of fertility changes induced by family planning programs. Both the first and second parts sought to place Mexican fertility trends in the context of the demographic transition and to observe the functioning and effects of demographic programs.

Effect of Lower Extremity Stretching Exercises on Balance in Geriatric Population.

PubMed

Reddy, Ravi Shankar; Alahmari, Khalid A

2016-07-01

The purpose of this study was to find "Effect of lower extremity stretching exercises on balance in the geriatric population. 60 subjects (30 male and 30 female) participated in the study. The subjects underwent 10 weeks of lower limb stretching exercise program. Pre and post 10 weeks stretching exercise program, the subjects were assessed for balance, using single limb stance time in seconds and berg balance score. These outcome measures were analyzed. Pre and post lower extremity stretching on balance was analyzed using paired t test. Of 60 subjects 50 subjects completed the stretching exercise program. Paired sample t test analysis showed a significant improvement in single limb stance time (eyes open and eyes closed) (p<0.001) and berg balance score (p<0.001). Lower extremity stretching exercises enhances balance in the geriatric population and thereby reduction in the number of falls.

An Innovative Approach to Improving the Accuracy of Delirium Assessments Using the Confusion Assessment Method for the Intensive Care Unit.

PubMed

DiLibero, Justin; O'Donoghue, Sharon C; DeSanto-Madeya, Susan; Felix, Janice; Ninobla, Annalyn; Woods, Allison

2016-01-01

Delirium occurs in up to 80% of intensive care unit (ICU) patients. Despite its prevalence in this population, there continues to be inaccuracies in delirium assessments. In the absence of accurate delirium assessments, delirium in critically ill ICU patients will remain unrecognized and will lead to negative clinical and organizational outcomes. The goal of this quality improvement project was to facilitate sustained improvement in the accuracy of delirium assessments among all ICU patients including those who were sedate or agitated. A pretest-posttest design was used to evaluate the effectiveness of a program to improve the accuracy of delirium screenings among patients admitted to a medical ICU or coronary care unit. Two hundred thirty-six delirium assessment audits were completed during the baseline period and 535 during the postintervention period. Compliance with performing at least 1 delirium assessment every shift was 85% at baseline and improved to 99% during the postintervention period. Baseline assessment accuracy was 70.31% among all patients and 53.49% among sedate and agitated patients. Postintervention assessment accuracy improved to 95.51% for all patients and 89.23% among sedate and agitated patients. The results from this project suggest the effectiveness of the program in improving assessment accuracy among difficult-to-assess patients. Further research is needed to demonstrate the effectiveness of this model across other critical care units, patient populations, and organizations.

Formative assessment in the development of an obesity prevention component for the expanded food and nutrition education program in Texas.

PubMed

Thompson, Debbe; Cullen, Karen Weber; Reed, Debra B; Konzelmann, Karen; Smalling, Aggie Lara

2011-01-01

This study conducted formative research (surveys, focus groups) to assess the nutrition education needs of clients in the Texas Expanded Food and Nutrition Education Program prior to curriculum revision. Participants were current Expanded Food and Nutrition Education Program participants in 3 Texas cities (Austin, Houston, San Antonio). Data were used to tailor the curriculum to the target population. This research provides evidence that members of the target audience can provide valuable insights into a particular topic. Formative work prior to intervention development should be conducted to identify key issues regarding a particular topic and to evaluate potential educational approaches.

A Social-Ecological Framework of Theory, Assessment, and Prevention of Suicide

PubMed Central

Cramer, Robert J.; Kapusta, Nestor D.

2017-01-01

The juxtaposition of increasing suicide rates with continued calls for suicide prevention efforts begs for new approaches. Grounded in the Centers for Disease Control and Prevention (CDC) framework for tackling health issues, this personal views work integrates relevant suicide risk/protective factor, assessment, and intervention/prevention literatures. Based on these components of suicide risk, we articulate a Social-Ecological Suicide Prevention Model (SESPM) which provides an integration of general and population-specific risk and protective factors. We also use this multi-level perspective to provide a structured approach to understanding current theories and intervention/prevention efforts concerning suicide. Following similar multi-level prevention efforts in interpersonal violence and Human Immunodeficiency Virus (HIV) domains, we offer recommendations for social-ecologically informed suicide prevention theory, training, research, assessment, and intervention programming. Although the SESPM calls for further empirical testing, it provides a suitable backdrop for tailoring of current prevention and intervention programs to population-specific needs. Moreover, the multi-level model shows promise to move suicide risk assessment forward (e.g., development of multi-level suicide risk algorithms or structured professional judgments instruments) to overcome current limitations in the field. Finally, we articulate a set of characteristics of social-ecologically based suicide prevention programs. These include the need to address risk and protective factors with the strongest degree of empirical support at each multi-level layer, incorporate a comprehensive program evaluation strategy, and use a variety of prevention techniques across levels of prevention. PMID:29062296

[The Study of Health in Pomerania (SHIP) reference values for cardiopulmonary exercise testing].

PubMed

Gläser, S; Ittermann, T; Schäper, C; Obst, A; Dörr, M; Spielhagen, T; Felix, S B; Völzke, H; Bollmann, T; Opitz, C F; Warnke, C; Koch, B; Ewert, R

2013-01-01

The interpretation of gas exchange measured by cardiopulmonary exercise testing (CPET) depends on reliable reference values. Within the population based Study of Health in Pomerania (SHIP) CPET was assessed in 1706 volunteers. The assessment based on symptom limited exercise tests on a bicycle in a sitting position according to a modified Jones protocol. CPET was embedded in an extensive examination program. After the exclusion of active smokers and volunteers with evidence of cardiopulmonary and musculoskeletal disorders the reference population comprised 616 healthy subjects (333 women) aged 25 to 85 years. Reference equations including upper and/or lower limits based on quantile regression were assessed. All values were corrected for the most important influencing factors.This study provides reference equations for gas exchange and exercise capacity assessed within a population in Germany. © Georg Thieme Verlag KG Stuttgart · New York.

Programmatic approaches to assessing and improving animal welfare in zoos and aquariums.

PubMed

Barber, Joseph C E

2009-11-01

There continues to be intense public, professional, and scientific focus on the welfare of animals in zoos and aquariums, but implementing welfare assessment tools consistently throughout this community remains challenging. Indirect measures can be used to assess "welfare potential"-the potential that animals will experience good welfare based on the care that they are provided with. Zoos and aquariums focus on welfare potential with their continued commitment to develop animal care guidelines (e.g. Animal Care Manuals) that can play a role within institutional accreditation or certification. The Association of Zoos and Aquariums Animal Welfare Committee has been pursuing approaches to maximize welfare potential by developing the concept of an integrated welfare approach or framework-an attempt to identify recommended animal care programs (e.g. enrichment, nutrition, veterinary care, research, and animal training programs) and their programmatic components. Objectively assessing the influence that animal care recommendations have on the welfare of individual animals is important to determine the efficacy of programmatic approaches. The future of welfare assessment within zoos and aquariums will include population-level evaluations-tracking emerging trends in health and behavior that come from both formal and informal institutional animal reports. Sharing this information, and performing meta-analyses of the data using epidemiological approaches, will become easier with advances in technology and database management software. Identifying welfare "red/green flags" throughout captive populations will provide direction for more focused assessments that will ultimately inform the design of more effective animal care programs.

Health advocacy for refugees

PubMed Central

Pottie, Kevin; Hostland, Sara

2007-01-01

PROBLEM BEING ADDRESSED Canadian family physicians serve a patient population that is increasingly diverse, both culturally and linguistically. Family medicine needs to take a leadership role in developing social accountability and cultural sensitivity among physicians. OBJECTIVE OF PROGRAM To train medical students to work with newly arriving refugees, to foster competence in handling cultural issues, to raise awareness of global health, and to engage medical students in work with underserviced populations in primary care. PROGRAM DESCRIPTION The program is composed of an Internet-based training module and a self-assessment quiz focused on global and refugee health, a workshop to increase competence in cultural matters, an experience working with at least 1 refugee family at a shelter for newly arriving refugees, family physician mentorship, and a debriefing workshop at the end of the experience. Students who complete this program are eligible for further electives at a refugee health clinic. CONCLUSION The program has been received enthusiastically by students, refugees, and family physicians. Working with refugees provides a powerful introduction to issues related to global health and competence in cultural matters. The program also provides an opportunity for medical students to work alongside family physicians and nurtures their interest in working with disadvantaged populations. PMID:18000269

Assessing the Link between Learning Assistance Programs and the Retention, Probation, and Grade Point Average of Freshman University Students

ERIC Educational Resources Information Center

Ballmer, Noelle C.

2017-01-01

As the push towards lowering attrition of university students intensifies, particularly for first-time-in-college freshmen, administrators and campus leaders are increasingly designing and implementing co-curricular programs to support this population in order to positively impact student outcomes, namely, the grade point average, student…

Follow-Up Study of Former Students of the Executive Secretarial Program. Volume XVI, No. 2.

ERIC Educational Resources Information Center

Jirak, Mary Ann; Lucas, John A.

A study was conducted at Illinois' William Rainey Harper College (WRHC) to assess the current employment experiences of students who had been enrolled in the college's Executive Secretarial Program. The study population consisted of all 232 students who completed SEC-237 (Secretarial Seminar and Internship) between fall 1976 and spring 1986, and…

Improved Processing Speed: Online Computer-Based Cognitive Training in Older Adults

ERIC Educational Resources Information Center

Simpson, Tamara; Camfield, David; Pipingas, Andrew; Macpherson, Helen; Stough, Con

2012-01-01

In an increasingly aging population, a number of adults are concerned about declines in their cognitive abilities. Online computer-based cognitive training programs have been proposed as an accessible means by which the elderly may improve their cognitive abilities; yet, more research is needed in order to assess the efficacy of these programs. In…

Assessment of Automated Analyses of Cell Migration on Flat and Nanostructured Surfaces

PubMed Central

Grădinaru, Cristian; Łopacińska, Joanna M.; Huth, Johannes; Kestler, Hans A.; Flyvbjerg, Henrik; Mølhave, Kristian

2012-01-01

Motility studies of cells often rely on computer software that analyzes time-lapse recorded movies and establishes cell trajectories fully automatically. This raises the question of reproducibility of results, since different programs could yield significantly different results of such automated analysis. The fact that the segmentation routines of such programs are often challenged by nanostructured surfaces makes the question more pertinent. Here we illustrate how it is possible to track cells on bright field microscopy images with image analysis routines implemented in an open-source cell tracking program, PACT (Program for Automated Cell Tracking). We compare the automated motility analysis of three cell tracking programs, PACT, Autozell, and TLA, using the same movies as input for all three programs. We find that different programs track overlapping, but different subsets of cells due to different segmentation methods. Unfortunately, population averages based on such different cell populations, differ significantly in some cases. Thus, results obtained with one software package are not necessarily reproducible by other software. PMID:24688640

Stanford Chronic Disease Self-Management Program in myotonic dystrophy: New opportunities for occupational therapists: Stanford Chronic Disease Self-Management Program dans la dystrophie myotonique : De nouvelles opportunités pour les ergothérapeutes.

PubMed

Raymond, Kateri; Levasseur, Mélanie; Chouinard, Maud-Christine; Mathieu, Jean; Gagnon, Cynthia

2016-06-01

Chronic disease self-management is a priority in health care. Personal and environmental barriers for populations with neuromuscular disorders might diminish the efficacy of self-management programs, although they have been shown to be an effective intervention in many populations. Owing to their occupational expertise, occupational therapists might optimize self-management program interventions. This study aimed to adapt the Stanford Chronic Disease Self-Management Program (CDSMP) for people with myotonic dystrophy type 1 (DM1) and assess its acceptability and feasibility in this population. Using an adapted version of the Stanford CDSMP, a descriptive pilot study was conducted with 10 participants (five adults with DM1 and their caregivers). A semi-structured interview and questionnaires were used. The Stanford CDSMP is acceptable and feasible for individuals with DM1. However, improvements are required, such as the involvement of occupational therapists to help foster concrete utilization of self-management strategies into day-to-day tasks using their expertise in enabling occupation. Although adaptations are needed, the Stanford CDSMP remains a relevant intervention with populations requiring the application of self-management strategies. © CAOT 2016.

Cost and detection rate of glaucoma screening with imaging devices in a primary care center

PubMed Central

Anton, Alfonso; Fallon, Monica; Cots, Francesc; Sebastian, María A; Morilla-Grasa, Antonio; Mojal, Sergi; Castells, Xavier

2017-01-01

Purpose To analyze the cost and detection rate of a screening program for detecting glaucoma with imaging devices. Materials and methods In this cross-sectional study, a glaucoma screening program was applied in a population-based sample randomly selected from a population of 23,527. Screening targeted the population at risk of glaucoma. Examinations included optic disk tomography (Heidelberg retina tomograph [HRT]), nerve fiber analysis, and tonometry. Subjects who met at least 2 of 3 endpoints (HRT outside normal limits, nerve fiber index ≥30, or tonometry ≥21 mmHg) were referred for glaucoma consultation. The currently established (“conventional”) detection method was evaluated by recording data from primary care and ophthalmic consultations in the same population. The direct costs of screening and conventional detection were calculated by adding the unit costs generated during the diagnostic process. The detection rate of new glaucoma cases was assessed. Results The screening program evaluated 414 subjects; 32 cases were referred for glaucoma consultation, 7 had glaucoma, and 10 had probable glaucoma. The current detection method assessed 677 glaucoma suspects in the population, of whom 29 were diagnosed with glaucoma or probable glaucoma. Glaucoma screening and the conventional detection method had detection rates of 4.1% and 3.1%, respectively, and the cost per case detected was 1,410 and 1,435€, respectively. The cost of screening 1 million inhabitants would be 5.1 million euros and would allow the detection of 4,715 new cases. Conclusion The proposed screening method directed at population at risk allows a detection rate of 4.1% and a cost of 1,410 per case detected. PMID:28243057

Increasing Student Ownership and Responsibility through the Collaborative Assessment Process.

ERIC Educational Resources Information Center

Branch, Myra; Grafelman, Brenda; Hurelbrink, Kurt

This report describes a program for increasing student ownership and responsibility to bring about quality work. The students were actively involved in the collaborative assessment process. The targeted population consisted of first and second grade students in a middle class community in Central Illinois. An increased sense of ownership,…

Predicting Early School Achievement with the EDI: A Longitudinal Population-Based Study

ERIC Educational Resources Information Center

Forget-Dubois, Nadine; Lemelin, Jean-Pascal; Boivin, Michel; Dionne, Ginette; Seguin, Jean R.; Vitaro, Frank; Tremblay, Richard E.

2007-01-01

School readiness tests are significant predictors of early school achievement. Measuring school readiness on a large scale would be necessary for the implementation of intervention programs at the community level. However, assessment of school readiness is costly and time consuming. This study assesses the predictive value of a school readiness…

INDICATORS OF ECOLOGICAL STRESS AND THEIR EXTENT IN THE POPULATION OF NORTHEASTERN LAKES: A REGIONAL-SCALE ASSESSMENT

EPA Science Inventory

One of the Environmental Monitoring and Assessment Program's first projects was a survey of 345 lakes in the eight states of the Northeast, during summers of 1991-1996. This survey was the first regional-scale attempt to use a probability-based sampling design to collect biolog...

Comparing Students' Attitudes towards the Use of Traditional and Alternative Assessment Practices.

ERIC Educational Resources Information Center

DeMauro, Tom; Helphrey, Traci; Schram, Greg; Spiekermann, Carrie

This paper describes a program designed to compare students' attitudes towards the use of traditional and alternative assessment practices. The targeted population consisted of a second and third grade general education class, a third grade physical education class, and an eighth grade applied technology class in three communities in northern…

Population evacuations in industrial accidents: a review of the literature about four major events.

PubMed

Soffer, Yechiel; Schwartz, Dagan; Goldberg, Avishay; Henenfeld, Maxim; Bar-Dayan, Yaron

2008-01-01

This article reviews the literature describing four chemical and nuclear accidents and the lessons learned from each regarding the evacuation of civilian populations. Evacuation may save lives however, if poorly orchestrated, it may cause serious problems. For example, an inaccurate assessment of danger may lead to the evacuation of the same population twice, as the area requiring evacuation becomes larger than originally expected. Evacuation programs should focus on the vulnerable components of the populations, such as the elderly, children, and the disabled, and also should include plans for the care of pets and other animals. Training programs for civilians living near industrial centers and other high-risk areas should be considered. Finally, pre-event planning and preparation can improve the evacuation process and prevent panic behavior, and thus result in fewer casualties.

Implementation of mass media community health education: the Forsyth County Cervical Cancer Prevention Project.

PubMed

Dignan, M; Bahnson, J; Sharp, P; Beal, P; Smith, M; Michielutte, R

1991-09-01

The Forsyth County Cervical Cancer Prevention Project (FCP) is a community-based health education project funded by the National Cancer Institute. The target population includes around 25 000 black women age 18 and older who reside in Forsyth County, North Carolina. The overall goal of the program is to prevent mortality from cervical cancer by promoting Pap smears and return for follow-up care when needed. Based on the principles of social marketing, a plan to reach the target population with mass media educational messages through electronic and print channels was developed. Guided by marketing objectives, the target population was divided into relatively discrete segments. The segments included church attenders, patients in waiting rooms of public and selected health providers, female students at local colleges, shoppers, viewers of radio and television, newspaper readers, and business owners and managers. Introduction of the program was based on strategies developed for reaching the target population in each segment with television, radio and print mass media messages. Qualitative assessment of the mass media developed by the program indicated that all forms of communication helped to increase awareness of the program.

Methods and challenges for the health impact assessment of vaccination programs in Latin America.

PubMed

Sartori, Ana Marli Christovam; Nascimento, Andréia de Fátima; Yuba, Tânia Yuka; Soárez, Patrícia Coelho de; Novaes, Hillegonda Maria Dutilh

2015-01-01

To describe methods and challenges faced in the health impact assessment of vaccination programs, focusing on the pneumococcal conjugate and rotavirus vaccines in Latin America and the Caribbean. For this narrative review, we searched for the terms "rotavirus", "pneumococcal", "conjugate vaccine", "vaccination", "program", and "impact" in the databases Medline and LILACS. The search was extended to the grey literature in Google Scholar. No limits were defined for publication year. Original articles on the health impact assessment of pneumococcal and rotavirus vaccination programs in Latin America and the Caribbean in English, Spanish or Portuguese were included. We identified 207 articles. After removing duplicates and assessing eligibility, we reviewed 33 studies, 25 focusing on rotavirus and eight on pneumococcal vaccination programs. The most frequent studies were ecological, with time series analysis or comparing pre- and post-vaccination periods. The main data sources were: health information systems; population-, sentinel- or laboratory-based surveillance systems; statistics reports; and medical records from one or few health care services. Few studies used primary data. Hospitalization and death were the main outcomes assessed. Over the last years, a significant number of health impact assessments of pneumococcal and rotavirus vaccination programs have been conducted in Latin America and the Caribbean. These studies were carried out few years after the programs were implemented, meet the basic methodological requirements and suggest positive health impact. Future assessments should consider methodological issues and challenges arisen in these first studies conducted in the region.

Underdiagnosis of bipolar disorder in men with substance use disorder.

PubMed

Albanese, Mark J; Clodfelter, Reynolds C; Pardo, Tamara B; Ghaemi, S Nassir

2006-03-01

Recent reports indicate that bipolar disorder is frequently underdiagnosed in the clinical population, leading to overuse of antidepressants and underuse of mood stabilizers. This study assessed rates of diagnosis of bipolar disorder in a substance abuse population. The study involved a retrospective chart review of data from 295 patients admitted to an inpatient substance abuse program for men. Data were then analyzed from the 85 patients in the sample who were diagnosed as meeting DSM-IV criteria for bipolar disorder on intake into the program. Charts were reviewed for relevant clinical and demographic data. The primary outcome measure was the rate of previous misdiagnosis. Of the 85 patients diagnosed with bipolar disorder upon intake, 42 (49%) had not been previously diagnosed with bipolar disorder; of these 42, 6 (14%) patients had not been assessed previously, while 36 (86%) had been assessed previously and had received many other psychiatric diagnoses, including major depression (77%), attention-deficit/hyperactivity disorder (20%), and panic disorder (3%). Among the comorbid substance use disorders in these patients, alcohol dependence was the most common (62%), followed by cocaine (38%), opioid (26%), polysubstance (12%), and sedative-hypnotic (2%) dependence. Other comorbid Axis I disorders included posttraumatic stress disorder (14%), attention-deficit/hyperactivity disorder (10%), panic disorder (2%), and generalized anxiety disorder (2%). This study found that bipolar disorder had not been previously diagnosed in approximately 50% of a sample of Caucasian males in a substance abuse population who were diagnosed with bipolar disorder upon admission to an inpatient substance abuse program.

The epidemiology of hepatitis C virus in Afghanistan: systematic review and meta-analysis.

PubMed

Chemaitelly, Hiam; Mahmud, Sarwat; Rahmani, Ahmad Masoud; Abu-Raddad, Laith J

2015-11-01

To characterize hepatitis C virus (HCV) epidemiology and inform public health research, policy, and programming priorities in Afghanistan. Records of HCV incidence and prevalence were reviewed systematically and synthesized following PRISMA guidelines. Meta-analyses were implemented using a DerSimonian-Laird random effects model with inverse variance weighting to estimate HCV prevalence among various at risk populations. A risk of bias assessment was incorporated. The search identified one HCV incidence and 76 HCV prevalence measures. HCV incidence was only assessed among people who inject drugs (PWID), and was reported at 66.7 per 100 person-years. Meta-analyses estimated HCV prevalence at 0.7% among the general population (range 0-9.1%, 95% confidence interval (CI) 0.5-0.9%), 32.6% among PWID (range 9.5-70.0%, 95% CI 24.5-41.3%), and 2.3% among populations at intermediate risk (range 0.0-8.3%, 95% CI 1.3-3.7%). No data were available for other high risk populations such as hemodialysis, thalassemia, and hemophilia patients. HCV prevalence among the general population in Afghanistan is comparable to global levels. Data are needed for the level of infection among key clinical populations at high risk of infection. There is also an immediate need for expansion of harm reduction programs among PWID and prisoners. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

Insecticide Rotation Programs with Entomopathogenic Organisms for Suppression of Western Flower Thrips (Thysanoptera: Thripidae) Adult Populations under Greenhouse Conditions.

PubMed

Kivett, Jessica M; Cloyd, Raymond A; Bello, Nora M

2015-08-01

Western flower thrips, Frankliniella occidentalis (Pergande), is one of the most destructive insect pests of greenhouse production systems with the ability to develop resistance to a wide variety of insecticides. A common resistance management strategy is rotating insecticides with different modes of action. By incorporating entomopathogenic organisms (fungi and bacteria), which have discrete modes of action compared to standard insecticides, greenhouse producers may preserve the effectiveness of insecticides used for suppression of western flower thrips populations. The objective of this study was to determine how different rotation programs that include entomopathogenic organisms (Beauveria bassiana, Isaria fumosoroseus, Metarhizium anisopliae, and Chromobacterium subtsugae) and commonly used standard insecticides (spinosad, chlorfenapyr, abamectin, and pyridalyl) may impact the population dynamics of western flower thrips adult populations by means of suppression. Eight-week rotation programs were applied to chrysanthemum, Dendranthema x morifolium plants and weekly counts of western flower thrips adults captured on yellow sticky cards were recorded as a means to evaluate the impact of the rotation programs. A final quality assessment of damage caused by western flower thrips feeding on foliage and flowers was also recorded. Furthermore, a cost comparison of each rotation program was conducted. Overall, insecticide rotation programs that incorporated entomopathogenic organisms were not significantly different than the standard insecticide rotation programs without entomopathogenic organisms in suppressing western flower thrips adult populations. However, there were no significant differences among any of the rotation programs compared to the water control. Moreover, there was no differential effect of the rotation programs on foliage and flower quality. Cost savings of up to 34% (in US dollars) are possible when including entomopathogenic organisms in the rotation program. Therefore, by incorporating entomopathogenic organisms into insecticide rotation programs, greenhouse producers can decrease costs without affecting suppression, as well as diminish selection pressure on western flower thrips adult populations, which may avoid or delay resistance development. © The Authors 2015. Published by Oxford University Press on behalf of Entomological Society of America. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

How Generalizable Is Your Experiment? An Index for Comparing Experimental Samples and Populations

ERIC Educational Resources Information Center

Tipton, Elizabeth

2014-01-01

Although a large-scale experiment can provide an estimate of the average causal impact for a program, the sample of sites included in the experiment is often not drawn randomly from the inference population of interest. In this article, we provide a generalizability index that can be used to assess the degree of similarity between the sample of…

Lot quality assurance sampling (LQAS) for monitoring a leprosy elimination program.

PubMed

Gupte, M D; Narasimhamurthy, B

1999-06-01

In a statistical sense, prevalences of leprosy in different geographical areas can be called very low or rare. Conventional survey methods to monitor leprosy control programs, therefore, need large sample sizes, are expensive, and are time-consuming. Further, with the lowering of prevalence to the near-desired target level, 1 case per 10,000 population at national or subnational levels, the program administrator's concern will be shifted to smaller areas, e.g., districts, for assessment and, if needed, for necessary interventions. In this paper, Lot Quality Assurance Sampling (LQAS), a quality control tool in industry, is proposed to identify districts/regions having a prevalence of leprosy at or above a certain target level, e.g., 1 in 10,000. This technique can also be considered for identifying districts/regions at or below the target level of 1 per 10,000, i.e., areas where the elimination level is attained. For simulating various situations and strategies, a hypothetical computerized population of 10 million persons was created. This population mimics the actual population in terms of the empirical information on rural/urban distributions and the distribution of households by size for the state of Tamil Nadu, India. Various levels with respect to leprosy prevalence are created using this population. The distribution of the number of cases in the population was expected to follow the Poisson process, and this was also confirmed by examination. Sample sizes and corresponding critical values were computed using Poisson approximation. Initially, villages/towns are selected from the population and from each selected village/town households are selected using systematic sampling. Households instead of individuals are used as sampling units. This sampling procedure was simulated 1000 times in the computer from the base population. The results in four different prevalence situations meet the required limits of Type I error of 5% and 90% Power. It is concluded that after validation under field conditions, this method can be considered for a rapid assessment of the leprosy situation.

Health education for a breast and cervical cancer screening program: using the ecological model to assess local initiatives.

PubMed

Holden, D J; Moore, K S; Holliday, J L

1998-06-01

This study investigates the development and implementation of health education strategies at the local level for a statewide breast and cervical cancer control program. Baseline data on these initiatives were collected from 88 local screening programs in North Carolina. Using the ecological model as a framework, health education initiatives were assessed and analyzed to determine the level of activity occurring at the local level and the comprehensiveness of programs. Types and levels of interventions used are described and initial analysis is provided of the impact these strategies are having on recruiting women from target populations into these screening programs. Specific examples illustrating the variety of interventions used at the individual, network, organizational and community levels, and the impact of certain variables, such as the use of local health education staff, on the comprehensiveness of interventions utilized, are provided. The importance to practitioners of establishing process indicators in assessing local initiatives and challenges to conducting evaluations of these strategies are also discussed.

Evaluation of a community health representative program among the Cree of northern Quebec.

PubMed

Lavallée, C; James, C A; Robinson, E J

1991-01-01

The James Bay Cree Community Health Representative (CHR) program was implemented in 1984 to train persons from the Cree population of northern Quebec to act as health care advocates and educators, as intermediaries between the Cree population, health services and local organizations, and as participants in assessing health needs. A formative evaluation was initiated which included quantitative analysis of the daily tasks of CHRs and a qualitative component based on documentary research, observation and semi-structured interviews. The evaluation revealed that CHRs actively participated in the ongoing community health programs mainly through health education; the people interviewed showed a high level of satisfaction. However, direct supervision, sufficient continuing education for the CHRs and better integration into health care teams are long-term goals which need to be emphasized in the program.

Assessment of the influence of test characteristics on the clinical and cost impacts of methicillin-resistant Staphylococcus aureus screening programs in US hospitals.

PubMed

Olchanski, Natalia; Mathews, Charles; Fusfeld, Lauren; Jarvis, William

2011-03-01

To compare the impacts of different methicillin-resistant Staphylococcus aureus (MRSA) screening test options (eg, polymerase chain reaction [PCR], rapid culture) and program characteristics on the clinical outcomes and budget of a typical US hospital. We developed an Excel-based decision-analytic model, using published literature to calculate and compare hospital costs and MRSA infection rates for PCR- or culture-based MRSA screening and then used multivariate sensitivity analysis to evaluate key variables. Same-day PCR testing for a representative 370-bed teaching hospital in the United States was assessed in different populations (high-risk patients, intensive care unit [ICU] patients, or all patients) and compared with other test options. Different screening program populations (all patients, high-risk patients, ICU patients, or patients with previous MRSA colonization or infection only) represented a potential savings of $12,158-$76,624 per month over no program ($188,618). Analysis of multiple test options in high-risk population screening indicated that same-day PCR testing of high-risk patients resulted in fewer infections over 1,720 patient-days (2.9, compared with 3.5 for culture on selective media and 3.8 for culture on nonselective media) and the lowest total cost ($112,012). The costs of other testing approaches ranged from $113,742 to $123,065. Sensitivity analysis revealed that variations in transmission rate, conversion to infection, prevalence increases, and hospital size are important to determine program impact. Among test characteristics, turnaround time is highly influential. All screening options showed reductions in infection rates and cost impact improvement over no screening program. Among the options, same-day PCR testing for high-risk patients slightly edges out the others in terms of fewest infections and greatest potential cost savings.

Development of a community pharmacy human papillomavirus vaccine program for underinsured university students along the United States/Mexico border.

PubMed

Navarrete, Jacquelyn P; Padilla, Margie E; Castro, Louise P; Rivera, José O

2014-01-01

To describe the development and implementation of a human papillomavirus (HPV) vaccine patient assistance program (PAP) for university students, and to acquire information on the number who accessed the program and completed the series. University of Texas at El Paso University Student Health Clinic Pharmacy, Fall 2011-Spring 2014. A community pharmacy located within the university student health clinic providing services to an underinsured student population. Existing evidence shows the benefit of using PAP in community pharmacies but is nonspecific regarding the use of PAP for vaccines in an uninsured and underinsured Hispanic student population. The implementation of this unique HPV vaccine program in a community setting aims to increase awareness, access, and rates. Primary measures included results from a needs-assessment questionnaire that were used to implement the HPV vaccine program. After implementation, utilization data were collected on the number of students who qualified and enrolled in the HPV PAP and the number of students who completed the HPV series. The preliminary data from a needs assessment indicated that a majority (72.1%, n = 80) of students did not understand how HPV is transmitted. A total of 89 students qualified for PAP. The majority were women (81%). A total of 71 students (79.8%) received their second dose and 43 (48.3%) completed the series. Although pharmacists continue to provide vaccine services, minorities such as the Hispanic population continue to be underimmunized. Students may not be taking the proper precautions to prevent the acquisition of HPV. For these reasons services such as this HPV vaccine program are warranted. Pharmacists need to continue to educate and advocate on the importance of vaccines and how they prevent disease.

A standardized patient model to teach and assess professionalism and communication skills: the effect of personality type on performance.

PubMed

Lifchez, Scott D; Redett, Richard J

2014-01-01

Teaching and assessing professionalism and interpersonal communication skills can be more difficult for surgical residency programs than teaching medical knowledge or patient care, for which many structured educational curricula and assessment tools exist. Residents often learn these skills indirectly, by observing the behavior of their attendings when communicating with patients and colleagues. The purpose of this study was to assess the results of an educational curriculum we created to teach and assess our residents in professionalism and communication. We assessed resident and faculty prior education in delivering bad news to patients. Residents then participated in a standardized patient (SP) encounter to deliver bad news to a patient's family regarding a severe burn injury. Residents received feedback from the encounter and participated in an education curriculum on communication skills and professionalism. As a part of this curriculum, residents underwent assessment of communication style using the Myers-Briggs type inventory. The residents then participated in a second SP encounter discussing a severe pulmonary embolus with a patient's family. Resident performance on the SP evaluation correlated with an increased comfort in delivering bad news. Comfort in delivering bad news did not correlate with the amount of prior education on the topic for either residents or attendings. Most of our residents demonstrated an intuitive thinking style (NT) on the Myers-Briggs type inventory, very different from population norms. The lack of correlation between comfort in delivering bad news and prior education on the subject may indicate the difficulty in imparting communication and professionalism skills to residents effectively. Understanding communication style differences between our residents and the general population can help us teach professionalism and communication skills more effectively. With the next accreditation system, residency programs would need to demonstrate that residents are acquiring these skills in their training. SP encounters are effective in teaching and assessing these skills. © 2013 Published by Association of Program Directors in Surgery on behalf of Association of Program Directors in Surgery.

Utilization of Healthcare in the Typhoid Fever Surveillance in Africa Program.

PubMed

Panzner, Ursula; Pak, Gi Deok; Aaby, Peter; Adu-Sarkodie, Yaw; Ali, Mohammad; Aseffa, Abraham; Baker, Stephen; Bjerregaard-Andersen, Morten; Crump, John A; Deerin, Jessica; Cruz Espinoza, Ligia Maria; Gasmelseed, Nagla; Heriniaina, Jean Noël; Hertz, Julian T; Im, Justin; von Kalckreuth, Vera; Keddy, Karen H; Lankoande, Bruno; Løfberg, Sandra; Meyer, Christian G; Oresto, Michael Munishi; Park, Jin Kyung; Park, Se Eun; Rakotozandrindrainy, Raphaël; Sarpong, Nimako; Soura, Abdramane Bassiahi; Gassama Sow, Amy; Tall, Adama; Teferi, Mekonnen; Worku, Alemayehu; Yeshitela, Biruk; Wierzba, Thomas F; Marks, Florian

2016-03-15

Assessing healthcare utilization is important to identify weaknesses of healthcare systems, to outline action points for preventive measures and interventions, and to more accurately estimate the disease burden in a population. A healthcare utilization survey was developed for the Typhoid Fever Surveillance in Africa Program (TSAP) to adjust incidences of salmonellosis determined through passive, healthcare facility-based surveillance. This cross-sectional survey was conducted at 11 sites in 9 sub-Saharan African countries. Demographic data and healthcare-seeking behavior were assessed at selected households. Overall and age-stratified percentages of each study population that sought healthcare at a TSAP healthcare facility and elsewhere were determined. Overall, 88% (1007/1145) and 81% (1811/2238) of the population in Polesgo and Nioko 2, Burkina Faso, respectively, and 63% (1636/2590) in Butajira, Ethiopia, sought healthcare for fever at any TSAP healthcare facility. A far smaller proportion-namely, 20%-45% of the population in Bissau, Guinea-Bissau (1743/3885), Pikine, Senegal (1473/4659), Wad-Medani, Sudan (861/3169), and Pietermaritzburg, South Africa (667/2819); 18% (483/2622) and 9% (197/2293) in Imerintsiatosika and Isotry, Madagascar, respectively; and 4% (127/3089) in Moshi, Tanzania-sought healthcare at a TSAP healthcare facility. Patients with fever preferred to visit pharmacies in Imerintsiatosika and Isotry, and favored self-management of fever in Moshi. Age-dependent differences in healthcare utilization were also observed within and across sites. Healthcare utilization for fever varied greatly across sites, and revealed that not all studied populations were under optimal surveillance. This demonstrates the importance of assessing healthcare utilization. Survey data were pivotal for the adjustment of the program's estimates of salmonellosis and other conditions associated with fever. © The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions@oup.com.

Achieving Workplace Health through Application of Wellness Strategies

NASA Technical Reports Server (NTRS)

Robinson, Judith L.

2008-01-01

Purpose: 1) Understand and measure JSC workplace health: a) levels, sources, indicators & effects of negative, work-related stress; b) define leading indicators of emerging issues. 2 Provide linkage to outcomes: a) Focus application of wellness strategies & HR tools; b) Increase quality of work life and productivity. 3) Current effort will result in: a) Online assessment tool; b) Assessment of total JSC population (civil service & contractors); c) Application of mitigation tools and strategies. 4) Product of the JSC Employee Wellness Program. 5) Collaboration with Corporate Health Improvement Program/University of Arizona.

Peer-Mediated Multimodal Intervention Program for the Treatment of Children with ADHD in India: One-Year Followup

PubMed Central

Mehta, Sagar; Shah, Devesh; Shah, Kushal; Mehta, Sanjiv; Mehta, Neelam; Mehta, Vivek; Mehta, Vijay; Mehta, Vaishali; Motiwala, Smita; Mehta, Naina; Mehta, Devendra

2012-01-01

The objective was to assess the efficacy of a one-year, peer-mediated interventional program consisting of yoga, meditation and play therapy maintained by student volunteers in a school in India. The population consisted of 69 students between the ages of 6 and 11 years, previously identified as having attention deficit hyperactivity disorder (ADHD). A program, known as Climb-Up, was initially embedded in the school twice weekly. Local high school student volunteers were then trained to continue to implement the program weekly over the period of one year. Improvements in ADHD symptoms and academic performance were assessed using Vanderbilt questionnaires completed by both parents and teachers. The performance impairment scores for ADHD students assessed by teachers improved by 6 weeks and were sustained through 12 months in 46 (85%) of the enrolled students. The improvements in their Vanderbilt scores assessed by parents were also seen in 92% (P < 0.0001, Wilcoxon). The Climb-Up program resulted in remarkable improvements in the students' school performances that were sustained throughout the year. These results show promise for a cost-effective program that could easily be implemented in any school. PMID:23316384

Coverage of Large-Scale Food Fortification of Edible Oil, Wheat Flour, and Maize Flour Varies Greatly by Vehicle and Country but Is Consistently Lower among the Most Vulnerable: Results from Coverage Surveys in 8 Countries123

PubMed Central

Aaron, Grant J; Friesen, Valerie M; Jungjohann, Svenja; Garrett, Greg S; Myatt, Mark

2017-01-01

Background: Large-scale food fortification (LSFF) of commonly consumed food vehicles is widely implemented in low- and middle-income countries. Many programs have monitoring information gaps and most countries fail to assess program coverage. Objective: The aim of this work was to present LSFF coverage survey findings (overall and in vulnerable populations) from 18 programs (7 wheat flour, 4 maize flour, and 7 edible oil programs) conducted in 8 countries between 2013 and 2015. Methods: A Fortification Assessment Coverage Toolkit (FACT) was developed to standardize the assessments. Three indicators were used to assess the relations between coverage and vulnerability: 1) poverty, 2) poor dietary diversity, and 3) rural residence. Three measures of coverage were assessed: 1) consumption of the vehicle, 2) consumption of a fortifiable vehicle, and 3) consumption of a fortified vehicle. Individual program performance was assessed based on the following: 1) achieving overall coverage ≥50%, 2) achieving coverage of ≥75% in ≥1 vulnerable group, and 3) achieving equity in coverage for ≥1 vulnerable group. Results: Coverage varied widely by food vehicle and country. Only 2 of the 18 LSFF programs assessed met all 3 program performance criteria. The 2 main program bottlenecks were a poor choice of vehicle and failure to fortify a fortifiable vehicle (i.e., absence of fortification). Conclusions: The results highlight the importance of sound program design and routine monitoring and evaluation. There is strong evidence of the impact and cost-effectiveness of LSFF; however, impact can only be achieved when the necessary activities and processes during program design and implementation are followed. The FACT approach fills an important gap in the availability of standardized tools. The LSFF programs assessed here need to be re-evaluated to determine whether to further invest in the programs, whether other vehicles are appropriate, and whether other approaches are needed. PMID:28404836

Coverage of Large-Scale Food Fortification of Edible Oil, Wheat Flour, and Maize Flour Varies Greatly by Vehicle and Country but Is Consistently Lower among the Most Vulnerable: Results from Coverage Surveys in 8 Countries.

PubMed

Aaron, Grant J; Friesen, Valerie M; Jungjohann, Svenja; Garrett, Greg S; Neufeld, Lynnette M; Myatt, Mark

2017-05-01

Background: Large-scale food fortification (LSFF) of commonly consumed food vehicles is widely implemented in low- and middle-income countries. Many programs have monitoring information gaps and most countries fail to assess program coverage. Objective: The aim of this work was to present LSFF coverage survey findings (overall and in vulnerable populations) from 18 programs (7 wheat flour, 4 maize flour, and 7 edible oil programs) conducted in 8 countries between 2013 and 2015. Methods: A Fortification Assessment Coverage Toolkit (FACT) was developed to standardize the assessments. Three indicators were used to assess the relations between coverage and vulnerability: 1 ) poverty, 2 ) poor dietary diversity, and 3 ) rural residence. Three measures of coverage were assessed: 1 ) consumption of the vehicle, 2 ) consumption of a fortifiable vehicle, and 3 ) consumption of a fortified vehicle. Individual program performance was assessed based on the following: 1 ) achieving overall coverage ≥50%, 2) achieving coverage of ≥75% in ≥1 vulnerable group, and 3 ) achieving equity in coverage for ≥1 vulnerable group. Results: Coverage varied widely by food vehicle and country. Only 2 of the 18 LSFF programs assessed met all 3 program performance criteria. The 2 main program bottlenecks were a poor choice of vehicle and failure to fortify a fortifiable vehicle (i.e., absence of fortification). Conclusions: The results highlight the importance of sound program design and routine monitoring and evaluation. There is strong evidence of the impact and cost-effectiveness of LSFF; however, impact can only be achieved when the necessary activities and processes during program design and implementation are followed. The FACT approach fills an important gap in the availability of standardized tools. The LSFF programs assessed here need to be re-evaluated to determine whether to further invest in the programs, whether other vehicles are appropriate, and whether other approaches are needed.

Genetic assessment of a summer chum salmon metapopulation in recovery

PubMed Central

Small, Maureen P; Johnson, Thom H; Bowman, Cherril; Martinez, Edith

2014-01-01

Programs to rebuild imperiled wild fish populations often include hatchery-born fish derived from wild populations to supplement natural spawner abundance. These programs require monitoring to determine their demographic, biological, and genetic effects. In 1990s in Washington State, the Summer Chum Salmon Conservation Initiative developed a recovery program for the threatened Hood Canal summer chum salmon Evolutionarily Significant Unit (ESU) (the metapopulation) that used in-river spawners (wild fish) for each respective supplementation broodstock in six tributaries. Returning spawners (wild-born and hatchery-born) composed subsequent broodstocks, and tributary-specific supplementation was limited to three generations. We assessed impacts of the programs on neutral genetic diversity in this metapopulation using 16 microsatellite loci and a thirty-year dataset spanning before and after supplementation, roughly eight generations. Following supplementation, differentiation among subpopulations decreased (but not significantly) and isolation by distance patterns remained unchanged. There was no decline in genetic diversity in wild-born fish, but hatchery-born fish sampled in the same spawning areas had significantly lower genetic diversity and unequal family representation. Despite potential for negative effects from supplementation programs, few were detected in wild-born fish. We hypothesize that chum salmon natural history makes them less vulnerable to negative impacts from hatchery supplementation. PMID:24567747

Researching reducing health disparities: mixed-methods approaches.

PubMed

Stewart, Miriam; Makwarimba, Edward; Barnfather, Alison; Letourneau, Nicole; Neufeld, Anne

2008-03-01

There is a pressing need for assessment and intervention research focused on reducing health disparities. In our research program, the use of mixed methods has enhanced assessment of the mediating impacts of social support on the health of vulnerable populations and enabled the design and testing of support interventions. This paper highlights the benefits and challenges of mixed methods for investigating inequities; and, illustrates the application of mixed methods in two exemplar studies focused on vulnerable populations in Canada. Qualitative methods fostered in-depth understanding of vulnerable populations' support needs, support resources, intervention preferences, and satisfaction with intervention strategies and impacts. Quantitative methods documented the effectiveness and outcomes of intervention strategies, and enhanced the reliability and validity of assessments and interventions. The researchers demonstrate that participatory strategies are needed to make studies more relevant to reducing health disparities, contextually appropriate, and empowering.

Neonatal health in Nepal: analysis of absolute and relative inequalities and impact of current efforts to reduce neonatal mortality

PubMed Central

2013-01-01

Background Nepal has made substantial progress in reducing under-five mortality and is on track to achieve Millennium Development Goal 4, but advances in neonatal health are less encouraging. The objectives of this study were to assess relative and absolute inequalities in neonatal mortality over time, and to review experience with major programs to promote neonatal health. Methods Using four nationally representative surveys conducted in 1996, 2001, 2006 and 2011, we calculated neonatal mortality rates for Nepal and for population groups based on child sex, geographical and socio-economic variables using a true cohort log probability approach. Inequalities based on different variables and years were assessed using rate differences (rd) and rate ratios (rr); time trends in neonatal mortality were measured using the annual rate of reduction. Through literature searches and expert consultation, information on Nepalese policies and programs implemented since 1990 and directly or indirectly attempting to reduce neonatal mortality was compiled. Data on timeline, coverage and effectiveness were extracted for major programs. Results The annual rate of reduction for neonatal mortality between 1996 and 2011 (2.8 percent per annum) greatly lags behind the achievements in under-five and infant mortality, and varies across population groups. For the year 2011, stark absolute and relative inequalities in neonatal mortality exist in relation to wealth status (rd = 21.4, rr = 2.2); these are less pronounced for other measures of socio-economic status, child sex and urban–rural residence, ecological and development region. Among many efforts to promote child and maternal health, three established programs and two pilot programs emerged as particularly relevant to reducing neonatal mortality. While these were designed based on national and international evidence, information about coverage of different population groups and effectiveness is limited. Conclusion Neonatal mortality varies greatly by socio-demographic variables. This study clearly shows that much remains to be achieved in terms of reducing neonatal mortality across different socio-economic, ethnic and geographical population groups in Nepal. In moving forward it will be important to scale up programs of proven effectiveness, conduct in-depth evaluation of promising new approaches, target unreached and hard-to-reach populations, and maximize use of financial and personnel resources through integration across programs. PMID:24373558

Neonatal health in Nepal: analysis of absolute and relative inequalities and impact of current efforts to reduce neonatal mortality.

PubMed

Paudel, Deepak; Shrestha, Ishwar B; Siebeck, Matthias; Rehfuess, Eva A

2013-12-28

Nepal has made substantial progress in reducing under-five mortality and is on track to achieve Millennium Development Goal 4, but advances in neonatal health are less encouraging. The objectives of this study were to assess relative and absolute inequalities in neonatal mortality over time, and to review experience with major programs to promote neonatal health. Using four nationally representative surveys conducted in 1996, 2001, 2006 and 2011, we calculated neonatal mortality rates for Nepal and for population groups based on child sex, geographical and socio-economic variables using a true cohort log probability approach. Inequalities based on different variables and years were assessed using rate differences (rd) and rate ratios (rr); time trends in neonatal mortality were measured using the annual rate of reduction. Through literature searches and expert consultation, information on Nepalese policies and programs implemented since 1990 and directly or indirectly attempting to reduce neonatal mortality was compiled. Data on timeline, coverage and effectiveness were extracted for major programs. The annual rate of reduction for neonatal mortality between 1996 and 2011 (2.8 percent per annum) greatly lags behind the achievements in under-five and infant mortality, and varies across population groups. For the year 2011, stark absolute and relative inequalities in neonatal mortality exist in relation to wealth status (rd = 21.4, rr = 2.2); these are less pronounced for other measures of socio-economic status, child sex and urban-rural residence, ecological and development region. Among many efforts to promote child and maternal health, three established programs and two pilot programs emerged as particularly relevant to reducing neonatal mortality. While these were designed based on national and international evidence, information about coverage of different population groups and effectiveness is limited. Neonatal mortality varies greatly by socio-demographic variables. This study clearly shows that much remains to be achieved in terms of reducing neonatal mortality across different socio-economic, ethnic and geographical population groups in Nepal. In moving forward it will be important to scale up programs of proven effectiveness, conduct in-depth evaluation of promising new approaches, target unreached and hard-to-reach populations, and maximize use of financial and personnel resources through integration across programs.

Technology Programs in Region 5, the Kokomo, Indiana Area. An Update Manpower Report. Manpower Report 84-7.

ERIC Educational Resources Information Center

Purdue Univ., Lafayette, IN. Office of Manpower Studies.

To assess the need for technology programs in the Kokomo, Indiana area, such background data (population projections for the region, the educational level of adults living in the region, and the number and size of firms located in the area) concerning Kokomo and the counties surrounding it were compiled. The researchers formulated projected…

Substance Use and Dependency Disorders in Adolescent Girls in Group Living Programs: Prevalence and Associations with Milieu Factors

ERIC Educational Resources Information Center

Baker, Amy J. L.; Ashare, Caryn; Charvat, Benjamin J.

2009-01-01

Fifty-three adolescent girls residing in community-based group-living child welfare programs were administered a standardized measure (SASS-2) in order to assess probability of a substance use/dependency disorder in this highly vulnerable population. Findings revealed that one third of the sample, and one half of the nonpregnant/parenting girls,…

Long Term Ecological Monitoring Program on the Kenai National Wildlife Refuge, Alaska: An FIA adjunct inventory

Treesearch

Bowser John M. Morton; Edward Berg; Dawn Magness; Todd Eskelin

2009-01-01

Kenai National Wildlife Refuge (KENWR) has a legislative mandate "to conserve fish and wildlife populations and habitats in their natural diversity". To improve our understanding of spatial and temporal variation at the landscape level, we are developing the Long Term Ecological Monitoring Program (LTEMP) to assess change in biota on the sample frame used by...

A Cognitive Approach to Child Mistreatment Prevention among Medically At-Risk Infants

ERIC Educational Resources Information Center

Bugental, Daphne Blunt; Schwartz, Alex

2009-01-01

The authors assessed the effectiveness of a home visitation program in enhancing the early parenting history of infants born at medical risk--a population that is at risk for mistreatment. A randomized clinical trial design was used to compare the effects of a cognitively based extension of the Healthy Start home visitation program (HV+) with a…

Randomized Trial of a Statewide Home Visiting Program: Impact in Preventing Child Abuse and Neglect

ERIC Educational Resources Information Center

Duggan, Anne; McFarlane, Elizabeth; Fuddy, Loretta; Burrell, Lori; Higman, Susan M.; Windham, Amy; Sia, Calvin

2004-01-01

Objectives: To assess the impact of home visiting in preventing child abuse and neglect in the first 3 years of life in families identified as at-risk of child abuse through population-based screening at the child's birth. Methods: This experimental study focused on Hawaii Healthy Start Program (HSP) sites operated by three community-based…

Proposing a Model Assessment and Intervention Program for Learning Disabled Adolescents in a Typical School Population.

ERIC Educational Resources Information Center

Currie, Winifred

Reported are results of screening over 1,000 eighth or ninth grade students for learning disabilities, and suggested is an intervention program utilizing available local resources. The Currie-Milonas Screening Test is described as consisting of eight subtests to identify problems in the basic skills of reading, writing, language, or mathematics.…

Development of a tool for assessment and care planning for dementia-related problem behaviors in home and community-based services programs: the Problem Behavior Inventory.

PubMed

Phillips, V L; Diwan, Sadhna; Egner, Amanda

2002-01-01

To describe development, validity, and application of the Problem Behavior Inventory (PBI), a tool to assess dementia-related problem behaviors (DRPBs) in community-based populations. Demographic, contact, and disease-specific data were extracted from client files from a Medicaid-funded home and community-based services program. Primary caregivers completed standard surveys relating to the care recipients' memory, mood, and behaviors. The client (care recipient) completed the Mini-Mental Status Exam (MMSE). Cognitively impaired clients, enrolled in the Community Care Services Program (CCSP) during a reference month, and their primary caregivers, were identified by CCSP case managers for participation in the study. Primary caregivers completed the Revised Memory and Behavior Problem Checklist (RMBPC). Clients screening positive for the presence of DRPBs based on caregiver responses to the RMBPC were then assessed using the Problem Behavior Inventory (PBI). Within the CCSP sample, the most prevalent behavior was appearing sad or depressed (67%), while the most frequent behavior was seeking attention, occurring at least daily in 58% of the group. The most bothersome behaviors were being sexually inappropriate, wandering, and misbehaving in public. Examination by behavior category (physical, verbal, mood, etc.) revealed a strong relationship between level of bother and behavior frequency. Frequency of verbal behaviors was positively related to MMSE scores, whereas frequency of ADL-related behaviors was inversely related to MMSE scores. Bother scores were not associated with MMSE scores. This study documents that the PBI is a valid, useful, and feasible tool for assessing DRPBs in community populations. Case managers using the PBI can determine specific problem behavior areas among client populations and for individual clients and institute client-specific interventions to address each issue.

Comparative status and assessment of Limulus polyphemus with emphasis on the New England and Delaware Bay populations

USGS Publications Warehouse

Smith, David; Millard, Michael J.; Carmichael, Ruth H.

2009-01-01

Increases in harvest of the American horseshoe crab (Limulus polyphemus) during the 1990s, particularly for whelk bait, coupled with decreases in species that depend on their eggs has reduced horseshoe crab abundance, threatened their ecological relationships, and dictated precautionary management of the horseshoe crab resource. Accordingly, population assessments and monitoring programs have been developed throughout much of the horseshoe crab’s range. We review and discuss implications for several recent assessments of Delaware Bay and New England populations and a meta-analysis of region-specific trends. These assessments show that the western Atlantic distribution of the horseshoe crab is comprised of regional or estuarine-specific meta-populations, which exhibit distinct population dynamics and require management as separate units. Modeling of Delaware Bay and Cape Cod populations confirmed that overharvest caused declines, but indicated that some harvest levels are sustainable and consistent with population growth. Coast-wide harvest was reduced by 70% from 1998 to 2006, with the greatest reductions within Delaware Bay states. Harvest regulations in Delaware Bay starting in the late 1990s, such as harvest quotas, seasonal closures, male-only harvest, voluntary use of bait-saving devices, and establishment of the Carl N. Shuster Jr. Horseshoe Crab Reserve, were followed by stabilization and recent evidence of increase in abundance of horseshoe crabs in the region. However, decreased harvest of the Delaware Bay population has redirected harvest to outlying populations, particularly in New York and New England. While the recent Delaware Bay assessments indicate positive population growth, increased harvest elsewhere is believed to be unsustainable. Two important considerations for future assessments include (1) managing Delaware Bay horseshoe crab populations within a multi-species context, for example, to help support migratory shorebirds and (2) anticipating the potential for harvest restrictions within Delaware Bay to redirect harvest onto outlying populations that cannot sustain the increased harvest.

Medical cost savings for participants and nonparticipants in health risk assessments, lifestyle management, disease management, depression management, and nurseline in a large financial services corporation.

PubMed

Serxner, Seth; Alberti, Angela; Weinberger, Sarah

2012-01-01

To compare changes in medical costs between participants and nonparticipants in five different health and productivity management (HPM) programs. Quasi-experimental pre/post intervention study. A large financial services corporation. A cohort population of employees enrolled in medical plans (n  =  49,723) [corrected]. A comprehensive HPM program, which addressed health risks, acute and chronic conditions, and psychosocial disorders from 2005 to 2007. Incentives were used to encourage health risk assessment participation in years 2 and 3. Program participation and medical claims data were collected for members at the end of each program year to assess the change in total costs from the baseline period. Analysis . Multivariate analyses for participation categories were conducted comparing baseline versus program year cost differences, controlling for demographics. All participation categories yielded a lower cost increase compared to nonparticipation and a positive return on investment (ROI) for years 2 and 3, resulting in a 2.45∶1 ROI for the combined program years. Medical cost savings exceeded program costs in a wide variety of health and productivity management programs by the second year.

Improving School Nurse Pain Assessment Practices for Students With Intellectual Disability.

PubMed

Quinn, Brenna L; Smolinski, Megan

2017-01-01

School nurses are afforded minimal resources related to assessing pain in students with intellectual disability (ID) and have called for continuing education. The purpose of this study was to measure the effectiveness of an education program regarding best practices for assessing pain in students with ID. Educational sessions were presented to 248 school nurses. Pre-, post-, and follow-up surveys measured (1) difficulty school nurses face when assessing pain, (2) knowledge and use of pain assessment methods, and (3) intent to change and actual changes to professional practices. Participants experienced less difficulty assessing pain following the educational program. Almost all participants intended to change pain assessment practices, but large caseloads limited new practice adoption. Policy makers must consider population size and acuity when determining school nurse staffing. Trainings and other resources should be made available to school nurses in order to make pain assessments for students with ID more thorough and efficient.

Middle School Curriculum, Instruction, and Assessment. The Handbook of Research in Middle Level Education.

ERIC Educational Resources Information Center

Anfara, Vincent A., Jr., Ed.; Stacki, Sandra L., Ed.

This volume theorizes, describes, and explains practices and some specific programs designed to help meet the needs and demands of a diverse student population. The central point of this volume is that curriculum, instruction, and assessment in middle-level education is a dynamic, interrelated system undergoing change. The book contains the…

Program Development and Outcomes Assessment of Social Emotional Curriculum Utilized with High School Special Education Population

ERIC Educational Resources Information Center

Wedam, Allison

2012-01-01

The present study will assess the effectiveness of a social emotional learning curriculum implemented in a Midwestern high school with special education students. The specific social emotional curriculum utilized at this particular school was organized and delivered by the school psychologists at the high school, based on the Strong Teens…

The Stoplight Program: A Proactive Physical Therapy Intervention for Children With Acute Lymphoblastic Leukemia.

PubMed

Tanner, Lynn; Sencer, Susan; Hooke, Mary C

Chemotherapy may cause neuromuscular impairments that can have life-long effects. The Stoplight Program (SLP) was developed as a proactive physical therapy (PT) intervention directed at impairments in children with acute lymphoblastic leukemia (ALL). In this program evaluation, we assessed the feasibility of the SLP delivered as part of standard care and identified body function and activity patterns in patients who received the intervention. Children ages 1 to 22 years, diagnosed with ALL, received an assessment by a physical therapist as part of usual care. The SLP intervention used 3 levels to categorize the impairment levels and intensity of PT. Of the children (n = 135) screened, 46% completed 5 intervention visits and 32% completed the program and met discharge criteria. At initial assessment, 46% of children ages 1 to 5 years and 67% of children ages 6 to 22 years had abnormal motor function. Those completing the program tested within the healthy norms. Research is needed on variables that influence adherence to a PT program and the range of functional impairment and activity limitations in this population.

Performance and Durability Assessment of Two Emission Control Technologies Installed on a Legacy High-Speed Marine Diesel Engine

DTIC Science & Technology

2015-11-05

program investigated cost- effective technologies to reduce emissions from legacy marine engines. High-speed, high-population engine models in both...respectively) were driven by health effects and environmental impacts. The U.S. Navy assessed its contribution to the domestic marine emission inventory...greatest potential. A laboratory developmental assessment was followed by a shipboard evaluation. Effective technology concepts applied to high

National Cancer Institute Patient Navigation Research Program: methods, protocol, and measures.

PubMed

Freund, Karen M; Battaglia, Tracy A; Calhoun, Elizabeth; Dudley, Donald J; Fiscella, Kevin; Paskett, Electra; Raich, Peter C; Roetzheim, Richard G

2008-12-15

Patient, provider, and systems barriers contribute to delays in cancer care, a lower quality of care, and poorer outcomes in vulnerable populations, including low-income, underinsured, and racial/ethnic minority populations. Patient navigation is emerging as an intervention to address this problem, but navigation requires a clear definition and a rigorous testing of its effectiveness. Pilot programs have provided some evidence of benefit, but have been limited by evaluation of single-site interventions and varying definitions of navigation. To overcome these limitations, a 9-site National Cancer Institute Patient Navigation Research Program (PNRP) was initiated. The PNRP is charged with designing, implementing, and evaluating a generalizable patient navigation program targeting vulnerable populations. Through a formal committee structure, the PNRP has developed a definition of patient navigation and metrics to assess the process and outcomes of patient navigation in diverse settings, compared with concurrent continuous control groups. The PNRP defines patient navigation as support and guidance offered to vulnerable persons with abnormal cancer screening or a cancer diagnosis, with the goal of overcoming barriers to timely, quality care. Primary outcomes of the PNRP are 1) time to diagnostic resolution; 2) time to initiation of cancer treatment; 3) patient satisfaction with care; and 4) cost effectiveness, for breast, cervical, colon/rectum, and/or prostate cancer. The metrics to assess the processes and outcomes of patient navigation have been developed for the NCI-sponsored PNRP. If the metrics are found to be valid and reliable, they may prove useful to other investigators.

A population-specific Mini-Nutritional Assessment can effectively grade the nutritional status of stroke rehabilitation patients in Taiwan.

PubMed

Tsai, Alan C; Shih, Chi-Ling

2009-01-01

To determine whether a modified version of the Mini-Nutritional Assessment without body mass index could effectively assess the nutritional risk status of stroke rehabilitation patients in Taiwan. The Mini-Nutritional Assessment was developed on the basis of clinical data of Western populations. Although widely used, its application to assess stroke rehabilitation patients has been limited. Further, to get best results, population-specific modifications to address anthropometric and lifestyle differences have been suggested, especially for non-Caucasian populations. The study assessed the nutritional status of stroke rehabilitation patients who enrolled in the Long-Term Care Service of Taipei. Strokes who were >40 years old, in the program for >1 month and cognitively able to answer the questions were recruited to participate in the study. An on-site in-person interview with structured questionnaire elicited information on personal data, disease history and healthcare use and answers to the Mini-Mental State Examination, the Activities of Daily Living and the Mini-Nutritional Assessment. Patient's nutritional status was assessed with the Mini-Nutritional Assessment in three versions: the original, population-specific (MNA-TI) and population-specific, without body mass index (MNA-TII). The original Mini-Nutritional Assessment rated 24% of patients malnourished and 57% at risk of malnutrition. Similar results, 14 and 64%, respectively, for MNA-TI; and 19 and 57%, respectively, for MNA-TII were observed. Both the original and the modified versions of the Mini-Nutritional Assessment can effectively rate the nutritional risk status of stroke rehabilitation patients in Taiwan. Version MNA-TII that adopted population-specific anthropometric cut-values but without body mass index can effectively predict the nutritional status of stroke patients. The modified scale (MNA-TII) can enhance the application of the tool and timely detection and intervention of undernutrition among stroke rehabilitation patients. It can also help to improve job efficiency of the primary care professionals.

Assessing and forecasting population health: integrating knowledge and beliefs in a comprehensive framework.

PubMed

Van Meijgaard, Jeroen; Fielding, Jonathan E; Kominski, Gerald F

2009-01-01

A comprehensive population health-forecasting model has the potential to interject new and valuable information about the future health status of the population based on current conditions, socioeconomic and demographic trends, and potential changes in policies and programs. Our Health Forecasting Model uses a continuous-time microsimulation framework to simulate individuals' lifetime histories by using birth, risk exposures, disease incidence, and death rates to mark changes in the state of the individual. The model generates a reference forecast of future health in California, including details on physical activity, obesity, coronary heart disease, all-cause mortality, and medical expenditures. We use the model to answer specific research questions, inform debate on important policy issues in public health, support community advocacy, and provide analysis on the long-term impact of proposed changes in policies and programs, thus informing stakeholders at all levels and supporting decisions that can improve the health of populations.

HIV epidemic among key populations in west Africa.

PubMed

Djomand, Gaston; Quaye, Silas; Sullivan, Patrick S

2014-09-01

Globally, HIV infection remains a significant issue for key populations such as men who have sex with men (MSM) and female sex workers. A review of recent articles was conducted for west African countries to assess the burden of disease among female sex workers and MSM, access to services and identify barriers to implementation of services for key populations. In west Africa, key populations engage in high-risk practices for the acquisition of HIV and other sexually transmitted infections. Available HIV prevalence data fluctuate across and within countries for both MSM and female sex workers and may be five to ten times as high as that of the general population. HIV prevalence varied from 15.9% in The Gambia to 68% in Benin among female sex workers, whereas it ranged from 9.8% in The Gambia to 34.9% in Nigeria for MSM. Yet, important data gaps exist, including key populations size estimations in several countries as well as HIV prevalence, incidence and other biomarkers of HIV risk. Because of sociocultural, legal, political and economic challenges, exacerbated by a poor health system infrastructure, the HIV response is not strategically directed toward programs for key populations in countries with concentrated epidemics. Noteworthy is the low coverage of prevention care and treatment interventions offered to key populations. Sufficient planning and political will with legal and structural frameworks that reconcile public health and human rights are needed to prioritize HIV prevention, care and treatment programming for key populations programs in west Africa.

[Safe drinking water supply to the Vologda Region's population using risk assessment methodology].

PubMed

Kuznetsova, I A; Figurina, T Ia; Shadrina, S Iu

2011-01-01

To supply the population with qualitative potable water is a priority problem in the provision of sanitary-and-epidemiologic well-being and in the prevention of disease in the Vologda Region. The monitoring of the results of laboratory control over the quality of drinking-water and the assessment of health risk enabled a package of measures to be proposed to optimize the conditions of drinking water supply in the Vologda Region. The risk assessment technology used by a state agency for sanitary-and-epidemiological surveillance makes it possible to substantiate a system of actions to organize household water use and to include scientifically grounded proposals into the developed regional and local programs.

Early impacts of biological control on canopy cover and water use of the invasive saltcedar tree (Tamarix spp.) in western Nevada, USA

Treesearch

Robert R. Pattison; Carla M. D' Antonio; Tom L. Dudley; Kip K. Allander; Benjamin Rice

2010-01-01

The success of biological control programs is rarely assessed beyond population level impacts on the target organism. The question of whether a biological control agent can either partially or completely restore ecosystem services independent of population level control is therefore still open to discussion. Using observational and experimental approaches, we...

Approaches to systematic assessment of environmental exposures posed at hazardous waste sites in the developing world: the Toxic Sites Identification Program.

PubMed

Ericson, Bret; Caravanos, Jack; Chatham-Stephens, Kevin; Landrigan, Philip; Fuller, Richard

2013-02-01

In the developing world, environmental chemical exposures due to hazardous waste sites are poorly documented. We describe the approach taken by the Blacksmith Institute's Toxic Sites Identification Program in documenting environmental chemical exposures due to hazardous waste sites globally, identifying sites of concern and quantifying pathways, populations, and severity of exposure. A network of local environmental investigators was identified and trained to conduct hazardous waste site investigations and assessments. To date, 2,095 contaminated sites have been identified within 47 countries having an estimated population at risk of 71,500,000. Trained researchers and investigators have visited 1,400 of those sites. Heavy metals are the leading primary exposures, with water supply and ambient air being the primary routes of exposure. Even though chemical production has occurred largely in the developed world to date, many hazardous waste sites in the developing world pose significant hazards to the health of large portions of the population. Further research is needed to quantify potential health and economic consequences and identify cost-effective approaches to remediation.

Guidelines for community supervision of DWI offenders

DOT National Transportation Integrated Search

2008-03-01

To protect the public and provide DWI offenders with adequate interventions to help promote behavior change, it is important for community corrections agencies to assess their practices and programs for this population. The guidelines presented in th...

Cost-effectiveness of a potential future Helicobacter pylori vaccine in the Netherlands: the impact of varying the discount rate for health.

PubMed

de Vries, Robin; Klok, Rogier M; Brouwers, Jacobus R B J; Postma, Maarten J

2009-02-05

To estimate the cost-effectiveness of a potential Helicobacter pylori (HP) vaccine for the Dutch situation, we developed a Markov model. Several HP prevalence scenarios were assessed. Additionally, we assessed the impact of the discount rate for health on the outcomes, as this influence can be profound for vaccines. When applying the current discount rate of 1.5% for health, the expected cost-effectiveness of HP vaccination is estimated below the informal Dutch threshold of euro 20,000/LYG when the HP prevalence is assumed > or =20% in the Dutch population. In conclusion, we showed that HP vaccination could possibly be a cost-effective intervention. However, this depends to a large extend on the prevalence of HP in the population. Furthermore, we showed the large impact of the discount rate for health on the cost-effectiveness of a HP vaccination program, illustrative for other vaccination programs.

[Weight-for-age percentile curves for the population of Catamarca province (Argentina)].

PubMed

López Barbancho, Diego; Terán de Frutos, José Manuel; Candelas González, Nieves; Díaz de Luna, María Cristina; Marrodán Serrano, María Dolores; Lomaglio, Delia Beatriz

2014-09-12

The assessment of fetal development and birth weight is a priority in the field of nutritional epidemiology and public health. Nowadays, the World Health Organization (WHO) does not have specific birth weight curves for the distinct gestational weeks considering that socio-economic, ecological and ethnic characteristics of the different human groups are found influencing their own growth patterns. This research develops centile curves for weight by gestational age concerning to resident populations in the province of Catamarca. In order to process data, SPSS statistical program was used, as well as LMS Chart Maker pro program for the subsequent performing of centile curves. The sample ascended to a total of 22,576 childbirths between 1994 and 2003. In the future, these curves make possible a better assessment of intrauterine development and birth weight in this region of Northwest of Argentina. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

Stakeholder assessment of comparative effectiveness research needs for Medicaid populations.

PubMed

Fischer, Michael A; Allen-Coleman, Cora; Farrell, Stephen F; Schneeweiss, Sebastian

2015-09-01

Patients, providers and policy-makers rely heavily on comparative effectiveness research (CER) when making complex, real-world medical decisions. In particular, Medicaid providers and policy-makers face unique challenges in decision-making because their program cares for traditionally underserved populations, especially children, pregnant women and people with mental illness. Because these patient populations have generally been underrepresented in research discussions, CER questions for these groups may be understudied. To address this problem, the Agency for Healthcare Research and Quality commissioned our team to work with Medicaid Medical Directors and other stakeholders to identify relevant CER questions. Through an iterative process of topic identification and refinement, we developed relevant, feasible and actionable questions based on issues affecting Medicaid programs nationwide. We describe challenges and limitations and provide recommendations for future stakeholder engagement.

Stakeholder assessment of comparative effectiveness research needs for Medicaid populations

PubMed Central

Fischer, Michael A; Allen-Coleman, Cora; Farrell, Stephen F; Schneeweiss, Sebastian

2015-01-01

Patients, providers and policy-makers rely heavily on comparative effectiveness research (CER) when making complex, real-world medical decisions. In particular, Medicaid providers and policy-makers face unique challenges in decision-making because their program cares for traditionally underserved populations, especially children, pregnant women and people with mental illness. Because these patient populations have generally been underrepresented in research discussions, CER questions for these groups may be understudied. To address this problem, the Agency for Healthcare Research and Quality commissioned our team to work with Medicaid Medical Directors and other stakeholders to identify relevant CER questions. Through an iterative process of topic identification and refinement, we developed relevant, feasible and actionable questions based on issues affecting Medicaid programs nationwide. We describe challenges and limitations and provide recommendations for future stakeholder engagement. PMID:26388438

Commentary: implications for assessment and treatment of addictive and mentally disordered offenders entering prisons.

PubMed

Easton, Caroline J; Devine, Susan; Scott, Melanie; Wupperman, Peggilee

2008-01-01

In this commentary, we discuss the main findings of the research study by Gunter et al., "The Frequency of Mental Health and Addictive Disorders Among 320 Men and Women Entering the Iowa Prison System: Use of the MINI-PLUS." This commentary provides an overview on the use of standardized assessments with prison populations; prevalence rates of mental and addictive disorders within prisons; substance use disorders, as opposed to substance-induced psychiatric disorders, among prison populations; and research on diversion treatment programs within the community for nonviolent mentally ill and substance-using offenders.

DEVELOPING A HUMAN RIGHTS-BASED PROGRAM FOR TUBERCULOSIS CONTROL IN GEORGIAN PRISONS

PubMed Central

Gegia, Medea; Kalandadze, Iagor; Madzgharashvili, Mikheil; Furin, Jennifer

2013-01-01

Tuberculosis (TB) is one of the leading infectious killers of adults globally. Incarcerated individuals represent a vulnerable population when it comes to TB exposure, development of disease, and poor treatment outcomes. The TB pandemic in prisons is a serious human rights issue, and multiple global organizations have called for human rights-based strategies to address it. There are, however, few countries implementing such programs on the ground. Georgia, a former Soviet republic located in the Caucasus Mountains, has high rates of TB and a large prison population. This paper describes a needs assessment carried out in one prison in Georgia and the human rights-based strategy being implemented by the Georgian National TB Program to address TB control in the prison setting. It is hoped that the proposed program can serve as a model for other countries with high rates of TB among incarcerated individuals. PMID:22773034

Culturally Sensitive Education Can Decrease Hispanic Workers' Risk of Metabolic Syndrome.

PubMed

Marks, Steven

2016-04-08

Metabolic syndrome is a continuing problem in the United States, and the Hispanic population is at increased risk of developing complications from this disease process. Many of the workers at a South Jersey yacht-building company are Hispanic, and a culturally sensitive education program was implemented to improve their overall health. Program assessments included the Latino Dietary Behavior Questionnaire (LDBQ), anthropomorphic measurements, and laboratory studies both pre and post intervention. The intervention included a Spanish-language lecture on metabolic syndrome and healthy nutrition, followed by an interactive culturally appropriate cooking demonstration for the participants and their significant others. Program participants showed reductions in body mass index, blood pressure, lipid levels, and hemoglobin A1c, and more knowledge of healthy nutrition as measured by the LDBQ. This finding supports culturally sensitive education programs to improve the health of Hispanic populations. © 2016 The Author(s).

Telehealth for diabetes self-management education and support in an underserved, free clinic population: A pilot study.

PubMed

Threatt, Tiffaney B; Ward, Eileen D

Primary study objectives were to (1) describe mean change in A1c from baseline of a free clinic population enrolled in telehealth diabetes self-management education and support (DSME/S) services and (2) to compare change in A1C and other clinical outcomes measures with free clinic patients enrolled in a traditional face-to-face DSME/S program. An exploratory study design and comparative evaluation of telehealth DSME/S services in a free clinic population was used. Baseline clinical measures were collected upon referral. Diabetes educators met with patients individually over 2-3 months. Clinical outcomes measures were collected within 6 months of program completion. Data from the telehealth group was assessed individually and compared to a free clinic traditional DSME/S program population. Twelve patients completed a telehealth free clinic DSME/S pilot program with a mean ± SD change in A1C from baseline of -1.03 ± 1.53% (P = 0.050). Mean ± SD change in A1C from baseline in the free clinic population participating in traditional face-to-face DSME/S services was -1.42 ± 1.80% (P = 0.001). No significant differences in secondary outcomes measures, including body mass index and blood pressure, were revealed among the study populations. Expanding access to care in populations faced with challenges of socioeconomics, limited education, and lower health literacy is a step toward reducing health disparities and positively affecting care. Mean A1C can be improved with telehealth DSME/S services in an underserved, free clinic population. Copyright © 2017 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.

Final Natural Resource Actions Environmental Assessment

DTIC Science & Technology

2005-06-22

populations through use of insecticides and rodenticides would be accomplished under the supervision of the Base Pest Management Office and coordinated... Insecticide , Fungicide, and Rodenticide Act; DoD Directive 4150.7, DoD Pest Management Program; AFI 32-1053, Pest Management Program; and the North... insecticide and herbicide. Grand Forks AFB constructed a 2,400-square-foot pest management facility in 1996 in accor- dance with the guidelines

Construction and validation of a population-based bone densitometry database.

PubMed

Leslie, William D; Caetano, Patricia A; Macwilliam, Leonard R; Finlayson, Gregory S

2005-01-01

Utilization of dual-energy X-ray absorptiometry (DXA) for the initial diagnostic assessment of osteoporosis and in monitoring treatment has risen dramatically in recent years. Population-based studies of the impact of DXA and osteoporosis remain challenging because of incomplete and fragmented test data that exist in most regions. Our aim was to create and assess completeness of a database of all clinical DXA services and test results for the province of Manitoba, Canada and to present descriptive data resulting from testing. A regionally based bone density program for the province of Manitoba, Canada was established in 1997. Subsequent DXA services were prospectively captured in a program database. This database was retrospectively populated with earlier DXA results dating back to 1990 (the year that the first DXA scanner was installed) by integrating multiple data sources. A random chart audit was performed to assess completeness and accuracy of this dataset. For comparison, testing rates determined from the DXA database were compared with physician administrative claims data. There was a high level of completeness of this database (>99%) and accurate personal identifier information sufficient for linkage with other health care administrative data (>99%). This contrasted with physician billing data that were found to be markedly incomplete. Descriptive data provide a profile of individuals receiving DXA and their test results. In conclusion, the Manitoba bone density database has great potential as a resource for clinical and health policy research because it is population based with a high level of completeness and accuracy.

Physical Activity in Patients Treated With Peritoneal Dialysis: A Protocol for a Systematic Review.

PubMed

Thangarasa, Tharshika; Imtiaz, Rameez; Hiremath, Swapnil; Zimmerman, Deborah

2017-01-01

Patients with chronic diseases are known to benefit from exercise. Despite a lack of compelling evidence, patients with end-stage kidney disease treated with peritoneal dialysis are often discouraged from participating in exercise programs that include resistance training due to concerns about the development of hernias and leaks. The actual effects of physical activity with or without structured exercise programs for these patients remain unclear. The purpose of this study is to more completely define the risks and benefits of physical activity in the end-stage kidney disease population treated with peritoneal dialysis. We will conduct a systematic review examining the effects of physical activity on end-stage kidney disease patients treated with peritoneal dialysis. For the purposes of this review, exercise will be considered a purposive subcategory of physical activity. The primary objective is to determine if physical activity in this patient population is associated with improvements in mental health, physical functioning, fatigue and quality of life and if there is an increase in adverse outcomes. With the help of a skilled librarian, we will search MEDLINE, EMBASE, CINAHL, and Cochrane Central Register of Controlled Trials for randomized trials and observational studies. We will include adult end-stage kidney disease patients treated with peritoneal dialysis that have participated in an exercise training program or had their level of physical activity assessed directly or by self-report. The study must include an assessment of the association between physical activity and one of our primary or secondary outcomes measures. We will report study quality using the Cochrane Risk of Bias Assessment Tool for randomized controlled trials and the Newcastle-Ottawa Scale for observational studies. Quality across studies will be assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. The results of this review may help to inform guideline development for exercise recommendations specific to this patient population. PROSPERO:CRD42016041695.

Population-Based Assessment of Exposure to Risk Behaviors in Motion Pictures.

PubMed

Sargent, James D; Worth, Keilah A; Beach, Michael; Gerrard, Meg; Heatherton, Todd F

2008-01-01

The aim of most population-based studies of media is to relate a specific exposure to an outcome of interest. A research program has been developed that evaluates exposure to different components of movies in an attempt of assess the association of such exposure with the adoption of substance use during adolescence. To assess exposure to movie substance use, one must measure both viewing time and content. In developing the exposure measure, the study team was interested in circumventing a common problem in exposure measurement, where measures often conflate exposure to media with attention to media. Our aim in this paper is to present a validated measure of exposure to entertainment media, the Beach method, which combines recognition of a movie title with content analysis of the movie for substance use, to generate population based measures of exposure to substance use in this form of entertainment.

Population-Based Assessment of Exposure to Risk Behaviors in Motion Pictures

PubMed Central

Sargent, James D.; Worth, Keilah A.; Beach, Michael; Gerrard, Meg; Heatherton, Todd F.

2008-01-01

The aim of most population-based studies of media is to relate a specific exposure to an outcome of interest. A research program has been developed that evaluates exposure to different components of movies in an attempt of assess the association of such exposure with the adoption of substance use during adolescence. To assess exposure to movie substance use, one must measure both viewing time and content. In developing the exposure measure, the study team was interested in circumventing a common problem in exposure measurement, where measures often conflate exposure to media with attention to media. Our aim in this paper is to present a validated measure of exposure to entertainment media, the Beach method, which combines recognition of a movie title with content analysis of the movie for substance use, to generate population based measures of exposure to substance use in this form of entertainment. PMID:19122801

Country News.

ERIC Educational Resources Information Center

Population Education Newsletter and Forum, 1988

1988-01-01

Summarizes information shared at an international seminar on teacher training, the management of population education, and adolescent education. Proposes an evaluative research activity to assess the achievements of these experiences. Indicates that experimental schools have reported positive outcomes for the program. Describes efforts in several…

Developing a Defense Sector Assessment Rating Tool

DTIC Science & Technology

2010-01-01

JUSTICE EDUCATION ENERGY AND ENVIRONMENT HEALTH AND HEALTH CARE INTERNATIONAL AFFAIRS NATIONAL SECURITY POPULATION AND AGING PUBLIC SAFETY SCIENCE AND...Cathryn Quantic Thurston, and Gregory F. Treverton (MG-863-OSD). • Making Liberia Safe: Transformation of the National Security Sector, by David C...Cathryn Quantic Thurston, and Gregory F. Treverton, A Framework to Assess Programs for Building Partnerships, Santa Monica, Calif.: RAND Corporation

Three Scales Assessing High School Students' Attitudes and Perceived Norms about Seeking Adult Help for Distress and Suicide Concerns

ERIC Educational Resources Information Center

Schmeelk-Cone, Karen; Pisani, Anthony R.; Petrova, Mariya; Wyman, Peter A.

2012-01-01

Validated measures that can be administered to school populations are needed to advance knowledge of help-seeking processes and to evaluate suicide prevention programs that target help-seeking. With 6,370 students from 22 high schools, we assessed the psychometric properties of three brief measures: Help-Seeking Acceptability at School, Adult Help…

Validity, Reliability, and Equity Issues in an Observational Talent Assessment Process in the Performing Arts

ERIC Educational Resources Information Center

Oreck, Barry A.; Owen, Steven V.; Baum, Susan M.

2003-01-01

The lack of valid, research-based methods to identify potential artistic talent hampers the inclusion of the arts in programs for the gifted and talented. The Talent Assessment Process in Dance, Music, and Theater (D/M/T TAP) was designed to identify potential performing arts talent in diverse populations, including bilingual and special education…

Evaluating an accelerated nursing program: a dashboard for diversity.

PubMed

Schmidt, Bonnie J; MacWilliams, Brent R

2015-01-01

Diversity is a topic of increasing attention in higher education and the nursing workforce. Experts have called for a nursing workforce that mirrors the population it serves. Students in nursing programs in the United States do not reflect our country's diverse population; therefore, much work is needed before that goal can be reached. Diversity cannot be successfully achieved in nursing education without inclusion and attention to quality. The Inclusive Excellence framework can be used by nurse educators to promote inclusion, diversity, and excellence. In this framework, excellence and diversity are linked in an intentional metric-driven process. Accelerated programs offer a possible venue to promote diversity, and one accelerated program is examined using a set of metrics and a dashboard approach commonly used in business settings. Several recommendations were made for future assessment, interventions, and monitoring. Nurse educators are called to examine and adopt a diversity dashboard in all nursing programs. Copyright © 2015 Elsevier Inc. All rights reserved.

Evaluation of the impact of the voucher and accreditation approach on improving reproductive behaviors and RH status: Bangladesh

PubMed Central

2011-01-01

Background Cost of delivering reproductive health services to low-income populations will always require total or partial subsidization by the government and/or development partners. Broadly termed "Demand-Side Financing" or "Output-Based Aid", includes a range of interventions that channel government or donor subsidies to the service user rather than the service provider. Initial findings from the few assessments of reproductive health voucher-and-accreditation programs suggest that, if implemented well, these programs have great potential for achieving the policy objectives of increasing access and use, reducing inequities and enhancing program efficiency and service quality. At this point in time, however, there is a paucity of evidence describing how the various voucher programs function in different settings, for various reproductive health services. Methods/Design Population Council-Nairobi, funded by the Bill and Melinda Gates Foundation, intends to address the lack of evidence around the pros and cons of 'voucher and accreditation' approaches to improving the reproductive health of low income women in five developing countries. In Bangladesh, the activities will be conducted in 11 accredited health facilities where Demand Side Financing program is being implemented and compared with populations drawn from areas served by similar non-accredited facilities. Facility inventories, client exit interviews and service provider interviews will be used to collect comparable data across each facility for assessing readiness and quality of care. In-depth interviews with key stakeholders will be conducted to gain a deeper understanding about the program. A population-based survey will also be carried out in two types of locations: areas where vouchers are distributed and similar locations where vouchers are not distributed. Discussion This is a quasi-experimental study which will investigate the impact of the voucher approach on improving maternal health behaviors and status and reducing inequities at the population level. We expect a significant increase in the utilization of maternal health care services by the accredited health facilities in the experimental areas compared to the control areas as a direct result of the interventions. If the voucher scheme in Bangladesh is found effective, it may help other countries to adopt this approach for improving utilization of maternity care services for reducing maternal mortality. PMID:21513528

Evaluation of the impact of the voucher and accreditation approach on improving reproductive behaviors and RH status: Bangladesh.

PubMed

Rob, Ubaidur; Rahman, Moshiur; Bellows, Benjamin

2011-04-22

Cost of delivering reproductive health services to low-income populations will always require total or partial subsidization by the government and/or development partners. Broadly termed "Demand-Side Financing" or "Output-Based Aid", includes a range of interventions that channel government or donor subsidies to the service user rather than the service provider. Initial findings from the few assessments of reproductive health voucher-and-accreditation programs suggest that, if implemented well, these programs have great potential for achieving the policy objectives of increasing access and use, reducing inequities and enhancing program efficiency and service quality. At this point in time, however, there is a paucity of evidence describing how the various voucher programs function in different settings, for various reproductive health services. Population Council-Nairobi, funded by the Bill and Melinda Gates Foundation, intends to address the lack of evidence around the pros and cons of 'voucher and accreditation' approaches to improving the reproductive health of low income women in five developing countries. In Bangladesh, the activities will be conducted in 11 accredited health facilities where Demand Side Financing program is being implemented and compared with populations drawn from areas served by similar non-accredited facilities. Facility inventories, client exit interviews and service provider interviews will be used to collect comparable data across each facility for assessing readiness and quality of care. In-depth interviews with key stakeholders will be conducted to gain a deeper understanding about the program. A population-based survey will also be carried out in two types of locations: areas where vouchers are distributed and similar locations where vouchers are not distributed. This is a quasi-experimental study which will investigate the impact of the voucher approach on improving maternal health behaviors and status and reducing inequities at the population level. We expect a significant increase in the utilization of maternal health care services by the accredited health facilities in the experimental areas compared to the control areas as a direct result of the interventions. If the voucher scheme in Bangladesh is found effective, it may help other countries to adopt this approach for improving utilization of maternity care services for reducing maternal mortality.

Application of mobile technology for improving expanded program on immunization among highland minority and stateless populations in northern Thailand border.

PubMed

Kaewkungwal, Jaranit; Apidechkul, Tawatchai; Jandee, Kasemsak; Khamsiriwatchara, Amnat; Lawpoolsri, Saranath; Sawang, Surasak; Sangvichean, Aumnuyphan; Wansatid, Peerawat; Krongrungroj, Sarinya

2015-01-14

Studies of undervaccinated children of minority/stateless populations have highlighted significant barriers at individual, community, and state levels. These include geography-related difficulties, poverty, and social norms/beliefs. The objective of this study was to assess project outcomes regarding immunization coverage, as well as maternal attitudes and practices toward immunization. The "StatelessVac" project was conducted in Thailand-Myanmar-Laos border areas using cell phone-based mechanisms to increase immunization coverage by incorporating phone-to-phone information sharing for both identification and prevention. With limitation of the study among vulnerable populations in low-resource settings, the pre/post assessments without comparison group were conducted. Immunization coverage was collected from routine monthly reports while behavior-change outcomes were from repeat surveys. This study revealed potential benefits of the initiative for case identification; immunization coverage showed an improved trend. Prevention strategies were successfully integrated into the routine health care workflows of immunization activities at point-of-care. A behavior-change-communication package contributes significantly in raising both concern and awareness in relation to child care. The mobile technology has proven to be an effective mechanism in improving a children's immunization program among these hard-to-reach populations. Part of the intervention has now been revised for use at health centers across the country.

Fall risk assessment and prevention.

PubMed

Kline, Nancy E; Davis, Mary Elizabeth; Thom, Bridgette

2011-02-01

Patient falls are a common cause of morbidity and are the leading cause of injury deaths in adults age 65 years and older. Injuries sustained as result of falls in a cancer hospital are often severe, regardless of patient age, due to the nature of the underlying cancer. Falls are a nursing-sensitive indicator and nurses are in a unique position to assess, design, implement, and evaluate programs for fall risk reduction. We analyzed our nursing processes related to falls and fall prevention in conjunction with an evidence-based review, a research study to improve our fall risk-assessment process, and development of a comprehensive fall-reduction program. This article outlines how our institution developed a fall risk assessment for the oncology patient population, and utilized this assessment in a comprehensive nursing approach to fall prevention in both inpatient and outpatient settings.

Reviewing the evidence on effectiveness and cost-effectiveness of HIV prevention strategies in Thailand.

PubMed

Pattanaphesaj, Juntana; Teerawattananon, Yot

2010-07-07

Following universal access to antiretroviral therapy in Thailand, evidence from National AIDS Spending Assessment indicates a decreasing proportion of expenditure on prevention interventions. To prompt policymakers to revitalize HIV prevention, this study identifies a comprehensive list of HIV/AIDs preventive interventions that are likely to be effective and cost-effective in Thailand. A systematic review of the national and international literature on HIV prevention strategies from 1997 to 2008 was undertaken. The outcomes used to consider the effectiveness of HIV prevention interventions were changes in HIV risk behaviour and HIV incidence. Economic evaluations that presented their results in terms of cost per HIV infection averted or cost per quality-adjusted life year (QALY) gained were also included. All studies were assessed against quality criteria. The findings demonstrated that school based-sex education plus life-skill programs, voluntary and routine HIV counselling and testing, male condoms, street outreach programs, needle and syringe programs, programs for the prevention of mother-to-child HIV transmission, male circumcision, screening blood products and donated organs for HIV, and increased alcohol tax were all effective in reducing HIV infection among target populations in a cost-effective manner. We found very limited local evidence regarding the effectiveness of HIV interventions amongst specific high risk populations. This underlines the urgent need to prioritise health research resources to assess the effectiveness and cost-effectiveness of HIV interventions aimed at reducing HIV infection among high risk groups in Thailand.

A likelihood framework for joint estimation of salmon abundance and migratory timing using telemetric mark-recapture

USGS Publications Warehouse

Bromaghin, Jeffrey F.; Gates, Kenneth S.; Palmer, Douglas E.

2010-01-01

Many fisheries for Pacific salmon Oncorhynchus spp. are actively managed to meet escapement goal objectives. In fisheries where the demand for surplus production is high, an extensive assessment program is needed to achieve the opposing objectives of allowing adequate escapement and fully exploiting the available surplus. Knowledge of abundance is a critical element of such assessment programs. Abundance estimation using mark—recapture experiments in combination with telemetry has become common in recent years, particularly within Alaskan river systems. Fish are typically captured and marked in the lower river while migrating in aggregations of individuals from multiple populations. Recapture data are obtained using telemetry receivers that are co-located with abundance assessment projects near spawning areas, which provide large sample sizes and information on population-specific mark rates. When recapture data are obtained from multiple populations, unequal mark rates may reflect a violation of the assumption of homogeneous capture probabilities. A common analytical strategy is to test the hypothesis that mark rates are homogeneous and combine all recapture data if the test is not significant. However, mark rates are often low, and a test of homogeneity may lack sufficient power to detect meaningful differences among populations. In addition, differences among mark rates may provide information that could be exploited during parameter estimation. We present a temporally stratified mark—recapture model that permits capture probabilities and migratory timing through the capture area to vary among strata. Abundance information obtained from a subset of populations after the populations have segregated for spawning is jointly modeled with telemetry distribution data by use of a likelihood function. Maximization of the likelihood produces estimates of the abundance and timing of individual populations migrating through the capture area, thus yielding substantially more information than the total abundance estimate provided by the conventional approach. The utility of the model is illustrated with data for coho salmon O. kisutch from the Kasilof River in south-central Alaska.

Population trends, bend use relative to available habitat and within-river-bend habitat use of eight indicator species of Missouri and Lower Kansas River benthic fishes: 15 years after baseline assessment

USGS Publications Warehouse

Wildhaber, Mark L.; Yang, Wen-Hsi; Arab, Ali

2016-01-01

A baseline assessment of the Missouri River fish community and species-specific habitat use patterns conducted from 1996 to 1998 provided the first comprehensive analysis of Missouri River benthic fish population trends and habitat use in the Missouri and Lower Yellowstone rivers, exclusive of reservoirs, and provided the foundation for the present Pallid Sturgeon Population Assessment Program (PSPAP). Data used in such studies are frequently zero inflated. To address this issue, the zero-inflated Poisson (ZIP) model was applied. This follow-up study is based on PSPAP data collected up to 15 years later along with new understanding of how habitat characteristics among and within bends affect habitat use of fish species targeted by PSPAP, including pallid sturgeon. This work demonstrated that a large-scale, large-river, PSPAP-type monitoring program can be an effective tool for assessing population trends and habitat usage of large-river fish species. Using multiple gears, PSPAP was effective in monitoring shovelnose and pallid sturgeons, sicklefin, shoal and sturgeon chubs, sand shiner, blue sucker and sauger. For all species, the relationship between environmental variables and relative abundance differed, somewhat, among river segments suggesting the importance of the overall conditions of Upper and Middle Missouri River and Lower Missouri and Kansas rivers on the habitat usage patterns exhibited. Shoal and sicklefin chubs exhibited many similar habitat usage patterns; blue sucker and shovelnose sturgeon also shared similar responses. For pallid sturgeon, the primary focus of PSPAP, relative abundance tended to increase in Upper and Middle Missouri River paralleling stocking efforts, whereas no evidence of an increasing relative abundance was found in the Lower Missouri River despite stocking.

New indicators proposed to assess tuberculosis control and elimination in Cuba.

PubMed

González, Edilberto R; Armas, Luisa

2012-10-01

Following 48 years of successful operation of the National Tuberculosis Control Program, Cuban health authorities have placed tuberculosis elimination on the agenda. To this end some tuberculosis control processes and their indicators need redesigned and new ones introduced, related to: number and proportion of suspected tuberculosis cases among vulnerable population groups; tuberculosis suspects with sputum microscopy and culture results useful for diagnosis (interpretable); and number of identified contacts of reported tuberculosis cases who were fully investigated. Such new indicators have been validated and successfully implemented in all provinces (2011-12) and are in the approval pipeline for generalized use in the National Tuberculosis Control Program. These indicators complement existing criteria for quality of case detection and support more comprehensive program performance assessment.

The Commander's Wellness Program: Assessing the Association Between Health Measures and Physical Fitness Assessment Scores, Fitness Assessment Exemptions, and Duration of Limited Duty.

PubMed

Tvaryanas, Col Anthony P; Greenwell, Brandon; Vicen, Gloria J; Maupin, Genny M

2018-03-26

Air Force Medical Service health promotions staff have identified a set of evidenced-based interventions targeting tobacco use, sleep habits, obesity/healthy weight, and physical activity that could be integrated, packaged, and deployed as a Commander's Wellness Program. The premise of the program is that improvements in the aforementioned aspects of the health of unit members will directly benefit commanders in terms of members' fitness assessment scores and the duration of periods of limited duty. The purpose of this study is to validate the Commander's Wellness Program assumption that body mass index (BMI), physical activity habits, tobacco use, sleep, and nutritional habits are associated with physical fitness assessment scores, fitness assessment exemptions, and aggregate days of limited duty in the population of active duty U.S. Air Force personnel. This study used a cross-sectional analysis of active duty U.S. Air Force personnel with an Air Force Web-based Health Assessment and fitness assessment data during fiscal year 2013. Predictor variables included age, BMI, gender, physical activity level (moderate physical activity, vigorous activity, and muscle activity), tobacco use, sleep, and dietary habits (consumption of a variety of foods, daily servings of fruits and vegetables, consumption of high-fiber foods, and consumption of high-fat foods). Nonparametric methods were used for the exploratory analysis and parametric methods were used for model building and statistical inference. The study population comprised 221,239 participants. Increasing BMI and tobacco use were negatively associated with the outcome of composite fitness score. Increasing BMI and tobacco use and decreasing sleep were associated with an increased likelihood for the outcome of fitness assessment exemption status. Increasing BMI and tobacco use and decreasing composite fitness score and sleep were associated with an increased likelihood for the outcome of limited duty status, whereas increasing BMI and decreasing sleep were associated with the outcome of increased aggregate days of limited duty. The observed associations were in the expected direction and the effect sizes were modest. Physical activity habits and nutritional habits were not observed to be associated with any of the outcome measures. The Commander's Wellness Program should be scoped to those interventions targeting BMI, composite fitness score, sleep, and tobacco use. Although neither self-reported physical activity nor nutritional habits were associated with the outcomes, it is still worthwhile to include related interventions in the Commander's Wellness Program because of the finding in other studies of a consistent association between the overall number of health risks and productivity outcomes.

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.

Towards gender-sensitivity: the Philippine POPCOM experience. How sensitive to gender issues are our family planning personnel?

PubMed

Danguilan, M

1995-04-01

The Philippine Commission on Population (POPCOM) sets and coordinates the country's population policy. POPCOM launched Gender I in early 1994 in the attempt to find out how aware and sensitive its board of commissioners, staff, and the provincial and city population officers were on gender and population issues. The assessment covered the respondents' gender relations at the workplace; gender, work, and family responsibilities; job satisfaction; their perceptions about gender-related issues in reproductive health; personal sex attitudes; and general perceptions on gender issues. The project also explored respondents' knowledge and perceptions on population growth and structure; population information generation and use; quality of life; reproductive health; law, ethics, and policy; and men's and women's roles. Having completed the institutional assessment, POPCOM has now implemented the Gender II project designed to strengthen the formulation, coordination, and implementation of gender-aware population and reproductive health policies and programs. Project activities include policy review and framework development, capability building through gender and reproductive health training and information management, and special research projects.

USE OF CITIZEN BIRD POPULATION MONITORING DATA FOR ECOLOGICAL RISK ASSESSMENT

EPA Science Inventory

Birds are among the most conspicuous and easily monitored indicators of environmental health and change. Although volunteer avian monitoring ('citizen science') programs provide unique opportunities to gather data at fine and broad geographic scales simultaneously, and over long...

Population dynamics and the economics of invasive species management: the greenhouse whitefly in California-grown strawberries.

PubMed

McKee, Gregory J; Goodhue, Rachael E; Zalom, Frank G; Carter, Colin A; Chalfant, James A

2009-01-01

In agriculture, relatively few efficacious control measures may be available for an invasive pest. In the case of a new insect pest, insecticide use decisions are affected by regulations associated with its registration, insect population dynamics, and seasonal market price cycles. We assess the costs and benefits of environmental regulations designed to regulate insecticide applications on an invasive species. We construct a bioeconomic model, based on detailed scientific data, of management decisions for a specific invasion: greenhouse whiteflies in California-grown strawberries. The empirical model integrates whitefly population dynamics, the effect of whitefly feeding on strawberry yields, and weekly strawberry price. We use the model to assess the optimality of alternative treatment programs on a simulated greenhouse whitefly population. Our results show that regulations may lead growers to "under-spray" when placed in an economic context, and provide some general lessons about the design of optimal invasive species control policies.

On the value of the phenotypes in the genomic era.

PubMed

Gonzalez-Recio, O; Coffey, M P; Pryce, J E

2014-12-01

Genetic improvement programs around the world rely on the collection of accurate phenotypic data. These phenotypes have an inherent value that can be estimated as the contribution of an additional record to genetic gain. Here, the contribution of phenotypes to genetic gain was calculated using traditional progeny testing (PT) and 2 genomic selection (GS) strategies that, for simplicity, included either males or females in the reference population. A procedure to estimate the theoretical economic contribution of a phenotype to a breeding program is described for both GS and PT breeding programs through the increment in genetic gain per unit of increase in estimated breeding value reliability obtained when an additional phenotypic record is added. The main factors affecting the value of a phenotype were the economic value of the trait, the number of phenotypic records already available for the trait, and its heritability. Furthermore, the value of a phenotype was affected by several other factors, including the cost of establishing the breeding program and the cost of phenotyping and genotyping. The cost of achieving a reliability of 0.60 was assessed for different reference populations for GS. Genomic reference populations of more sires with small progeny group sizes (e.g., 20 equivalent daughters) had a lower cost than those reference populations with either large progeny group sizes for fewer genotyped sires, or female reference populations, unless the heritability was large and the cost of phenotyping exceeded a few hundred dollars; then, female reference populations were preferable from an economic perspective. Copyright © 2014 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

Health Outcomes for Clients of Needle and Syringe Programs in Prisons.

PubMed

Lazarus, Jeffrey V; Safreed-Harmon, Kelly; Hetherington, Kristina L; Bromberg, Daniel J; Ocampo, Denise; Graf, Niels; Dichtl, Anna; Stöver, Heino; Wolff, Hans

2018-04-12

High levels of drug dependence have been observed in the prison population globally, and the sharing of injecting drug equipment in prisons has contributed to higher prevalence of bloodborne diseases in prisoners than in the general population. Few prison needle and syringe programs (PNSPs) exist. We conducted a systematic review to assess evidence regarding health outcomes of PNSPs. We searched peer-reviewed databases for data relating to needle and syringe programs in prisons. The search methodology was conducted in accordance with accepted guidelines. Five studies met review inclusion criteria, and all presented evidence associating PNSPs with one or more health benefits, but the strength of the evidence was low. The outcomes for which the studies collectively demonstrated the strongest evidence were prevention of human immunodeficiency virus and viral hepatitis. Few negative consequences from PNSPs were observed, consistent with previous evidence assessments. More research is needed on PNSP effectiveness, and innovative study designs are needed to overcome methodological limitations of previous research. Until stronger evidence becomes available, policymakers are urged to recognize that not implementing PNSPs has the potential to cause considerable harm, in light of what is currently known about the risks and benefits of needle and syringe programs and PNSPs and about the high prevalence of human immunodeficiency virus and viral hepatitis in prisons.

What linear programming contributes: world food programme experience with the "cost of the diet" tool.

PubMed

Frega, Romeo; Lanfranco, Jose Guerra; De Greve, Sam; Bernardini, Sara; Geniez, Perrine; Grede, Nils; Bloem, Martin; de Pee, Saskia

2012-09-01

Linear programming has been used for analyzing children's complementary feeding diets, for optimizing nutrient adequacy of dietary recommendations for a population, and for estimating the economic value of fortified foods. To describe and apply a linear programming tool ("Cost of the Diet") with data from Mozambique to determine what could be cost-effective fortification strategies. Based on locally assessed average household dietary needs, seasonal market prices of available food products, and food composition data, the tool estimates the lowest-cost diet that meets almost all nutrient needs. The results were compared with expenditure data from Mozambique to establish the affordability of this diet by quintiles of the population. Three different applications were illustrated: identifying likely "limiting nutrients," comparing cost effectiveness of different fortification interventions at the household level, and assessing economic access to nutritious foods. The analysis identified iron, vitamin B2, and pantothenic acid as "limiting nutrients." Under the Mozambique conditions, vegetable oil was estimated as a more cost-efficient vehicle for vitamin A fortification than sugar; maize flour may also be an effective vehicle to provide other constraining micronutrients. Multiple micronutrient fortification of maize flour could reduce the cost of the "lowest-cost nutritious diet" by 18%, but even this diet can be afforded by only 20% of the Mozambican population. Within the context of fortification, linear programming can be a useful tool for identifying likely nutrient inadequacies, for comparing fortification options in terms of cost effectiveness, and for illustrating the potential benefit of fortification for improving household access to a nutritious diet.

Ethnographic Assessment of an Alternative to Incarceration for Women with Minor Children

PubMed Central

Goshin, Lorie S.

2015-01-01

Allowing criminal justice-involved women to remain with their children in the community may decrease some of the negative intergenerational effects of incarceration. Little is known about potential program models to safely support community co-residence in this population. Ethnographic methods were used to explore the historical development of and life within a supportive housing alternative to incarceration (ATI) program for women with minor children and how they impact the health and social needs of resident families. Participants included 8 current and former adult tenant, 12 of the their resident children, 3 program staff, the program administrator, and 5 prosecutors who originally conceptualized it. Women also reported information about their 8 non-resident children. Analysis revealed three major themes: “The Cycle,” “This is My Home,” and “This Doesn’t Go With That.” While the program built on a core value of family preservation, results illustrate that keeping families together is only the beginning. Clinical and research implications for co-residence ATI programs are discussed in relation to the uniqueness of this context and population. PMID:26460706

Assessment of the relationship of government spending on social assistance programs with Brazilian macroeconomic variables

NASA Astrophysics Data System (ADS)

de Senna, Viviane; Souza, Adriano Mendonça

2016-11-01

Since the 1988 Federal Constitution social assistance has become a duty of the State and a right to everyone, guaranteeing the population a dignified life. To ensure these rights federal government has created programs that can supply the main needs of people in extreme poverty. Among the programs that provide social assistance to the population, the best known are the ;Bolsa Família; Program - PBF and the Continuous Cash Benefit - Continuous Cash Benefit - BPC. This research's main purpose is to analyze the relationship between the main macroeconomic variables and the Federal government spending on social welfare policy in the period from January 2004 to August 2014. The used methodologies are the Vector auto regression model - VAR and Error Correction Vector - VEC. The conclusion, was that there is a meaningful relationship between macroeconomic variables and social assistance programs. This indicates that if the government takes a more abrupt resolution in changing the existing programs it will result in fluctuations in the main macroeconomic variables interfering with the stability of Brazilian domestic economy up to twelve months.

Economic Evidence for U.S. Asthma Self-Management Education and Home-Based Interventions

PubMed Central

Hsu, Joy; Wilhelm, Natalie; Lewis, Lillianne; Herman, Elizabeth

2016-01-01

The health and economic burden of asthma in the United States is substantial. Asthma self-management education (AS-ME) and home-based interventions for asthma can improve asthma control and prevent asthma exacerbations, and interest in health care-public health collaboration regarding asthma is increasing. However, outpatient AS-ME and home-based asthma intervention programs are not widely available; economic sustainability is a common concern. Thus, we conducted a narrative review of existing literature regarding economic outcomes of outpatient AS-ME and home-based intervention programs for asthma in the United States. We identified 9 outpatient AS-ME programs and 17 home-based intervention programs with return on investment (ROI) data. Most programs were associated with a positive ROI; a few programs observed positive ROIs only among selected populations (e.g., higher health care utilization). Interpretation of existing data is limited by heterogeneous ROI calculations. Nevertheless, the literature suggests promise for sustainable opportunities to expand access to outpatient AS-ME and home-based asthma intervention programs in the United States. More definitive knowledge about how to maximize program benefit and sustainability could be gained through more controlled studies of specific populations and increased uniformity in economic assessments. PMID:27658535

Population health intervention research training: the value of public health internships and mentorship.

PubMed

Hamelin, Anne-Marie; Paradis, Gilles

2018-01-01

Better alignment between academia and public health practice and policies are critical to improve public health actions. Training of future researchers to address complex issues and to conduct transdisciplinary and collaborative research will help improve this alignment. In this paper, we describe the role of internship placements and mentorship for trainees' skills development in population health intervention research and the benefits of embedding research trainees within public health organizations. This qualitative descriptive study assessed the perceptions of the role and benefits of internships and mentorship for population health intervention research training among former doctoral and postdoctoral students, public health mentors, and senior public health managers who participated in the 4P Program, a research training program which bridges academic training and the public health system in Quebec, Canada. Two types of interviews were conducted: telephone semi-structured interviews by an external evaluator and face-to-face trainee "exit" interviews by the Program co-director. Semi-annual evaluation reports from each trainee were also reviewed. Qualitative data were subjected to a thematic analysis. Internships provided trainees with a working knowledge of the public health system and the context in which decisions and public health interventions are implemented. It was an opportunity for trainees to interact with knowledge-user partners and assess the gap between research and practice. Effective mentorship was key to help trainees interpret the public health reality and develop population health intervention research skills. Trainees learned to ask the "how" questions that are critical for in-depth understanding of complex interventions and the conditions under which they can be best implemented. Conditions of success of internships and mentorship for population health intervention research included the alignment of the interests between the trainee, the mentor and the public health organization, quality mentoring, and the acquisition of specific population health intervention skills, especially collaborative research skills. The findings suggest that public health internships and mentorship facilitate trainee engagement in applied public health research.

Framework for assessing causality in disease management programs: principles.

PubMed

Wilson, Thomas; MacDowell, Martin

2003-01-01

To credibly state that a disease management (DM) program "caused" a specific outcome it is required that metrics observed in the DM population be compared with metrics that would have been expected in the absence of a DM intervention. That requirement can be very difficult to achieve, and epidemiologists and others have developed guiding principles of causality by which credible estimates of DM impact can be made. This paper introduces those key principles. First, DM program metrics must be compared with metrics from a "reference population." This population should be "equivalent" to the DM intervention population on all factors that could independently impact the outcome. In addition, the metrics used in both groups should use the same defining criteria (ie, they must be "comparable" to each other). The degree to which these populations fulfill the "equivalent" assumption and metrics fulfill the "comparability" assumption should be stated. Second, when "equivalence" or "comparability" is not achieved, the DM managers should acknowledge this fact and, where possible, "control" for those factors that may impact the outcome(s). Finally, it is highly unlikely that one study will provide definitive proof of any specific DM program value for all time; thus, we strongly recommend that studies be ongoing, at multiple points in time, and at multiple sites, and, when observational study designs are employed, that more than one type of study design be utilized. Methodologically sophisticated studies that follow these "principles of causality" will greatly enhance the reputation of the important and growing efforts in DM.

The Medicare Hospital Readmissions Reduction Program: potential unintended consequences for hospitals serving vulnerable populations.

PubMed

Gu, Qian; Koenig, Lane; Faerberg, Jennifer; Steinberg, Caroline Rossi; Vaz, Christopher; Wheatley, Mary P

2014-06-01

To explore the impact of the Hospital Readmissions Reduction Program (HRRP) on hospitals serving vulnerable populations. Medicare inpatient claims to calculate condition-specific readmission rates. Medicare cost reports and other sources to determine a hospital's share of duals, profit margin, and characteristics. Regression analyses and projections were used to estimate risk-adjusted readmission rates and financial penalties under the HRRP. Findings were compared across groups of hospitals, determined based on their share of duals, to assess differential impacts of the HRRP. Both patient dual-eligible status and a hospital's dual-eligible share of Medicare discharges have a positive impact on risk-adjusted hospital readmission rates. Under current Centers for Medicare and Medicaid Service methodology, which does not adjust for socioeconomic status, high-dual hospitals are more likely to have excess readmissions than low-dual hospitals. As a result, HRRP penalties will disproportionately fall on high-dual hospitals, which are more likely to have negative all-payer margins, raising concerns of unintended consequences of the program for vulnerable populations. Policies to reduce hospital readmissions must balance the need to ensure continued access to quality care for vulnerable populations. © Health Research and Educational Trust.

The Medicare Hospital Readmissions Reduction Program: Potential Unintended Consequences for Hospitals Serving Vulnerable Populations

PubMed Central

Gu, Qian; Koenig, Lane; Faerberg, Jennifer; Steinberg, Caroline Rossi; Vaz, Christopher; Wheatley, Mary P

2014-01-01

Objective To explore the impact of the Hospital Readmissions Reduction Program (HRRP) on hospitals serving vulnerable populations. Data Sources/Study Setting Medicare inpatient claims to calculate condition-specific readmission rates. Medicare cost reports and other sources to determine a hospital's share of duals, profit margin, and characteristics. Study Design Regression analyses and projections were used to estimate risk-adjusted readmission rates and financial penalties under the HRRP. Findings were compared across groups of hospitals, determined based on their share of duals, to assess differential impacts of the HRRP. Principal Findings Both patient dual-eligible status and a hospital's dual-eligible share of Medicare discharges have a positive impact on risk-adjusted hospital readmission rates. Under current Centers for Medicare and Medicaid Service methodology, which does not adjust for socioeconomic status, high-dual hospitals are more likely to have excess readmissions than low-dual hospitals. As a result, HRRP penalties will disproportionately fall on high-dual hospitals, which are more likely to have negative all-payer margins, raising concerns of unintended consequences of the program for vulnerable populations. Conclusions Policies to reduce hospital readmissions must balance the need to ensure continued access to quality care for vulnerable populations. PMID:24417309

Ex-ante assessment of different vaccination-based control schedules against the peste des petits ruminants virus in sub-Saharan Africa

PubMed Central

Lancelot, Renaud; Domenech, Joseph; Lesnoff, Matthieu

2018-01-01

Background Peste des petits ruminants (PPR) is a highly contagious and widespread viral infection of small ruminants (goats and sheep), causing heavy economic losses in many developing countries. Therefore, its progressive control and global eradication by 2030 was defined as a priority by international organizations addressing animal health. The control phase of the global strategy is based on mass vaccination of small ruminant populations in endemic regions or countries. It is estimated that a 70% post-vaccination immunity rate (PVIR) is needed in a given epidemiological unit to prevent PPR virus spread. However, implementing mass vaccination is difficult and costly in smallholder farming systems with scattered livestock and limited facilities. Regarding this, controlling PPR is a special challenge in sub-Saharan Africa. In this study, we focused on this region to assess the effect of several variables of PVIR in two contrasted smallholder farming systems. Methods Using a seasonal matrix population model of PVIR, we estimated its decay in goats reared in sub-humid areas, and sheep reared in semi-arid areas, over a 4-year vaccination program. Assuming immunologically naive and PPR-free epidemiological unit, we assessed the ability of different vaccination scenarios to reach the 70% PVIR throughout the program. The tested scenarios differed in i) their overall schedule, ii) their delivery month and iii) their vaccination coverage. Results In sheep reared in semi-arid areas, the vaccination month did affect the PVIR decay though it did not in goats in humid regions. In both cases, our study highlighted i) the importance of targeting the whole eligible population at least during the two first years of the vaccination program and ii) the importance of reaching a vaccination coverage as high as 80% of this population. This study confirmed the relevance of the vaccination schedules recommended by international organizations. PMID:29351277

Economic Impact of a Medicaid Population Health Management Program

PubMed Central

Strothers, Harry; Miller, William Johnson; McLaren, Susan; Moore, Barbara; Sambamoorthi, Usha

2011-01-01

Abstract A population health management program was implemented to assess growth in health care expenditures for the disabled segment of Georgia's Medicaid population before and during the first year of a population health outcomes management program, and to compare those expenditures with projected costs based on various cost inflation trend assumptions. A retrospective, nonexperimental approach was used to analyze claims data from Georgia Medicaid claims files for all program-eligible persons for each relevant time period (intent-to-treat basis). These included all non-Medicare, noninstitutionalized Medicaid aged-blind-disabled adults older than 18 years of age. Comparisons of health care expenditures and utilization were made between base year (2003–2004) and performance year one (2006–2007), and of the difference between actual expenditures incurred in the performance year vs. projected expenditures based on various cost inflation assumptions. Demographic characteristics and clinical complexity of the population (as measured by the Chronic Illness and Disability Payment System risk score) actually increased from baseline to implementation. Actual expenditures were less than projected expenditures using any relevant medical inflation assumption. Actual expenditures were less than projected expenditures by $9.82 million when using a conservative US general medical inflation rate, by $43.6 million using national Medicaid cost trends, and by $106 million using Georgia Medicaid's own cost projections for the non-dually eligible disabled segment of Medicaid enrollees. Quadratic growth curve modeling also demonstrated a lower rate of increase in total expenditures. The rate of increase in expenditures was lower over the first year of program implementation compared with baseline. Weighted utilization rates were also lower in high-cost categories, such as inpatient days, despite increases in the risk profile of the population. Varying levels of cost avoidance could be inferred from differences between actual and projected expenditures using each of the health-related inflation assumptions. (Population Health Management 2011;14:215–222) PMID:21506728

Environmental Assessment: Demolish 934 of Grand Forks Air Force Base

DTIC Science & Technology

2006-03-01

adverse human health or environmental effects of their programs, policies , and activities on minority and low-income populations. There is no minority...AF Form 813 fulfill the requirements of the National Environmental Policy Act (NEPA), the Council of Environmental Quality (CEQ) regulations...Designation: Final Environmental Assessment (EA) Abstract: This EA has been prepared in accordance with the National Environmental Policy Act, and

Assessing the Strengths of Young Children at Risk: Examining Use of the Preschool Behavioral and Emotional Rating Scale with a Head Start Population

ERIC Educational Resources Information Center

Griffith, Annette K.; Hurley, Kristin Duppong; Trout, Alexandra L.; Synhorst, Lori; Epstein, Michael H.; Allen, Elizabeth

2010-01-01

Over the past decade, there has been an increased need for the development and use of psychometrically acceptable measures to assess the behavioral and emotional strengths of young children served in statewide preschool and Head Start programs. One measure developed to address this need is the Preschool Behavioral and Emotional Rating Scale…

The patient perspective: utilizing focus groups to inform care coordination for high-risk medicaid populations.

PubMed

Sheff, Alex; Park, Elyse R; Neagle, Mary; Oreskovic, Nicolas M

2017-07-25

Care coordination programs for high-risk, high-cost patients are a critical component of population health management. These programs aim to improve outcomes and reduce costs and have proliferated over the last decade. Some programs, originally designed for Medicare patients, are now transitioning to also serve Medicaid populations. However, there are still gaps in the understanding of what barriers to care Medicaid patients experience, and what supports will be most effective for providing them care coordination. We conducted two focus groups (n = 13) and thematic analyses to assess the outcomes drivers and programmatic preferences of Medicaid patients enrolled in a high-risk care coordination program at a major academic medical center in Boston, MA. Two focus groups identified areas where care coordination efforts were having a positive impact, as well as areas of unmet needs among the Medicaid population. Six themes emerged from the focus groups that clustered in three groupings: In the first group (1) enrollment in an existing medical care coordination programs, and (2) provider communication largely presented as positive accounts of assistance, and good relationships with providers, though participants also pointed to areas where these efforts fell short. In the second group (3) trauma histories, (4) mental health challenges, and (5) executive function difficulties all presented challenges faced by high-risk Medicaid patients that would likely require redress through additional programmatic supports. Finally, in the third group, (6) peer-to-peer support tendencies among patients suggested an untapped resource for care coordination programs. Programs aimed at high-risk Medicaid patients will want to consider programmatic adjustments to attend to patient needs in five areas: (1) provider connection/care coordination, (2) trauma, (3) mental health, (4) executive function/paperwork and coaching support, and (5) peer-to-peer support.

Acculturation, psychiatric comorbidity and posttraumatic stress disorder in a Taiwanese aboriginal population.

PubMed

Lee, Chau-Shoun; Chang, Jung-Chen; Liu, Chia-Yih; Chang, Ching-Jui; Chen, Tony H H; Chen, Chien-Hsiun; Cheng, Andrew T A

2009-01-01

This study investigates acculturation and other antecedent psychiatric and socio-environmental risk factors for posttraumatic stress disorder (PTSD) in one aboriginal group (the Bunun) exposed to an earthquake disaster in Taiwan. Respondents (n = 196) were assessed 5 months after the disaster, using a Chinese version of the Schedules for Clinical Assessment in Neuropsychiatry and the Taiwan Aboriginal Acculturation Scale. Four risk factors exerted independent effect on the risk of PTSD, including magnitude of the earthquake, subsequent traumas, antecedent major depressive disorder and acculturation status. Public mental health programs need to consider the liability to PTSD in populations with different ethnicity and socio-cultural environments.

Dental manpower planning in the Indian Health Service.

PubMed

Collins, R J; Broderick, E B; Herman, D J

1993-01-01

As a public health agency, the Indian Health Service (IHS) must plan for the needs of the entire American Indian and Alaskan Native (AI/AN) population and distribute resources as equitably as possible. To facilitate this process, the IHS has developed a manpower planning model to provide for the distribution of dental providers based upon the dental needs of the AI/AN population and within the limits of annual appropriations of funds. This paper briefly describes the original IHS Dental Program manpower planning model and the development of modifications over time. The need-based approach to manpower planning developed by the IHS Dental Program has exhibited utility and flexibility over time. It allows a determination of clinic size (number of operatories) and dental staffing requirements, and may be generalizable to other public health programs if an accurate assessment of utilization rate and treatment need can be made for the defined population. Nonetheless, the availability of resources in public programs is subject to the compromises inherent in the political process; thus, the use of a manpower planning model alone may not be sufficient to ensure the equitable distribution of dental resources and dental providers.

ColoNav: patient navigation for colorectal cancer screening in deprived areas - Study protocol.

PubMed

Allary, C; Bourmaud, A; Tinquaut, F; Oriol, M; Kalecinski, J; Dutertre, V; Lechopier, N; Pommier, M; Benoist, Y; Rousseau, S; Regnier, V; Buthion, V; Chauvin, F

2016-07-07

The mass colorectal cancer screening program was implemented in 2008 in France, targeting 16 million French people aged between 50 and 74. The current adhesion is insufficient and the participation rate is even lower among the underserved population, increasing health inequalities within our health care system. Patient Navigation programs have proved their efficiency to promote the access to cancer screening and diagnosis. The purpose of the study is to assess the implementation of a patient navigation intervention that has been described in another cultural environment and another health care system. The main objective of the program is to increase the colorectal cancer screening participation rate among the deprived population through the intervention of a navigator to promote the Fecal Occult Blood Test (FOBT) and complementary exams. We performed a multisite cluster randomized controlled trial, with three groups (one experimental group and two control groups) for 18 months. The study attempts to give a better understanding of the adhesion barriers to colorectal cancer screening among underserved populations. If this project is cost-effective, it could create a dynamic based on peer approaches that could be developed for other cancer screening programs and other chronic diseases. NCT02369757.

The evolution and geographic distribution of headache medicine fellowship programs and graduates: an observational study.

PubMed

Rizzoli, Paul; Weizenbaum, Emma; Loder, Thomas; Friedman, Deborah; Loder, Elizabeth

2014-01-01

We sought to assess the experiences, growth, and distribution of accredited headache medicine fellowships since accreditation began in 2007, and to examine the number and current practice locations of fellows graduated from those programs. There are no data on the distribution of headache fellowship programs and their graduates throughout the United States. We surveyed directors of Headache Medicine fellowship programs accredited by the United Council of Neurologic Subspecialties as of April 1, 2014. We recorded the geographic locations of accredited programs and fellowship graduates and determined their distribution in relation to the overall and selected minority populations of US census divisions, regions, and states. In early 2014, there were 25 accredited Headache Medicine fellowship programs in the United States. Thirty-two (63%) US states lack a headache fellowship program and 24 (47%) do not have a practicing United Council for Neurologic Subspecialties fellowship graduate. Fifty-two of 96 fellows (54%) entered practice in the same state where they did their training. The northeastern United States has the best ratio of fellowship programs and graduates to population (0.28 and 0.35 per million inhabitants) and land area (6.38 and 8 per 100,000 square miles). The Pacific Northwest has the worst (0.05 and 0.02 fellowship programs and graduates per million inhabitants and 2.3 and 1.1 per 100,000 square miles). Fifty-five percent of the US Hispanic population lives in areas of the country with only 32% of practicing certified headache specialists, 28% of accredited fellowship programs, and which have attracted only 27% of fellowship graduates. Thirty-three percent of the US black population lives in areas with just 8% of fellowship programs and 27% of fellowship graduates. Fellowship directors report that funding for fellowship positions is an important challenge. The number of fellowship programs has increased dramatically since 2007, but their geographic distribution is uneven and so are the subsequent practice locations of fellow graduates. At present, the distribution of training programs and headache specialists is not well matched to the US population as a whole or to the location of important racial and ethnic minorities. Increasing the overall supply of headache specialists is important, but geographic inequalities in specialist distribution must also be addressed or disparities will increase. © 2014 American Headache Society.

Population and habitat viability assessment for the Wyoming toad (Bufo baxteri): Final workshop report

USGS Publications Warehouse

2001-01-01

The Wyoming toad was listed as an endangered species under the Endangered Species Act on January 17, 1984, with a recovery plan approved in 1991. Currently the total population of the Wyoming toad includes approximately 200 animals in the captive breeding program and as few as 62 toads surviving at reintroduction sites in the Laramie Basin based upon fall 2000 survey data (after releases of more than 10,000 toads and tadpoles since 1995). Necessary conservation measures include improving reproduction and survival in the captive breeding program, improving survival at reintroduction sites, developing techniques to control the effects of the amphibian chytrid fungus, and eliminating threats and further habitat degradation in the wild.

Matgéné: a program to develop job-exposure matrices in the general population in France.

PubMed

Févotte, Joëlle; Dananché, Brigitte; Delabre, Laurène; Ducamp, Stephane; Garras, Loïc; Houot, Marie; Luce, Danièle; Orlowski, Ewa; Pilorget, Corinne; Lacourt, Aude; Brochard, Patrick; Goldberg, Marcel; Imbernon, Ellen

2011-10-01

Matgéné is a program to develop job-exposure matrices (JEMs) adapted to the general population in France for the period since 1950. The aim is to create retrospective exposure assessment tools for estimating the prevalence of occupational exposure to various agents that can then be correlated to health-related parameters. JEMs were drawn up by a team of six industrial hygienists who based their assessments on available occupational measurement, economic and statistical data, and several thousand job descriptions from epidemiological studies performed in France since 1984. Each JEM is specific to one agent, assessing exposure for a set of homogeneous combinations (occupation × activity × period) according to two occupational classifications (ISCO 1968 and PCS 1994) and one economic activities classification (NAF 2000). The cells of the JEM carry an estimate of the probability and level of exposure. Level is estimated by the duration and intensity of exposure-linked tasks or by description of the tasks when exposure measurement data are lacking for the agent in question. The JEMs were applied to a representative sample of the French population in 2007, and prevalence for each exposure was estimated in various population groups. All documents and data are available on a dedicated website. By the end of 2010, 18 JEMs have been developed and eight are under development, concerning a variety of chemical agents: organic and mineral dust, mineral fibers, and solvents. By implementation in the French population, exposure prevalences were calculated at different dates and for complete careers, and attributable risk fractions were estimated for certain pathologies. Some of these results were validated by comparison with those of other programs. Initial Matgéné JEMs results are in agreement with the French and international literature, thus validating the methodology. Exposure estimates precision, however, vary between agents and according to the amount of exposure measurement data available. These JEMs are important epidemiological tools, and improving their quality will require investment in occupational health data harvesting, especially in the case of low-level exposures.

BIRD COMMUNITIES AND HABITAT AS ECOLOGICAL INDICATORS OF FOREST CONDITION IN REGIONAL MONITORING

EPA Science Inventory

Ecological indicators for long-term monitoring programs are needed to detect and assess changing environmental conditions, We developed and tested community-level environmental indicators for monitoring forest bird populations and associated habitat. We surveyed 197 sampling plo...

42 CFR 438.206 - Availability of services.

Code of Federal Regulations, 2010 CFR

2010-10-01

... female enrollees with direct access to a women's health specialist within the network for covered care... (CONTINUED) MEDICAL ASSISTANCE PROGRAMS MANAGED CARE Quality Assessment and Performance Improvement Access... health care needs of specific Medicaid populations represented in the particular MCO, PIHP, and PAHP...

42 CFR 438.206 - Availability of services.

Code of Federal Regulations, 2014 CFR

2014-10-01

... female enrollees with direct access to a women's health specialist within the network for covered care... (CONTINUED) MEDICAL ASSISTANCE PROGRAMS MANAGED CARE Quality Assessment and Performance Improvement Access... health care needs of specific Medicaid populations represented in the particular MCO, PIHP, and PAHP...

42 CFR 438.206 - Availability of services.

Code of Federal Regulations, 2012 CFR

2012-10-01

... female enrollees with direct access to a women's health specialist within the network for covered care... (CONTINUED) MEDICAL ASSISTANCE PROGRAMS MANAGED CARE Quality Assessment and Performance Improvement Access... health care needs of specific Medicaid populations represented in the particular MCO, PIHP, and PAHP...

42 CFR 438.206 - Availability of services.

Code of Federal Regulations, 2011 CFR

2011-10-01

... female enrollees with direct access to a women's health specialist within the network for covered care... (CONTINUED) MEDICAL ASSISTANCE PROGRAMS MANAGED CARE Quality Assessment and Performance Improvement Access... health care needs of specific Medicaid populations represented in the particular MCO, PIHP, and PAHP...

Use of fictional medical television in health sciences education: a systematic review.

PubMed

Hoffman, Beth L; Hoffman, Robert; Wessel, Charles B; Shensa, Ariel; Woods, Michelle S; Primack, Brian A

2018-03-01

While medical television programs are popular among health profession trainees, it is not clear to what extent these programs affect their knowledge, perceptions, and/or behaviors. Therefore, we conducted a systematic review of research evaluating associations between program exposure and outcomes. We conducted systematic literature searches in Pubmed, CINAHL, and PsycINFO. Selected studies were required to be scholarly research, involve exposure to fictionalized medical television programming by health professional students, and assess associations between exposure and outcomes. Studies were classified according to quality and factors related to population, exposure, and outcomes. Of 3541 studies identified, 13 met selection criteria. Six studies involved undergraduate medical students, one involved nursing students, two involved both medical and nursing students, two involved medical residents, one involved medical students, residents and attending physicians, and one involved graduate epidemiology students. Mean study quality according to the MERSQI was 8.27. The most commonly assessed television programs were ER and Grey's Anatomy (six each). Five studies assessed regular viewing habits, and found that fictional medical programs are popular among students and that students recall health topics from episodes. The eight studies that assessed the association with outcomes when using clips as educational tools reported high satisfaction and increased knowledge of the presented health topics. While relatively few published studies have explored influences of fictional medical television on health professional students, those conducted suggest that students often view these television programs independently and that integration of this programming into medical education is feasible and acceptable.

Assessing the effect of physical activity classes in public spaces on leisure-time physical activity: "Al Ritmo de las Comunidades" A natural experiment in Bogota, Colombia.

PubMed

Torres, Andrea; Díaz, María Paula; Hayat, Matthew J; Lyn, Rodney; Pratt, Michael; Salvo, Deborah; Sarmiento, Olga L

2017-10-01

The Recreovia program provides free physical activity (PA) classes in public spaces in Bogota, Colombia. The purpose of this study was to assess the effectiveness of the Recreovia program in increasing PA among users of nine parks in Bogota. This study was a natural experiment conducted between 2013 and 2015 in Bogota. Community members and park users living nearby three groups of parks were compared: Group 1 were parks implementing new Recreovias (n=3), Group 2 were control parks (n=3) without Recreovias, and Group 3 were parks with existing Recreovías. Individuals in the "intervention" group were exposed to newly implemented Recreovia programs in parks near their homes. Measurements were collected at baseline and 6-8months after the intervention started. A total of 1533 participants were enrolled in the study: 501 for the existing Recreovias (included in a cross-sectional assessment) and 1032 participants (from the new Recreovias and control parks) included in the cross-sectional and pre-post study. Most participants were low income females. Twenty-three percent of the intervention group started participating in the program. Users of existing Recreovias were significantly more active and less likely to be overweight/obese compared to new Recreovia users at baseline. No changes on PA were found when comparing the intervention and control groups. Recreovias may have potential for increasing PA at the population level in urban areas given their rapid scalability, the higher levels of PA observed among program users, and its potential to reach women, low-income, less educated populations, and the overweight and obese. Copyright © 2016 Elsevier Inc. All rights reserved.

Tailored community cancer education programs: Pawsox and prostates.

PubMed

Glicksman, Arvin S; Meyer, Andrea; Dipiero, Maureen

2010-06-01

To assess the prostate cancer screening practices in Rhode Island, we designed a questionnaire which was sent to 150 primary care physicians. A population-based survey was distributed to 194 men over 40 asking about screening history and risk factors. Eighty-five percent of primary care physicians reported performing annual prostate-specific antigen tests (PSAs) and digital rectal exams, 63% recognized family history as a risk factor, and 14% identified African Americans as a high-risk population. The survey found that 48% of men recognized family history as a risk factor and 6% understood that African Americans were at high risk. Each year, 200 men, primarily SED, are invited to a PawSox baseball game where physicians provide information on prostate cancer risk, treatment options, and outcomes. Free PSAs are provided. The questionnaire and survey demonstrate a need for more public education regarding prostate cancer in high-risk populations. Tailored community-based interventions, such as the Pawsox & Prostate program, can be effective professional and public education strategies to increase screening in high-risk populations.

The role of the community health nurse in military humanitarian operations: lessons from operation sea signal--Guantanamo Bay, Cuba.

PubMed

Samuels, G L; Sommer, M D

1997-01-01

The military humanitarian mission is an "Operation-Other-Than-War" with a goal of restoring or promoting the ability of a population to care for themselves (U.S. Army, 1990b). One of the primary foci of these operations is the medical care of the target populace. The elements and techniques of primary health care have been used for this purpose, especially as the situation of a population stabilizes and demands a community base for health care programs (Downing, 1989). The knowledge and expertise of a community health nurse is indispensable in both acute and chronic humanitarian situations in performing a comprehensive community needs assessment for the formulation of a community base for health care programs while facilitating a health care system that meets the overall needs of the population. The contributions of community health nurses assigned to Joint Task Force 160, during Operation Sea Signal, bear testimony as to the efficacy of such a "specialized" role in the care of displaced populations.

Reference allocations and use of a disparity measure to inform the design of allocation funding formulas in public health programs.

PubMed

Buehler, James W; Bernet, Patrick M; Ogden, Lydia L

2012-01-01

Funding formulas are commonly used by federal agencies to allocate program funds to states. As one approach to evaluating differences in allocations resulting from alternative formula calculations, we propose the use of a measure derived from the Gini index to summarize differences in allocations relative to 2 referent allocations: one based on equal per-capita funding across states and another based on equal funding per person living in poverty, which we define as the "proportionality of allocation" (PA). These referents reflect underlying values that often shape formula-based allocations for public health programs. The size of state populations serves as a general proxy for the amount of funding needed to support programs across states. While the size of state populations living in poverty is correlated with overall population size, allocations based on states' shares of the national population living in poverty reflect variations in funding need shaped by the association between poverty and multiple adverse health outcomes. The PA measure is a summary of the degree of dispersion in state-specific allocations relative to the referent allocations and provides a quick assessment of the impact of selecting alternative funding formula designs. We illustrate the PA values by adjusting a sample allocation, using various measures of the salary costs and in-state wealth, which might modulate states' needs for federal funding.

Prevalence of Dental Caries among School Children in Chennai, Based on ICDAS II

PubMed Central

Arangannal, Ponnudurai; Jayaprakash, Jeevarathan

2016-01-01

Introduction Dental caries is a common dental disease, which occurs during childhood and continues to be a major public health problem. The prevalence of dental caries was associated with oral hygiene practice, sugar consumption and implementation of the preventive oral health program. Aim The purpose of this study was to assess the prevalence of dental caries in school children aged between 6-14 years using the International Caries Detection and Assessment System (ICDAS II). Materials and Methods The study population consisted of 2796 school children living in Pallikkaranai, Chennai, India and studying in government recognized schools. Each student was examined by a single examiner using ICDAS system under natural light during normal school hours. Results The prevalence of dental caries was 68.8% in the total surveyed population. The gender-wise prevalence of dental caries shows, females to have slightly higher prevalence than male. The prevalence of dental caries at the age group of 6 years was 57%, seven year 67%, eight year 63%, nine year 74%, 10 year 76%, 11 year 74%, 12 year 69%, 13 year 71%, and 14 year 69%. The distribution of CARS (Caries associated with Sealants and Restorations) in the surveyed population was only 1.4% Conclusion The distribution of non-cavitated/early enamel lesions was higher in the studied population and indicated a requirement of a sustained dental health preventive program targeting specific segments of the population. PMID:27190939

Great Salt Lake basins study unit

USGS Publications Warehouse

Waddell, Kidd M.; Baskin, Robert L.

1994-01-01

In 1991, the U.S. Geological Survey (USGS) began implementing a full-scale National Water-Quality Assessment (NAWQA) Program.The long-term goals of the NAWQA Program are to describe the status and trends in the quality of a large, representative part of the Nation’s surface- and ground-water resources and to provide a sound, scientific understanding of the primary natural and human factors that affect the quality of these resources. In meeting these goals, the program will produce a wealth of water-quality information that will be useful to policy makers and managers at Federal, State, and local levels.A major design feature of the NAWQA Program will enable water-quality information at different areal scales to be integrated. A major component of the program is study-unit investigations, which ae the principal building blocks of the program upon which national-level assessment activities will be based. The 60 study-unit investigations that make up the program are hydrologic systems that include principal river basins and aquifer systems throughout the Nation. These study units cover areas from less than 1.000 to greater than 60,000 mi2 and incorporate from about 60 to 70 percent of the Nation’s water use and population served by public water supply. In 1993, assessment activities began in the Great Salt Lake Basins NAWQA study unit.

Budget impact analysis of switching to digital mammography in a population-based breast cancer screening program: a discrete event simulation model.

PubMed

Comas, Mercè; Arrospide, Arantzazu; Mar, Javier; Sala, Maria; Vilaprinyó, Ester; Hernández, Cristina; Cots, Francesc; Martínez, Juan; Castells, Xavier

2014-01-01

To assess the budgetary impact of switching from screen-film mammography to full-field digital mammography in a population-based breast cancer screening program. A discrete-event simulation model was built to reproduce the breast cancer screening process (biennial mammographic screening of women aged 50 to 69 years) combined with the natural history of breast cancer. The simulation started with 100,000 women and, during a 20-year simulation horizon, new women were dynamically entered according to the aging of the Spanish population. Data on screening were obtained from Spanish breast cancer screening programs. Data on the natural history of breast cancer were based on US data adapted to our population. A budget impact analysis comparing digital with screen-film screening mammography was performed in a sample of 2,000 simulation runs. A sensitivity analysis was performed for crucial screening-related parameters. Distinct scenarios for recall and detection rates were compared. Statistically significant savings were found for overall costs, treatment costs and the costs of additional tests in the long term. The overall cost saving was 1,115,857€ (95%CI from 932,147 to 1,299,567) in the 10th year and 2,866,124€ (95%CI from 2,492,610 to 3,239,638) in the 20th year, representing 4.5% and 8.1% of the overall cost associated with screen-film mammography. The sensitivity analysis showed net savings in the long term. Switching to digital mammography in a population-based breast cancer screening program saves long-term budget expense, in addition to providing technical advantages. Our results were consistent across distinct scenarios representing the different results obtained in European breast cancer screening programs.

Budget Impact Analysis of Switching to Digital Mammography in a Population-Based Breast Cancer Screening Program: A Discrete Event Simulation Model

PubMed Central

Comas, Mercè; Arrospide, Arantzazu; Mar, Javier; Sala, Maria; Vilaprinyó, Ester; Hernández, Cristina; Cots, Francesc; Martínez, Juan; Castells, Xavier

2014-01-01

Objective To assess the budgetary impact of switching from screen-film mammography to full-field digital mammography in a population-based breast cancer screening program. Methods A discrete-event simulation model was built to reproduce the breast cancer screening process (biennial mammographic screening of women aged 50 to 69 years) combined with the natural history of breast cancer. The simulation started with 100,000 women and, during a 20-year simulation horizon, new women were dynamically entered according to the aging of the Spanish population. Data on screening were obtained from Spanish breast cancer screening programs. Data on the natural history of breast cancer were based on US data adapted to our population. A budget impact analysis comparing digital with screen-film screening mammography was performed in a sample of 2,000 simulation runs. A sensitivity analysis was performed for crucial screening-related parameters. Distinct scenarios for recall and detection rates were compared. Results Statistically significant savings were found for overall costs, treatment costs and the costs of additional tests in the long term. The overall cost saving was 1,115,857€ (95%CI from 932,147 to 1,299,567) in the 10th year and 2,866,124€ (95%CI from 2,492,610 to 3,239,638) in the 20th year, representing 4.5% and 8.1% of the overall cost associated with screen-film mammography. The sensitivity analysis showed net savings in the long term. Conclusions Switching to digital mammography in a population-based breast cancer screening program saves long-term budget expense, in addition to providing technical advantages. Our results were consistent across distinct scenarios representing the different results obtained in European breast cancer screening programs. PMID:24832200

School-located influenza vaccination and absenteeism among elementary school students in a Hispanic community.

PubMed

Keck, Patricia C; Ynalvez, Marcus Antonius; Gonzalez, Hector F; Castillo, Keila D

2013-08-01

Seasonal influenza is recognized as a significant health burden to children and is a cause of excess school absenteeism in children. In 2008, the Advisory Committee on Immunization Practices recommended annual influenza vaccination for all children 6 months to 18 years of age. School nurses influence participation in this recommendation by conducting school-located influenza vaccination (SLIV) programs at their campuses. Knowing the effect of SLIV programs on student absenteeism may motivate school nurses and district administrators to conduct such vaccination programs. This study examines the impact of an SLIV program on elementary school absenteeism in an inner city school district with a predominantly Hispanic population. Using Poisson regression models with robust standard errors, we analyzed data from 3,775 records obtained by stratified random sampling. Results of the study indicate that students vaccinated through an SLIV program have fewer absences than unvaccinated students. A surprising result of the study shows that students vaccinated through an SLIV program had fewer absences than students vaccinated elsewhere. These results are of particular importance to school nurses who work with large Hispanic populations. Our study illustrates one way that a school nurse can assess the effect of an SLIV program on absenteeism.

Resurrecting social infrastructure as a determinant of urban tuberculosis control in Delhi, India

PubMed Central

2014-01-01

Background The key to universal coverage in tuberculosis (TB) management lies in community participation and empowerment of the population. Social infrastructure development generates social capital and addresses the crucial social determinants of TB, thereby improving program performance. Recently, there has been renewed interest in the concept of social infrastructure development for TB control in developing countries. This study aims to revive this concept and highlight the fact that documentation on ways to operationalize urban TB control is required from a holistic development perspective. Further, it explains how development of social infrastructure impacts health and development outcomes, especially with respect to TB in urban settings. Methods A wide range of published Government records pertaining to social development parameters and TB program surveillance, between 2001 and 2011 in Delhi, were studied. Social infrastructure development parameters like human development index along with other indicators reflecting patient profile and habitation in urban settings were selected as social determinants of TB. These include adult literacy rates, per capita income, net migration rates, percentage growth in slum population, and percentage of urban population living in one-room dwelling units. The impact of the Revised National Tuberculosis Control Program on TB incidence was assessed as an annual decline in new TB cases notified under the program. Univariate linear regression was employed to examine the interrelationship between social development parameters and TB program outcomes. Results The decade saw a significant growth in most of the social development parameters in the State. TB program performance showed 46% increment in lives saved among all types of TB cases per 100,000 population. The 7% reduction in new TB case notifications from the year 2001 to 2011, translates to a logarithmic decline of 5.4 new TB cases per 100,000 population. Except per capita income, literacy, and net migration rates, other social determinants showed significant correlation with decline in new TB cases per 100,000 population. Conclusions Social infrastructure development leads to social capital generation which engenders positive growth in TB program outcomes. Strategies which promote social infrastructure development should find adequate weightage in the overall policy framework for urban TB control in developing countries. PMID:24438431

Resurrecting social infrastructure as a determinant of urban tuberculosis control in Delhi, India.

PubMed

Chandra, Shivani; Sharma, Nandini; Joshi, Kulanand; Aggarwal, Nishi; Kannan, Anjur Tupil

2014-01-17

The key to universal coverage in tuberculosis (TB) management lies in community participation and empowerment of the population. Social infrastructure development generates social capital and addresses the crucial social determinants of TB, thereby improving program performance. Recently, there has been renewed interest in the concept of social infrastructure development for TB control in developing countries. This study aims to revive this concept and highlight the fact that documentation on ways to operationalize urban TB control is required from a holistic development perspective. Further, it explains how development of social infrastructure impacts health and development outcomes, especially with respect to TB in urban settings. A wide range of published Government records pertaining to social development parameters and TB program surveillance, between 2001 and 2011 in Delhi, were studied. Social infrastructure development parameters like human development index along with other indicators reflecting patient profile and habitation in urban settings were selected as social determinants of TB. These include adult literacy rates, per capita income, net migration rates, percentage growth in slum population, and percentage of urban population living in one-room dwelling units. The impact of the Revised National Tuberculosis Control Program on TB incidence was assessed as an annual decline in new TB cases notified under the program. Univariate linear regression was employed to examine the interrelationship between social development parameters and TB program outcomes. The decade saw a significant growth in most of the social development parameters in the State. TB program performance showed 46% increment in lives saved among all types of TB cases per 100,000 population. The 7% reduction in new TB case notifications from the year 2001 to 2011, translates to a logarithmic decline of 5.4 new TB cases per 100,000 population. Except per capita income, literacy, and net migration rates, other social determinants showed significant correlation with decline in new TB cases per 100,000 population. Social infrastructure development leads to social capital generation which engenders positive growth in TB program outcomes. Strategies which promote social infrastructure development should find adequate weightage in the overall policy framework for urban TB control in developing countries.

An epidemiologic perspective on a case management program.

PubMed

Kahler, Deborah; Salber, Patricia; Wilson, Thomas

2010-01-01

to improve a case management (CM) program using the principles and tools of epidemiology. Specifically, to use epidemiology to describe the population being managed, to analyze factors influencing outcomes, to assess the degree to which the CM process (or intervention) is related to those outcomes, to utilize the findings in order to make recommendations (to take action) for both better evaluation and improved and more efficient CM process, to provide an estimate of the impact of the CM program based on the comparison of pre-CM and post-CM interventions, and finally to discuss the caveat that pre-CM period probably does not provide a prediction of patterns to be expected in the post-CM period had CM not been present (an ideal, but difficult-to-find referent population for this kind of effectiveness analysis). a Medicare Advantage health plan. there were a total of 12,185 individuals who met the continuous enrollment requirement of 6 months (28 days) prior to initial contact with the CM department and 6 months after the contact date: 53% were female; the average age was 73.9 (standard deviation = ± 9.5). There was a linear relationship between the average "dose" of CM-as measured by the number of times a case manager had contact with a case-and the risk profile of the case-as measured by a standard risk assessment tool provided by the Centers for Medicare & Medicaid Services. The month-to-month costs for the study population prior to CM showed a sharp rise in the month prior to the initial contact with CM and a sharp decline beginning before the contact. This pattern was consistent across different risk profiles and our operational definition of CM "dose."The average costs 6 months prior to CM were higher than the average costs 6 months after the CM. The difference in cost varied by "dose" category. When coupled with the number of cases per dosage category, the greatest value for the CM program was in the management of moderate risk cases called two to four times.However, some of the overall decline that begins prior to the initial CM contact is likely attributed to "regression to the mean" (i.e., costs may have shown a decline in spite of CM) but not all. Subsequent studies will be designed to assess the degree to which this is the case by including an equivalent referent; ideally, one that has not experienced CM or, in the absence of that, one that experienced a different kind of CM so that a valid "comparative effectiveness" study can be conducted. the "dose" of CM to its cases was in synch with an independent assessment of risk of the cases. This implies that case managers were directing their resources to those in need. However, case managers and CM processes are a limited resource and it is of interest for management to allocate those CM resources in the most efficient way possible. Methods of assessment based on individual experiences of case managers can be improved with structured, population-based assessment. These population-based tools, according to the principles of epidemiology, will be used to better allocate CM resources for optimized impact on patient populations in the future.

Consolidated principles for screening based on a systematic review and consensus process.

PubMed

Dobrow, Mark J; Hagens, Victoria; Chafe, Roger; Sullivan, Terrence; Rabeneck, Linda

2018-04-09

In 1968, Wilson and Jungner published 10 principles of screening that often represent the de facto starting point for screening decisions today; 50 years on, are these principles still the right ones? Our objectives were to review published work that presents principles for population-based screening decisions since Wilson and Jungner's seminal publication, and to conduct a Delphi consensus process to assess the review results. We conducted a systematic review and modified Delphi consensus process. We searched multiple databases for articles published in English in 1968 or later that were intended to guide population-based screening decisions, described development and modification of principles, and presented principles as a set or list. Identified sets were compared for basic characteristics (e.g., number, categorization), a citation analysis was conducted, and principles were iteratively synthesized and consolidated into categories to assess evolution. Participants in the consensus process assessed the level of agreement with the importance and interpretability of the consolidated screening principles. We identified 41 sets and 367 unique principles. Each unique principle was coded to 12 consolidated decision principles that were further categorized as disease/condition, test/intervention or program/system principles. Program or system issues were the focus of 3 of Wilson and Jungner's 10 principles, but comprised almost half of all unique principles identified in the review. The 12 consolidated principles were assessed through 2 rounds of the consensus process, leading to specific refinements to improve their relevance and interpretability. No gaps or missing principles were identified. Wilson and Jungner's principles are remarkably enduring, but increasingly reflect a truncated version of contemporary thinking on screening that does not fully capture subsequent focus on program or system principles. Ultimately, this review and consensus process provides a comprehensive and iterative modernization of guidance to inform population-based screening decisions. © 2018 Joule Inc. or its licensors.

Consolidated principles for screening based on a systematic review and consensus process

PubMed Central

Hagens, Victoria; Chafe, Roger; Sullivan, Terrence; Rabeneck, Linda

2018-01-01

BACKGROUND: In 1968, Wilson and Jungner published 10 principles of screening that often represent the de facto starting point for screening decisions today; 50 years on, are these principles still the right ones? Our objectives were to review published work that presents principles for population-based screening decisions since Wilson and Jungner’s seminal publication, and to conduct a Delphi consensus process to assess the review results. METHODS: We conducted a systematic review and modified Delphi consensus process. We searched multiple databases for articles published in English in 1968 or later that were intended to guide population-based screening decisions, described development and modification of principles, and presented principles as a set or list. Identified sets were compared for basic characteristics (e.g., number, categorization), a citation analysis was conducted, and principles were iteratively synthesized and consolidated into categories to assess evolution. Participants in the consensus process assessed the level of agreement with the importance and interpretability of the consolidated screening principles. RESULTS: We identified 41 sets and 367 unique principles. Each unique principle was coded to 12 consolidated decision principles that were further categorized as disease/condition, test/intervention or program/system principles. Program or system issues were the focus of 3 of Wilson and Jungner’s 10 principles, but comprised almost half of all unique principles identified in the review. The 12 consolidated principles were assessed through 2 rounds of the consensus process, leading to specific refinements to improve their relevance and interpretability. No gaps or missing principles were identified. INTERPRETATION: Wilson and Jungner’s principles are remarkably enduring, but increasingly reflect a truncated version of contemporary thinking on screening that does not fully capture subsequent focus on program or system principles. Ultimately, this review and consensus process provides a comprehensive and iterative modernization of guidance to inform population-based screening decisions. PMID:29632037

MCPS Special Education at a Glance 2012-2013

ERIC Educational Resources Information Center

Montgomery County Public Schools, 2013

2013-01-01

Montgomery County Public Schools (MCPS) "Special Education at a Glance," which includes a copy of the "Guide to Planning and Assessing School-Based Special Education Programs," provides in a single document, information about the special education population at each Montgomery County (Maryland) public school, including…

MCPS Special Education at a Glance 2011-2012

ERIC Educational Resources Information Center

Montgomery County Public Schools, 2012

2012-01-01

Montgomery County Public Schools (MCPS) "Special Education at a Glance," which includes a copy of the "Guide to Planning and Assessing School-Based Special Education Programs," provides in a single document, information about the special education population at each Montgomery County (Maryland) public school, including…

Pediatric HIV Infection and Developmental Disabilities.

ERIC Educational Resources Information Center

Seidel, John F.

This paper presents an overview of the developmental disabilities associated with pediatric Human Immunodeficiency Virus (HIV) infection, and examines efficacious practices for assessment and intervention programming. The focus population is early childhood into school age. The paper describes the complex array of challenges presented by these…

Assessing change in perceived community leadership readiness in the Obesity Prevention and Lifestyle program.

PubMed

Kostadinov, Iordan; Daniel, Mark; Jones, Michelle; Cargo, Margaret

2016-02-01

Issue addressed The context of community-based childhood obesity prevention programs can influence the effects of these intervention programs. Leadership readiness for community mobilisation for childhood obesity prevention is one such contextual factor. This study assessed perceived community leadership readiness (PCLR) at two time points in a state-wide, multisite community-based childhood obesity prevention program. Methods PCLR was assessed across 168 suburbs of 20 intervention communities participating in South Australia's Obesity Prevention and Lifestyle (OPAL) program. Using a validated online PCLR tool, four key respondents from each community rated each suburb within their respective community on a nine-point scale for baseline and 2015. Average PCLR and change scores were calculated using the general linear model with suburbs nested in communities. Relationships between demographic variables and change in PCLR were evaluated using multiple regression. Ease of survey use was also assessed. Results Average PCLR increased between baseline (3.51, s.d.=0.82) and 2015 (5.23, s.d.=0.89). PCLR rose in 18 of 20 intervention communities. PCLR was inversely associated with suburb population size (r 2 =0.03, P=0.03, β=-0.25) and positively associated with intervention duration (r 2 change=0.08, P=0.00, β=0.29). Only 8% of survey respondents considered the online assessment tool difficult to use. Conclusions PCLR increased over the course of the OPAL intervention. PCLR varied between and within communities. Online assessment of PCLR has utility for multisite program evaluations. So what? Use of a novel, resource-efficient online tool to measure the key contextual factors of PCLR has enabled a better understanding of the success and generalisability of the OPAL program.

Why evolutionary biologists should get seriously involved in ecological monitoring and applied biodiversity assessment programs

PubMed Central

Brodersen, Jakob; Seehausen, Ole

2014-01-01

While ecological monitoring and biodiversity assessment programs are widely implemented and relatively well developed to survey and monitor the structure and dynamics of populations and communities in many ecosystems, quantitative assessment and monitoring of genetic and phenotypic diversity that is important to understand evolutionary dynamics is only rarely integrated. As a consequence, monitoring programs often fail to detect changes in these key components of biodiversity until after major loss of diversity has occurred. The extensive efforts in ecological monitoring have generated large data sets of unique value to macro-scale and long-term ecological research, but the insights gained from such data sets could be multiplied by the inclusion of evolutionary biological approaches. We argue that the lack of process-based evolutionary thinking in ecological monitoring means a significant loss of opportunity for research and conservation. Assessment of genetic and phenotypic variation within and between species needs to be fully integrated to safeguard biodiversity and the ecological and evolutionary dynamics in natural ecosystems. We illustrate our case with examples from fishes and conclude with examples of ongoing monitoring programs and provide suggestions on how to improve future quantitative diversity surveys. PMID:25553061

Direct assessment as a measure of institutional effectiveness in a dental hygiene distance education program.

PubMed

Olmsted, Jodi L

2014-10-01

This ten-year, longitudinal examination of a dental hygiene distance education (DE) program considered student performance on standard benchmark assessments as direct measures of institutional effectiveness. The aim of the study was to determine if students face-to-face in a classroom with an instructor performed differently from their counterparts in a DE program, taking courses through the alternative delivery system of synchronous interactive television (ITV). This study used students' grade point averages and National Board Dental Hygiene Examination scores to assess the impact of ITV on student learning, filling a crucial gap in current evidence. The study's research population consisted of 189 students who graduated from one dental hygiene program between 1997 and 2006. One hundred percent of the institution's data files for these students were used: 117 students were face-to-face with the instructor, and seventy-two received instruction through the ITV system. The results showed that, from a year-by-year perspective, no statistically significant performance differences were apparent between the two student groups when t-tests were used for data analysis. The DE system examined was considered effective for delivering education if similar performance outcomes were the evaluation criteria used for assessment.

National Water-Quality Assessment Program: Central Arizona Basins

USGS Publications Warehouse

Cordy, Gail E.

1994-01-01

In 1991, the U.S. Geological Survey (USGS) began to implement a full-scale National Water-Quality Assessment (NAWQA) program. The long-term goals of the NAWQA program are to describe the status and trends in the quality of a large, representative part of the Nation's surface-water and ground-water resources and to provide a sound, scientific understanding of the primary natural and human factors affecting the quality of these resources. In meeting these goals, the program will produce a wealth of water-quality information that will be useful to policymakers and managers at the National, State, and local levels. Studies of 60 hydrologic systems that include parts of most major river basins and aquifer systems (study-unit investigations) are the building blocks of the national assessment. The 60 study units range in size from 1,000 to about 60,000 mi2 and represent 60 to 70 percent of the Nation's water use and population served by public water supplies. Twenty study-unit investigations were started in 1991, 20 additional studies started in 1994, and 20 more are planned to start in 1997. The Central Arizona Basins study unit began assessment activities in 1994.

Design and Operation of the Transformed National Healthy Start Evaluation.

PubMed

Banks, Jamelle E; Dwyer, Maura; Hirai, Ashley; Ghandour, Reem M; Atrash, Hani K

2017-12-01

Purpose Improving pregnancy outcomes for women and children is one of the nation's top priorities. The Healthy Start (HS) program was created to address factors that contribute to high infant mortality rates (IMRs) and persistent disparities in IMRs. The program began in 1991 and was transformed in 2014 to apply lessons from emerging research, past evaluation findings, and expert recommendations. To understand the implementation and impact of the transformed program, there is a need for a robust and comprehensive evaluation. Description The national HS evaluation will include an implementation evaluation, which will describe program components that affect outcomes; a utilization evaluation, which will examine the characteristics of women and infants who did and did not utilize the program; and an outcome evaluation, which will assess the program's effectiveness with regard to producing expected outcomes among the target population. Data sources include the National HS Program Survey, a HS participant survey, and individual-level program data linked to vital records and the Pregnancy Risk Assessment Monitoring System (PRAMS) survey. Assessment Descriptive analyses will be used to examine differences in risk profiles between participants and non-participants, as well as to calculate penetration rates for high-risk women in respective service areas. Multivariable analyses will be used to determine the impact of the program on key outcomes and will explore variation by dose, type of services received, and grantee characteristics. Conclusion Evaluation findings are expected to inform program decisions and direction, including identification of effective program components that can be spread and scaled.

Accumulation and potential health effects of organohalogenated compounds in the arctic fox (Vulpes lagopus)--a review.

PubMed

Pedersen, Kathrine Eggers; Styrishave, Bjarne; Sonne, Christian; Dietz, Rune; Jenssen, Bjørn Munro

2015-01-01

This review addresses biological effects of anthropogenic organohalogenated compounds in the arctic fox (Vulpes lagopus). When considering the current levels, spatial and tissue distributions of selected organic pollutants in arctic fox subpopulations, especially the Svalbard based populations accumulate high levels. The dominating contaminant groups are the polychlorinated biphenyls (PCBs) and chlordanes (CHLs), which reach high levels in adipose tissues, adrenals and liver. Recent controlled exposure studies on domesticated arctic fox and Greenland sledge dogs, show adverse health effects associated with OC concentrations lower than those measured in free-ranging populations. This indicates that especially populations at Svalbard may be at risk of experiencing OC related effects. The arctic fox as such may be an overlooked species in the Arctic Monitoring and Assessment Programs and it would add further information about pollution in the Arctic to include this species in the monitoring program. Copyright © 2014 Elsevier B.V. All rights reserved.

The need for supplemental breast cancer screening modalities: a perspective of population-based breast cancer screening programs in Japan.

PubMed

Uematsu, Takayoshi

2017-01-01

This article discusses possible supplemental breast cancer screening modalities for younger women with dense breasts from a perspective of population-based breast cancer screening program in Japan. Supplemental breast cancer screening modalities have been proposed to increase the sensitivity and detection rates of early stage breast cancer in women with dense breasts; however, there are no global guidelines that recommend the use of supplemental breast cancer screening modalities in such women. Also, no criterion standard exists for breast density assessment. Based on the current situation of breast imaging in Japan, the possible supplemental breast cancer screening modalities are ultrasonography, digital breast tomosynthesis, and breast magnetic resonance imaging. An appropriate population-based breast cancer screening program based on the balance between cost and benefit should be a high priority. Further research based on evidence-based medicine is encouraged. It is very important that the ethnicity, workforce, workflow, and resources for breast cancer screening in each country should be considered when considering supplemental breast cancer screening modalities for women with dense breasts.

Cultural competence: assessment and education resources for home care and hospice clinicians.

PubMed

Hines, Deborah

2014-05-01

Home healthcare and hospice clinicians face many challenges in the complex healthcare system caring for patients and their families in the home environment. One of those challenges is providing culturally competent care for an increasingly diverse population. This article will highlight free, easily accessible, online resources to assist clinicians and organizations to assess organizational and individual cultural competence and provide many resources for cultural competency education programs.

Application of Mobile Technology for Improving Expanded Program on Immunization Among Highland Minority and Stateless Populations in Northern Thailand Border

PubMed Central

Apidechkul, Tawatchai; Jandee, Kasemsak; Khamsiriwatchara, Amnat; Lawpoolsri, Saranath; Sawang, Surasak; Sangvichean, Aumnuyphan; Wansatid, Peerawat; Krongrungroj, Sarinya

2015-01-01

Background Studies of undervaccinated children of minority/stateless populations have highlighted significant barriers at individual, community, and state levels. These include geography-related difficulties, poverty, and social norms/beliefs. Objective The objective of this study was to assess project outcomes regarding immunization coverage, as well as maternal attitudes and practices toward immunization. Methods The “StatelessVac” project was conducted in Thailand-Myanmar-Laos border areas using cell phone-based mechanisms to increase immunization coverage by incorporating phone-to-phone information sharing for both identification and prevention. With limitation of the study among vulnerable populations in low-resource settings, the pre/post assessments without comparison group were conducted. Immunization coverage was collected from routine monthly reports while behavior-change outcomes were from repeat surveys. Results This study revealed potential benefits of the initiative for case identification; immunization coverage showed an improved trend. Prevention strategies were successfully integrated into the routine health care workflows of immunization activities at point-of-care. A behavior-change-communication package contributes significantly in raising both concern and awareness in relation to child care. Conclusions The mobile technology has proven to be an effective mechanism in improving a children’s immunization program among these hard-to-reach populations. Part of the intervention has now been revised for use at health centers across the country. PMID:25589367

Long-term Results from the Empowering a Multimodal Pathway Toward Healthy Youth Program, a Multimodal School-Based Approach, Show Marked Reductions in Suicidality, Depression, and Anxiety in 6,227 Students in Grades 6–12 (Aged 11–18)

PubMed Central

Silverstone, Peter H.; Bercov, Marni; Suen, Victoria Y. M.; Allen, Andrea; Cribben, Ivor; Goodrick, Jodi; Henry, Stu; Pryce, Catherine; Langstraat, Pieter; Rittenbach, Katherine; Chakraborty, Samprita; Engles, Rutger C.; McCabe, Christopher

2017-01-01

Here, we report on findings from a 15-month follow-up of a school-based program called Empowering a Multimodal Pathway Toward Healthy Youth (EMPATHY). This was primarily intended to reduce suicidal thinking in pre-teens, adolescents, and youth students aged 11–18 in middle schools (Grades 6–8) and high SCHOOLS (Grades 9–12). It also aimed to reduce depression and anxiety. The EMPATHY multimodal program consisted of repeated data collection, identification of a high-risk group, a rapid intervention for this high-risk group including offering supervised online cognitive behavioral therapy (CBT) program, a universal CBT intervention for those in Grades 6–8, a variety of interactions with trained staff (“Resiliency Coaches”), and referral to external medical and psychiatric services where appropriate. There were four time-points at which assessments were made: baseline, 3, 7, and 15 months. Here, we report cross-sectional findings over 15 months in a total of 6,227 students who were assessed at least once during the study period. Additionally, we report longitudinal findings from the 1,884 students who completed all 4 assessments. Our results found highly statistically significant decreases in suicidality rates, with the percentage of the total school population who were actively suicidal decreasing from 4.4% at baseline (n = 143 of 3,244) to 2.8% at 15 months (n = 125 of 4,496) (p < 0.001). There were also highly statistically significant reductions in depression and anxiety scores at each time-point. Thus, Mean Depression scores at baseline for the entire student population were 3.73 ± 3.87 (n = 3,244) at baseline and decreased to 3.22 ± 3.52 (n = 4,496) (p < 0.001). Since most students were not depressed, whole population changes such as this may indicate impact in many areas. In the longitudinal analysis of students who completed all four assessments, there were also highly statistically significant improvements in depression and anxiety scores at all time-points. For example, depression scores decreased from a mean of 3.43 ± 3.67 (n = 1,884) at baseline to 2.95 ± 3.53 (n = 1,884) at 15-months (p < 0.001), while the number who were actively suicidal decreased from 69 to 37. These results suggest that school-based multimodal programs, utilizing a combination of interventions, can have meaningful benefits across entire school populations. PMID:28555115

Effectiveness of fecal immunochemical testing in reducing colorectal cancer mortality from the One Million Taiwanese Screening Program.

PubMed

Chiu, Han-Mo; Chen, Sam Li-Sheng; Yen, Amy Ming-Fang; Chiu, Sherry Yueh-Hsia; Fann, Jean Ching-Yuan; Lee, Yi-Chia; Pan, Shin-Liang; Wu, Ming-Shiang; Liao, Chao-Sheng; Chen, Hsiu-Hsi; Koong, Shin-Lan; Chiou, Shu-Ti

2015-09-15

The effectiveness of fecal immunochemical testing (FIT) in reducing colorectal cancer (CRC) mortality has not yet been fully assessed in a large, population-based service screening program. A prospective cohort study of the follow-up of approximately 5 million Taiwanese from 2004 to 2009 was conducted to compare CRC mortality for an exposed (screened) group and an unexposed (unscreened) group in a population-based CRC screening service targeting community residents of Taiwan who were 50 to 69 years old. Given clinical capacity, this nationwide screening program was first rolled out in 2004. In all, 1,160,895 eligible subjects who were 50 to 69 years old (ie, 21.4% of the 5,417,699 subjects of the underlying population) participated in the biennial nationwide screening program by 2009. The actual effectiveness in reducing CRC mortality attributed to the FIT screening was 62% (relative rate for the screened group vs the unscreened group, 0.38; 95% confidence interval, 0.35-0.42) with a maximum follow-up of 6 years. The 21.4% coverage of the population receiving FIT led to a significant 10% reduction in CRC mortality (relative rate, 0.90; 95% confidence interval, 0.84-0.95) after adjustments for a self-selection bias. This large, prospective Taiwanese cohort undergoing population-based FIT screening for CRC had the statistical power to demonstrate a significant CRC mortality reduction, although the follow-up time was short. Although such findings are informative for health decision makers, continued follow-up of this large cohort will be required to estimate the long-term impact of FIT screening if the covered population is expanded. © 2015 American Cancer Society.

Native bees and plant pollination

USGS Publications Warehouse

Ginsberg, H.S.

2004-01-01

Bees are important pollinators, but evidence suggests that numbers of some species are declining. Decreases have been documented in the honey bee, Apis mellifera (which was introduced to North America), but there are no monitoring programs for the vast majority of native species, so we cannot be sure about the extent of this problem. Recent efforts to develop standardized protocols for bee sampling will help us collect the data needed to assess trends in bee populations. Unfortunately, diversity of bee life cycles and phenologies, and the large number of rare species, make it difficult to assess trends in bee faunas. Changes in bee populations can affect plant reproduction, which can influence plant population density and cover, thus potentially modifying horizontal and vertical structure of a community, microclimate near the ground, patterns of nitrogen deposition, etc. These potential effects of changes in pollination patterns have not been assessed in natural communities. Effects of management actions on bees and other pollinators should be considered in conservation planning.

Assessment of policy and access to HIV prevention, care, and treatment services for men who have sex with men and for sex workers in Burkina Faso and Togo.

PubMed

Duvall, Sandra; Irani, Laili; Compaoré, Cyrille; Sanon, Patrice; Bassonon, Dieudonne; Anato, Simplice; Agounke, Jeannine; Hodo, Ama; Kugbe, Yves; Chaold, Gertrude; Nigobora, Berry; MacInnis, Ron

2015-03-01

In Burkina Faso and Togo, key populations of men who have sex with men (MSM) and sex workers (SW) have a disproportionately higher HIV prevalence. This study analyzed the 2 countries' policies impacting MSM and SW; to what extent the policies and programs have been implemented; and the role of the enabling environment, country leadership, and donor support. The Health Policy Project's Policy Assessment and Advocacy Decision Model methodology was used to analyze policy and program documents related to key populations, conduct key informant interviews, and hold stakeholder meetings to validate the findings. Several policy barriers restrict MSM/SW from accessing services. Laws criminalizing MSM/SW, particularly anti-solicitation laws, result in harassment and arrests of even nonsoliciting MSM/SW. Policy gaps exist, including few MSM/SW-supportive policies and HIV prevention measures, e.g., lubricant not included in the essential medicines list. The needs of key populations are generally not met due to policy gaps around MSM/SW participation in decision-making and funding allocation for MSM/SW-specific programming. Misaligned policies, eg, contradictory informed consent laws and protocols, and uneven policy implementation, such as stockouts of sexually transmitted infection kits, HIV testing materials, and antiretrovirals, undermine evidence-based policies. Even in the presence of a supportive donor and political community, public stigma and discrimination (S&D) create a hostile enabling environment. Policies are needed to address S&D, particularly health care provider and law enforcement training, and to authorize, fund, guide, and monitor services for key populations. MSM/SW participation and development of operational guidelines can improve policy implementation and service uptake.

Weight-Related Goal Setting in a Telephone-Based Preventive Health-Coaching Program: Demonstration of Effectiveness.

PubMed

O'Hara, Blythe J; Gale, Joanne; McGill, Bronwyn; Bauman, Adrian; Hebden, Lana; Allman-Farinelli, Margaret; Maxwell, Michelle; Phongsavan, Philayrath

2017-11-01

This study investigated whether participants in a 6-month telephone-based coaching program, who set physical activity, nutrition, and weight loss goals had better outcomes in these domains. Quasi-experimental design. The Australian Get Healthy Information and Coaching Service (GHS), a free population-wide telephone health-coaching service that includes goal setting as a key component of its coaching program. Consenting GHS coaching participants who had completed coaching between February 2009 and December 2012 (n = 4108). At baseline, participants select a goal for the coaching program, and sociodemographic variables are collected. Self-reported weight, height, waist circumference, physical activity, and nutrition-related behaviors are assessed at baseline and 6 months. Descriptive analysis was performed on key sociodemographic variables, and the relationship between goal type and change in health outcomes was assessed using a series of linear mixed models that modeled change from baseline to 6 months. Participants who set goals in relation to weight management and physical activity achieved better results in these areas than those who set alternate goals, losing more than those who set alternate goals (1.5 kg and 0.9 cm in waist circumference) and increasing walking per week (40 minutes), respectively. There was no difference in food-related outcomes for those that set nutrition-related goals. Goal setting for weight management and increasing physical activity in the overweight and obese population, undertaken in a telephone-based coaching program, can be effective.

Computer-aided system of evaluation for population-based all-in-one service screening (CASE-PASS): from study design to outcome analysis with bias adjustment.

PubMed

Chen, Li-Sheng; Yen, Amy Ming-Fang; Duffy, Stephen W; Tabar, Laszlo; Lin, Wen-Chou; Chen, Hsiu-Hsi

2010-10-01

Population-based routine service screening has gained popularity following an era of randomized controlled trials. The evaluation of these service screening programs is subject to study design, data availability, and the precise data analysis for adjusting bias. We developed a computer-aided system that allows the evaluation of population-based service screening to unify these aspects and facilitate and guide the program assessor to efficiently perform an evaluation. This system underpins two experimental designs: the posttest-only non-equivalent design and the one-group pretest-posttest design and demonstrates the type of data required at both the population and individual levels. Three major analyses were developed that included a cumulative mortality analysis, survival analysis with lead-time adjustment, and self-selection bias adjustment. We used SAS AF software to develop a graphic interface system with a pull-down menu style. We demonstrate the application of this system with data obtained from a Swedish population-based service screen and a population-based randomized controlled trial for the screening of breast, colorectal, and prostate cancer, and one service screening program for cervical cancer with Pap smears. The system provided automated descriptive results based on the various sources of available data and cumulative mortality curves corresponding to the study designs. The comparison of cumulative survival between clinically and screen-detected cases without a lead-time adjustment are also demonstrated. The intention-to-treat and noncompliance analysis with self-selection bias adjustments are also shown to assess the effectiveness of the population-based service screening program. Model validation was composed of a comparison between our adjusted self-selection bias estimates and the empirical results on effectiveness reported in the literature. We demonstrate a computer-aided system allowing the evaluation of population-based service screening programs with an adjustment for self-selection and lead-time bias. This is achieved by providing a tutorial guide from the study design to the data analysis, with bias adjustment. Copyright © 2010 Elsevier Inc. All rights reserved.

Novel approach to an effective community-based chlamydia screening program within the routine operation of a primary healthcare service.

PubMed

Buhrer-Skinner, Monika; Muller, Reinhold; Menon, Arun; Gordon, Rose

2009-03-01

A prospective study was undertaken to develop an evidence-based outreach chlamydia screening program and to assess the viability and efficiency of this complementary approach to chlamydia testing within the routine operations of a primary healthcare service. A primary healthcare service based in Townsville, Queensland, Australia, identified high-prevalence groups for chlamydia in the community. Subsequently, a series of outreach clinics were established and conducted between August 2004 and November 2005 at a defence force unit, a university, high school leavers' festivities, a high school catering for Indigenous students, youth service programs, and backpacker accommodations. All target groups were easily accessible and yielded high participation. Chlamydia prevalence ranged between 5 and 15% for five of the six groups; high school leavers had no chlamydia. All participants were notified of their results and all positive cases were treated (median treatment interval 7 days). Five of the six assessed groups were identified as viable for screening and form the basis for the ongoing outreach chlamydia screening program. The present study developed an evidence-based outreach chlamydia screening program and demonstrated its viability as a complementary approach to chlamydia testing within the routine operations of the primary healthcare service, i.e. without the need for additional funding. It contributes to the evidence base necessary for a viable and efficient chlamydia management program. Although the presented particulars may not be directly transferable to other communities or health systems, the general two-step approach of identifying local high-risk populations and then collaborating with community groups to access these populations is.

Evaluating the implementation of a multicomponent asthma education program for Head Start staff.

PubMed

Ruvalcaba, Elizabeth; Chung, Shang-En; Rand, Cynthia; Riekert, Kristin A; Eakin, Michelle

2018-03-15

Asthma disproportionately affects minority groups, low income populations, and young children under 5. Head Start (HS) programs predominantly serve this high-risk population, yet staff are not trained on asthma management. The objective of this study was to assess a 5-year, multicomponent HS staff asthma education program in Baltimore City HS programs. All HS programs were offered annual staff asthma education by a medical research team that included didactic lectures and hands-on training. Attendees received continuing education credits. HS staff were anonymously surveyed on asthma knowledge and skills and asthma medication management practices in Year 1 (preimplementation) and Year 5. There was an estimated response rate of 94% for Year 1 and 82% for Year 5. Compared to staff in Year 1, Year 5 staff were significantly more likely to report they had very good knowledge and skills related to asthma [odds ratio (OR) 1.63; p < 0.05] and were engaged in asthma care activities (OR 2.02; p < 0.05). Self-reported presence of asthma action plans for all children with asthma was 82% at Year 1 and increased to 89% in Year 5 (p = 0.064). Year 5 HS staff reported higher self-assessed knowledge and skills, self-reports of asthma medication management practices, and self-reports of asthma activities compared to Year 1 staff. HS serves high-risk children with asthma, and a multicomponent program can adequately prepare staff to manage asthma in the child care setting. Our results indicate the feasibility of providing efficacious health skill education into child care provider training to reduce asthma knowledge gaps.

Caring for children with special healthcare needs in the managed care environment.

PubMed

Hawkins, Michelle R; Diehl-Svrjcek, Beth; Dunbar, Linda J

2006-01-01

Dramatic medical and technological advances over the past 15 years have resulted in the survival into adulthood of children with chronic health conditions. As this population subset has increased, the demand of caring for these children in the managed care arena has become challenging from a clinical, fiscal, and member satisfaction perspective. A disease management program was designed for children, ages birth through age 18, identified as having special needs at the time of birth or at any point throughout childhood related to disease processes such as diabetes, sickle cell disease, genetic aberrations, or the multiple complications of extreme prematurity. Components of the program included identification of the population, coordinated risk assessment, and ongoing case management interventions. Most important, outcome indicators were tracked to demonstrate program effectiveness. The formulation and function of a dedicated disease management database is also discussed.

HIV drug resistance early warning indicators in cohorts of individuals starting antiretroviral therapy between 2004 and 2009: World Health Organization global report from 50 countries.

PubMed

Bennett, Diane E; Jordan, Michael R; Bertagnolio, Silvia; Hong, Steven Y; Ravasi, Giovanni; McMahon, James H; Saadani, Ahmed; Kelley, Karen F

2012-05-01

The World Health Organization developed a set of human immunodeficiency virus drug resistance (HIVDR) early warning indicators (EWIs) to assess antiretroviral therapy clinic and program factors associated with HIVDR. EWIs are monitored by abstracting data routinely recorded in clinical records, and the results enable clinics and program managers to identify problems that should be addressed to minimize preventable emergence of HIVDR in clinic populations. As of June 2011, 50 countries monitored EWIs, covering 131 686 patients initiating antiretroviral treatment between 2004 and 2009 at 2107 clinics. HIVDR prevention is associated with patient care (appropriate prescribing and patient monitoring), patient behavior (adherence), and clinic/program management efforts to reduce treatment interruptions (follow up, retention on first-line ART, procurement and supply management of antiretroviral drugs). EWIs measure these factors and the results have been used to optimize patient and population treatment outcomes.

National Water-Quality Assessment program: The Trinity River Basin

USGS Publications Warehouse

Land, Larry F.

1991-01-01

In 1991, the U.S. Geological Survey (USGS) began to implement a full-scale National Water-Quality Assessment (NAWQA) program. The long-term goals of the NAWQA program are to describe the status and trends in the quality of a large, representative part of the Nation's surface- and ground-water resources and to provide a sound, scientific understanding of the primary natural and human factors affecting the quality of these resources. In meeting these goals, the program will produce a wealth of water-quality information that will be useful to policy makers and managers at the national, State, and local levels. A major design feature of the NAWQA program will enable water-quality information at different areal scales to be integrated. A major component of the program is study-unit investigations, which comprise the principal building blocks of the program on which national-level assessment activities will be based. The 60 study-unit investigations that make up the program are hydrologic systems that include parts of most major river basins and aquifer systems. These study units cover areas of 1,200 to more than 65,000 square miles and incorporate about 60 to 70 percent of the Nation's water use and population served by public water supply. In 1991, the Trinity River basin study was among the first 20 NAWQA study units selected for study under the full-scale implementation plan.

Status and trends of adult Lost River (Deltistes luxatus) and shortnose (Chasmistes brevirostris) sucker populations in Upper Klamath Lake, Oregon, 2014

USGS Publications Warehouse

Hewitt, David A.; Janney, Eric C.; Hayes, Brian S.; Harris, Alta C.

2015-10-02

Despite relatively high survival in most years, we conclude that both species have experienced substantial decreases in the abundance of spawning adults because losses from mortality have not been balanced by recruitment of new individuals. Although capture-recapture data indicate substantial recruitment of new individuals into the spawning populations for SNS and river spawning LRS in some years, size data do not corroborate these estimates. As a result, the status of the endangered sucker populations in Upper Klamath Lake remains worrisome, especially for shortnose suckers. Our monitoring program provides a robust platform for estimating vital population parameters, evaluating the status of the populations, and assessing the effectiveness of conservation and recovery efforts.

Cost-effectiveness and budget impact analysis of a population-based screening program for colorectal cancer.

PubMed

Pil, L; Fobelets, M; Putman, K; Trybou, J; Annemans, L

2016-07-01

Colorectal cancer (CRC) is one of the leading causes of cancer mortality in Belgium. In Flanders (Belgium), a population-based screening program with a biennial immunochemical faecal occult blood test (iFOBT) in women and men aged 56-74 has been organised since 2013. This study assessed the cost-effectiveness and budget impact of the colorectal population-based screening program in Flanders (Belgium). A health economic model was conducted, consisting of a decision tree simulating the screening process and a Markov model, with a time horizon of 20years, simulating natural progression. Predicted mortality and incidence, total costs, and quality-adjusted life-years (QALYs) with and without the screening program were calculated in order to determine the incremental cost-effectiveness ratio of CRC screening. Deterministic and probabilistic sensitivity analyses were conducted, taking into account uncertainty of the model parameters. Mortality and incidence were predicted to decrease over 20years. The colorectal screening program in Flanders is found to be cost-effective with an ICER of 1681/QALY (95% CI -1317 to 6601) in males and €4,484/QALY (95% CI -3254 to 18,163). The probability of being cost-effective given a threshold of €35,000/QALY was 100% and 97.3%, respectively. The budget impact analysis showed the extra cost for the health care payer to be limited. This health economic analysis has shown that despite the possible adverse effects of screening and the extra costs for the health care payer and the patient, the population-based screening program for CRC in Flanders is cost-effective and should therefore be maintained. Copyright © 2016 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

Cost-Effectiveness of Breast Cancer Screening in Turkey, a Developing Country: Results from Bahçeşehir Mammography Screening Project.

PubMed

Özmen, Vahit; Gürdal, Sibel Ö; Cabioğlu, Neslihan; Özcinar, Beyza; Özaydın, A Nilüfer; Kayhan, Arda; Arıbal, Erkin; Sahin, Cennet; Saip, Pınar; Alagöz, Oğuzhan

2017-07-01

We used the results from the first three screening rounds of Bahcesehir Mammography Screening Project (BMSP), a 10-year (2009-2019) and the first organized population-based screening program implemented in a county of Istanbul, Turkey, to assess the potential cost-effectiveness of a population-based mammography screening program in Turkey. Two screening strategies were compared: BMSP (includes three biennial screens for women between 40-69) and Turkish National Breast Cancer Registry Program (TNBCRP) which includes no organized population-based screening. Costs were estimated using direct data from the BMSP project and the reimbursement rates of Turkish Social Security Administration. The life-years saved by BMSP were estimated using the stage distribution observed with BMSP and TNBCRP. A total of 67 women (out of 7234 screened women) were diagnosed with breast cancer in BMSP. The stage distribution for AJCC stages O, I, II, III, IV was 19.4%, 50.8%, 20.9%, 7.5%, 1.5% and 4.9%, 26.6%, 44.9%, 20.8%, 2.8% with BMSP and TNBCRP, respectively. The BMSP program is expected to save 279.46 life years over TNBCRP with an additional cost of $677.171, which implies an incremental cost-effectiveness ratio (ICER) of $2.423 per saved life year. Since the ICER is smaller than the Gross Demostic Product (GDP) per capita in Turkey ($10.515 in 2014), BMSP program is highly cost-effective and remains cost-effective in the sensitivity analysis. Mammography screening may change the stage distribution of breast cancer in Turkey. Furthermore, an organized population-based screening program may be cost-effective in Turkey and in other developing countries. More research is needed to better estimate life-years saved with screening and further validate the findings of our study.

National addictions vigilance intervention and prevention program (NAVIPPRO): a real-time, product-specific, public health surveillance system for monitoring prescription drug abuse.

PubMed

Butler, Stephen F; Budman, Simon H; Licari, Andrea; Cassidy, Theresa A; Lioy, Katherine; Dickinson, James; Brownstein, John S; Benneyan, James C; Green, Traci Craig; Katz, Nathaniel

2008-12-01

The National Addictions Vigilance Intervention and Prevention Program (NAVIPPRO) is a scientific, comprehensive risk management program for scheduled therapeutics. NAVIPPRO provides post-marketing surveillance, signal detection, signal verification and prevention and intervention programs. Here we focus on one component of NAVIPPRO surveillance, the Addiction Severity Index-Multimedia Version (ASI-MV) Connect, a continuous, real-time, national data stream that assesses pharmaceutical abuse by patients entering substance abuse treatment by collecting product-specific, geographically-detailed information. We evaluate population characteristics for data collected through the ASI-MV Connect in 2007 and 2008 and assess the representativeness, geographic coverage, and timeliness of report of the data. Analyses based on 41,923 admissions to 265 treatment centers in 29 states were conducted on product-specific opioid abuse rates, source of drug, and route of administration. ASI-MV Connect data revealed that 11.5% of patients reported abuse of at least one opioid analgesic product in the 30 days prior to entering substance abuse treatment; differences were observed among sub-populations of prescription opioid abusers, among products, and also within various geographic locations. The ASI-MV Connect component of NAVIPPRO represents a potentially valuable data stream for post-marketing surveillance of prescription drugs. Analyses conducted with data obtained from the ASI-MV Connect allow for the characterization of product-specific and geospatial differences for drug abuse and can serve as a tool to monitor responses of the abuse population to newly developed "abuse deterrent" drug formulations. Additional data, evaluation, and comparison to other systems are important next steps in establishing NAVIPPRO as a comprehensive, post-marketing surveillance system for prescription drugs. Copyright (c) 2008 John Wiley & Sons, Ltd.

INDICATORS OF ECOLOGICAL STRESS AND THEIR EXTENT IN THE POPULATION OF NORTHEASTERN LAKES

EPA Science Inventory

The Environmental Monitoring and Assessment Program (EMAP) surveyed 345 northeastern lakes, during 1991-1996, in the first regional-scale survey to use a probability-based sampling design to collect biological assemblage data along with a broad range of physical and chemical indi...

Investigation of pheromone-based factors that may reduce capture of boll weevils in traps

USDA-ARS?s Scientific Manuscript database

Boll weevil (Anthonomus grandis Boheman) eradication programs rely almost exclusively on pheromone traps to detect weevils, assess populations, and indicate the need for insecticide treatment. However, instances have been reported recently in Medina Co., TX, where field infestations occur without p...

Success in Community College: Do Institutions Differ?

ERIC Educational Resources Information Center

Clotfelter, Charles T.; Ladd, Helen F.; Muschkin, Clara G.; Vigdor, Jacob L.

2013-01-01

Community colleges are complex organizations and assessing their performance, though important, is difficult. Compared to 4-year colleges and universities, community colleges serve a more diverse population and provide a wider variety of educational programs that include continuing education and technical training for adults, and diplomas,…

MCPS Special Education at a Glance 2013-2014

ERIC Educational Resources Information Center

Montgomery County Public Schools, 2014

2014-01-01

Montgomery County Public Schools (MCPS) "Special Education at a Glance," which includes a copy of the "Guide to Planning and Assessing School-Based Special Education Programs," provides in a single document, information about the special education population at each Montgomery County public school, including enrollment,…

Economic impact of a Medicaid population health management program.

PubMed

Rust, George; Strothers, Harry; Miller, William Johnson; McLaren, Susan; Moore, Barbara; Sambamoorthi, Usha

2011-10-01

A population health management program was implemented to assess growth in health care expenditures for the disabled segment of Georgia's Medicaid population before and during the first year of a population health outcomes management program, and to compare those expenditures with projected costs based on various cost inflation trend assumptions. A retrospective, nonexperimental approach was used to analyze claims data from Georgia Medicaid claims files for all program-eligible persons for each relevant time period (intent-to-treat basis). These included all non-Medicare, noninstitutionalized Medicaid aged-blind-disabled adults older than 18 years of age. Comparisons of health care expenditures and utilization were made between base year (2003-2004) and performance year one (2006-2007), and of the difference between actual expenditures incurred in the performance year vs. projected expenditures based on various cost inflation assumptions. Demographic characteristics and clinical complexity of the population (as measured by the Chronic Illness and Disability Payment System risk score) actually increased from baseline to implementation. Actual expenditures were less than projected expenditures using any relevant medical inflation assumption. Actual expenditures were less than projected expenditures by $9.82 million when using a conservative US general medical inflation rate, by $43.6 million using national Medicaid cost trends, and by $106 million using Georgia Medicaid's own cost projections for the non-dually eligible disabled segment of Medicaid enrollees. Quadratic growth curve modeling also demonstrated a lower rate of increase in total expenditures. The rate of increase in expenditures was lower over the first year of program implementation compared with baseline. Weighted utilization rates were also lower in high-cost categories, such as inpatient days, despite increases in the risk profile of the population. Varying levels of cost avoidance could be inferred from differences between actual and projected expenditures using each of the health-related inflation assumptions.

Exposure assessment in SMES: a low-cost approach to bring OHS services to small-scale enterprises.

PubMed

Seneviratne, Mahinda; Phoon, Wai On

2006-01-01

There is increased attention to improving occupational health and safety in small to medium-sized Enterprises (SMEs). The Workers Health Centre, a not-for-profit OHS service in western Sydney, assessed workplace exposures in two SMEs following intervention by regulatory agencies. A low-cost monitoring program for noise, airbone dust, fibers and chemicals was conducted at these two metal working industry workplaces. Results showed that exposure to the hazards were above the statutory limits and there was generally an unhealthy access to OHS information by the predominantly immigrant or low literate worker population, were identified. The potential for using a program of low-cost exposure assessments, accompanied by a strategy to provide OHSs information for workers in small-scale enterprises, is discussed.

Integrating smoking cessation into substance use disorder treatment for military veterans: measurement and treatment engagement efforts.

PubMed

Shealy, Suzanne E; Winn, Jaime L

2014-02-01

Military personnel and veterans smoke at higher rates than the general population, compromising physical performance readiness and health (Committee on Smoking Cessation in Military and Veteran Populations & Institute of Medicine, 2009). While efforts are being made within both the Department of Defense and the Veterans' Administration (VA) hospitals to prevent onset, change the smoking culture, and promote smoking cessation; smoking rates are increasing among combat deployed service members, and smoking rates are particularly high among veterans with mental health and other substance use disorders (McFall, 2006). Recent research supports making smoking cessation widely available and integrated with other forms of care (Gierisch et al., 2012; McFall et al., 2010). This paper describes the efforts of one VA substance use disorder (SUD) treatment program to integrate smoking cessation in routine care, including assessment of tobacco use and motivation and intention to quit via the proposed Nic-BAM assessment. Our team was 100% successful in incorporating the Nic-BAM into our regular assessment of treatment program participants. This suggests that staff members are amenable to assessing for tobacco addiction alongside other substance addictions. Although smoking did not decrease according to the Nic-BAM, an increase in the use of nicotine-replacement products suggests that participants are willing to initiate a quit attempt during SUD treatment. The availability of new evidence-based approaches for integration of tobacco cessation with mental health and SUD treatment may help to enhance programmatic efforts. Environmental changes are needed to fully incorporate tobacco recovery into SUD programming, and additional resources may include peer support specialists. © 2013.

Wheelchair Propulsion Biomechanics in Junior Basketball Players: A Method for the Evaluation of the Efficacy of a Specific Training Program

PubMed Central

Bergamini, Elena; Morelli, Francesca; Marchetti, Flavia; Vannozzi, Giuseppe; Polidori, Lorenzo; Paradisi, Francesco; Traballesi, Marco; Cappozzo, Aurelio

2015-01-01

As participation in wheelchair sports increases, the need of quantitative assessment of biomechanical performance indicators and of sports- and population-specific training protocols has become central. The present study focuses on junior wheelchair basketball and aims at (i) proposing a method to identify biomechanical performance indicators of wheelchair propulsion using an instrumented in-field test and (ii) developing a training program specific for the considered population and assessing its efficacy using the proposed method. Twelve athletes (10 M, 2 F, age = 17.1 ± 2.7 years, years of practice = 4.5 ± 1.8) equipped with wheelchair- and wrist-mounted inertial sensors performed a 20-metre sprint test. Biomechanical parameters related to propulsion timing, progression force, and coordination were estimated from the measured accelerations and used in a regression model where the time to complete the test was set as dependent variable. Force- and coordination-related parameters accounted for 80% of the dependent variable variance. Based on these results, a training program was designed and administered for three months to six of the athletes (the others acting as control group). The biomechanical indicators proved to be effective in providing additional information about the wheelchair propulsion technique with respect to the final test outcome and demonstrated the efficacy of the developed program. PMID:26543852

High Prevalence of Malnutrition among Elderly Veterans in Home Based Primary Care.

PubMed

Win, A Z; Ceresa, C; Arnold, K; Allison, T A

2017-01-01

Elderly Veterans enrolled in VA Home Based Primary Care (HBPC) programs suffer from many diseases including malnutrition. Nutrition screening tools exist in the VA system but they are inconsistently utilized across ambulatory care programs and are neither research validated nor comparable with non-VA populations. The Mini-Nutritional Assessment short-form (MNA-SF) has been validated in international studies in a variety of settings. The primary aim of this study was to find the prevalence of malnutrition among Veterans enrolled in HBPC programs. The secondary objective was to determine the feasibility of adopting a validated nutrition screening tool (Mini-Nutritional Assessment short-form (MNA-SF)). 2252 veterans age 65 and older from 18 HBPC programs from across the country participated in the study. The study period was between April and September 2012. WinPepi (version 11.25) was used for descriptive analysis. We found that the prevalence of malnutrition was 15% (344/2252) and the prevalence of at risk for malnutrition was 40.3% (909/2252). The MNA-SF is an efficient nutrition screening tool and it can be successfully used for the elderly veterans. The prevalence of malnutrition among veterans was high compared to the community dwelling U.S. civilian elderly population. By preventing and treating malnutrition, health care systems should be able to reduce overall health care costs.

Focus on training at CAFS.

PubMed

Azorbo, S; Muna, C

1993-01-01

The training and technical assistance programs of the Center for African Family Studies (CAFS), which is part of the International Planned Parenthood Federation for the African Region, were described. Programs included service delivery, management development, family life education, family planning communication, and research monitoring and evaluation. Several courses were offered: a week-long contraceptive technology update course for trainers and supervisors of family planning programs. Management training needs were filled through a 6-week middle level management course, a 2-week senior level management course, a 4-week community based family planning program course, a 6-week financial management of family planning and reproductive health programs course, and a 5-week course in leadership skills for management of women and health programs. Family life education courses were offered under the CAFS Women and Health Program for teachers, curriculum developers, youth leaders, and those working with young people for 3 weeks. Course issues of discussion included population and development, the family in contemporary African life, and policy legislation and laws to promote young people's health and social psychological and ethical aspects of adolescent sexuality. Family planning communication training programs were directed to strengthening IEC knowledge and skills over a 4-week period for senior and middle level personnel. The 3-week press course aimed to train journalists in print and electronic media for French-speaking countries who could gain cover population and family planning issues. The family planning research and evaluation course over 4 weeks aimed to increase the knowledge and skills of health personnel in project design, implementation, monitoring, and evaluation, in order to conduct assessment of program effectiveness. The course was directed to senior and middle level manager researchers, population project directors, and personnel of women-centered projects.

Adverse event management in mass drug administration for neglected tropical diseases.

PubMed

Caplan, Arthur; Zink, Amanda

2014-03-01

The ethical challenges of reporting and managing adverse events (AEs) and serious AEs (SAEs) in the context of mass drug administration (MDA) for the treatment of neglected tropical diseases (NTDs) require reassessment of domestic and international policies on a global scale. Although the World Health Organization has set forth AE/SAE guidelines specifically for NTD MDA that incorporate suspected causality, and recommends that only SAEs get reported in this setting, most regulatory agencies continue to require the reporting of all SAEs exhibiting even a merely temporal relationship to activities associated with an MDA program. This greatly increases the potential for excess "noise" and undue risk aversion and is not only impractical but arguably unethical where huge proportions of populations are being treated for devastating diseases, and no good baseline exists against which to compare possible AE/SAE reports. Other population-specific variables that might change the way drug safety ought to be assessed include differing efficacy rates of a drug, background morbidity/mortality rates of the target disease in question, the growth rate of the incidence of disease, the availability of rescue or salvage therapies, and the willingness of local populations to take risks that other populations might not. The fact that NTDs are controllable and potentially eradicable with well-tolerated, effective, existing drugs might further alter our assessment of MDA safety and AE/SAE tolerability. At the same time, diffuseness of population, communication barriers, lack of resources, and other difficult surveillance challenges may present in NTD-affected settings. These limitations could impair the ability to monitor an MDA program's success, as well as hinder efforts to obtain informed consent or provide rescue therapy. Denying beneficial research interventions and MDA programs intended to benefit millions requires sound ethical justification based on more than the identification of and rote response to AEs and SAEs. Copyright © 2014 Elsevier HS Journals, Inc. All rights reserved.

Methodology of the Comprehensive Program on Prevention and Control of Overweight and Obesity in Iranian Children and Adolescents: The IRAN-Ending Childhood Obesity (IRAN-ECHO) Program

PubMed Central

Sayyari, Ali-Akbar; Abdollahi, Zahra; Ziaodini, Hassan; Olang, Beheshteh; Fallah, Hossein; Salehi, Forouzan; Heidari-Beni, Motahar; Imanzadeh, Farid; Abasalti, Zahra; Fozouni, Fereshteh; Jafari, Sakineh; Lashkarlouki, Farhad; Sahebdel, Mahnoush; Siadati, Arash; Aslani, Hamideh; Hosseini, Mostafa; Goodarzi, Azam; Yngve, Agneta; Kelishadi, Roya

2017-01-01

Background: The World Health Organization program on Ending Childhood Obesity (WHO-ECHO) has developed a comprehensive and integrated package of recommendations to address childhood obesity. The present study, entitled IRAN-ECHO, was designed and implemented in the framework of the WHO-ECHO program. Methods: The IRAN-ECHO program is implementing multicomponent interventions by considering life course dimensions. The program has two parts: a population approach and an individual approach. The population approach considers different periods in life, including prenatal, infancy, childhood, and adolescence, as well as family and society. The individual approach targets those children or adolescents with overweight or obesity; this part is conducted as a referral system that is now integrated in the current national health system. As part of the population approach, a quasi-experimental study was conducted in six provinces to compare the status before and after implementing parts of the interventions. By intersectoral collaboration with different organizations, multicomponent interventions are conducted for different age groups. Results: The IRAN-ECHO program is being conducted in six provinces, and will be considered in all provinces in the near future. Its main effects could be assessed in future years. Part of this program that was conducted as a quasi-experimental survey comprised 7149 students and showed that a high percentage of students had acceptable knowledge about adverse health effects of overweight and obesity. However, the knowledge about the low nutritional value of unhealthy snacks such as potato chips, puffs, industrial juices, and carbonated drinks was not appropriate. Many participants had the undesirable attitude of skipping one of the main meals when attempting to lose weight. Conclusions: The IRAN-ECHO program is presenting the feasibility of conducting the WHO-ECHO recommendations in Iran. The scope of potential policy recommendations to decrease childhood obesity is extensive and includes various elements. This program considers multisectoral interventions through population and individual approaches. The multicomponent interventions of this program address the obesogenic environment by considering the life course dimensions. It is expected that, by its life course interventions, it could help in primordial and primary prevention of noncommunicable diseases. PMID:29416836

Methodology of the Comprehensive Program on Prevention and Control of Overweight and Obesity in Iranian Children and Adolescents: The IRAN-Ending Childhood Obesity (IRAN-ECHO) Program.

PubMed

Sayyari, Ali-Akbar; Abdollahi, Zahra; Ziaodini, Hassan; Olang, Beheshteh; Fallah, Hossein; Salehi, Forouzan; Heidari-Beni, Motahar; Imanzadeh, Farid; Abasalti, Zahra; Fozouni, Fereshteh; Jafari, Sakineh; Lashkarlouki, Farhad; Sahebdel, Mahnoush; Siadati, Arash; Aslani, Hamideh; Hosseini, Mostafa; Goodarzi, Azam; Yngve, Agneta; Kelishadi, Roya

2017-01-01

The World Health Organization program on Ending Childhood Obesity (WHO-ECHO) has developed a comprehensive and integrated package of recommendations to address childhood obesity. The present study, entitled IRAN-ECHO, was designed and implemented in the framework of the WHO-ECHO program. The IRAN-ECHO program is implementing multicomponent interventions by considering life course dimensions. The program has two parts: a population approach and an individual approach. The population approach considers different periods in life, including prenatal, infancy, childhood, and adolescence, as well as family and society. The individual approach targets those children or adolescents with overweight or obesity; this part is conducted as a referral system that is now integrated in the current national health system. As part of the population approach, a quasi-experimental study was conducted in six provinces to compare the status before and after implementing parts of the interventions. By intersectoral collaboration with different organizations, multicomponent interventions are conducted for different age groups. The IRAN-ECHO program is being conducted in six provinces, and will be considered in all provinces in the near future. Its main effects could be assessed in future years. Part of this program that was conducted as a quasi-experimental survey comprised 7149 students and showed that a high percentage of students had acceptable knowledge about adverse health effects of overweight and obesity. However, the knowledge about the low nutritional value of unhealthy snacks such as potato chips, puffs, industrial juices, and carbonated drinks was not appropriate. Many participants had the undesirable attitude of skipping one of the main meals when attempting to lose weight. The IRAN-ECHO program is presenting the feasibility of conducting the WHO-ECHO recommendations in Iran. The scope of potential policy recommendations to decrease childhood obesity is extensive and includes various elements. This program considers multisectoral interventions through population and individual approaches. The multicomponent interventions of this program address the obesogenic environment by considering the life course dimensions. It is expected that, by its life course interventions, it could help in primordial and primary prevention of noncommunicable diseases.

The "Pathological Gambling and Epidemiology" (PAGE) study program: design and fieldwork.

PubMed

Meyer, Christian; Bischof, Anja; Westram, Anja; Jeske, Christine; de Brito, Susanna; Glorius, Sonja; Schön, Daniela; Porz, Sarah; Gürtler, Diana; Kastirke, Nadin; Hayer, Tobias; Jacobi, Frank; Lucht, Michael; Premper, Volker; Gilberg, Reiner; Hess, Doris; Bischof, Gallus; John, Ulrich; Rumpf, Hans-Jürgen

2015-03-01

The German federal states initiated the "Pathological Gambling and Epidemiology" (PAGE) program to evaluate the public health relevance of pathological gambling. The aim of PAGE was to estimate the prevalence of pathological gambling and cover the heterogenic presentation in the population with respect to comorbid substance use and mental disorders, risk and protective factors, course aspects, treatment utilization, triggering and maintenance factors of remission, and biological markers. This paper describes the methodological details of the study and reports basic prevalence data. Two sampling frames (landline and mobile telephone numbers) were used to generate a random sample from the general population consisting of 15,023 individuals (ages 14 to 64) completing a telephone interview. Additionally, high-risk populations have been approached in gambling locations, via media announcements, outpatient addiction services, debt counselors, probation assistants, self-help groups and specialized inpatient treatment facilities. The assessment included two steps: (1) a diagnostic interview comprising the gambling section of the Composite International Diagnostic Interview (CIDI) for case finding; (2) an in-depth clinical interview with participants reporting gambling problems. The in-depth clinical interview was completed by 594 participants, who were recruited from the general or high-risk populations. The program provides a rich epidemiological database which is available as a scientific use file. Copyright © 2015 John Wiley & Sons, Ltd.

Population screening for genetic disorders in the 21st century: evidence, economics, and ethics.

PubMed

Grosse, S D; Rogowski, W H; Ross, L F; Cornel, M C; Dondorp, W J; Khoury, M J

2010-01-01

Proposals for population screening for genetic diseases require careful scrutiny by decision makers because of the potential for harms and the need to demonstrate benefits commensurate with the opportunity cost of resources expended. We review current evidence-based processes used in the United States, the United Kingdom, and the Netherlands to assess genetic screening programs, including newborn screening programs, carrier screening, and organized cascade testing of relatives of patients with genetic syndromes. In particular, we address critical evidentiary, economic, and ethical issues that arise in the appraisal of screening tests offered to the population. Specific case studies include newborn screening for congenital adrenal hyperplasia and cystic fibrosis and adult screening for hereditary hemochromatosis. Organizations and countries often reach different conclusions about the suitability of screening tests for implementation on a population basis. Deciding when and how to introduce pilot screening programs is challenging. In certain cases, e.g., hereditary hemochromatosis, a consensus does not support general screening although cascade screening may be cost-effective. Genetic screening policies have often been determined by technological capability, advocacy, and medical opinion rather than through a rigorous evidence-based review process. Decision making should take into account principles of ethics and opportunity costs. Copyright 2009 S. Karger AG, Basel.

Toward a joint health and disease management program. Toronto hospitals partner to provide system leadership.

PubMed

Macleod, Anne Marie; Gollish, Jeffrey; Kennedy, Deborah; McGlasson, Rhona; Waddell, James

2009-01-01

The Joint Health and Disease Management Program in the Toronto Central Local Health Integration Network (TC LHIN) is envisioned as a comprehensive model of care for patients with hip and knee arthritis. It includes access to assessment services, education, self-management programs and other treatment programs, including specialist care as needed. As the first phase of this program, the hospitals in TC LHIN implemented a Hip and Knee Replacement Program to focus on improving access and quality of care, coordinating services and measuring wait times for patients waiting for hip or knee replacement surgery. The program involves healthcare providers, consumers and constituent hospitals within TC LHIN. The approach used for this program involved a definition of governance structure, broad stakeholder engagement to design program elements and plans for implementation and communication to ensure sustainability. The program and approach were designed to provide a model that is transferrable in its elements or its entirety to other patient populations and programs. Success has been achieved in creating a single wait list, developing technology to support referral management and wait time reporting, contributing to significant reductions in waits for timely assessment and treatment, building human resource capacity and improving patient and referring physician satisfaction with coordination of care.

Fitness and Activity Assessments among U.S. Army Populations: Implications for NCHS General Population Surveys,

DTIC Science & Technology

1986-01-01

and in some cases -body fat ), are measured twice yearly in the U.S. Army through age 60. Field measures are defined as those conducted by army units...weight and fat standards were originally part of the fitness program and fitness regulations. Because of a considerable increase in emphasis in this...service. Absolute b max is 4/0% less in women but only15% less when adjusted for difference in fat free weight. The relatively small overlap between

How Successful are U.S. Efforts to Build Capacity in Developing Countries? A Framework to Assess the Global Train and Equip 1206 Program

DTIC Science & Technology

2011-01-01

CARE INFRASTRUCTURE AND TRANSPORTATION INTERNATIONAL AFFAIRS LAW AND BUSINESS NATIONAL SECURITY POPULATION AND AGING PUBLIC SAFETY SCIENCE AND...Prevention—International cooperation—Evaluation. 5. Combined operations (Military science )—Evaluation. 6. United States—Military relations—Foreign...as well as to elicit informa- tion regarding assessment guidance and skills. 7 See Jennifer D. P. Moroney, Jefferson P. Marquis, Cathryn Quantic

Rehabilitation Counselor Preparation for Working with Youth with Psychiatric Disabilities

ERIC Educational Resources Information Center

Mellin, Elizabeth A.; Hunt, Brandon; Lorenz, Dawn C.

2009-01-01

Faculty in CORE-accredited rehabilitation counseling programs (N = 46) were surveyed to assess preparation for work with youth with psychiatric disabilities and to identify barriers to developing and maintaining a specialization focused on this population within the curriculum. Although faculty reported that students enrolled in their programs…

Mathematics Placement at the University of Illinois

ERIC Educational Resources Information Center

Ahlgren Reddy, Alison; Harper, Marc

2013-01-01

Data from the ALEKS-based placement program at the University of Illinois is presented visually in several ways. The placement exam (an ALEKS assessment) contains precise item-specific information and the data show many interesting properties of the student populations of the placement courses, which include Precalculus, Calculus, and Business…

78 FR 35287 - Agency Information Collection Activities; Submission to OMB for Review and Approval; Public...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-12

... areas of leadership, change management, teamwork, panel or population management, competency assessment... Administration (HRSA) has submitted an Information Collection Request (ICR) to the Office of Management and... surveys are Irvine's Leadership Behavior Survey and the Faculty Skill & Program Feasibility Survey. The...

Cost-Effectiveness of a School-Based Emotional Health Screening Program

ERIC Educational Resources Information Center

Kuo, Elena; Stoep, Ann Vander; McCauley, Elizabeth; Kernic, Mary A.

2009-01-01

Background: School-based screening for health conditions can help extend the reach of health services to underserved populations. Screening for mental health conditions is growing in acceptability, but evidence of cost-effectiveness is lacking. This study assessed costs and effectiveness associated with the Developmental Pathways Screening…

High-Throughput Simulation of Environmental Chemical Fate for Exposure Prioritization (Annual Meeting of ISES)

EPA Science Inventory

The U.S. EPA must consider thousands of chemicals when allocating resources to assess risk in human populations and the environment. High-throughput screening assays to characterize biological activity in vitro are being implemented in the ToxCastTM program to rapidly characteri...

Planning a Nutrition Curriculum: Assessing Availability, Affordability, and Cultural Appropriateness of Recommended Foods.

ERIC Educational Resources Information Center

Ford, Valeria L.; Harris, Mary B.

1988-01-01

The first step in planning a healthy heart nutrition program for a rural American Indian population involved surveying the foods available at local grocery stores. Some healthy foods were found to be unavailable or very expensive. Awareness of the cultural acceptability of foods is emphasized. (CB)

PRESCHOOL INTERVENTION--A PRELIMINARY REPORT OF THE PERRY PRESCHOOL PROJECT.

ERIC Educational Resources Information Center

WEIKART, DAVID P., ED.

THE PERRY PRESCHOOL PROJECT IS AN EXPERIMENT WITH REPLICATIONS DESIGNED TO ASSESS THE LONGITUDINAL EFFECTS OF A 2-YEAR, COGNITIVELY ORIENTED, COMPENSATORY EDUCATION PROGRAM. SELECTED FROM A POPULATION WHICH IS NEGRO, FUNCTIONALLY RETARDED, AND CULTURALLY DEPRIVED, CONTROL AND EXPERIMENTAL GROUPS ARE EQUATED FOR MEAN CULTURAL-DEPRIVATION RATING AND…

Tobacco, Marijuana, and Alcohol Use in University Students: A Cluster Analysis

ERIC Educational Resources Information Center

Primack, Brian A.; Kim, Kevin H.; Shensa, Ariel; Sidani, Jaime E.; Barnett, Tracey E.; Switzer, Galen E.

2012-01-01

Objective: Segmentation of populations may facilitate development of targeted substance abuse prevention programs. The authors aimed to partition a national sample of university students according to profiles based on substance use. Participants: The authors used 2008-2009 data from the National College Health Assessment from the American College…

An Updated Measure for Assessing Subtle Rape Myths

ERIC Educational Resources Information Center

McMahon, Sarah; Farmer, G. Lawrence

2011-01-01

Social workers responsible for developing rape prevention programs on college campuses must have valid evaluation instruments. This article presents the challenges encountered by the authors when they attempted to keep rape myth measures relevant to student populations by updating the language to reflect the subtleties involved with rape myths.…

Occupational Preparation. Module 2: Career Exploration. Instructor Guide. Student Guide.

ERIC Educational Resources Information Center

Gunderson, Margaret; Jurgesmeyer, Patricia A.

This unit is one of three self-contained modules for self-assessment, career exploration, and life skills designed for use with special populations (persons with disabilities, educationally and economically disadvantaged persons, persons with limited English proficiency, students in programs designed to eliminate sex bias, and prisoners) in…

The Ecuadorian Professional Preparation Program

ERIC Educational Resources Information Center

Berzins, Anton Robert

2008-01-01

Across all fields of psychology within the United States, many mental health and educational professionals involved in the assessment of school-age children are not members of a minority population. As a result, these professionals are unfamiliar with the diverse cultural and linguistic characteristics of the individuals that they serve. This…

Adult-Literacy Education in Jamaica.

ERIC Educational Resources Information Center

Miller, Harry; And Others

Some 42% of Jamaica's adult population was not functionally literate in 1962--figures that precipitated expansion in adult literacy and Basic Education programs as described in this survey report. Following a seven-page introductory historical profile, the authors note attempts made to assess adult illiteracy, such as the 1975 survey that found…

Prison Literacy: Implications for Program and Assessment Policy.

ERIC Educational Resources Information Center

Newman, Anabel P.; And Others

The United States confronts the problem of a large and growing prison population, the majority of which is insufficiently literate. Added to the general effects of educational disability are the marginalizing factors of ethnicity, class, socioeconomic deprivation, and other handicaps. Historically, the situation in prison literacy is 150 years of…

An Integrated Nurse Practitioner-Run Subspecialty Referral Program for Incontinent Children.

PubMed

Jarczyk, Kimberly S; Pieper, Pam; Brodie, Lori; Ezzell, Kelly; D'Alessandro, Tina

Evidence suggests that urinary and fecal incontinence and abnormal voiding and defecation dynamics are different manifestations of the same syndrome. This article reports the success of an innovative program for care of children with incontinence and dysfunctional elimination. This program is innovative because it is the first to combine subspecialty services (urology, gastroenterology, and psychiatry) in a single point of care for this population and the first reported independent nurse practitioner-run specialty referral practice in a free-standing pediatric ambulatory subspecialty setting. Currently, services for affected children are siloed in the aforementioned subspecialties, fragmenting care. Retrospective data on financial, patient satisfaction, and patient referral base were compiled to assess this program. Analysis indicates that this model is fiscally sound, has similar or higher patient satisfaction scores when measured against physician-run subspecialty clinics, and has an extensive geographic referral base in the absence of marketing. This model has potential transformative significance: (a) the impact of children achieving continence cannot be underestimated, (b) configuration of services that cross traditional subspecialty boundaries may have broader application to other populations, and (c) demonstration of effectiveness of non-physician provider reconfiguration of health care delivery in subspecialty practice may extend to the care of other populations. Copyright © 2017 National Association of Pediatric Nurse Practitioners. Published by Elsevier Inc. All rights reserved.

Near-Field Cosmology with Resolved Stellar Populations Around Local Volume LMC Stellar-Mass Galaxies

NASA Astrophysics Data System (ADS)

Carlin, Jeffrey L.; Sand, David J.; Willman, Beth; Brodie, Jean P.; Crnojevic, Denija; Forbes, Duncan; Hargis, Jonathan R.; Peter, Annika; Pucha, Ragadeepika; Romanowsky, Aaron J.; Spekkens, Kristine; Strader, Jay

2018-06-01

We discuss our ongoing observational program to comprehensively map the entire virial volumes of roughly LMC stellar mass galaxies at distances of ~2-4 Mpc. The MADCASH (Magellanic Analog Dwarf Companions And Stellar Halos) survey will deliver the first census of the dwarf satellite populations and stellar halo properties within LMC-like environments in the Local Volume. Our results will inform our understanding of the recent DES discoveries of dwarf satellites tentatively affiliated with the LMC/SMC system. This program has already yielded the discovery of the faintest known dwarf galaxy satellite of an LMC stellar-mass host beyond the Local Group, based on deep Subaru+HyperSuprimeCam imaging reaching ~2 magnitudes below its TRGB, and at least two additional candidate satellites. We will summarize the survey results and status to date, highlighting some challenges encountered and lessons learned as we process the data for this program through a prototype LSST pipeline. Our program will examine whether LMC stellar mass dwarfs have extended stellar halos, allowing us to assess the relative contributions of in-situ stars vs. merger debris to their stellar populations and halo density profiles. We outline the constraints on galaxy formation models that will be provided by our observations of low-mass galaxy halos and their satellites.

Impact Evaluation of an After-school Cooking Skills Program in a Disadvantaged Community: Back to Basics.

PubMed

Burrows, Tracy L; Lucas, Hannah; Morgan, Philip J; Bray, James; Collins, Clare E

2015-09-01

Few efficacious child obesity interventions have been converted into ongoing community programs in the after-school setting. The aim of this study was to evaluate the impact of phase 2 of the Back to Basics cooking club on dietary behaviours and fruit and vegetable variety in a population at risk of obesity at a low income school with > 10% indigenous population. Baseline and 3-month dietary intake and social cognitive theory (SCT) constructs were collected in 51 children, mean age 9 years, 61% female. McNemar tests were used for comparison of proportions between categorical variables. Cohen's d was used to compare effect sizes across different measures. Consumption of one or more fruit servings per day significantly increased from 41% to 67% (P = 0.02, d = 0.13) and there was a trend for increasing the weekly variety of fruit and vegetables. The SCT constructs assessed within the current study improved significantly (P < 0.05), with moderate to large effect sizes (d = 0.33-0.78). This study documents that a previous efficacious healthy lifestyle program can be adapted for use as an obesity prevention program addressing improvements in vegetable and fruit intakes in a low income community with a relatively high indigenous population.

The promises and limitations of gender-transformative health programming with men: critical reflections from the field.

PubMed

Dworkin, Shari L; Fleming, Paul J; Colvin, Christopher J

2015-01-01

Since the 1994 International Conference on Population and Development, researchers and practitioners have engaged in a series of efforts to shift health programming with men from being gender-neutral to being more gender-sensitive and gender-transformative. Efforts in this latter category have been increasingly utilised, particularly in the last decade, and attempt to transform gender relations to be more equitable in the name of improved health outcomes for both women and men. We begin by assessing the conceptual progression of social science contributions to gender-transformative health programming with men. Next, we briefly assess the empirical evidence from gender-transformative health interventions with men. Finally, we examine some of the challenges and limitations of gender-transformative health programmes and make recommendations for future work in this thriving interdisciplinary area of study.

The promises and limitations of gender-transformative health programming with men: critical reflections from the field

PubMed Central

Dworkin, Shari L.; Fleming, Paul J.; Colvin, Christopher J.

2015-01-01

Since the 1994 International Conference on Population and Development, researchers and practitioners have engaged in a series of efforts to shift health programming with men from being gender-neutral to being more gender-sensitive and gender-transformative. Efforts in this latter category have been increasingly utilised, particularly in the last decade, and attempt to transform gender relations to be more equitable in the name of improved health outcomes for both women and men. We begin by assessing the conceptual progression of social science contributions to gender-transformative health programming with men. Next, we briefly assess the empirical evidence from gender-transformative health interventions with men. Finally, we examine some of the challenges and limitations of gender-transformative health programmes and make recommendations for future work in this thriving interdisciplinary area of study. PMID:25953008

Using population viability criteria to assess strategies to minimize disease threats for an endangered carnivore.

PubMed

Doak, Daniel F; Bakker, Victoria J; Vickers, Winston

2013-04-01

Outbreaks of infectious disease represent serious threats to the viability of many vertebrate populations, but few studies have included quantitative evaluations of alternative approaches to the management of disease. The most prevalent management approach is monitoring for and rapid response to an epizootic. An alternative is vaccination of a subset of the free-living population (i.e., a "vaccinated core") such that some individuals are partially or fully immune in the event of an epizootic. We developed a simulation model describing epizootic dynamics, which we then embedded in a demographic simulation to assess these alternative approaches to managing rabies epizootics in the island fox (Urocyon littoralis), a species composed of only 6 small populations on the California Channel Islands. Although the monitor and respond approach was superior to the vaccinated-core approach for some transmission models and parameter values, this type of reactive management did not protect the population from rabies under many disease-transmission assumptions. In contrast, a logistically feasible program of prophylactic vaccination for part of the wild population yielded low extinction probabilities across all likely disease-transmission scenarios, even with recurrent disease introductions. Our use of a single metric of successful management-probability of extreme endangerment (i.e., quasi extinction)-to compare very different management approaches allowed an objective assessment of alternative strategies for controlling the threats posed by infectious disease outbreaks. © 2013 Society for Conservation Biology.

Evidence-Based Program Service Deserts: A Geographic Information Systems (GIS) Approach to Identifying Service Gaps for State-Level Implementation Planning.

PubMed

Walker, Sarah Cusworth; Hurvitz, Philip M; Leith, Jessica; Rodriguez, Felix I; Endler, Gregory C

2016-11-01

The long term effects of untreated mental health need for individuals, families and society has prompted a number of federal policy statements encouraging the use of evidence-based programs (EBP) in children's healthcare. However, among other challenges of evidence-based practice implementation, states often do not know where to make investments based on population need. In this paper we present the use of a Geographic Information System approach to undertake a mental health needs assessment for Washington State. Our study found that this technology can be beneficially applied to conducting needs assessment for EBP implementation, and we provide recommendations for future applications.

[Risk factors for the spine: nursing assessment and care].

PubMed

Bringuente, M E; de Castro, I S; de Jesus, J C; Luciano, L dos S

1997-01-01

The present work aimed at studying risk factor that affect people with back pain, identifying them and implementing an intervention proposal of a health education program based on self-care teaching, existential humanist philosophical projects and stress equalization approach line, skeletal-muscle reintegration activities, basic techniques on stress equalization and massage. It has been developed for a population of 42 (forty-two) clients. Two instruments which integrate nursing consultation protocol have been used in data collection. The results showed the existence of associated risk factors which are changeable according to health education programs. The assessment process has contributed for therapeutic measures focus, using non-conventional care methods for this approach providing an improvement to these clients life quality.

Predictors of Substance Abuse Assessment and Treatment Completion for Parents Involved with Child Welfare: One State's Experience in Matching across Systems.

PubMed

Traube, Dorian E; He, Amy S; Zhu, Limei; Scalise, Christine; Richardson, Tyrone

2015-01-01

To date, few studies have examined the effect of interagency collaboration on substance abuse assessment ity of Southern California and treatment completion for parents who are involved in child welfare. The purpose of this paper is to: (1) describe a statewide, interagency collaborative program aimed at providing targeted substance abuse assessment and treatment to parents engaged in the child welfare system; (2) document the specialized assessment and treatment outcomes for parents engaged through this collaborative program; and (3) determine factors related to successful treatment completion for parents involved in the child welfare system. This is a retrospective study of an open cohort of 13,829 individuals admitted to the New Jersey Child Protection Substance Abuse Initiative (CPSAI) program from October 1, 2009, through September 30, 2010. Data were drawn from two unique administrative data sources. Multivariate Cox regression models were used to explore factors related to successfil treatment completion for parents involved in the child welfare system. Trend analysis for the total sample in the CPSAI program revealed that, of the 10,909 individuals who received a CPSAI assessment, 59% were referred to treatment. Of those referred to treatment, 40% enrolled in a treatment program. Once enrolled in a treatment program, 55% completed or were in the process of completing substance abuse treatment. These findings suggest that when adequate screening and treatment is available through a streamlined process, many of the ethnic and gender disparities present among other populations of individuals seeking treatment are minimized. Utilizing inherent child welfare case factors appears to be an important motivating element that aids parents during the assessment and treatment process.

Evidence for the effect of disease management: is $1 billion a year a good investment?

PubMed

Mattke, Soeren; Seid, Michael; Ma, Sai

2007-12-01

To assess the evidence for the effect of disease management on quality of care, disease control, and cost, with a focus on population-based programs. Literature review. We conducted a literature search for and a structured review of studies on population-based disease management programs, as well as for reviews and meta-analyses of disease management interventions. We identified 3 evaluations of large-scale population-based programs, as well as 10 meta-analyses and 16 systematic reviews, covering 317 unique studies. We found consistent evidence that disease management improves processes of care and disease control but no conclusive support for its effect on health outcomes. Overall, disease management does not seem to affect utilization except for a reduction in hospitalization rates among patients with congestive heart failure and an increase in outpatient care and prescription drug use among patients with depression. When the costs of the intervention were appropriately accounted for and subtracted from any savings, there was no conclusive evidence that disease management leads to a net reduction of direct medical costs. Although disease management seems to improve quality of care, its effect on cost is uncertain. Most of the evidence to date addresses small-scale programs targeting high-risk individuals, while only 3 studies evaluate large population-based interventions, implying that little is known about their effect. Payers and policy makers should remain skeptical about vendor claims and should demand supporting evidence based on transparent and scientifically sound methods.

National Water-Quality Assessment Program: The Sacramento River Basin

USGS Publications Warehouse

Domagalski, Joseph L.; Brown, Larry R.

1994-01-01

In 1991, the U.S. Geological Survey (USGS) began to implement a full-scale National Water-Quality Assessment (NAWQA) program. The long-term goals of the NAWQA program are to describe the status of and trends in the quality of a large, representative part of the Nation's surface- and ground-water resources and to identify the major natural and human factors that affect the quality of those resources. In addressing these goals, the program will provide a wealth of water- quality information that will be useful to policy makers and managers at the national, State, and local levels. A major asset of the NAWQA program is that it will allow for the integration of water-quality information collected at several scales. A major component of the program is the study-unit investigation-the foundation of national- level assessment. The 60 study units of the NAWQA program are hydrologic systems that include parts of most major river basins and aquifer systems of the conterminous United States. These study units cover areas of 1,000 to more than 60,000 square miles and represent 60 to 70 percent of the Nation's water use and population served by public water supplies. Investigations of the first 20 study units began in 1991. In 1994, the Sacramento River Basin was among the second set of 20 NAWQA study units selected for investigation.

Advanced primary care in San Antonio: linking practice and community strategies to improve health.

PubMed

Ferrer, Robert L; Gonzalez Schlenker, Carolina; Lozano Romero, Raquel; Poursani, Ramin; Bazaldua, Oralia; Davidson, DeWayne; Ann Gonzales, Melissa; Dehoyos, Janie; Castilla, Martha; Corona, Betty A; Tysinger, James; Alsip, Bryan; Trejo, Jonathan; Jaén, Carlos Roberto

2013-01-01

Improving health among people living in poverty often transcends narrowly focused illness care. Meaningful success is unlikely without confronting the complex social origins of illness. We describe an emerging community of solution to improve health outcomes for a population of 6000 San Antonio, Texas, residents enrolled in a county health care program. The community of solution comprises a county health system, a family medicine residency program, a metropolitan public health department, and local nonprofit organizations and businesses. Community-based activities responding to the needs of individuals and their neighborhoods are driven by a cohort of promotores (community health workers) whose mission encompasses change at both the individual and community levels. Centered on patients' functional goals, promotores mobilize family and community resources and consider what community-level action will address the social determinants of health. On the clinical side, care teams implement population-based risk assessment and nurse care management with a focus on care transitions as well as other measures to meet the needs of patients with high morbidity and high use of health care. Population-based outcome metrics include reductions in hospitalizations, emergency department and urgent care visits, and the associated charges. Promotores also assess patients' progress along the trajectory of their selected functional goals.

Worksite health promotion programs in college settings

PubMed Central

Hill-Mey, Patricia E.; Kumpfer, Karol L.; Merrill, Ray M.; Reel, Justine; Hyatt-Neville, Beverly; Richardson, Glenn E.

2015-01-01

The purpose of this paper is to describe the multifaceted nature and benefits of worksite health promotion programs (WHPPs), with emphasis on the college setting. An assessment of the peer-reviewed literature was conducted of articles published since 2000. Several search engines were accessed and selected key words were used. Most studies examining WHPPs have focused on return on investment and productivity. Research that targets the softer side-benefits of health promotion programs in the workplace is less available. Although the college setting offers some advantages for implementing health promotion programs. They may also have unique challenges due to their large and diverse employee population. There is little research to show the effectiveness and unique challenges of college-based health promotion programs. PMID:25861657

National Water-Quality Assessment Program; the Allegheny-Monongahela River Basin

USGS Publications Warehouse

McAuley, Steven D.

1995-01-01

In 1991, the U.S. Geological Survey (USGS) began a National Water-Quality Assessment (NAWQA) program. The three major objectives of the NAWQA program are to provide a consistent description of current water-quality conditions for a large part of the Nation's water resources, define long-term trends in water quality, and identify, describe, and explain the major factors that affect water-quality conditions and trends. The program produces water-quality information that is useful to policy makers and managers at the National, State, and local levels.The program will be implemented through 60 separate investigations of river basins and aquifer systems called study units. These study-unit investigations will be conducted at the State and local level and will form the foundation on which national- and regional-level assessments are based. The 60 study units are hydrologic systems that include parts of most major river basins and aquifer systems. The study-unit areas range from 1,000 to more than 60,000 square miles and include about 60 to 70 percent of the Nation's water use and population served by public water supplies. Twenty studyunit investigations were started in 1991, 20 started in 1994, and 20 more are planned to start in 1997. The Allegheny-Monongahela River Basin was selected to begin assessment activities as a NAWQA study unit in 1994. The study team will work from the office of the USGS in Pittsburgh, Pa.

Assessment of darkling beetle fauna after implementation of an environmental restoration program in the southern Iberian Peninsula affected by the Aznalcóllar toxic spill.

PubMed

Cárdenas, Ana M; Bujalance, José L; Hidalgo, Juan M

2011-01-01

This study is part of the Follow up Restoration Program of animal communities that colonize the Guadiamar River Basin. In 1998, the area was affected by a release of toxic sludge after the retention walls of the Aznalcóllar Mines (southern Iberian Peninsula) broke. The main objective of this study was to assess the current state of the population of Tenebrionidae, one of the most representative groups of edaphic Coleoptera inhabiting the Guadiamar River Basin. This paper analyses the progress made by the darkling beetle community six years after the disaster occurred and the Restoration Program was implemented. The study is based on faunistic data from systematic sampling carried out for six years to monitor plots distributed across the damaged area. To make an overall assessment of the tenebrionid fauna in relation to adjacent areas qualitative and quantitative ecological indices were applied, and temporal follow up and biogeographical comparisons were also made. The results indicate that, on the whole, tenebrionid fauna was somewhat affected by the Aznalcóllar Mine spill, and that a greater loss of fauna was detected closer to the accident site. The analysis of the temporal population dynamic suggests that the most affected zones are undergoing a process of re-colonization. However, this process varies widely by species and has not yet reached the expected levels of a non-affected river basin in the southern Iberian Peninsula.

Genetic diversity and population structure of bocachico Prochilodus magdalenae (Pisces, Prochilodontidae) in the Magdalena River basin and its tributaries, Colombia

PubMed Central

Berdugo, Gilberto Orozco; Narváez Barandica, Juan C.

2014-01-01

Prochilodus magdalenae is an endemic freshwater fish that occurs in the Magdalena, Sinú and Atrato hydrographic basins. It has an important economic role and is a food resource for the artisanal fishing communities. Its socioeconomic importance contrasts with the current status of its fisheries, where stocks are being depleted. Considering its importance and lack of information on its genetic structure, we used seven microsatellite markers to assess the genetic structure of wild populations of P. magdalenae. The genetic diversity was assessed and the population genetic structure was estimated through Fst, analysis of molecular variance and Bayesian analysis. A total of 290 alleles were found in all loci throughout all population. The high polymorphism contrasts with the levels of observed heterozygosity (Ho = 0.276), which are the lowest values recorded for the family. We found three populations of bocachico coexisting throughout the studied system, contradicting the hypothesis that freshwater migratory fish form panmictic populations. These results on the genetic structure of P. magdalenae constitute tools for a better understanding of the behavior and biology of this species, contributing to fish management and conservation programs. PMID:24688289

Wildlife as valuable natural resources vs. intolerable pests: A suburban wildlife management model

USGS Publications Warehouse

DeStefano, S.; Deblinger, R.D.

2005-01-01

Management of wildlife in suburban environments involves a complex set of interactions between both human and wildlife populations. Managers need additional tools, such as models, that can help them assess the status of wildlife populations, devise and apply management programs, and convey this information to other professionals and the public. We present a model that conceptualizes how some wildlife populations can fluctuate between extremely low (rare, threatened, or endangered status) and extremely high (overabundant) numbers over time. Changes in wildlife abundance can induce changes in human perceptions, which continually redefine species as a valuable resource to be protected versus a pest to be controlled. Management programs thatincorporate a number of approaches and promote more stable populations of wildlife avoid the problems of the resource versus pest transformation, are less costly to society, and encourage more positive and less negative interactions between humans and wildlife. We presenta case example of the beaver Castor canadensis in Massachusetts to illustrate how this model functions and can be applied. ?? 2005 Springer Science + Business Media, Inc.

Large-scale academic achievement testing of deaf and hard-of-hearing students: past, present, and future.

PubMed

Qi, Sen; Mitchell, Ross E

2012-01-01

The first large-scale, nationwide academic achievement testing program using Stanford Achievement Test (Stanford) for deaf and hard-of-hearing children in the United States started in 1969. Over the past three decades, the Stanford has served as a benchmark in the field of deaf education for assessing student academic achievement. However, the validity and reliability of using the Stanford for this special student population still require extensive scrutiny. Recent shifts in educational policy environment, which require that schools enable all children to achieve proficiency through accountability testing, warrants a close examination of the adequacy and relevance of the current large-scale testing of deaf and hard-of-hearing students. This study has three objectives: (a) it will summarize the historical data over the last three decades to indicate trends in academic achievement for this special population, (b) it will analyze the current federal laws and regulations related to educational testing and special education, thereby identifying gaps between policy and practice in the field, especially identifying the limitations of current testing programs in assessing what deaf and hard-of-hearing students know, and (c) it will offer some insights and suggestions for future testing programs for deaf and hard-of-hearing students.

Reach and effectiveness of a community program to reduce smoking among ethnic Turkish residents in Rotterdam, the Netherlands: a quasi-experimental design.

PubMed

Nierkens, Vera; Kunst, Anton E; De Vries, Hein; Voorham, Toon A J; Stronks, Karien

2013-01-01

Community interventions have been considered promising strategies to reduce smoking prevalence among ethnic minority populations. We assessed the reach and effectiveness of a community program targeted at the Turkish population in Rotterdam, the Netherlands. The study had a quasi-experimental design, with 1 pretest and 1 posttest among 18- to 60-year-old Turkish residents in a district in Rotterdam (n = 388 at pretest) and in a comparison area in the city of Utrecht (n = 389 at pretest). The surveys included measures of reach and measures of effectiveness. Logistic regression analysis assessed changes in the outcome measures over time, adjusting for sex, age, and educational level. At posttest, more smokers (62.5%) perceived pros of quitting, and 8.2% had quit. Compared with the comparison group, in the intervention group the changes tended to be greater, but differences were not statistically significant. Of all respondents, 61.2% recognized at least 1 program component, and 23.1% participated in at least 1. Based on the greater changes in the intervention group (particularly regarding quit rates and pros of smoking), this community intervention can become a promising strategy. To increase potential effectiveness, participation rates need to increase and interventions should last longer and include smoking-cessation support.

Population prevalence of hereditary breast cancer phenotypes and implementation of a genetic cancer risk assessment program in southern Brazil

PubMed Central

2009-01-01

In 2004, a population-based cohort (the Núcleo Mama Porto Alegre - NMPOA Cohort) was started in Porto Alegre, southern Brazil and within that cohort, a hereditary breast cancer study was initiated, aiming to determine the prevalence of hereditary breast cancer phenotypes and evaluate acceptance of a genetic cancer risk assessment (GCRA) program. Women from that cohort who reported a positive family history of cancer were referred to GCRA. Of the 9218 women enrolled, 1286 (13.9%) reported a family history of cancer. Of the 902 women who attended GCRA, 55 (8%) had an estimated lifetime risk of breast cancer ≥ 20% and 214 (23.7%) had pedigrees suggestive of a breast cancer predisposition syndrome; an unexpectedly high number of these fulfilled criteria for Li-Fraumeni-like syndrome (122 families, 66.7%). The overall prevalence of a hereditary breast cancer phenotype was 6.2% (95%CI: 5.67-6.65). These findings identified a problem of significant magnitude in the region and indicate that genetic cancer risk evaluation should be undertaken in a considerable proportion of the women from this community. The large proportion of women who attended GCRA (72.3%) indicates that the program was well-accepted by the community, regardless of the potential cultural, economic and social barriers. PMID:21637504

Environmental Hazards Assessment Program. Volume 4: Annual report, July 1, 1993--June 30, 1994

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

Not Available

The Medical University of South Carolina`s (MUSC) vision is to become the premier national resource for medical information and for environmental/health risk assessment. A key component to the success of the many missions of the Environmental Hazards Assessment Program (EHAP) is timely access to large volumes of data. The significant growth in the number of environmental/health information systems that has occurred over the past few years has made data access challenging. This study documents the results of the needs assessment effort conducted to determine the information access and processing requirements of EHAP. The following topics are addressed in this report:more » immunological consequences of beryllium exposure; assessment of genetic risks to environmental diseases; low dose-rate radiation health effects; environmental risk perception in defined populations; information support and access systems; and environmental medicine and risk communication: curriculum and a professional support network-Department of Family Medicine.« less

Faculty Development for Metro New York City Postdoctoral Dental Program Directors: Delphi Assessment and Program Response.

PubMed

Rubin, Marcie S; Millery, Mari; Edelstein, Burton L

2017-03-01

Faculty development for dental academicians is essential to cultivate a continuous faculty workforce, retain existing faculty members, enhance their teaching skill sets, and remain responsive to changing program requirements and curricular reforms. To maximize the utility of dental faculty development, it is important to systematically assess and address faculty members' perceived training needs. The aims of this study were to determine priority topics among one group of postdoctoral program directors and to translate those topics into faculty development programs as part of Columbia University's Health Resources and Services Administration (HRSA)-sponsored faculty training program for primary care educators. The study was conducted in 2013-16. A Delphi consensus technique was implemented with three sequential surveys of 26 New York City metropolitan area general, pediatric, and public health dentistry residency program directors. On the first survey, the five respondents (19% response rate) identified 31 topics. On the second survey, 17 respondents (response rate 65%) rated the 15 most important topics. In the third and final round, 19 respondents (73% response rate) ranked teaching research methods and teaching literature reviews as the topics of greatest interest. Overall, the responses highlighted needs for faculty development on teaching research methods, motivating trainees, trainee evaluation, and clinical care assessment. Based on these results, a series of six Faculty Forums was developed and implemented for dental educators in the metropolitan area, starting with the topic of teaching research methods. The process flow used for assessing training needs and developing and evaluating training can be applied to a variety of populations of educators.

Implementation of the first worldwide quality assurance program for cystic fibrosis multiple mutation detection in population-based screening.

PubMed

Earley, Marie C; Laxova, Anita; Farrell, Philip M; Driscoll-Dunn, Rena; Cordovado, Suzanne; Mogayzel, Peter J; Konstan, Michael W; Hannon, W Harry

2011-07-15

CDC's Newborn Screening Quality Assurance Program collaborated with several U.S. Cystic Fibrosis Care Centers to collect specimens for development of a molecular CFTR proficiency testing program using dried-blood spots for newborn screening laboratories. Adult and adolescent patients or carriers donated whole blood that was aliquoted onto filter paper cards. Five blind-coded specimens were sent to participating newborn screening laboratories quarterly. Proficiency testing results were evaluated based on presumptive clinical assessment. Individual evaluations and summary reports were sent to each participating laboratory and technical consultations were offered if incorrect assessments were reported. The current CDC repository contains specimens with 39 different CFTR mutations. Up to 45 laboratories have participated in the program. Three years of data showed that correct assessments were reported 97.7% of the time overall when both mutations could be determined. Incorrect assessments that could have lead to a missed case occurred 0.9% of the time, and no information was reported 1.1% of the time due to sample failure. Results show that laboratories using molecular assays to detect CFTR mutations are performing satisfactorily. The programmatic results presented demonstrate the importance and complexity of providing proficiency testing for DNA-based assays. Published by Elsevier B.V.

Impact of a 3-year pet management program on pet population and owner's perception.

PubMed

Dias Costa, Esther; Martins, Camila Marinelli; Cunha, Graziela Ribeiro; Catapan, Dariane Cristina; Ferreira, Fernando; Oliveira, Simone Tostes; Garcia, Rita de Cassia Maria; Biondo, Alexander Welker

2017-04-01

Although pet population management programs have been established worldwide, few reports on program evaluation have been carried out to date. Accordingly, a 3-year longitudinal study has been carried out in a 4000 household neighborhood located within the metropolitan area of Curitiba, the eighth most populated city of Brazil. Visits were conducted and questionnaires completed to estimate and characterize the local pet population (animal sex, reproductive and vaccination status, street access). Care provided by owners, community perception on stray dog management and the possible changes were compared in these variables over time (2010 and 2013) were evaluated, after the establishment of a city pet population management program. In addition, associations between having children, owning dogs and cats, responsible pet ownership education and owner's perception on stray dogs were statistically tested. A total of 354/4000 (8.9%) household families were interviewed in 2010 and 70/354 (19.8%) of the same families again in 2013. No significant changes were found in overall number of dogs and cats and average pet age, animal care and owner's perception on stray dogs following the 3-year population management program. In 2010, an average of 1.6 dogs and 0.3 cats were found per family, with slightly more females (51.3% dogs and 51.1% cats), adults (4.0±3.5years for dogs and 2.1±2.4 for cats), intact (not neutered; 94.2% dogs and 84.0% cats) and lacking regular visit to veterinarian (71.6%). Although more families (53.1%) had children under 12 years old, no association was found between having children and having dogs and cats. Questionnaires revealed that owners perceived neutering/spaying to be the best pet population control method (42.4%), with "society" (50%) and "government" (49.4%) as responsible for pet population management. A significant positive association has been found between education level and the best way to control stray dogs (p=0.03), between having dogs and in favor of neutering/spaying (p=0.04) and considering neutering/spaying as the best control method (p=0.02). The chances of thinking the best way to control stray dogs by neutering/spaying and adoption were almost 2.0 fold higher than other methods. In conclusion, the present study has provided indicators (education level, having dogs) for pet population control program assessment and effectiveness evaluation. Moreover, this study may serve as a warning on the real long-term effect of such programs, which should be periodically evaluated to identify necessary adjustments and/or improvements. Copyright © 2017 Elsevier B.V. All rights reserved.

Evaluation of the impact of the voucher and accreditation approach on improving reproductive behaviors and status in Cambodia

PubMed Central

2011-01-01

Background Cost of delivering reproductive health services to low income populations will always require total or partial subsidization by government and/or development partners. Broadly termed "demand-side financing" or "output-based aid", these strategies include a range of interventions that channel government or donor subsidies to the user rather than the service provider. Initial pilot assessments of reproductive health voucher programs suggest that they can increase access, reduce inequities, and enhance program efficiency and service quality. However, there is a paucity of evidence describing how these programs function in different settings for various reproductive health services. Methods/Design Population Council, funded by the Bill and Melinda Gates Foundation, intends to generate evidence around the "voucher and accreditation" approaches to improving the reproductive health of low-income women in Cambodia. The study comprises of four populations: facilities, providers, women of reproductive age using facilities, and women and men who have been pregnant and/or used family planning within the previous 12 months. The study will be carried out in a sample of 20 health facilities that are accredited to provide maternal and newborn health and family planning services to women holding vouchers from operational districts in three provinces: Kampong Thom, Kampot and Prey Veng and a matched sample of non-accredited facilities in three other provinces. Health facility assessments will be conducted at baseline and endline to track temporal changes in quality-of-care, client out-of-pocket costs, and utilization. Facility inventories, structured observations, and client exit interviews will be used to collect comparable data across facilities. Health providers will also be interviewed and observed providing care. A population survey of about 3000 respondents will also be conducted in areas where vouchers are distributed and similar non-voucher locations. Discussion A quasi-experimental study will investigate the impact of the voucher approach on improving reproductive health behaviors, reproductive health status and reducing inequities at the population level and assess effects on access, equity and quality of care at the facility level. If the voucher scheme in Cambodia is found effective, it may help other countries adopt this approach for improving utilization and access to reproductive health and family planning services. PMID:21864405

Impact of a Web-based worksite health promotion program on absenteeism.

PubMed

Niessen, Maurice A J; Kraaijenhagen, Roderik A; Dijkgraaf, Marcel G W; Van Pelt, Danielle; Van Kalken, Coen K; Peek, Niels

2012-04-01

To evaluate the effect of participation in a comprehensive, Web-based worksite health promotion program on absenteeism. Study population consists of Dutch workers employed at a large financial services company. Linear regression was used to assess the impact of program attendance on the difference between baseline and follow-up absenteeism rates, controlling for gender, age, job level, years of employment, and noncompletion of the program. Data from 20,797 individuals were analyzed; 3826 individuals enrolled in the program during the study period. A 20.3% reduction in absenteeism was shown among program attendees compared with nonparticipants during a median follow-up period of 23.3 months. Participating in the worksite health promotion program led to an immediate reduction in absenteeism. Improved psychological well-being, increased exercise, and weight reduction are possible pathways toward this reduction.

Evaluation of the impact of the voucher and accreditation approach on improving reproductive health behaviors and status in Kenya.

PubMed

Warren, Charlotte; Abuya, Timothy; Obare, Francis; Sunday, Joseph; Njue, Rebecca; Askew, Ian; Bellows, Ben

2011-03-23

Alternatives to the traditional 'supply-side' approach to financing service delivery are being explored. These strategies are termed results-based finance, demand-side health financing or output-based aid which includes a range of interventions that channel government or donor subsidies to the user rather than the provider. Initial pilot assessments of reproductive health voucher programs suggest that, they can increase access and use, reducing inequities and enhancing program efficiency and service quality. However, there is a paucity of evidence describing how the programs function in different settings, for various reproductive health services. Population Council, funded by the Bill and Melinda Gates Foundation, intends to generate evidence around the 'voucher and accreditation' approaches to improving the reproductive health of low income women in Kenya. A quasi-experimental study will investigate the impact of the voucher approach on improving reproductive health behaviors, reproductive health status and reducing inequities at the population level; and assessing the effect of vouchers on increasing access to, and quality of, and reducing inequities in the use of selected reproductive health services. The study comprises of four populations: facilities, providers, women of reproductive health age using facilities and women and men who have been pregnant and/or used family planning within the previous 12 months. The study will be carried out in samples of health facilities - public, private and faith-based in: three districts; Kisumu, Kiambu, Kitui and two informal settlements in Nairobi which are accredited to provide maternal and newborn health and family planning services to women holding vouchers for the services; and compared with a matched sample of non-accredited facilities. Health facility assessments (HFA) will be conducted at two stages to track temporal changes in quality of care and utilization. Facility inventories, structured observations, and client exit interviews will be used to collect comparable data across facilities. Health providers will also be interviewed and observed providing care. A population survey of about 3000 respondents will also be carried out in areas where vouchers are distributed and similar locations where vouchers are not distributed.

Are we making the grade? Practices and reported efficacy measures of primate conservation education programs.

PubMed

Kling, Katherine J; Hopkins, Mariah E

2015-04-01

Conservation education is often employed alongside primate conservation efforts with the aim of changing knowledge, attitudes, and behaviors toward non-human primates. Recommended best-use practices include longevity, use of program incentives, collaboration among educators, and adaptive program assessment, among others. This study surveys primate conservation education programs (PCEPs) to assess the frequency of suggested best-use practices, and to investigate impacts on program efficacy. Online surveys were collected from PCEPs in 2013-2014 (N = 43). The majority of programs reported lengths of 5-10 years, with participant involvement ranging widely from a day to several years. Non-economic and economic incentives were distributed by approximately half of all programs, with programs that provided economic incentives reporting positive participant attitude changes more frequently than those that did not (P = 0.03). While >70% of PCEPs consulted with community leaders, local teachers, and research scientists, only 45.9% collaborated with other conservation educators and only 27% collaborated with cultural experts such as cultural anthropologists. Programs that collaborated with other conservation educators were more likely to report reductions in threats to primates, specifically to bushmeat hunting and capture of primates for the pet trade (P = 0.07). Formal program evaluations were employed by 72.1% of all programs, with the majority of programs using surveys to assess changes to participant attitudes and knowledge. Formal evaluations of participant behavior, community attitudes and behaviors, and threats to primate populations were less common. While results indicate that PCEPs follow many suggested best-use practices, program impacts may be enhanced by greater discussion of economic incentivization, increased collaboration between conservation educators, and improved commitment to adaptive evaluation of changes to behaviors in addition to attitudes and knowledge. © 2014 Wiley Periodicals, Inc.

Environmental impact assessment in higher education institutions in East Africa: the case of Rwanda.

PubMed

Kabera, Telesphore

2017-03-01

Due to the pressure on limited resources produced by a growing population and due to a decade of war, Rwanda is facing a major problem in environmental protection. Because of such problems, it seems only reasonable that environment-related courses should play an important role in the curricula of institutions of higher learning. The main aim of this research is to present a comprehensive picture of Environmental Impact Assessment (EIA) integration in graduate and undergraduate programs in Rwandese higher education institutions and to make recommendations for its improvement. During this study, two surveys were conducted: the first survey targeted Environmental Impact Assessment lecturers and the second survey was for Environmental Impact Assessment practitioners (including EIA certified experts and competent authorities). The study found that Environmental Impact Assessment is not well established in these institutions and it is not taught in some programs; civil engineering, for example, has no Environmental Impact Assessment courses. Recommendations to improve EIA education are proposed, such as requiring that a common core course in Environmental Impact Assessment be made available in Rwandese higher learning institutions.

Marketing and population problems.

PubMed

Farley, J U; Leavitt, H J

1971-07-01

There are many elements in population programs that are more familiar to marketing men than to some population experts. Advertising is essential to reach the target population, and advertising evaluation techniques (e.g., surrogate indexes or audience measures) might be useful for evaluating both population information activities and the import of the entire program. Fundamental research on basid demand for fertility control is needed and a marketer's experience with planning and evaluating test markets can be useful in assessing potential selling targets and evaluating alternative promotional and distributional strategies. Special family planning clinics have certain disadvantages: expensive and scarce personnel are needed; red tape may be present; the network is based on the assumption that the client is willing to travel relatively great distances repeatedly; and clinics lack anonymity which may scare potential acceptors away. Most developing cultures have an intensively functioning distribution structure which delivers basic commodities to the most remote areas, providing relatively anonymous outlets that are physically close to the customs. Materials requiring a prescription might be distributed in exchange for script issued at and ultimately redeemed by clinics, this requiring only an occasional visit to a clinic. Mail-order service can be used to supplement a clinic's distribution of some contraceptives. It should be remembered that population administrators often have an antipathetic view toward business and marketing and "suspect" the profit motive.

[Reversion of overweight and obesity in Vilafranca del Penedès child population: ACTIVA'T Program (2012)].

PubMed

Bibiloni, Maria Del Mar; Fernández-Blanco, Jordi; Pujol-Plana, Noemí; Surià Sonet, Sònia; Pujol-Puyané, Maria Cèlia; Mercadé Fuentes, Sílvia; Ojer Fernández de Soto, Laura; Tur, Josep A

2017-11-20

To assess a 6-month nutritional and physical activity intervention program on the nutritional status of overweight or obese and not very active 8-14 years old children by means of a controlled pre-post design (ACTIVA'T program). Pre-post study in 8-14 years old overweight or obese and low active children from Vilafranca del Penedès (Barcelona, Spain) randomized in control group (n = 51, 47.1% girls, nutritional intervention and ≤3h/wk physical activity) and ACTIVA'T group (n = 45, 37.8% girls, nutritional and physical activity ≥5h/wk intervention). Body mass index, waist/height index, and diet quality by means of KIDMED test at the beginning and at the end of the program were assessed. During the intervention, each participant was accompanied by a relative (father or mother) who performed the same activities as the children. Dietary recommendations have positively changed the habits of both ACTIVA'T and control group. The reversion in the prevalence of overweight and obesity was 93.8% and 58.6%, respectively, in the ACTIVA'T group, compared to 25.0% and 35.8% in the control group. Abdominal obesity was decreased from 42.2% to 17.8% in the ACTIVA'T group and from 47.1% to 27.5% in the control group. The program ACTIVA'T (nutritional education and physical activity promotion) improves the quality of diet and reverses the prevalence of overweight and obesity in the underactive child population. Copyright © 2017 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

Piloting proactive marketing to recruit disadvantaged adults to a community-wide obesity prevention program.

PubMed

O'Hara, Blythe J; Eggins, Dianne; Phongsavan, Philayrath; Milat, Andrew J; Bauman, Adrian E; Wiggers, John

2015-03-30

Population-wide obesity prevention and treatment programs are fundamental to addressing the increasing overweight and obesity rates in socioeconomically disadvantaged populations. Innovative recruitment strategies, including proactive marketing strategies, are needed to ensure such programs have universal reach and target vulnerable populations. This study aimed to determine the success of proactive recruitment to Australia's Get Healthy Information and Coaching Service® (GHS) and to assess whether the recruitment strategy influenced participants' outcomes. Sociodemographic information was collected from all GHS participants who joined the service between February 2009 and August 2013, and anthropometric information regarding behavioural risk factors was collected from all GHS coaching participants at baseline and six months. Data were analysed according to the participants' referral source (self-referral and secondary referral versus proactive recruitment). Participants recruited through proactive marketing were more likely to be male, aged 50 years or older, have high school education, not be in paid employment and be from the lowest three quintiles of socioeconomic advantage. The risk factor profile of coaching participants recruited through proactive marketing did not vary significantly from those recruited via other mechanisms, although they were less likely to be obese and less likely to have a higher 'at risk' waist circumference measurement. Proactively recruited coaching participants reported significant improvements from baseline to six months (consistent with improvements made by participants recruited through other strategies), although they were significantly more likely to withdraw from coaching before they completed the six-month program.Proactive marketing facilitated use of an obesity prevention service; similar services may have greater reach if proactive marketing recruitment strategies are used. These strategies could be encouraged to assist such services to achieve optimal population impact among hard-to-reach populations.

A case study of population health improvement at a Midwest regional hospital employer.

PubMed

Long, D Adam; Sheehan, Paula

2010-06-01

This article reviews the population health improvement initiative of a Midwest regional hospital employer. Services included health risk assessments, health education, and motivational health coaching conducted telephonically. Outcomes categories for this program evaluation comprised participation rates, participant satisfaction, health status and behavior change, productivity change, health care claims savings, and return on investment. Participation rates varied widely with incentive structure, although retention of participants in coaching programs averaged 89%. The participant satisfaction rate for the last 14 months of interventions was 96%. Four years of population health status and behavior trending showed significant improvements in smoking status, dietary fat and fiber intake, exercise, mental health (ie, stress, effects depressive symptoms in the past year, life satisfaction), readiness to change (ie, diet, exercise, stress, smoking, body weight), perceptions of overall health, an index of good health habits, sum of lifestyle health risks, and sum of risks and chronic conditions. Body mass index showed nonsignificant improvements during the years of greatest participation (years 2 to 4). Indicators of productivity demonstrated improvements as well. These gains were noted for employees across all health risk statuses, which suggests population health improvement strategies can influence productivity even for healthy employees. Program year 3 was evaluated for health care claims savings using a 2-stage multivariate regression approach. Stage 1 was a computation of propensity-to-participate scores. Stage 2 was an estimation of per member per month (PMPM) claims savings for participant cohorts using a propensity score-weighted linear regression analysis. Participants averaged $40.65 PMPM savings over the control population. Program return on investment, including incentive costs and vendor fees, was 2.87:1.

Temporal analysis of genetic structure to assess population dynamics of reintroduced swift foxes.

PubMed

Cullingham, Catherine I; Moehrenschlager, Axel

2013-12-01

Reintroductions are increasingly used to reestablish species, but a paucity of long-term postrelease monitoring has limited understanding of whether and when viable populations subsequently persist. We conducted temporal genetic analyses of reintroduced populations of swift foxes (Vulpes velox) in Canada (Alberta and Saskatchewan) and the United States (Montana). We used samples collected 4 years apart, 17 years from the initiation of the reintroduction, and 3 years after the conclusion of releases. To assess program success, we genotyped 304 hair samples, subsampled from the known range in 2000 and 2001, and 2005 and 2006, at 7 microsatellite loci. We compared diversity, effective population size, and genetic connectivity over time in each population. Diversity remained stable over time and there was evidence of increasing effective population size. We determined population structure in both periods after correcting for differences in sample sizes. The geographic distribution of these populations roughly corresponded with the original release locations, which suggests the release sites had residual effects on the population structure. However, given that both reintroduction sites had similar source populations, habitat fragmentation, due to cropland, may be associated with the population structure we found. Although our results indicate growing, stable populations, future connectivity analyses are warranted to ensure both populations are not subject to negative small-population effects. Our results demonstrate the importance of multiple sampling years to fully capture population dynamics of reintroduced populations. Análisis Temporal de la Estructura Genética para Evaluar la Dinámica Poblacional de Zorros (Vulpes velox) Reintroducidos. © 2013 Society for Conservation Biology.

Aid to people with disabilities: Medicaid's growing role.

PubMed

Carbaugh, Alicia L; Elias, Risa; Rowland, Diane

2006-01-01

Medicaid is the nation's largest health care program providing assistance with health and long-term care services for millions of low-income Americans, including people with chronic illness and severe disabilities. This article traces the evolution of Medicaid's now-substantial role for people with disabilities; assesses Medicaid's contributions over the last four decades to improving health insurance coverage, access to care, and the delivery of care; and examines the program's future challenges as a source of assistance to children and adults with disabilities. Medicaid has shown that it is an important source of health insurance coverage for this population, people for whom private coverage is often unavailable or unaffordable, substantially expanding coverage and helping to reduce the disparities in access to care between the low-income population and the privately insured.

Validity of the Medical College Admission Test for predicting MD-PhD student outcomes.

PubMed

Bills, James L; VanHouten, Jacob; Grundy, Michelle M; Chalkley, Roger; Dermody, Terence S

2016-03-01

The Medical College Admission Test (MCAT) is a quantitative metric used by MD and MD-PhD programs to evaluate applicants for admission. This study assessed the validity of the MCAT in predicting training performance measures and career outcomes for MD-PhD students at a single institution. The study population consisted of 153 graduates of the Vanderbilt Medical Scientist Training Program (combined MD-PhD program) who matriculated between 1963 and 2003 and completed dual-degree training. This population was divided into three cohorts corresponding to the version of the MCAT taken at the time of application. Multivariable regression (logistic for binary outcomes and linear for continuous outcomes) was used to analyze factors associated with outcome measures. The MCAT score and undergraduate GPA (uGPA) were treated as independent variables; medical and graduate school grades, time-to-PhD defense, USMLE scores, publication number, and career outcome were dependent variables. For cohort 1 (1963-1977), MCAT score was not associated with any assessed outcome, although uGPA was associated with medical school preclinical GPA and graduate school GPA (gsGPA). For cohort 2 (1978-1991), MCAT score was associated with USMLE Step II score and inversely correlated with publication number, and uGPA was associated with preclinical GPA (mspGPA) and clinical GPA (mscGPA). For cohort 3 (1992-2003), the MCAT score was associated with mscGPA, and uGPA was associated with gsGPA. Overall, MCAT score and uGPA were inconsistent or weak predictors of training metrics and career outcomes for this population of MD-PhD students.

[Development of technologies of population health management in Kazakhstan based on an integrated assessment of the combined exposure to environmental factors].

PubMed

Sraubaev, E N; Serik, B

2013-01-01

At present there is overdue necessity of an integral approach to the assessment of health status and the impact of environmental factors on it, in the development of science-based management decisions and programs on improvement of the health status of the population of Kazakhstan and in the increase in life expectancy from the birth and healthy life expectancy. The purpose of the proposed program--improving health and increasing life expectancy from the birth and healthy life expectancy of the population of Kazakhstan. Based on a meta-analysis to justify the target age group in which an implementation of complex of preventive measures will increase both the life expectancy from the birth and healthy life expectancy, to perform a comprehensive health screening for the basic classes of diseases and behavioral characteristics of the target group in the course of a multicentre studies to give a comprehensive hygienic characteristics of the ecological status of the studied regions and to develop the Health Passport of the region, to develop a model of the combined effects of environmental factors on health; to create a theoretical model for the calculation of life expectancy from the birth and healthy life expectancy, taking into account the limits of modifiability of factors that affect them, and justify a comprehensive program of management decisions on modification of factors, to carry out pilot studies on the development and validation technological (managemental) solutions to control modifiable factors that affect life expectancy from the birth and healthy life expectancy.

Improving population health or the population itself? Health technology assessment and our genetic future.

PubMed

Bassett, Ken; Lee, Patricia M; Green, Carolyn J; Mitchell, Lisa; Kazanjian, Arminée

2004-01-01

The province of British Columbia (BC), Canada is developing its first population-wide prenatal genetic screening program, known as triple-marker screening (TMS). TMS, initiated with a simple blood test, is most commonly used to screen for fetuses with the chromosomal abnormality known as Down syndrome or neural tube disorders. Women testing TMS-positive are offered diagnostic amniocentesis and, if the diagnosis is confirmed, selective second-trimester abortion. The project described in this study was initiated to address the broad range of issues arising from this testing technology and provides an example of the new type of health technology assessment (HTA) contribution emerging (and likely to become increasing necessary) in health policy development. With the advent of prenatal genetic screening programs, would-be parents gain the promise of identifying target conditions and, hence, the option of selective abortion of affected fetuses. There is considerable awareness that these developments pose challenges in every dimension (ethical, political, economic, and clinical) of the health-care environment. In the effort to construct an appropriate prenatal screening policy, therefore, administrators have understandably sought guidance from within the field of HTA. The report authors concluded that, within the restricted path open to it, the role of government is relatively clear. It has the responsibility to maintain equal access to prenatal testing, as to any other health service. It should also require maintenance of medical standards and evaluation of program performance. At the same time, policy-makers need actively to support those individuals born with disabilities and their families.

National Water-Quality Assessment (NAWQA) Program, Long Island-New Jersey (LINJ) Coastal Drainages Study Unit

USGS Publications Warehouse

Stackelberg, Paul E.; Ayers, Mark A.

1994-01-01

In 1991, the U.S. Geological Survey (USGS) began its National Water-Quality Assessment (NAWQA ) program to (1) document the quality of a large, representative part of the Nation's water resources; (2) define water-quality trends; and (3) identify major factors that affect water quality. In addressing these goals, the program will produce information that will be useful to water policy makers and managers at National, State, and local levels.Studies of 60 hydrologic systems that include parts of most major river and aquifer systems form the building blocks of the NAWQA program. Study units range in size from about 1,000 mi ² (square miles) to more than 60,000 mi² and represent 60 to 70 percent of the Nation's water use and population served by public water supply. The first 20 studies were begun in 1991; 20 more were begun in 1994, and the remaining 20 are to begin in 1997.

PROMOTING CANCER PREVENTION AND CONTROL IN COMMUNITY-BASED HIV/AIDS SERVICE ORGANIZATIONS: ARE THEY READY?

PubMed Central

Guidry, John A.; Lubetkin, Erica I.; Corner, Geoffrey W.; Lord-Bessen, Jennifer; Kornegay, Mark; Burkhalter, Jack E.

2015-01-01

Community-based organizations (CBOs) serving persons living with HIV or AIDS face the challenge of an aging population with more chronic diseases. This study assessed cancer programming needs of AIDS service organizations (ASOs) in New York, New Jersey, and Connecticut by conducting a community needs assessment. Sixty (58%) of 103 organizations completed the survey. ASOs conduct activities most related to early steps along the cancer care continuum, but they also express great interest in expanding cancer-focused programming into new areas. ASOs have resources or capacities in assisting HIV+ clients with mental health or substance abuse problems, but there exists a need for funding in undertaking or expanding cancer-focused programs. ASOs are receptive to collaborating with researchers on disseminating cancer prevention and control knowledge in their settings. Community-academic research partnerships enable resonant training and technical assistance methods to be explored that will enhance the abilities of ASOs to bring cancer-related programming to their clients. PMID:24450277

Promoting cancer prevention and control in community-based HIV/AIDS service organizations: are they ready?

PubMed

Guidry, John A; Lubetkin, Erica; Corner, Geoffrey; Lord-Bessen, Jennifer; Kornegay, Mark; Burkhalter, Jack E

2014-02-01

Community-based organizations (CBOs) serving persons living with HIV or AIDS face the challenge of an aging population with more chronic diseases. This study assessed cancer programming needs of AIDS service organizations (ASOs) in New York, New Jersey, and Connecticut by conducting a community needs assessment. Sixty (58%) of 103 organizations completed the survey. ASOs conduct activities most related to early steps along the cancer care continuum, but they also express great interest in expanding cancer-focused programming into new areas. ASOs have resources or capacities in assisting HIV+ clients with mental health or substance abuse problems, but there exists a need for funding in undertaking or expanding cancer-focused programs. ASOs are receptive to collaborating with researchers on disseminating cancer prevention and control knowledge in their settings. Community-academic research partnerships enable resonant training and technical assistance methods to be explored that will enhance the abilities of ASOs to bring cancer-related programming to their clients.

Multiple pathway asbestos exposure assessment for a Superfund community.

PubMed

Noonan, Curtis W; Conway, Kathrene; Landguth, Erin L; McNew, Tracy; Linker, Laura; Pfau, Jean; Black, Brad; Szeinuk, Jaime; Flores, Raja

2015-01-01

Libby, MT, USA, was the home to workers at a historical vermiculite mining facility and served as the processing and distribution center for this industrial product that was contaminated with amphibole asbestos. Several pathways of environmental asbestos exposure to the general population have been identified. The local clinic and health screening program collects data from participants on past occupational and environmental exposures to vermiculite and asbestos. Health studies among this population have demonstrated associations between amphibole exposure and health outcomes, but critical questions regarding the nature and level of exposure associated with specific outcomes remain unanswered. The objective of this study was to develop a comprehensive exposure assessment approach that integrates information on individuals' contact frequency with multiple exposure pathways. For 3031 participants, we describe cumulative exposure metrics for environmental exposures, occupational exposures, and residents' contact with carry-home asbestos from household workers. As expected, cumulative exposures for all three occupational categories were higher among men compared with women, and cumulative exposures for household contact and environmental pathways were higher among women. The comprehensive exposure assessment strategies will advance health studies and risk assessment approaches in this population with a complex history of both occupational and environmental asbestos exposure.

Coherence between harvest and habitat management -- Joint venture perspectives

USGS Publications Warehouse

Baxter, C.K.; Nelson, J.W.; Reinecke, K.J.; Stephens, S.E.

2006-01-01

Introduction: In recent months, an ad hoc group of waterfowl scientists, representing the International Association of Fish and Wildlife Agencies (IAFWA) Adaptive Harvest Management (ARM) Task Force and the North American Waterfowl Management Plan (NAWMP) Committee, have collaborated as a Joint Task Group (JTG) to assess options for unifying the population goals guiding waterfowl harvest management and habitat management. The JTG has been charged with bringing coherence to the population goals of the two programs. Characterizing the problem as one of coherence indicates value judgments exist regarding its significance or perhaps existence. For purposes of this paper, we characterize the lack of coherence as the absence of consistent population goals in the two related components of waterfowl conservation habitat and harvest management. Our purpose is to support continued dialogue on the respective goals of these programs and the possible implications of discordant goals to habitat joint ventures. Our objectives are two-fold: (1) illustrate how NAWMP habitat management goals and strategies have been interpreted and pursued in both breeding and wintering areas, and (2) provide perspectives on the linkages between regional habitat management programs and harvest management. The Lower Mississippi Valley and the Prairie Pothole joint ventures (LMVJV and PPJV, respectively) will be used as examples.

Lifetime influences for cannabis cessation in male incarcerated indigenous australians.

PubMed

Jacups, Susan; Rogerson, Bernadette

2015-01-01

Urban non-indigenous populations report life events (marriages, employment) as influences for self-initiated cannabis cessation. However, this hasn't been investigated in remote indigenous populations with different social paradigms. We investigate cannabis use, harms, and poly-substance misuse in 101 consenting male incarcerated indigenous Australians. Interviews applied quantitative and qualitative questions assessing demographic characteristics, criminal history, drug use, the Marijuana Problems Inventory (MPI), and cannabis-cessation influences. Comparisons used Chi Square, Analysis of Variance, and Nvivo software. Cannabis use groups (current users, ex-users, and never users) were demographically similar except that current users reported more juvenile legal problems, younger school departure, and lower school achievement (p < 0.05). Mean cannabis consumption was 12.3 cones/day. Incarceration and family responsibilities were the strongest cessation influences. Employment responsibilities and negative self-image were rarely cited as influences. High cannabis use, with its associated problems, is concerning. These identified influences indicate incarceration should be used for substance reduction programs, plus post-release follow-up. Community-based programs focusing on positive influences, such as family responsibilities and social cohesion, may be successful within indigenous populations with strong kinship responsibilities, rather than programs that focus solely on substance harms.

Hey girlfriend: an evaluation of AIDS prevention among women in the sex industry.

PubMed

Dorfman, L E; Derish, P A; Cohen, J B

1992-01-01

Increasingly, acquired immunodeficiency syndrome (AIDS) prevention programs have been developed to reach and influence street-based populations. Standard methods of evaluation do not fit the conditions of such programs. This article describes a process and outcome evaluation of an AIDS prevention program for sex workers in which qualitative and quantitative methods were combined in order to mediate research problems endemic to street-based populations. Methods included epidemiological questionnaires, open-ended interviews with participants, and ethnographic field notes. Process evaluation findings show that field staff who were indigenous to the neighborhood and population readily gained access to the community of sex workers and simultaneously became role models for positive behavior change. Outcome findings show that sex workers do feel at risk for AIDS, but usually from clients rather than from husbands or boyfriends. Accordingly, they use condoms more frequently with clients than with steady partners. Increasing condom use among sex workers with their steady partners remains an important challenge for AIDS prevention. Combining qualitative and quantitative research data provided a more comprehensive assessment of how to reach sex workers with effective AIDS risk reduction messages than either method could have provided alone.

Feasibility of a Telehealth Educational Program on Self-Management of Pain and Fatigue in Adult Cancer Patients.

PubMed

Rocque, Gabrielle B; Halilova, Karina I; Varley, Allyson L; Williams, Courtney P; Taylor, Richard A; Masom, David G; Wright, William J; Partridge, Edward E; Kvale, Elizabeth A

2017-06-01

Pain and fatigue are common symptoms among cancer patients and often lead to substantial distress. Innovative self-management programs for pain and fatigue are needed. The primary objective was to assess the feasibility of a telehealth pain and fatigue self-management program among adult cancer patients. Secondary objectives included assessment of differences in patient characteristics, recruitment, and retention of patients based on two screening strategies: 1) navigator-collected, patient-reported pain or fatigue and 2) in-clinic, physician-identified pain or fatigue. This prospective, nonrandomized, pre-post evaluation assessed feasibility, which was defined as 50% of eligible patients choosing to participate and completing the intervention. Patient demographics and patient-reported outcomes (patient activation, distress, symptoms, and quality of life) were collected at baseline and study completion. Differences in baseline characteristics were compared between cohorts and for patients who did vs. did not graduate from the program. The program did not meet feasibility requirements because of only 34% of eligible patients choosing to participate. However, 50% of patients starting the program graduated. Differences in baseline characteristics and retention rates were noted by recruitment strategy. At baseline, 27.3% of navigated patients were at the highest activation level compared with 7.1% in the physician-referred, non-navigated patients (P = 0.17); more than 15% of non-completers were at the lowest activation level compared with 9% of completers (P = 0.85). Telehealth self-management program for pain and fatigue may be better accepted among selected segments of cancer patients. Larger scale studies are needed to assess the efficacy of this program in a more selective activated population. Copyright © 2017 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

National Water-Quality Assessment Program--Southern High Plains, Texas and New Mexico

USGS Publications Warehouse

Woodward, Dennis G.; Diniz, Cecilia G.

1994-01-01

BACKGROUND In 1991, the U.S. Geological Survey (USGS) began a National Water-Quality Assessment (NAWQA) program. The long-term goals of the NAWQA program are to describe the status of, and trends in, the quality of a large, representative part of the Nation's surface- and ground-water resources and to identify the major natural and human factors that affect the quality of these resources. In addressing these goals, the program will produce a wealth of water-quality information that will be useful to policy makers and managers at the National, State, and local levels. The NAWQA program emphasis is on regional water-quality problems. The program will not diminish the need for smaller studies and monitoring designed and currently being conducted by Federal, State, and local agencies to meet their individual needs. The NAWQA program, however, will provide a large-scale framework for conducting many of these activities and an understanding about National and regional water-quality conditions that cannot be acquired from individual, small-scale programs and studies. Studies of 60 hydrologic systems that include parts of most major river basins and aquifer systems (study-unit investigations) are the building blocks of the National assessment. The 60 study units range in size from 1,000 mi 2 (square miles) to more than 60,000 mi 2 and represent 60 to 70 percent of the Nation's water use and population served by public water supplies. Twenty study-unit investigations were started in 1991, 20 additional are starting in 1994, and 20 more are planned to start in 1997. The Southern High Plains study unit was selected as one of 20 study units to begin assessment activities in 1994. This study will be run from the New Mexico District office of the USGS in Albuquerque, New Mexico.

Development of a Colorectal Cancer Screening Intervention for Iranian Adults: Appling Intervention Mapping

PubMed

Besharati, Fereshteh; Karimi-Shahanjarini, Akram; Hazavehei, Seyed Mohammad Mehdi; Bashirian, Saeid; Bagheri, Fahimeh; Faradmal, Javad

2017-08-27

Background: While the incidence rate of the colorectal cancer (CRC) has been increasing over the last three decades in Iran, very limited interventions to increase CRC screening have been developed for Iranian population. The purpose of this study was to describe the use of Intervention Mapping (IM) for applying theory and evidence and considering local contexts to develop a CRC screening program among adults in Iran. Materials and Methods: From April 2014 to July 2016 following the IM process, six steps were formulated and implemented. First a need assessment was conducted involving relevant stakeholders and using focus groups discussions (n=10), individual interviews (n=20), and a household survey (n= 480). Then a matrix of change objectives was developed for each behavioral outcome and theoretical methods and their practical applications were identified to guide intervention development and implementation. A multi-component intervention was developed and piloted. Decision on suitable parts of intervention was made based on feedback of pilot study. Finally, evaluation plan including process and outcome evaluation was generated and conducted to inform future scale up. Results: The needs assessment highlighted factors affecting CRC screening including knowledge, self efficacy, social support and perceived benefit and barriers (financial problems, fear of detection of cancer and etc). Results of needs assessment were used to develop next steps IM. The program utilized methods like information delivery, modeling, and persuasion. Practical applications included video presentation, group discussion, role playing and postcards.This program was assessed through a cluster-randomized controlled trial. Results showed that there were significant differences in CRC screening uptake between intervention groups and control (P<0.001). Conclusions: IM is a useful process in the design of a theory-based intervention addressing CRC screening among Iranian population. Creative Commons Attribution License

The Study of the Impact of Professional Learning Communities and Student Achievement

ERIC Educational Resources Information Center

Phillips, Jori K.

2014-01-01

The purpose of this study was to determine if a difference existed between student learning, using the Missouri Assessment Program (MAP), and Professional Learning Community (PLC) implementation within fifth-grade populations in the state of Missouri. The following research questions were utilized to drive the research: What is the difference in…

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…

Child Demographics Associated with Outcomes in a Community-Based Pivotal Response Training Program

ERIC Educational Resources Information Center

Baker-Ericzen, Mary J.; Stahmer, Aubyn C.; Burns, Amelia

2007-01-01

Although knowledge about the efficacy of treatments such as pivotal response training (PRT) for children with autism is increasing, studies of large-scale effectiveness for and transportability to diverse community populations are needed. The current study provides a large-scale preliminary assessment of (a) the effectiveness of a community-based…

Urban Agriculture Programs on the Rise: Agriculture Education Model Can Reach Students Other Classes Leave Behind

ERIC Educational Resources Information Center

Fritsch, Julie M.

2013-01-01

Agricultural education begins with hands-on classroom and laboratory instruction. Because agriculture is such a broad topic, schools typically tailor agriculture class offerings to match the interests of the student population, needs of nearby businesses and industry, or topics relevant to their state's standard assessments. Within most…

Aspects of Tutor and Writing Ability

ERIC Educational Resources Information Center

Zaidin, M. Arifin

2015-01-01

The purpose of this study is to assess the correlation between aspects of tutor and the students' basic writing outcomes of the Elementary School Teacher Education at the Distance Learning Program Unit, Open University of Palu. This is ex post facto correlation with the population research of 387 people and the total sample of 100 people. This…

Assessing American Indian Needs in New Mexico.

ERIC Educational Resources Information Center

French, Laurence; And Others

This paper focuses on New Mexico's high-risk Indian children and programs. Specifically, Western New Mexico University has been involved with the Gallup/McKinley public school district, the largest school district (5,000 square miles) in the United States (larger than New Jersey) with a school population that is 73% Indian. This paper examines…

Web-Based Intervention for Alcohol Use in Women of Childbearing Potential

ERIC Educational Resources Information Center

Howlett, Katia Delrahim

2010-01-01

There is a need for more effective assessment and primary prevention programs aimed at accurately measuring and reducing alcohol consumption among women before conception in underserved, high-risk populations. Health Information Technology (HIT) may serve this purpose; however, the effectiveness of such tools is not known. We conducted a…

Featured articles from regional centers - National Site for the Regional

Science.gov Websites

Assess Bee Health Goes Viral Seven years ago bee populations were tumbling into decline, threatening a -value commodity. Few pesticides are available for it, because it's a small-market crop with small the key to an incredibly successful soil health and areawide integrated pest management program - and

Are Teachers Ready to Integrate Science Concepts into Secondary Agriculture Programs?

ERIC Educational Resources Information Center

Scales, Jason; Terry, Robert, Jr.; Torres, Robert M.

2009-01-01

For the past two decades, the idea of integrating more science concepts into the secondary agriculture curriculum has gained support. The purpose of this study was to assess the confidence and competence of agriculture instructors to teach concepts related to science. The sample was derived from the population of agriculture instructors teaching…

Recruitment and Retention of Homeless Youth in a Substance Use and HIV-Risk Reduction Program

ERIC Educational Resources Information Center

Garvey, Rick; Pedersen, Eric R.; D'Amico, Elizabeth J.; Ewing, Brett A.; Tucker, Joan S.

2018-01-01

Conducting intervention studies with homeless populations can be difficult, particularly in terms of retaining participants across multiple sessions and locating them for subsequent follow-up assessments. Homeless youth are even more challenging to engage due to substance use, mental health problems, wariness of authority figures, and frequent…

Pupil Transportation Safety Program Plan.

ERIC Educational Resources Information Center

Delahanty, Joseph F.; And Others

This study has been undertaken to assess the magnitude of the school bus safety problem and to develop a plan to improve pupil transportation safety. The resulting report provides estimates of school bus population and daily usage, gives an account of injuries and fatalities that occur annually, and compares the safety records of school buses to…

Comprehensive Development Plan in Office Skills. Final Performance Report.

ERIC Educational Resources Information Center

Waubonsee Community Coll., Sugar Grove, IL.

The Waubonsee Community College Comprehensive Development Plan in Office Skills served 208 students by assessment of basic skills and referral to appropriate programs or help with job skills and referral to employment during the 18-month grant period from December 1988 through June 30, 1990. The target population was minority women or economically…

Taking the Metropolitan University to a Rural Community: The Role of a Needs Assessment Survey.

ERIC Educational Resources Information Center

Ahmed, Shamima

1999-01-01

When metropolitan universities refer to serving the entire metropolitan area, they often refer to rural fringes as well as concentrated urban populations. Working with rural communities requires somewhat different approaches to planning programs and understanding needs. Survey research helps the campus understand the perceptions and realities of…

Assessing Cultural and Linguistic Competencies in Doctoral Clinical Psychology Students

ERIC Educational Resources Information Center

Rivero, Rosanna

2017-01-01

The increase of Spanish-speaking populations in the U.S. has resulted in an increased demand for culturally competent, Spanish-speaking mental health providers. Yet, little is known about the methods in which academic programs and clinical training sites are preparing their bilingual students to deliver services in Spanish to the Latino…

Feasibility of assessing the public health impacts of air pollution reduction programs on a local scale: New Haven accountability case study

EPA Science Inventory

Background: New approaches on how to link health surveillance data with environmental and population exposure information are needed in order to examine the health benefits of risk management decisions. Objective: This study's objective was to examine the feasibility of conductin...

Human Exposure Model (HEM): A modular, web-based application to characterize near-field chemical exposures and releases

EPA Science Inventory

The U.S. EPA’s Chemical Safety and Sustainability research program is developing the Human Exposure Model (HEM) to assess near-field exposures to chemicals that occur in various populations over the entire life cycle of a consumer product. The model will be implemented as a...

A novel approach for assessing density and range-wide abundance of prairie dogs

Treesearch

Aaron N. Facka; Paulette L. Ford; Gary W. Roemer

2008-01-01

Habitat loss, introduced disease, and government-sponsored eradication programs have caused population declines in all 5 species of prairie dogs. Black-tailed prairie dogs (Cynomys ludovicianus) currently occupy only about 2% of an extensive geographic range (160 million hectares) and were recently considered for listing under the United States...

Developing Collaboratively an International School Special Needs Plan for Multicultural, Multilingual, and Multinational Secondary Students.

ERIC Educational Resources Information Center

Jonietz, Patricia L.

The International School of Brussels (Belgium) developed a program of Curriculum-Based Assessment (CBA) to increase support for "at risk" multicultural, multilingual, and multinational students. The at-risk population included three groups: those who passed standardized English as a Foreign Language tests but were not literate enough for…

Antecedents to Disposition to Trust: Online Assessment as an Enabler of Individualized Instruction

ERIC Educational Resources Information Center

Campbell, Natalie Cathalyn

2017-01-01

The study investigated the antecedents to disposition to trust with regard to the Accelerated Reader program. The areas considered were teachers' experience, teachers' peer experience, teachers' peer support, gender, and age. The population for this study consisted of teachers who used Accelerated Reader from four school districts in Louisiana.…

Construct Equivalence of a National Certification Examination that Uses Dual Languages and Audio Assistance

ERIC Educational Resources Information Center

Wang, Shudong; Wang, Ning; Hoadley, David

2007-01-01

This study used confirmatory factor analysis (CFA) to examine the comparability of the National Nurse Aide Assessment Program (NNAAP[TM]) test scores across language and administration condition groups for calibration and validation samples that were randomly drawn from the same population. Fit statistics supported both the calibration and…

The American Freshman: National Norms for Fall 2000.

ERIC Educational Resources Information Center

Sax, Linda J.; Astin, Alexander W.; Korn, William S.; Mahoney, Kathryn M.

This 35th annual report of national normative data on college freshmen is part of the Cooperative Institutional Research Program (CIRP) longitudinal study to assess the effects of college on students. The freshman data reported here are weighted to provide a normative profile of the U.S. freshman population for use in policy analysis, human…

Children's tooth decay in a public health program to encourage low-income pregnant women to utilize dental care.

PubMed

Milgrom, Peter; Sutherland, Marilynn; Shirtcliff, R Mike; Ludwig, Sharity; Smolen, Darlene

2010-02-18

A community-based public health program to provide a dental home for women covered by the Oregon Health Plan (Medicaid) in Klamath County, Oregon USA was instituted with the long-term goal to promote preventive oral care for both mothers and their new infants provided by dental managed care companies. As part of the evaluation of the program, children in Klamath and comparable non-program counties were examined in their 2nd year of life to begin to determine if benefits accrued to the offspring of the mothers in Klamath County. Eighty-five and 58.9% of the children were caries free in the Klamath and comparison county samples, respectively (RR = 1.48, 95% CI 1.13, 1.93). The mean (SD) number of teeth with any decay was .75 (2.5) in the test population and 1.6 (2.5) in the comparison population (t = 2.08, p = .04). The assessment showed that children of mothers in the Klamath County program were about one and a half times more likely to be caries free than children in the comparison counties. Additional controlled studies are being undertaken.

Assessment and d/Deaf and Hard of Hearing Multilingual Learners: Considerations and Promising Practices.

PubMed

Pizzo, Lianna; Chilvers, Amanda

2016-01-01

The authors address considerations and promising practices relating to assessment of d/Deaf and Hard of Hearing Multilingual Learners. DMLs' unique culture(s), language(s), and learning needs must be considered when assessments of this population are being planned, conducted, and interpreted. The authors address theory and research on (a) general considerations for the overarching assessment process, (b) specific assessment approaches used to assess DMLs, and (c) assessment of language proficiency for diverse language learners. In addition, basic recommendations for the assessment of DMLs are made, including increased availability of assessments in various languages, use of multiple sources of individual and family data, assessment of all languages, and incorporation of a strong assessment component (that includes nondiscrimination practices) into teacher preparation programs.

The importance of socio-economic context for social marketing models for improving reproductive health: evidence from 555 years of program experience.

PubMed

Meekers, Dominique; Rahaim, Stephen

2005-01-27

Over the past two decades, social marketing programs have become an important element of the national family planning and HIV prevention strategy in several developing countries. As yet, there has not been any comprehensive empirical assessment to determine which of several social marketing models is most effective for a given socio-economic context. Such an assessment is urgently needed to inform the design of future social marketing programs, and to avoid that programs are designed using an ineffective model. This study addresses this issue using a database of annual statistics about reproductive health oriented social marketing programs in over 70 countries. In total, the database covers 555 years of program experience with social marketing programs that distribute and promote the use of oral contraceptives and condoms. Specifically, our analysis assesses to what extent the model used by different reproductive health social marketing programs has varied across different socio-economic contexts. We then use random effects regression to test in which socio-economic context each of the models is most successful at increasing use of socially marketed oral contraceptives and condoms. The results show that there has been a tendency to design reproductive health social marketing program with a management structure that matches the local context. However, the evidence also shows that this has not always been the case. While socio-economic context clearly influences the effectiveness of some of the social marketing models, program maturity and the size of the target population appear equally important. To maximize the effectiveness of future social marketing programs, it is essential that more effort is devoted to ensuring that such programs are designed using the model or approach that is most suitable for the local context.

The importance of socio-economic context for social marketing models for improving reproductive health: Evidence from 555 years of program experience

PubMed Central

Meekers, Dominique; Rahaim, Stephen

2005-01-01

Background Over the past two decades, social marketing programs have become an important element of the national family planning and HIV prevention strategy in several developing countries. As yet, there has not been any comprehensive empirical assessment to determine which of several social marketing models is most effective for a given socio-economic context. Such an assessment is urgently needed to inform the design of future social marketing programs, and to avoid that programs are designed using an ineffective model. Methods This study addresses this issue using a database of annual statistics about reproductive health oriented social marketing programs in over 70 countries. In total, the database covers 555 years of program experience with social marketing programs that distribute and promote the use of oral contraceptives and condoms. Specifically, our analysis assesses to what extent the model used by different reproductive health social marketing programs has varied across different socio-economic contexts. We then use random effects regression to test in which socio-economic context each of the models is most successful at increasing use of socially marketed oral contraceptives and condoms. Results The results show that there has been a tendency to design reproductive health social marketing program with a management structure that matches the local context. However, the evidence also shows that this has not always been the case. While socio-economic context clearly influences the effectiveness of some of the social marketing models, program maturity and the size of the target population appear equally important. Conclusions To maximize the effectiveness of future social marketing programs, it is essential that more effort is devoted to ensuring that such programs are designed using the model or approach that is most suitable for the local context. PMID:15676068

Impact of a daily 10-minute strength and flexibility program in a manufacturing plant.

PubMed

Pronk, S J; Pronk, N P; Sisco, A; Ingalls, D S; Ochoa, C

1995-01-01

In summary, employees' flexibility and mood showed modest improvements following the implementation of a plant-wide, 10-minute, daily flexibility and strength program. The initial six-week pilot study, administered prior to the plant-wide program implementation, successfully assessed program feasibility, assessed the efficiency of program implementation, identified administrative and logistical concerns, and generated pilot data needed to secure managerial support. Despite the noted significant increases in grip strength in the pilot study, no increases were observed following the six months of plant-wide implementation. This may be related to the differences in low average pretest grip strength for the pilot study compared to the higher scores for the main study population. The pilot study subjects may have received a sufficient exercise stimulus to increase grip strength over the course of six weeks. In contrast, this may not have been the case for the main study subjects due to their higher initial mean grip strength. An increased number of exercises designed to directly impact grip strength may be needed to improve this parameter.

Costs and Cost-Effectiveness of Hypertension Screening and Treatment in Adults with Hypertension in Rural Nigeria in the Context of a Health Insurance Program

PubMed Central

Verhagen, Mark D.; Bolarinwa, Oladimeji A.; Sanya, Emmanuel O.; Kolo, Philip M.; Adenusi, Peju; Agbede, Kayode; van Eck, Diederik; Tan, Siok Swan; Akande, Tanimola M.; Redekop, William; Schultsz, Constance; Gomez, Gabriela B.

2016-01-01

Background High blood pressure is a leading risk factor for death and disability in sub-Saharan Africa (SSA). We evaluated the costs and cost-effectiveness of hypertension care provided within the Kwara State Health Insurance (KSHI) program in rural Nigeria. Methods A Markov model was developed to assess the costs and cost-effectiveness of population-level hypertension screening and subsequent antihypertensive treatment for the population at-risk of cardiovascular disease (CVD) within the KSHI program. The primary outcome was the incremental cost per disability-adjusted life year (DALY) averted in the KSHI scenario compared to no access to hypertension care. We used setting-specific and empirically-collected data to inform the model. We defined two strategies to assess eligibility for antihypertensive treatment based on 1) presence of hypertension grade 1 and 10-year CVD risk of >20%, or grade 2 hypertension irrespective of 10-year CVD risk (hypertension and risk based strategy) and 2) presence of hypertension in combination with a CVD risk of >20% (risk based strategy). We generated 95% confidence intervals around the primary outcome through probabilistic sensitivity analysis. We conducted one-way sensitivity analyses across key model parameters and assessed the sensitivity of our results to the performance of the reference scenario. Results Screening and treatment for hypertension was potentially cost-effective but the results were sensitive to changes in underlying assumptions with a wide range of uncertainty. The incremental cost-effectiveness ratio for the first and second strategy respectively ranged from US$ 1,406 to US$ 7,815 and US$ 732 to US$ 2,959 per DALY averted, depending on the assumptions on risk reduction after treatment and compared to no access to antihypertensive treatment. Conclusions Hypertension care within a subsidized private health insurance program may be cost-effective in rural Nigeria and public-private partnerships such as the KSHI program may provide opportunities to finance CVD prevention care in SSA. PMID:27348310

Workplace health promotion and utilization of health services: follow-up data findings.

PubMed

Deitz, Diane; Cook, Royer; Hersch, Rebekah

2005-01-01

This article reports findings from a workplace substance abuse prevention program designed to investigate best practices. The study sought to assess the effects of the worksite wellness program and employee assistance program (EAP) on healthcare utilization and costs, identify predictors of outpatient costs and visits, and assess the effect of the intervention on health attitudes, behaviors, and behavioral health-related costs and visits. Results indicated that visits to the EAP increased as did overall healthcare visits, that utilization of healthcare services and costs were higher in the population receiving substance abuse prevention intervention, and that employees in the substance abuse prevention intervention reported lower heavy drinking and binge drinking. Data suggest that substance abuse prevention may result in higher healthcare costs and utilization in the short term, but a reduction in health risk behaviors such as heavy drinking may result in lower healthcare costs and utilization in the long term.

Development of macaronic Hindi-English ‘Hinglish’ text message content for a coronary heart disease secondary prevention programme

PubMed Central

Thakkar, Jay; Karthikeyan, Ganesan; Purohit, Gaurav; Thakkar, Swetha; Sharma, Jitender; Verma, Sunilkumar; Parakh, Neeraj; Seth, Sandeep; Mishra, Sundeep; Yadav, Rakesh; Singh, Sandeep; Joshi, Rohina; Thiagalingam, Aravinda; Chow, Clara K; Redfern, Julie

2016-01-01

Background Coronary heart disease (CHD) is a leading cause of morbidity and mortality in India. Text message based prevention programs have demonstrated reduction in cardiovascular risk factors among patients with CHD in selected populations. Customisation is important as behaviour change is influenced by culture and linguistic context. Objectives To customise a mobile phone text message program supporting behaviour and treatment adherence in CHD for delivery in North India. Methods We used an iterative process with mixed methods involving three phases: (1) Initial translation, (2) Review and incorporation of feedback including review by cardiologists in India to assess alignment with local guidelines and by consumers on perceived utility and clarity and (3) Pilot testing of message management software. Results Messages were translated in three ways: symmetrical translation, asymmetrical translation and substitution. Feedback from cardiologists and 25 patients was incorporated to develop the final bank. Patients reported Hinglish messages were easy to understand (93%) and useful (78%). The software located in Australia successfully delivered messages to participants based in Delhi-surrounds (India). Conclusions Our process for customisation of a text message program considered cultural, linguistic and the medical context of potential participants. This is important in optimising intervention fidelity across populations enabling examination of the generalisability of text message programs across populations. We also demonstrated the customised program was acceptable to patients in India and that a centralised cross-country delivery model was feasible. This process could be used as a guide for other groups seeking to customise their programs. Trial registration number TEXTMEDS Australia (Parent study)—ACTRN 12613000793718. PMID:27752288

Metabolic disorders and cardiovascular risk in people living with HIV/AIDS without the use of antiretroviral therapy.

PubMed

Raposo, Mariana Amaral; Armiliato, Geyza Nogueira de Almeida; Guimarães, Nathalia Sernizon; Caram, Camila Abrahão; Silveira, Raíssa Domingues de Simoni; Tupinambás, Unaí

2017-01-01

Metabolic disorders in people living with HIV/AIDS (PLH) have been described even before the introduction of antiretroviral (ARV) drugs in the treatment of HIV infection and are risk factors for cardiovascular diseases. Based on this, the purpose of this study was to assess metabolic disorders and cardiovascular risk in PLH before the initiation of antiretroviral treatment (ART). This was a cross-sectional descriptive study of 87 PLH without the use of ART, which was carried out between January and September 2012 at a specialized infectious diseases center in Minas Gerais, Brazil. The main metabolic disorders in the population were low serum levels of HDL-cholesterol, hypertriglyceridemia and abdominal obesity. Dyslipidemia was prevalent in 62.6% of the study population, whereas metabolic syndrome (MS) was prevalent in 11.5% of patients assessed by the International Diabetes Federation (IDF) criteria and 10.8% assessed by the National Cholesterol Education Program-Adult Treatment Panel (NCEP-ATPIII) criteria. Regarding cardiovascular risk, 89.7% of the population presented a low coronary risk according to the Framingham Risk Score. A greater proportion of patients diagnosed with MS presented low cardiovascular risk (80% assessed by IDF criteria and 77.8% assessed by NCEP-ATPIII criteria). Metabolic disorders in this population may be due to HIV infection or lifestyle (smoking, sedentary lifestyle and inadequate diet). The introduction of ART can enhance dyslipidemia, increasing cardiovascular risk, especially among those who have classic risks of cardiovascular disease.

Urban environment interventions linked to the promotion of physical activity. A mixed methods study applied to the urban context of Latin America

PubMed Central

Gomez, Luis F; Sarmiento, Rodrigo; Ordoñez, Maria Fernanda; Pardo, Carlos Felipe; de Sá, Thiago Hérick; Mallarino, Christina H; Miranda, J Jaime; Mosquera, Janeth; Parra, Diana Celmira; Reis, Rodrigo; Quistberg, Alex

2015-01-01

This study summarizes the evidence from quantitative systematic reviews that assessed the association between urban environment attributes and physical activity. It also documents sociopolitical barriers and facilitators involved in urban interventions linked with active living in the ten most populated urban settings of Latin America. The synthesis of evidence indicates that several attributes of urban environments are associated with physical activity, including land-use mix and cycling infrastructure. The documentary analysis indicated that despite the benefits and opportunities provided by the programs and existing infrastructure in the examined cities, an overall concern is the rising inequality in the coverage and distribution of the initiatives in the region. If these programs and initiatives are to achieve a real population level effect that helps to reduce health disparities, they need to examine their social and spatial distribution within the cities so they can reach underserved populations and develop to their full potential. PMID:25748111

Urban environment interventions linked to the promotion of physical activity: a mixed methods study applied to the urban context of Latin America.

PubMed

Gomez, Luis F; Sarmiento, Rodrigo; Ordoñez, Maria Fernanda; Pardo, Carlos Felipe; de Sá, Thiago Hérick; Mallarino, Christina H; Miranda, J Jaime; Mosquera, Janeth; Parra, Diana C; Reis, Rodrigo; Quistberg, D Alex

2015-04-01

This study summarizes the evidence from quantitative systematic reviews that assessed the association between urban environment attributes and physical activity. It also documents sociopolitical barriers and facilitators involved in urban interventions linked with active living in the ten most populated urban settings of Latin America. The synthesis of evidence indicates that several attributes of urban environments are associated with physical activity, including land-use mix and cycling infrastructure. The documentary analysis indicated that despite the benefits and opportunities provided by the programs and existing infrastructure in the examined cities, an overall concern is the rising inequality in the coverage and distribution of the initiatives in the region. If these programs and initiatives are to achieve a real population level effect that helps to reduce health disparities, they need to examine their social and spatial distribution within the cities so they can reach underserved populations and develop to their full potential. Copyright © 2015 Elsevier Ltd. All rights reserved.

Smoking cessation results in a clinical lung cancer screening program.

PubMed

Borondy Kitts, Andrea K; McKee, Andrea B; Regis, Shawn M; Wald, Christoph; Flacke, Sebastian; McKee, Brady J

2016-07-01

Lung cancer screening may provide a "teachable moment" for promoting smoking cessation. This study assessed smoking cessation and relapse rates among individuals undergoing follow-up low-dose chest computed tomography (CT) in a clinical CT lung screening program and assessed the influence of initial screening results on smoking behavior. Self-reported smoking status for individuals enrolled in a clinical CT lung screening program undergoing a follow-up CT lung screening exam between 1st February, 2014 and 31st March, 2015 was retrospectively reviewed and compared to self-reported smoking status using a standardized questionnaire at program entry. Point prevalence smoking cessation and relapse rates were calculated across the entire population and compared with exam results. All individuals undergoing screening fulfilled the National Comprehensive Cancer Network Clinical Practice Guidelines in Oncology: Lung Cancer Screening v1.2012(®) high-risk criteria and had an order for CT lung screening. A total of 1,483 individuals underwent a follow-up CT lung screening exam during the study interval. Smoking status at time of follow-up exam was available for 1,461/1,483 (98.5%). A total of 46% (678/1,461) were active smokers at program entry. The overall point prevalence smoking cessation and relapse rates were 20.8% and 9.3%, respectively. Prior positive screening exam results were not predictive of smoking cessation (OR 1.092; 95% CI, 0.715-1.693) but were predictive of reduced relapse among former smokers who had stopped smoking for 2 years or less (OR 0.330; 95% CI, 0.143-0.710). Duration of program enrollment was predictive of smoking cessation (OR 0.647; 95% CI, 0.477-0.877). Smoking cessation and relapse rates in a clinical CT lung screening program rates are more favorable than those observed in the general population. Duration of participation in the screening program correlated with increased smoking cessation rates. A positive exam result correlated with reduced relapse rates among smokers recently quit smoking.

Assessment of a strain 19 brucellosis vaccination program in elk

USGS Publications Warehouse

Maichak, Eric J.; Scurlock, Brandon M.; Cross, Paul C.; Rogerson, Jared D.; Edwards, William H.; Wise, Benjamin; Smith, Scott G.; Kreeger, Terry J.

2017-01-01

Zoonotic diseases in wildlife present substantial challenges and risks to host populations, susceptible domestic livestock populations, and affected stakeholders. Brucellosis, a disease caused by the bacterium Brucella abortus, is endemic among elk (Cervus canadensis) attending winter feedgrounds and adjacent areas of western Wyoming, USA. To minimize transmission of brucellosis from elk to elk and elk to livestock, managers initiated a B. abortus strain 19 ballistic vaccination program in 1985. We used brucellosis prevalence (1971–2015) and reproductive outcome (2006–2015) data collected from female elk attending feedgrounds to assess efficacy of the strain 19 program while controlling for potentially confounding factors such as site and age. From our generalized linear models, we found that seroprevalence of brucellosis was 1) not lower following inception of vaccination; 2) not inversely associated with proportion of juveniles vaccinated over time; 3) not inversely associated with additional yearlings and adults vaccinated over time; and 4) associated more with feeding end-date than proportion of juveniles vaccinated. Using vaginal implant transmitters in adult females that were seropositive for brucellosis, we found little effect of vaccination coverage at reducing reproductive failures (i.e., abortion or stillbirth). Because we found limited support for efficacy of the strain 19 program, we support research to develop an oral vaccine and suggest that continuing other spatio-temporal management actions will be most effective to minimize transmission of brucellosis and reduce dependency of elk on supplemental winter feeding.

Protocol for a randomised controlled trial of chronic disease self-management support for older Australians with multiple chronic diseases.

PubMed

Reed, Richard L; Battersby, Malcolm; Osborne, Richard H; Bond, Malcolm J; Howard, Sara L; Roeger, Leigh

2011-11-01

The prevalence of older Australians with multiple chronic diseases is increasing and now accounts for a large proportion of total health care utilisation. Chronic disease self-management support (CDSMS) has become a core service component of many community based health programs because it is considered a useful tool in improving population health outcomes and reducing the financial burden of chronic disease care. However, the evidence base to justify these support programs is limited, particularly for older people with multiple chronic diseases. We describe an ongoing trial examining the effectiveness of a particular CDSMS approach called the Flinders Program. The Flinders Program is a clinician-led generic self-management intervention that provides a set of tools and a structured process that enables health workers and patients to collaboratively assess self-management behaviours, identify problems, set goals, and develop individual care plans covering key self-care, medical, psychosocial and carer issues. A sample of 252 older Australians that have two or more chronic conditions will be randomly assigned to receive either CDSMS or an attention control intervention (health information only) for 6 months. Outcomes will be assessed using self-reported health measures taken at baseline and post-intervention. This project will be the first comprehensive evaluation of CDSMS in this population. Findings are expected to guide consumers, clinicians and policymakers in the use of CDSMS, as well as facilitate prioritisation of public monies towards evidence-based services. Copyright © 2011 Elsevier Inc. All rights reserved.

Effect of a Mat Pilates Program with TheraBand on Dynamic Balance in Patients with Parkinson's Disease: Feasibility Study and Randomized Controlled Trial.

PubMed

Mollinedo-Cardalda, Irimia; Cancela-Carral, José María; Vila-Suárez, María Helena

2018-01-24

The aim of this study was to assess the effect of a physical exercise program based on Mat Pilates (MP) with TheraBand ® on the dynamic balance of a sample population diagnosed with Parkinson's disease (PD). After random selection, 26 participants were allocated to a MP group or a control group where they performed calisthenics exercises. Both interventions lasted 12 weeks and involved 2 weekly sessions of 60 minutes. Assessments took place at baseline, 12 weeks after the intervention started and 4 weeks after the intervention was completed using the body mass index (BMI), the Timed Up and Go (TUG) test with Wiva ® sensors, the 30 Second Chair Stand test, and the Five Times Sit to Stand test. The group that completed the MP program presented significant improvements in BMI (F 1,21  = 3.986; p = 0.038), the 30 Second Chair Stand test (F 1,21  = 6.716; p = 0.014), the Five Times Sit to Stand test (F 1,21  = 5.213; p = 0.032), and the time required to complete the TUG dynamic balance test (F 1,21  = 5.035; p = 0.035). The MP program performed by a sample population with PD led to improvements in dynamic balance, and participants in the MP group showed increased strength in the lower limbs, but such improvements were not permanent after the activity ceased.

A method to quantify and compare clinicians' assessments of patient understanding during counseling of standardized patients.

PubMed

Farrell, Michael H; Kuruvilla, Pramita; Eskra, Kerry L; Christopher, Stephanie A; Brienza, Rebecca S

2009-10-01

To introduce a method for quantifying clinicians' use of assessment of understanding (AU) questions, and to examine medicine residents' AU usage during counseling of standardized patients about prostate or breast cancer screening. Explicit-criteria abstraction was done on 86 transcripts, using a data dictionary for 4 AU types. We also developed a procedure for estimating the "load" of informational content for which the clinician has not yet assessed understanding. Duplicate abstraction revealed reliability kappa=0.96. Definite criteria for at least one AU were found in 68/86 transcripts (79%). Of these, 2 transcripts contained a request for a teach-back ("what is your understanding of this?"), 2 contained an open-ended AU, 46 (54%) contained only a close-ended AU, and 18 (21%) only contained an "OK?" question. The load calculation identified long stretches of conversation without an AU. Many residents' transcripts lacked AUs, and included AUs were often ineffectively phrased or inefficiently timed. Many patients may not understand clinicians, and many clinicians may be unaware of patients' confusion. Effective AU usage is important enough to be encouraged by training programs and targeted by population-scale quality improvement programs. This quantitative method should be useful in population-scale measurement of AU usage. 2009 Elsevier Ireland Ltd.

Neurocognitive performance and prior injury among U.S. Department of Defense military personnel.

PubMed

Proctor, Susan P; Nieto, Kenneth; Heaton, Kristin J; Dillon, Caitlin C; Schlegel, Robert E; Russell, Michael L; Vincent, Andrea S

2015-06-01

This study examined the neurocognitive performance of U.S. military personnel completing the Automated Neuropsychological Assessment Metrics (version 4) TBI Military (ANAM4 TBI-MIL) battery as part of the Department of Defense Neurocognitive Functional Assessment Program. Descriptive analyses utilizing the ANAM4TBI Military Performance Database were performed. We examined ANAM Composite Score (ACS) differences between five injury subgroups (no injury, brain injury with current symptoms, brain injury without current symptoms, nonbrain injury with current symptoms, and nonbrain injury without current symptoms) using general linear mixed modeling. Almost 11% (70,472/641,285) reported brain injury in the 4 years before assessment. The ACS differed significantly by injury group (p < 0.0001). In comparison to the no injury group, those reporting brain injury with current symptoms (d = -0.44) and nonbrain injury with current symptoms (d = -0.24) demonstrated significantly reduced ACS scores (p < 0.0001) indicative of reduced neurocognitive proficiency. In this population-based study of U.S. military personnel, neurocognitive performance was significantly associated with reported injury within the past 4 years among those experiencing current symptoms. Occupational programs focusing on prospective brain health of injured population groups are warranted. Reprint & Copyright © 2015 Association of Military Surgeons of the U.S.

Community-based exercise programs as a strategy to optimize function in chronic disease: a systematic review.

PubMed

Desveaux, Laura; Beauchamp, Marla; Goldstein, Roger; Brooks, Dina

2014-03-01

Chronic diseases are the leading cause of death and disability worldwide. Preliminary evidence suggests that community-based exercise (CBE) improves functional capacity (FC) and health-related quality of life (HRQL). To describe the structure and delivery of CBE programs for chronic disease populations and compare their impact on FC and HRQL to standard care. Randomized trials examining CBE programs for individuals with stroke, chronic obstructive pulmonary disease, osteoarthritis, diabetes, and cardiovascular disease were identified. Quality was assessed using the Cochrane risk of bias tool. Meta-analyses were conducted using Review Manager 5.1. The protocol was registered on PROSPERO (CRD42012002786). Sixteen studies (2198 individuals, mean age 66.8±4.9 y) were included to describe program structures, which were comparable in their design and components, irrespective of the chronic disease. Aerobic exercise and resistance training were the primary interventions in 85% of studies. Nine studies were included in the meta-analysis. The weighted mean difference for FC, evaluated using the 6-minute walk test, was 41.7 m (95% confidence interval [CI], 20.5-62.8). The standardized mean difference for all FC measures was 0.18 (95% CI, 0.05-0.3). The standardized mean difference for the physical component of HRQL measures was 0.21 (95% CI, 0.05-0.4) and 0.38 (95% CI, 0.04-0.7) for the total score. CBE programs across chronic disease populations have similar structures. These programs appear superior to standard care with respect to optimizing FC and HRQL in individuals with osteoarthritis; however, the effect beyond this population is unknown. Long-term sustainability of these programs remains to be established.

Geriatric Oncology Program Development and Gero-Oncology Nursing.

PubMed

Lynch, Mary Pat; DeDonato, Dana Marcone; Kutney-Lee, Ann

2016-02-01

To provide a critical analysis of current approaches to the care of older adults with cancer, outline priority areas for geriatric oncology program development, and recommend strategies for improvement. Published articles and reports between 1999 and 2015. Providing an interdisciplinary model that incorporates a holistic geriatric assessment will ensure the delivery of patient-centered care that is responsive to the comprehensive needs of older patients. Nursing administrators and leaders have both an opportunity and responsibility to shape the future of geriatric oncology. Preparations include workforce development and the creation of programs that are designed to meet the complex needs of this population. Copyright © 2015 Elsevier Inc. All rights reserved.

A School-Based Dental Program Evaluation: Comparison to the Massachusetts Statewide Survey.

PubMed

Culler, Corinna S; Kotelchuck, Milton; Declercq, Eugene; Kuhlthau, Karen; Jones, Kari; Yoder, Karen M

2017-10-01

School-based dental programs target high-risk communities and reduce barriers to obtaining dental services by delivering care to students in their schools. We describe the evaluation of a school-based dental program operating in Chelsea, a city north of Boston, with a low-income and largely minority population, by comparing participants' oral health to a Massachusetts oral health assessment. Standardized dental screenings were conducted for students in kindergarten, third, and sixth grades. Outcomes were compared in bivariate analysis, stratified by grade and income levels. A greater percentage of Chelsea students had untreated decay and severe treatment need than students statewide. Yet, fewer Chelsea third graders had severe treatment need, and more had dental sealants. There was no significant difference in the percentage of Chelsea students having severe treatment need or dental sealants by income level. Students participating in our program do not have lower decay levels than students statewide. However, they do have lower levels of severe treatment need, likely due to treatment referrals. Our results confirm that school-based prevention programs can lead to increased prevalence of dental sealants among high-risk populations. Results provide support for the establishment of full-service school-based programs in similar communities. © 2017, American School Health Association.

[Effectiveness of dog-assisted therapy in the elderly. A preliminary study].

PubMed

Folch, Anabel; Torrente, Margarita; Heredia, Luis; Vicens, Paloma

2016-01-01

Animal-assisted therapy is increasingly present in several educational and health areas. The aim of this study is to assess the effectiveness of such interventions in the elderly population living in residential settings. A 12-week dog-assisted intervention program was designed, with 16 participants from a nursing home divided into an experimental group and a control group. Several physical and psychological variables were assessed before and after the intervention. While there were no significant differences in the control group, the experimental group improved significantly after participating in the program. The results support the hypothesis that animal-assisted interventions may be beneficial for residents in elderly care homes. Copyright © 2015 SEGG. Publicado por Elsevier España, S.L.U. All rights reserved.

South Fork Flathead Watershed Westslope Cutthroat Trout Conservation Program, Annual Report 2002.

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

Grisak, Grant; Marotz, Brian

2003-06-01

In 1999, Montana Fish, Wildlife & Parks (MFWP) began a program aimed at conserving the genetically pure populations of westslope cutthroat trout in the South Fork Flathead River drainage. The objective of this program is to eliminate all of the exotic and hybrid trout that threaten the genetically pure westslope cutthroat populations in the South Fork Flathead. The exotic and hybrid trout populations occur in several headwater lakes and their outflow streams. In 2001 MFWP released a draft environmental assessment, pursuant to the Montana Environmental Policy Act (MEPA), that addressed the use of motorized equipment to deliver personnel and materialsmore » to some of these lakes in the Bob Marshall and Great Bear Wildernesses (Grisak 2001). After a 30-day public comment period, MFWP determined that the complexity of issues was too great and warranted a more detailed analysis. These issues included transportation options for personnel, equipment and materials, the use of motorized equipment in wilderness, fish removal methods, fish stocking, and the status and distribution of amphibian populations in the project area. Because the program also involves the U.S. Forest Service (USFS) and Bonneville Power Administration (BPA), the environmental analysis needs to comply with the National Environmental Policy Act (NEPA). In October 2001, pursuant to NEPA, MFWP, along with the USFS and BPA initiated an environmental assessment to address these issues. In June 2002, the three agencies determined that the scope of these issues warranted an Environmental Impact Statement. This specialist report describes the logistical, technical and biological issues associated with this project and provides an analysis of options for fish removal, transportation and fish stocking. It further analyzes issues and concerns associated with amphibian populations and creating new domesticated stocks of westslope cutthroat trout. Finally, this document provides a description of each lake, the best method of fish removal that would achieve the goals of the project, logistics for carrying out the fish removal, and the immediate management direction for each lake following fish removal. The USFS is preparing a specialist report detailing land management issues that relate to National Forest, designated Hiking Areas, and Wilderness. Information from these two documents will be used by BPA to prepare an Environmental Impact Statement.« less

Home-Based Palliative Care Program Relieves Chronic Pain in Kerala, India: Success Realized Through Patient, Family Narratives.

PubMed

Ajjarapu, Aparna Sai; Broderick, Ann

2018-06-14

An estimated 1.5 billion people across the globe live with chronic pain, and an estimated 61 million people worldwide experience unrelieved serious health-related suffering. One-sixth of the global population lives in India, where approximately 10 million people endure unrelieved serious health-related suffering. The state of Kerala is home to Pallium India, one of the most sophisticated palliative care programs in the country. This private organization in Trivandrum provides palliative and hospice care to underresourced populations and emphasizes holistic pain treatment. The current project features the pain stories of six patients who received treatment from Pallium India. Basic patient demographic information was collected, and a Pallium India staff member who was fluent in Malayalam and English asked questions about each patient's pain experience. Pain narratives illustrate the substantial impact of Pallium India's home visit program and the role of total pain assessment in delivering high-quality palliative care.

Estimation of the Cost-Effectiveness of Breast Cancer Screening Using Mammography in Mexico Through a Simulation.

PubMed

Ulloa-Pérez, Ernesto; Mohar-Betancourt, Alejandro; Reynoso-Noverón, Nancy

2016-01-01

Currently, breast cancer is the most prevalent tumor among Mexican women. Screening methods such as mammography could potentially reduce the health and economic burden of breast cancer; however, its risk-benefit balance is still unclear. To estimate the cost-effectiveness of different breast cancer screening programs using mammography in Mexico and to contribute to the decision-making process on this preventive measure. A simulation study was performed using population data and incidence rates. Several screening programs were assessed using the cost-effectiveness methodology recommended by the World Health Organization. The feasible recommended screening program has an examination schedule periodicity of every three years, with a population coverage of 0, 15, 18, 20, 25, 20, 18, and 0% for the age groups of 25-40, 40-45, 45-50, 50-55, 55-60, 60-65, 65-70, and 70-75 years, respectively. Given the present coverage in Mexico, it is necessary to optimize our resource allocation to improve the country's breast cancer prevention policy.

Equity monitoring for social marketing: use of wealth quintiles and the concentration index for decision making in HIV prevention, family planning, and malaria programs.

PubMed

Chakraborty, Nirali M; Firestone, Rebecca; Bellows, Nicole

2013-01-01

The majority of social marketing programs are intended to reach the poor. It is therefore essential that social marketing organizations monitor the health equity of their programs and improve targeting when the poor are not being reached. Current measurement approaches are often insufficient for decision making because they fail to show a program's ability to reach the poor and demonstrate progress over time. Further, effective program equity metrics should be benchmarked against a national reference population and consider exposure, not just health outcomes, to measure direct results of implementation. This study compares two measures of health equity, concentration indices and wealth quintiles, using a defined reference population, and considers benefits of both measures together to inform programmatic decision making. Three datasets from recent cross-sectional behavioral surveys on malaria, HIV, and family planning from Nepal and Burkina Faso were used to calculate concentration indices and wealth quintiles. Each sample was standardized to national wealth distributions based on recent Demographic and Health Surveys. Wealth quintiles were generated and concentration indices calculated for health outcomes and program exposure in each sample. Chi-square and t-tests were used to assess statistical significance of results. Reporting wealth quintiles showed that recipients of Population Services International (PSI) interventions were wealthier than national populations. Both measures indicated that desirable health outcomes were usually concentrated among wealthier populations. Positive and significant concentration indices in all three surveys indicated that wealth and program exposure were correlated; however this relationship was not necessarily linear. In analyzing the equity of modern contraceptive use stratified by exposure to family planning messages in Nepal, the outcome was equitable (concentration index = 0.006, p = 0.68) among the exposed, while the wealthy were more likely to use modern contraceptives (concentration index = 0.071, p < 0.01) among the unexposed. Using wealth quintiles and concentration indices together for equity monitoring improves usability of findings for decision making. Applying both metrics, and analyzing equity of exposure along with health outcomes, provides results that have statistical and programmatic significance. Benchmarking equity data against national data improves generalizability. This approach benefits social marketers and global health implementers to improve strategic decision making and programs' ability to reach the poor.

Equity monitoring for social marketing: use of wealth quintiles and the concentration index for decision making in HIV prevention, family planning, and malaria programs

PubMed Central

2013-01-01

Background The majority of social marketing programs are intended to reach the poor. It is therefore essential that social marketing organizations monitor the health equity of their programs and improve targeting when the poor are not being reached. Current measurement approaches are often insufficient for decision making because they fail to show a program's ability to reach the poor and demonstrate progress over time. Further, effective program equity metrics should be benchmarked against a national reference population and consider exposure, not just health outcomes, to measure direct results of implementation. This study compares two measures of health equity, concentration indices and wealth quintiles, using a defined reference population, and considers benefits of both measures together to inform programmatic decision making. Methods Three datasets from recent cross-sectional behavioral surveys on malaria, HIV, and family planning from Nepal and Burkina Faso were used to calculate concentration indices and wealth quintiles. Each sample was standardized to national wealth distributions based on recent Demographic and Health Surveys. Wealth quintiles were generated and concentration indices calculated for health outcomes and program exposure in each sample. Chi-square and t-tests were used to assess statistical significance of results. Results Reporting wealth quintiles showed that recipients of Population Services International (PSI) interventions were wealthier than national populations. Both measures indicated that desirable health outcomes were usually concentrated among wealthier populations. Positive and significant concentration indices in all three surveys indicated that wealth and program exposure were correlated; however this relationship was not necessarily linear. In analyzing the equity of modern contraceptive use stratified by exposure to family planning messages in Nepal, the outcome was equitable (concentration index = 0.006, p = 0.68) among the exposed, while the wealthy were more likely to use modern contraceptives (concentration index = 0.071, p < 0.01) among the unexposed. Conclusions Using wealth quintiles and concentration indices together for equity monitoring improves usability of findings for decision making. Applying both metrics, and analyzing equity of exposure along with health outcomes, provides results that have statistical and programmatic significance. Benchmarking equity data against national data improves generalizability. This approach benefits social marketers and global health implementers to improve strategic decision making and programs' ability to reach the poor. PMID:23902715

MLS student active learning within a "cloud" technology program.

PubMed

Tille, Patricia M; Hall, Heather

2011-01-01

In November 2009, the MLS program in a large public university serving a geographically large, sparsely populated state instituted an initiative for the integration of technology enhanced teaching and learning within the curriculum. This paper is intended to provide an introduction to the system requirements and sample instructional exercises used to create an active learning technology-based classroom. Discussion includes the following: 1.) define active learning and the essential components, 2.) summarize teaching methods, technology and exercises utilized within a "cloud" technology program, 3.) describe a "cloud" enhanced classroom and programming 4.) identify active learning tools and exercises that can be implemented into laboratory science programs, and 5.) describe the evaluation and assessment of curriculum changes and student outcomes. The integration of technology in the MLS program is a continual process and is intended to provide student-driven active learning experiences.

Population Education Country Programmes.

ERIC Educational Resources Information Center

Population Education in Asia and the Pacific Newsletter, 1983

1983-01-01

Describes population programs in Afghanistan (nonformal, population education literacy program), India (problems in planning/managing population education in higher education), Indonesia (training for secondary/out-of-school inspectors), and Pakistan (integration of population education into school curricula). Programs in China, Korea, Vietnam,…

HPV vaccination: Population approaches for improving rates.

PubMed

Oliver, Kristin; Frawley, Alean; Garland, Elizabeth

2016-06-02

To review the literature on interventions to increase HPV vaccinations and assess whether The Community Preventive Services Task Force recommendations are supported by current evidence. We used a PubMed search to identify studies that assessed interventions that looked at provider assessment and feedback, provider reminders, client reminder and recall, and clinic based education programs. Of the 13 studies identified, 8 included client reminder and recall interventions, 4 included provider assessment and feedback and/or provider reminders and 2 included clinic based education. 11 of the 13 studies demonstrated a positive effect on HPV vaccine initiation or completion. Provider assessment and feedback studies were more likely to report a positive effect on HPV vaccine initiation than on series completion, while client reminder recall interventions more frequently produced an effect on series completion than on initiation. There is evidence to support the application of the Community Preventive Services Task Force recommendations specifically to HPV vaccination both for client reminder and recall programs and for provider assessment and feedback interventions. Multiple targeted approaches will be needed to substantially impact HPV vaccine rates.

An Information Needs Assessment of School Nurses in a Metropolitan County

PubMed Central

Schweikhard, April J.

2016-01-01

School nurses are an integral though often underserved population within the health care and education professions. To develop an effective outreach program for this group, an academic health sciences library conducted an information needs assessment of public school nurses in Tulsa County, Oklahoma. An online survey collected perceptions regarding information needs and behaviors, and a focus group session further explored the survey results. The assessment revealed that school nurses frequently require specific types of information to perform their responsibilities but also face challenges accessing and integrating research into their daily practice. This article presents the implications and results of this assessment. PMID:26794194

Automated multi-lesion detection for referable diabetic retinopathy in indigenous health care.

PubMed

Pires, Ramon; Carvalho, Tiago; Spurling, Geoffrey; Goldenstein, Siome; Wainer, Jacques; Luckie, Alan; Jelinek, Herbert F; Rocha, Anderson

2015-01-01

Diabetic Retinopathy (DR) is a complication of diabetes mellitus that affects more than one-quarter of the population with diabetes, and can lead to blindness if not discovered in time. An automated screening enables the identification of patients who need further medical attention. This study aimed to classify retinal images of Aboriginal and Torres Strait Islander peoples utilizing an automated computer-based multi-lesion eye screening program for diabetic retinopathy. The multi-lesion classifier was trained on 1,014 images from the São Paulo Eye Hospital and tested on retinal images containing no DR-related lesion, single lesions, or multiple types of lesions from the Inala Aboriginal and Torres Strait Islander health care centre. The automated multi-lesion classifier has the potential to enhance the efficiency of clinical practice delivering diabetic retinopathy screening. Our program does not necessitate image samples for training from any specific ethnic group or population being assessed and is independent of image pre- or post-processing to identify retinal lesions. In this Aboriginal and Torres Strait Islander population, the program achieved 100% sensitivity and 88.9% specificity in identifying bright lesions, while detection of red lesions achieved a sensitivity of 67% and specificity of 95%. When both bright and red lesions were present, 100% sensitivity with 88.9% specificity was obtained. All results obtained with this automated screening program meet WHO standards for diabetic retinopathy screening.

Automated Multi-Lesion Detection for Referable Diabetic Retinopathy in Indigenous Health Care

PubMed Central

Pires, Ramon; Carvalho, Tiago; Spurling, Geoffrey; Goldenstein, Siome; Wainer, Jacques; Luckie, Alan; Jelinek, Herbert F.; Rocha, Anderson

2015-01-01

Diabetic Retinopathy (DR) is a complication of diabetes mellitus that affects more than one-quarter of the population with diabetes, and can lead to blindness if not discovered in time. An automated screening enables the identification of patients who need further medical attention. This study aimed to classify retinal images of Aboriginal and Torres Strait Islander peoples utilizing an automated computer-based multi-lesion eye screening program for diabetic retinopathy. The multi-lesion classifier was trained on 1,014 images from the São Paulo Eye Hospital and tested on retinal images containing no DR-related lesion, single lesions, or multiple types of lesions from the Inala Aboriginal and Torres Strait Islander health care centre. The automated multi-lesion classifier has the potential to enhance the efficiency of clinical practice delivering diabetic retinopathy screening. Our program does not necessitate image samples for training from any specific ethnic group or population being assessed and is independent of image pre- or post-processing to identify retinal lesions. In this Aboriginal and Torres Strait Islander population, the program achieved 100% sensitivity and 88.9% specificity in identifying bright lesions, while detection of red lesions achieved a sensitivity of 67% and specificity of 95%. When both bright and red lesions were present, 100% sensitivity with 88.9% specificity was obtained. All results obtained with this automated screening program meet WHO standards for diabetic retinopathy screening. PMID:26035836

Assessing vaccination as a control strategy in an ongoing epidemic: Bovine tuberculosis in African buffalo

USGS Publications Warehouse

Cross, Paul C.; Getz, W.M.

2006-01-01

Bovine tuberculosis (BTB) is an exotic disease invading the buffalo population (Syncerus caffer) of the Kruger National Park (KNP), South Africa. We used a sex and age-structured epidemiological model to assess the effectiveness of a vaccination program and define important research directions. The model allows for dispersal between a focal herd and background population and was parameterized with a combination of published data and analyses of over 130 radio-collared buffalo in the central region of the KNP. Radio-tracking data indicated that all sex and age categories move between mixed herds, and males over 8 years old had higher mortality and dispersal rates than any other sex or age category. In part due to the high dispersal rates of buffalo, sensitivity analyses indicate that disease prevalence in the background population accounts for the most variability in the BTB prevalence and quasi-eradication within the focal herd. Vaccination rate and the transmission coefficient were the second and third most important parameters of the sensitivity analyses. Further analyses of the model without dispersal suggest that the amount of vaccination necessary for quasi-eradication (i.e. prevalence < 5%) depends upon the duration that a vaccine grants protection. Vaccination programs are more efficient (i.e. fewer wasted doses) when they focus on younger individuals. However, even with a lifelong vaccine and a closed population, the model suggests that >70% of the calf population would have to be vaccinated every year to reduce the prevalence to less than 1%. If the half-life of the vaccine is less than 5 years, even vaccinating every calf for 50 years may not eradicate BTB. Thus, although vaccination provides a means of controlling BTB prevalence it should be combined with other control measures if eradication is the objective.

Tagging methods for estimating population size and mortality rates of inland striped bass populations

USGS Publications Warehouse

Hightower, Joseph E.; Pollock, Kenneth H.

2013-01-01

Striped bass Morone saxatilis in inland reservoirs play an important role ecologically and in supporting recreational fishing. To manage these populations, biologists need information about abundance and mortality. Abundance estimates can be used to assess the effectiveness of stocking programs that maintain most reservoir striped bass populations. Mortality estimates can indicate the relative impact of fishing versus natural mortality and the need for harvest regulation. The purpose of this chapter is to evaluate tagging studies as a way of obtaining information about abundance and mortality. These approaches can be grouped into three broad categories: tag recapture, tag return, and telemetry. Tag-recapture methods are typically used to estimate population size and other demographic parameters but are often difficult to apply in large systems. A fishing tournament can be an effective way of generating tagging or recapture effort in large systems, compared to using research sampling only. Tag-return methods that rely on angler harvest and catch and release can be used to estimate fishing (F) and natural (M) mortality rates and are a practical approach in large reservoirs. The key to success in tag-return studies is to build in auxiliary studies to estimate short-term tagging mortality, short- and longterm tag loss, reporting rate, and mortality associated with catch and release. F and M can also be estimated using telemetry tags. Advantages of this approach are that angler nonreporting does not bias estimates and fish with transmitters provide useful ecological data. Cost can be a disadvantage of telemetry studies; thus, combining telemetry tags with conventional tag returns in an integrated analysis is often the optimal approach. In summary, tagging methods can be a powerful tool for assessing the effectiveness of inland striped bass stocking programs and the relative impact of fishing versus natural mortality

Impact of a letter-grade program on restaurant sanitary conditions and diner behavior in New York City.

PubMed

Wong, Melissa R; McKelvey, Wendy; Ito, Kazuhiko; Schiff, Corinne; Jacobson, J Bryan; Kass, Daniel

2015-03-01

We evaluated the impact of the New York City restaurant letter-grading program on restaurant hygiene, food safety practices, and public awareness. We analyzed data from 43,448 restaurants inspected between 2007 and 2013 to measure changes in inspection score and violation citations since program launch in July 2010. We used binomial regression to assess probability of scoring 0 to 13 points (A-range score). Two population-based random-digit-dial telephone surveys assessed public perceptions of the program. After we controlled for repeated restaurant observations, season of inspection, and chain restaurant status, the probability of scoring 0 to 13 points on an unannounced inspection increased 35% (95% confidence interval [CI]=31%, 40%) 3 years after compared with 3 years before grading. There were notable improvements in compliance with some specific requirements, including having a certified kitchen manager on site and being pest-free. More than 91% (95% CI=88%, 94%) of New Yorkers approved of the program and 88% (95% CI=85%, 92%) considered grades in dining decisions in 2012. Restaurant letter grading in New York City has resulted in improved sanitary conditions on unannounced inspection, suggesting that the program is an effective regulatory tool.

The Role of Public-Sector Family Planning Programs in Meeting the Demand for Contraception in Sub-Saharan Africa.

PubMed

Bongaarts, John; Hardee, Karen

2017-06-01

Commonly used indicators of contraceptive behavior in a population-modern contraceptive prevalence (mCPR), unmet need for contraception, demand for contraception and demand satisfied-are not well-suited for evaluating the progress made by government family planning programs in helping women and men achieve their reproductive goals. Trends in these measures in 26 Sub-Saharan African countries between 1990 and 2014 were examined. Trends in a proposed new indicator, the public-sector family planning program impact score (PFPI), and its relationship to mCPR and the family planning effort score were also assessed. Case studies were used to review public family planning program development and implementation in four countries (Nigeria, Ethiopia, Rwanda and Kenya). The four commonly used indicators capture the extent to which women use family planning and to which demand is satisfied, but shed no direct light on the role of family planning programs. PFPI provides evidence that can be used to hold governments accountable for meeting the demand for family planning, and was closely related to policy developments in the four case-study countries. PFPI provides a useful addition to the indicators currently used to assess progress in reproductive health and family planning programs.

Postpartum hemorrhage prevention in Nepal: a program assessment.

PubMed

Rajbhandari, Swaraj Pradhan; Aryal, Kamal; Sheldon, Wendy R; Ban, Bharat; Upreti, Senendra Raj; Regmi, Kiran; Aryal, Shilu; Winikoff, Beverly

2017-06-05

In 2009, the Nepal Ministry of Health and Population launched a national program for prevention of postpartum hemorrhage (PPH) during home births that features advance distribution of misoprostol to pregnant women. In the years since, the government has scaled-up the program throughout much of the country. This paper presents findings from the first large-scale assessment of the effectiveness of the advance distribution program. Data collection was carried out in nine districts and all three ecological zones. To assess knowledge, receipt and use of misoprostol, household interviews were conducted with 2070 women who had given birth within the past 12 months. To assess supply and provision of misoprostol, interviews were conducted with 270 Female Community Health Volunteers (FCHVs) and staff at 99 health facilities. Among recently delivered women, only 15% received information about misoprostol and 13% received misoprostol tablets in advance of delivery. Yet 87% who received advance misoprostol and delivered at home used it for PPH prevention. Among FCHVs, 96% were providing advance misoprostol for PPH prevention; however 81% had experienced at least one misoprostol stock out within the past year. About one-half of FCHVs were providing incomplete information about the use of misoprostol; in addition, many did not discuss side effects, how to recognize PPH or where to go if PPH occurs. Among health facilities, just one-half had sufficient misoprostol stock, while 95% had sufficient oxytocin stock, at the time of this assessment. In Nepal, women who receive advance misoprostol are both willing and able to use the medication for PPH prevention during home births. However the supply and personnel challenges identified raise questions about scalability and impact of the program over the long-term. Further assessment is needed.

Growing the IBCLC Workforce: A Florida Needs Assessment.

PubMed

Eden, Aimee R; Anstey, Erica H; Orriola, Deidre

2018-02-01

Florida has fewer International Board Certified Lactation Consultants (IBCLCs) per 1,000 live births than the national average. An important strategy to support breastfeeding entails creating opportunities to prepare and train IBCLCs from underrepresented groups. However, it can be difficult for individuals to access lactation education and gain clinical experience necessary to become an IBCLC. Research aim: The Building a Better Breastfeeding Network project was a needs assessment designed to assess the interest in an IBCLC training program in Florida and perceived barriers and facilitators to completing such a program. An online survey was distributed via email to non-IBCLC students and maternal and child healthcare workers in Florida. Microsoft Excel was used to complete descriptive analyses. Surveys were initiated by 1,939 eligible individuals from diverse racial and ethnic backgrounds across the state, 86% of whom responded that they would be possibly to very interested in an IBCLC training program. For those interested, cost was perceived as a potential barrier to enrolling in a program, but flexible course schedules and scholarship or financial aid availability would further attract participants. More than half were interested in working with underserved populations or in low-resource settings, but Black and Hispanic participants were significantly more likely to express interest in working in those settings. Due to the high level of interest in an IBCLC training program in Florida, a formal lactation training program may be successful in attracting diverse students, particularly if funding and program flexibility needs are met.

Diversifying the Midwifery Workforce: Inclusivity, Culturally Sensitive Bridging, and Innovation.

PubMed

Tyson, Holliday; Wilson-Mitchell, Karline

2016-11-01

Midwifery educators and regulators in Canada have begun to address diversity, equity, and inclusion in admission processes and program curricula. Populations served by midwives value internationally educated midwives from their countries of origin. The International Midwifery Pre-Registration Program at Ryerson University in Toronto, Ontario, provides assessment, midwifery workplace orientation, and accelerated education for internationally educated midwives on behalf of the regulatory College of Midwives of Ontario. Between 2003 and 2015, midwives from 41 countries participated in the bridging program, and 214 (80%) successfully completed the program and qualified for licensure. Of these 214 graduates, 100% passed the Canadian Midwifery Registration Examination and 193 (90%) were employed full time as midwives within 4 months of graduation. The program curriculum enables the integration of these midwives into health care workplaces utilizing innovative approaches to assessment and competency enhancement. Critical to the bridging process are simulation-based practices to develop effective psychomotor learning, virtual and real primary care community placements, and coaching in empathetic, client-centered communication. Cultural sensitivity is embedded into the multiple assessment and learning modalities, and addresses relevant barriers faced by immigrant midwives in the workplace. Findings from the 13 years of the program may be applicable to increase diversity in other North American midwifery settings. This article describes the process, content, outcomes, and findings of the program. Midwifery educators and regulators may consider the utility of these approaches for their settings. © 2016 by the American College of Nurse-Midwives.

A single issue program in an isolated area: mammography screening in Darwin, NT.

PubMed

McLean, M J; Condon, J R

1999-08-01

A process evaluation of the Northern Territory (NT) mammography program, NT Breast Screen (NTBS), during its initial 18 months of operation. The study was undertaken in Darwin, NT, from December 1994 to May 1996. Clinical outcomes were obtained by reviewing computerised and manual program records to determine waiting times for results, recall rates and cancer detection rates. Client satisfaction was assessed by a questionnaire sent to all women with normal results over a 12-week period. General practitioner satisfaction was assessed by a questionnaire sent to all general practitioners in the region who had one or more clients who had attended the service. During this time, 2,882 screening mammograms were performed; 98 women were recalled for assessment (3.4%). Breast cancer was detected in 10 women (3.5 per 1000 women screened). The program was well accepted by clients and general practitioners. Performance criteria were not met for waiting times for results. NTBS faced challenges because of its small and dispersed population, a lack of local radiologists with mammographic experience and the conflict with other pressing health issues, particularly in Aboriginal health. Despite these challenges, the program functioned effectively during its initial 18 months. Mammography screening programs in isolated areas can function effectively. The constraints encountered by NTBS are likely to apply to similar programs. Issues identified requiring further research are the psychological consequences of long waiting times for results, and the prioritisation of mammography for Aboriginal women.

Assessing Face Validity of a Food Behavior Checklist for Limited-resource Filipinos

PubMed Central

Buchthal, Opal Vanessa; Tauyan, Socorro

2015-01-01

Abstract Diet-related chronic health conditions are prevalent in the Filipino American community; however, there is a lack of rigorously validated nutrition education evaluation tools in Tagalog for use in this population. This study aimed to develop and evaluate the face validity of a Tagalog-language food behavior checklist (FBC). A multi-step method was used, involving translation of questionnaire text from English to Tagalog by a team of professionals, creation of accompanying color photographs, cognitive testing with the target population, final review by the team of professionals, and assessment of readability. Subjects for cognitive testing were men (n=6) and women (n=14) 18 years or older in Hawai‘i who received or were eligible to receive Supplemental Nutrition Assistance Program (SNAP) benefits, self-identified as Filipino, and preferred Tagalog rather than English. Participants were recruited from churches, the Filipino Center, and other community sites. Cognitive interviews revealed several issues with text and photographs, such as preferences for specific terms, and images that did not adequately illustrate the text. Image changes were made to reflect items most commonly consumed. The team of professionals agreed with participant suggestions. Assessment of readability revealed a reading level appropriate for a low-literacy population of grade 5.9. The multi-step process, which allowed members of the target audience to reveal the appropriateness of the questionnaire, yielded a Tagalog-language FBC found to have adequate face validity. After further evaluation of validity and reliability, this tool may be used to evaluate behavior change resulting from the United States Department of Agriculture's (USDA) nutrition education programs. PMID:26535163

Internet-Based Delivery of Evidence-Based Health Promotion Programs Among American Indian and Alaska Native Youth: A Case Study

PubMed Central

Craig Rushing, Stephanie; Jessen, Cornelia; Gorman, Gwenda; Torres, Jennifer; Lambert, William E; Prokhorov, Alexander V; Miller, Leslie; Allums-Featherston, Kelly; Addy, Robert C; Peskin, Melissa F; Shegog, Ross

2016-01-01

Background American Indian and Alaska Native (AI/AN) youth face multiple health challenges compared to other racial/ethnic groups, which could potentially be ameliorated by the dissemination of evidence-based adolescent health promotion programs. Previous studies have indicated that limited trained personnel, cultural barriers, and geographic isolation may hinder the reach and implementation of evidence-based health promotion programs among AI/AN youth. Although Internet access is variable in AI/AN communities across the United States, it is swiftly and steadily improving, and it may provide a viable strategy to disseminate evidence-based health promotion programs to this underserved population. Objective We explored the potential of using the Internet to disseminate evidence-based health promotion programs on multiple health topics to AI/AN youth living in diverse communities across 3 geographically dispersed regions of the United States. Specifically, we assessed the Internet’s potential to increase the reach and implementation of evidence-based health promotion programs for AI/AN youth, and to engage AI/AN youth. Methods This randomized controlled trial was conducted in 25 participating sites in Alaska, Arizona, and the Pacific Northwest. Predominantly AI/AN youth, aged 12-14 years, accessed 6 evidence-based health promotion programs delivered via the Internet, which focused on sexual health, hearing loss, alcohol use, tobacco use, drug use, and nutrition and physical activity. Adult site coordinators completed computer-based education inventory surveys, connectivity and bandwidth testing to assess parameters related to program reach (computer access, connectivity, and bandwidth), and implementation logs to assess barriers to implementation (program errors and delivery issues). We assessed youths’ perceptions of program engagement via ratings on ease of use, understandability, credibility, likeability, perceived impact, and motivational appeal, using previously established measures. Results Sites had sufficient computer access and Internet connectivity to implement the 6 programs with adequate fidelity; however, variable bandwidth (ranging from 0.24 to 93.5 megabits per second; mean 25.6) and technical issues led some sites to access programs via back-up modalities (eg, uploading the programs from a Universal Serial Bus drive). The number of youth providing engagement ratings varied by program (n=40-191; 48-60% female, 85-90% self-identified AI/AN). Across programs, youth rated the programs as easy to use (68-91%), trustworthy (61-89%), likeable (59-87%), and impactful (63-91%). Most youth understood the words in the programs (60-83%), although some needed hints to complete the programs (16-49%). Overall, 37-66% of the participants would recommend the programs to a classmate, and 62-87% found the programs enjoyable when compared to other school lessons. Conclusions Findings demonstrate the potential of the Internet to enhance the reach and implementation of evidence-based health promotion programs, and to engage AI/AN youth. Provision of back-up modalities is recommended to address possible connectivity or technical issues. The dissemination of Internet-based health promotion programs may be a promising strategy to address health disparities for this underserved population. Trial Registration Clinicaltrials.gov NCT01303575; https://clinicaltrials.gov/ct2/show/NCT01303575 (Archived by WebCite at http://www.webcitation.org/6m7DO4g7c) PMID:27872037

Internet-Based Delivery of Evidence-Based Health Promotion Programs Among American Indian and Alaska Native Youth: A Case Study.

PubMed

Markham, Christine M; Craig Rushing, Stephanie; Jessen, Cornelia; Gorman, Gwenda; Torres, Jennifer; Lambert, William E; Prokhorov, Alexander V; Miller, Leslie; Allums-Featherston, Kelly; Addy, Robert C; Peskin, Melissa F; Shegog, Ross

2016-11-21

American Indian and Alaska Native (AI/AN) youth face multiple health challenges compared to other racial/ethnic groups, which could potentially be ameliorated by the dissemination of evidence-based adolescent health promotion programs. Previous studies have indicated that limited trained personnel, cultural barriers, and geographic isolation may hinder the reach and implementation of evidence-based health promotion programs among AI/AN youth. Although Internet access is variable in AI/AN communities across the United States, it is swiftly and steadily improving, and it may provide a viable strategy to disseminate evidence-based health promotion programs to this underserved population. We explored the potential of using the Internet to disseminate evidence-based health promotion programs on multiple health topics to AI/AN youth living in diverse communities across 3 geographically dispersed regions of the United States. Specifically, we assessed the Internet's potential to increase the reach and implementation of evidence-based health promotion programs for AI/AN youth, and to engage AI/AN youth. This randomized controlled trial was conducted in 25 participating sites in Alaska, Arizona, and the Pacific Northwest. Predominantly AI/AN youth, aged 12-14 years, accessed 6 evidence-based health promotion programs delivered via the Internet, which focused on sexual health, hearing loss, alcohol use, tobacco use, drug use, and nutrition and physical activity. Adult site coordinators completed computer-based education inventory surveys, connectivity and bandwidth testing to assess parameters related to program reach (computer access, connectivity, and bandwidth), and implementation logs to assess barriers to implementation (program errors and delivery issues). We assessed youths' perceptions of program engagement via ratings on ease of use, understandability, credibility, likeability, perceived impact, and motivational appeal, using previously established measures. Sites had sufficient computer access and Internet connectivity to implement the 6 programs with adequate fidelity; however, variable bandwidth (ranging from 0.24 to 93.5 megabits per second; mean 25.6) and technical issues led some sites to access programs via back-up modalities (eg, uploading the programs from a Universal Serial Bus drive). The number of youth providing engagement ratings varied by program (n=40-191; 48-60% female, 85-90% self-identified AI/AN). Across programs, youth rated the programs as easy to use (68-91%), trustworthy (61-89%), likeable (59-87%), and impactful (63-91%). Most youth understood the words in the programs (60-83%), although some needed hints to complete the programs (16-49%). Overall, 37-66% of the participants would recommend the programs to a classmate, and 62-87% found the programs enjoyable when compared to other school lessons. Findings demonstrate the potential of the Internet to enhance the reach and implementation of evidence-based health promotion programs, and to engage AI/AN youth. Provision of back-up modalities is recommended to address possible connectivity or technical issues. The dissemination of Internet-based health promotion programs may be a promising strategy to address health disparities for this underserved population. Clinicaltrials.gov NCT01303575; https://clinicaltrials.gov/ct2/show/NCT01303575 (Archived by WebCite at http://www.webcitation.org/6m7DO4g7c). ©Christine M Markham, Stephanie Craig Rushing, Cornelia Jessen, Gwenda Gorman, Jennifer Torres, William E Lambert, Alexander V Prokhorov, Leslie Miller, Kelly Allums-Featherston, Robert C Addy, Melissa F Peskin, Ross Shegog. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 21.11.2016.

Survey of U.S. zoo and aquarium animal care staff attitudes regarding humane euthanasia for population management.

PubMed

Powell, David M; Ardaiolo, Matthew

2016-05-01

The humane euthanasia of animals for population management, or culling, has been suggested as one possible tool for managing animal populations for sustainability, and recent, highly publicized euthanasia of zoo animals in Copenhagen has stimulated global conversation about population management in zoos. We conducted a nationwide survey of U.S. zoo and aquarium personnel, including keepers, managers, and leaders of AZA animal programs, to assess their overall attitudes regarding population management euthanasia. The surveyed populations were generally very aware of the concept of population management euthanasia. Managers and animal program leaders were more supportive of euthanasia than keepers. We found that regardless of role, men were more supportive of euthanasia than women. Those personnel who were aware of instances of population management euthanasia at their institutions before were more supportive of it than those who were not. Support for culling varied with the kind of animal being considered for it, with three general taxon acceptability groupings emerging. Education, tenure in the profession, taxonomic expertise, and whether or not the responder took the survey before or after the Copenhagen events were not strong predictors of attitudes. Overall, the surveyed populations were approximately evenly split in terms of being in favor of euthanasia, not supporting euthanasia, or being unsure. Most responders indicated that they would be more likely to accept culling if more information was provided on its rationale. These results will form the basis for further discussions on the role of humane euthanasia for population management. Zoo Biol. 35:187-200, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

What does a Performance Measurement System Tell Us about the National Comprehensive Cancer Control Program?

PubMed Central

Townsend, Julie S.; Moore, Angela R.; Mulder, Tiffani N.; Boyd, Mary

2015-01-01

Context The National Comprehensive Cancer Control Program (NCCCP) performance measurement system seeks to understand both the processes that funded programs undertake with their respective coalitions to implement the objectives of their cancer plans and outcomes of those efforts. Objective To identify areas of achievement and technical assistance needs of NCCCP awardees. Design Program performance was assessed through surveys completed by program directors on performance indicators in 2009 and 2010 and queries from a web-based management information system in 2011 and 2012. Setting Programs funded by CDC’s NCCCP. Participants 69 programs. Main Outcome Measure(s) The key performance measures assessed were: inclusion of diverse partners and key sectors in cancer coalitions; partners’ involvement in activities; receiving in-kind resources from partners; using evidence-based interventions and data for setting priorities; conducting program evaluation; using community- or organization-level strategies to address cancer control efforts; and demonstrating progress toward achieving health outcomes. Results Most programs reported having active coalitions that represent diverse organizational sectors. Nearly all programs routinely assess the burden of cancer. In-kind resources to implement activities peaked at $64,716 in the second year of a five year funding cycle, and declined in subsequent project years. By year 3, over 70% of programs reported having an evaluation plan. While programs reported that nearly two-thirds of their interventions were evidence-based, some programs implemented non-evidence-based interventions. A majority of programs successfully used at least one community- or organization-level change strategy. However, many programs did not incorporate objectives linked to health outcomes as they reported progress in implementing interventions. Conclusions: While NCCCP programs were strong at building and maintaining infrastructure, some programs may need additional technical assistance to increase the adoption of evidence-based interventions, develop solid and responsive evaluation plans, and better link efforts to population-based measures that demonstrate impact toward reducing the burden of cancer. PMID:25136936

Assessing Infant Feeding Attitudes of Expectant Women in a Provincial Population in Canada: Validation of the Iowa Infant Feeding Attitude Scale.

PubMed

Twells, Laurie K; Midodzi, William K; Ludlow, Valerie; Murphy-Goodridge, Janet; Burrage, Lorraine; Gill, Nicole; Halfyard, Beth; Schiff, Rebecca; Newhook, Leigh Anne

2016-08-01

Maternal attitudes to infant feeding are predictive of intent and initiation of breastfeeding. The Iowa Infant Feeding Attitude Scale (IIFAS) has not been validated in the Canadian population. This study was conducted in Newfoundland and Labrador, a Canadian province with low breastfeeding rates. Objectives were to assess the reliability and validity of the IIFAS in expectant mothers; to compare attitudes to infant feeding in urban and rural areas; and to examine whether attitudes are associated with intent to breastfeed. The IIFAS assessment tool was administered to 793 pregnant women. Differences in the total IIFAS scores were compared between urban and rural areas. Reliability and validity analysis was conducted on the IIFAS. The receiver operating characteristic (ROC) of the IIFAS was assessed against mother's intent to breastfeed. The mean ± SD of the total IIFAS score of the overall sample was 64.0 ± 10.4. There were no significant differences in attitudes between urban (63.9 ± 10.5) and rural (64.4 ± 9.9) populations. There were significant differences in total IIFAS scores between women who intend to breastfeed (67.3 ± 8.3) and those who do not (51.6 ± 7.7), regardless of population region. The high value of the area under the curve (AUC) of the ROC (AUC = 0.92) demonstrates excellent ability of the IIFAS to predict intent to breastfeed. The internal consistency of the IIFAS was strong, with a Cronbach's alpha greater than .80 in the overall sample. The IIFAS examined in this provincial population provides a valid and reliable assessment of maternal attitudes toward infant feeding. This tool could be used to identify mothers less likely to breastfeed and to inform health promotion programs. © The Author(s) 2014.

The critical role of social workers in home-based primary care.

PubMed

Reckrey, Jennifer M; Gettenberg, Gabrielle; Ross, Helena; Kopke, Victoria; Soriano, Theresa; Ornstein, Katherine

2014-01-01

The growing homebound population has many complex biomedical and psychosocial needs and requires a team-based approach to care (Smith, Ornstein, Soriano, Muller, & Boal, 2006). The Mount Sinai Visiting Doctors Program (MSVD), a large interdisciplinary home-based primary care program in New York City, has a vibrant social work program that is integrated into the routine care of homebound patients. We describe the assessment process used by MSVD social workers, highlight examples of successful social work care, and discuss why social workers' individualized care plans are essential for keeping patients with chronic illness living safely in the community. Despite barriers to widespread implementation, such social work involvement within similar home-based clinical programs is essential in the interdisciplinary care of our most needy patients.

National Water-Quality Assessment Program - Western Lake Michigan Drainage Basin

USGS Publications Warehouse

Setmire, J.O.

1991-01-01

A major component of the program is study-unit investigations, which comprise the princ ipal bui lding blocks of the program on which national-level asses ment activities a re based . The 60 study-unit in vestigations that make up the program are hydrologic systems that include parts of most major river bas ins and a qui fer systems. These study units cover areas of I ,200 to more than 65 ,000 square mi les and incorporate about 60 to 70 percent of the Nation's water use and popul ation e rved by public water supply. In 1991 , the Western Lake Michigan drainage basin was among the fir st 20 NA WQA study unit selected for study under the full -scale implementation plan.

Is the Partners in Recovery program connecting with the intended population of people living with severe and persistent mental illness? What are their prioritised needs?

PubMed

Hancock, Nicola; Smith-Merry, Jennifer; Gillespie, James A; Yen, Ivy

2017-10-01

Objective The Partners in Recovery (PIR) program is an Australian government initiative designed to make the mental health and social care sectors work in more coordinated ways to meet the needs of those with severe and complex mental illness. Herein we reflect on demographic data collected during evaluation of PIR implementation in two Western Sydney sites. The aims of the present study were to: (1) explore whether two Sydney-based PIR programs had recruited their intended population, namely people living with severe and persistent mental illness; and (2) learn more about this relatively unknown population and their self-identified need priorities. Methods Routinely collected initial client assessment data were analysed descriptively. Results The data suggest that the two programs are engaging the intended population. The highest unmet needs identified included psychological distress, lack of daytime activities and company, poor physical health and inadequate accommodation. Some groups remain hard to connect, including people from Aboriginal and other culturally diverse communities. Conclusions The data confirm that the PIR program, at least in the two regions evaluated, is mostly reaching its intended audience. Some data were being collected inconsistently, limiting the usefulness of the data and the ability to build on PIR findings to develop ongoing support for this population. What is known about the topic? PIR is a unique national program funded to engage with and address the needs of Australians living with severe and persistent mental illness by facilitating service access. What does this paper add? This paper reports on recruitment of people living with severe and persistent mental illness, their need priorities and data collection. These are three central elements to successful roll-out of the much anticipated mental health component of the National Disability Insurance Scheme, as well as ongoing PIR operation. What are the implications for practitioners? Active recruitment, exploration of self-reported need priorities and routine outcome measurement are essential yet challenging work practices when working with people living with severe and persistent mental illness.

Sampling Simulations for Assessing the Accuracy of U.S. Agricultural Crop Mapping from Remotely Sensed Imagery

NASA Astrophysics Data System (ADS)

Dwyer, Linnea; Yadav, Kamini; Congalton, Russell G.

2017-04-01

Providing adequate food and water for a growing, global population continues to be a major challenge. Mapping and monitoring crops are useful tools for estimating the extent of crop productivity. GFSAD30 (Global Food Security Analysis Data at 30m) is a program, funded by NASA, that is producing global cropland maps by using field measurements and remote sensing images. This program studies 8 major crop types, and includes information on cropland area/extent, if crops are irrigated or rainfed, and the cropping intensities. Using results from the US and the extensive reference data available, CDL (USDA Crop Data Layer), we will experiment with various sampling simulations to determine optimal sampling for thematic map accuracy assessment. These simulations will include varying the sampling unit, the sampling strategy, and the sample number. Results of these simulations will allow us to recommend assessment approaches to handle different cropping scenarios.

National Water-Quality Assessment Program - South-Central Texas

USGS Publications Warehouse

,

1994-01-01

Studies of 60 hydrologic systems that include parts of most major river basins and aquifer systems (study-unit investigations) are the building blocks of the national assessment. Areas of the 60 study units range in size from less than 1,000 to more than 60,000 square miles (mi2) and represent 60 to 70 percent of the Nation's water use and population served by public water supplies. Twenty study-unit investigations were started in 1991, 20 additional started in 1994, and 20 are planned to start in 1997. Assessment activities in the South-Central Texas study area (see fig.) began in 1994.

Adult Bronchoscopy Training

PubMed Central

Wahidi, Momen M.; Read, Charles A.; Buckley, John D.; Addrizzo-Harris, Doreen J.; Shah, Pallav L.; Herth, Felix J. F.; de Hoyos Parra, Alberto; Ornelas, Joseph; Yarmus, Lonny; Silvestri, Gerard A.

2015-01-01

BACKGROUND: The determination of competency of trainees in programs performing bronchoscopy is quite variable. Some programs provide didactic lectures with hands-on supervision, other programs incorporate advanced simulation centers, whereas others have a checklist approach. Although no single method has been proven best, the variability alone suggests that outcomes are variable. Program directors and certifying bodies need guidance to create standards for training programs. Little well-developed literature on the topic exists. METHODS: To provide credible and trustworthy guidance, rigorous methodology has been applied to create this bronchoscopy consensus training statement. All panelists were vetted and approved by the CHEST Guidelines Oversight Committee. Each topic group drafted questions in a PICO (population, intervention, comparator, outcome) format. MEDLINE data through PubMed and the Cochrane Library were systematically searched. Manual searches also supplemented the searches. All gathered references were screened for consideration based on inclusion criteria, and all statements were designated as an Ungraded Consensus-Based Statement. RESULTS: We suggest that professional societies move from a volume-based certification system to skill acquisition and knowledge-based competency assessment for trainees. Bronchoscopy training programs should incorporate multiple tools, including simulation. We suggest that ongoing quality and process improvement systems be introduced and that certifying agencies move from a volume-based certification system to skill acquisition and knowledge-based competency assessment for trainees. We also suggest that assessment of skill maintenance and improvement in practice be evaluated regularly with ongoing quality and process improvement systems after initial skill acquisition. CONCLUSIONS: The current methods used for bronchoscopy competency in training programs are variable. We suggest that professional societies and certifying agencies move from a volume- based certification system to a standardized skill acquisition and knowledge-based competency assessment for pulmonary and thoracic surgery trainees. PMID:25674901

Systematic Assessment of Linkage to Care for Persons with HIV Released from Corrections Facilities Using Existing Datasets

PubMed Central

Montague, Brian T.; Rosen, David L.; Sammartino, Cara; Costa, Michael; Gutman, Roee; Solomon, Liza; Rich, Josiah

2016-01-01

Abstract Populations in corrections continue to have high prevalence of HIV. Expanded testing and treatment programs allow persons to be identified and stabilized on treatment while incarcerated. However, these gains and frequently lost on reentry. Systemic frameworks are needed to monitor linkage to care to guide programs supporting linkage to care. To assess the adequacy of linkage to care on reentry, incarceration data from the National Corrections Reporting Program and data from the Ryan White Services Report from 2010 to 2012 were linked using an encrypted client identification (eUCI). Time from release to the first visit and presence of detectable HIV RNA at linkage were assessed. Multivariate survival analyses were performed to identify associations between patient characteristics and time to linkage. Among those linking, only 43% in Rhode Island and 49% in North Carolina linked within 90 days, and 33% in both states had detectable viremia at the first visit. Those not previously in care and with shorter incarceration experiences longer linkage times. Persons identified as black, had median times greater than 1 year. Using existing datasets, significant gaps in linkage to care for persons with HIV on release from corrections were demonstrated in Rhode Island and North Carolina. Systemically implementing this monitoring to evaluate changes over time would provide important information to support interventions to improve linkage in high-risk populations. Using national datasets for both corrections and clinical data, this framework equally could be used to evaluate experiences of persons with HIV linking to care on release from corrections facilities nationwide. PMID:26836237

Two criteria for evaluating risk prediction models

PubMed Central

Pfeiffer, R.M.; Gail, M.H.

2010-01-01

SUMMARY We propose and study two criteria to assess the usefulness of models that predict risk of disease incidence for screening and prevention, or the usefulness of prognostic models for management following disease diagnosis. The first criterion, the proportion of cases followed PCF(q), is the proportion of individuals who will develop disease who are included in the proportion q of individuals in the population at highest risk. The second criterion is the proportion needed to follow-up, PNF(p), namely the proportion of the general population at highest risk that one needs to follow in order that a proportion p of those destined to become cases will be followed. PCF(q) assesses the effectiveness of a program that follows 100q% of the population at highest risk. PNF(p) assess the feasibility of covering 100p% of cases by indicating how much of the population at highest risk must be followed. We show the relationship of those two criteria to the Lorenz curve and its inverse, and present distribution theory for estimates of PCF and PNF. We develop new methods, based on influence functions, for inference for a single risk model, and also for comparing the PCFs and PNFs of two risk models, both of which were evaluated in the same validation data. PMID:21155746

Breeding of White-tailed Tropicbirds (Phaethon lepturus) in the western South Atlantic.

PubMed

Leal, G R; Serafini, P P; Simão-Neto, I; Ladle, R J; Efe, M A

2016-04-19

Basic information on natural history is crucial for assessing the viability of populations, but is often lacking for many species of conservation concern. One such species is the White-tailed Tropicbird, Phaethon lepturus (Mathews, 1915). Here, we address this shortfall by providing detailed information on reproductive biology, distribution and threats on the Fernando de Noronha archipelago, Brazil - the largest colony of P. lepturus in the South Atlantic. We assessed reproduction from August 2011 to January 2012 by monitoring tropicbird nests and their contents. A population estimate was obtained through a combination of active searches for nests and by census at sea between 2010 and 2012. Breeding success was calculated by traditional methods. The growth curve of chicks and life table were also calculated. Additional information on nest and mate fidelity and on age of breeding birds was obtained from the banded birds. Our results indicate that the unusual nest form (limestone pinnacles) and predation by crabs may be responsible for the observed patterns of hatching and fledging success. Although the Fernando de Noronha population appears to be stable (at between 100-300 birds), a long term monitoring program would be desirable to assess fluctuations in this globally important population. Conservation strategies should focus on controlling predation by land crabs and tegu lizards.

Determinants of bird conservation-action implementation and associated population trends of threatened species.

PubMed

Luther, David A; Brooks, Thomas M; Butchart, Stuart H M; Hayward, Matt W; Kester, Marieke E; Lamoreux, John; Upgren, Amy

2016-12-01

Conservation actions, such as habitat protection, attempt to halt the loss of threatened species and help their populations recover. The efficiency and the effectiveness of actions have been examined individually. However, conservation actions generally occur simultaneously, so the full suite of implemented conservation actions should be assessed. We used the conservation actions underway for all threatened and near-threatened birds of the world (International Union for Conservation of Nature Red List of Threatened Species) to assess which biological (related to taxonomy and ecology) and anthropogenic (related to geoeconomics) factors were associated with the implementation of different classes of conservation actions. We also assessed which conservation actions were associated with population increases in the species targeted. Extinction-risk category was the strongest single predictor of the type of conservation actions implemented, followed by landmass type (continent, oceanic island, etc.) and generation length. Species targeted by invasive nonnative species control or eradication programs, ex situ conservation, international legislation, reintroduction, or education, and awareness-raising activities were more likely to have increasing populations. These results illustrate the importance of developing a predictive science of conservation actions and the relative benefits of each class of implemented conservation action for threatened and near-threatened birds worldwide. © 2016 Society for Conservation Biology.

Economic and demographic issues related to deployment of the Satellite Power System (SPS)

NASA Technical Reports Server (NTRS)

Baldwin, T. E.; Hill, L. G.; Santini, D. J.; Stenehjem, E. J.

1978-01-01

Growth in energy consumption stimulated interest in exploitation of renewable sources of electric energy. One technology that was proposed is the Satellite Power System (SPS). Before committing the U.S. to such a large program, the Department of Energy and the National Aeronautics and Space Administration are jointly participating in an SPS Concept Development and Evaluation Program. This white paper on industrial and population relocation is part of the FY 78 preliminary evaluation of related socio-economic issues. Results of four preliminary assessment activities are documented.

Clinical observations of a Cantonese cognitive-behavioral treatment program for Chinese immigrants.

PubMed

Shen, Edward K; Alden, Lynn E; Söchting, Ingrid; Tsang, Pheobe

2006-01-01

In this article, the authors describe our clinical observations about the process of delivering a Cantonese-language cognitive- behavioral therapy program to treat depression in Hong Kong immigrants to Vancouver, Canada. Our experiences indicated that standard referral and assessment procedures were not optimal for this population. Other factors that required consideration were how to convert Cantonese terms for dysphoric affect into English equivalents and how to implement cognitive modification strategies when dealing with culture-syntonic beliefs about social relationships. (PsycINFO Database Record (c) 2010 APA, all rights reserved).

A National Research Survey of Technology Use in the BSW Teaching and Learning Process

ERIC Educational Resources Information Center

Buquoi, Brittany; McClure, Carli; Kotrlik, Joseph W.; Machtmes, Krisanna; Bunch, J. C.

2013-01-01

The purpose of this descriptive-correlational research study was to assess the overall use of technology in the teaching and learning process (TLP) by BSW educators. The accessible and target population included all full-time, professorial-rank, BSW faculty in Council on Social Work Education--accredited BSW programs at land grant universities.…

Caught in the Shadows: Immigrant Educational Access -- The Amnesty Population.

ERIC Educational Resources Information Center

Spicer, Scot L.; Sanchez, Jorge R.

A study was conducted by Glendale Community College (California) in 1991 to obtain information about amnesty applicants participating in programs offered by the California community colleges. Two sets of data were used for the study. The first set was collected as part of a spring 1989 needs assessment survey in English as a Second Language…

Construct Equivalence of a National Certification Examination that Uses Dual Languages and Audio Assistant.

ERIC Educational Resources Information Center

Wang, Shudong; Wang, Ning; Hoadley, David

This study examined the comparability of scores on the National Nurses Aides Assessment Program (NNAAP) test across language and administration condition groups for calibration and validation samples that were randomly drawn from the same population. A sample of 20,568 candidate responses to 1 test form was used. This examination is given in…

Near-infrared spectroscopy, a rapid method for predicting the age of male and female wild-type and Wolbachia infected Aedes aegypti

USDA-ARS?s Scientific Manuscript database

Estimating the age distribution of mosquito populations is crucial for assessing their capacity to transmit disease and for evaluating the efficacy of available vector control programs. This study reports on the capacity of near-infrared spectroscopy (NIRS) technique to rapidly predict the ages of t...

Impact of Counseling on Repeated Unplanned Pregnancy and Contraceptive Behavior in Low SES Abortion Population.

ERIC Educational Resources Information Center

Burnhill, Michael S.; And Others

High numbers of repeat abortions at a medical school clinic prompted clinic personnel to develop an experimental fertility control counseling program. Counseling objectives included the following: (1) to engender rapport and trust; (2) to assess the patient's past contraceptive use and psychosocial history; (3) to improve patient's knowledge of…

A Status Report on Hunger and Homelessness in America's Cities, 2002: A 25-City Survey.

ERIC Educational Resources Information Center

Lowe, Eugene T.

To assess the status of hunger and homelessness in U.S. cities during 2002, 25 major cities completed surveys regarding demand for emergency food assistance and emergency shelter and capacity of local agencies to meet the demand; causes of hunger and homelessness and demographics of populations experiencing these problems; exemplary programs or…

The Performance of Latinos in Rural Public Schools: A Comparative Analysis of Test Scores in Grades 3, 6, and 12.

ERIC Educational Resources Information Center

Hampton, Steve; And Others

1995-01-01

Examines effects of socioeconomic status, school funding, English proficiency, and Latino population concentration on achievement scores of students in grades 3, 6, and 12 in 66 rural California school districts. Performance on the California Assessment Program was predicted primarily by parental socioeconomic status, and, unexpectedly, improved…

Assessment for Effective Intervention: Enrichment Science Academic Program

ERIC Educational Resources Information Center

Sasson, Irit; Cohen, Donita

2013-01-01

Israel suffers from a growing problem of socio-economic gaps between those who live in the center of the country and residents of outlying areas. As a result, there is a low level of accessibility to higher education among the peripheral population. The goal of the Sidney Warren Science Education Center for Youth at Tel-Hai College is to…

Designing Successful Transitions: A Guide for Orienting Students to College. 3rd Edition. The First-Year Experience Monograph Series No. 13

ERIC Educational Resources Information Center

Ward-Roof, Jeanine A., Ed.

2010-01-01

The 2010 edition of this monograph addresses many topics (e.g., administration of orientation programs, family involvement, student characteristics and needs, assessment, and orientation for specific student populations and institutional types) that were included in previous editions but approaches them with new information, updated data, and…

University-School Partnerships for Clinical Experiences: Design, Implementation, Assessment, and Data Collection

ERIC Educational Resources Information Center

Sivakumaran, Thillainatarajan; Holland, Glenda; Clark, Leonard; Heyning, Katharina; Wishart, William; Flowers-Gibson, Beverly

2011-01-01

University teacher education programs establish partnerships with P-12 schools, in part to place their teacher education candidates in a learning environment that allows candidates to work with a diverse population of learners. The purpose of this study was to examine three universities in regard to the partnerships utilized for field and clinical…

The Heavy Burden of Psychiatric Comorbidity in Youth with Autism Spectrum Disorders: A Large Comparative Study of a Psychiatrically Referred Population

ERIC Educational Resources Information Center

Joshi, Gagan; Petty, Carter; Wozniak, Janet; Henin, Aude; Fried, Ronna; Galdo, Maribel; Kotarski, Meghan; Walls, Sarah; Biederman, Joseph

2010-01-01

The objective of the study was to systematically examine patterns of psychiatric comorbidity in referred youth with autism spectrum disorders (ASD) including autistic disorder and pervasive developmental disorder not otherwise specified. Consecutively referred children and adolescents to a pediatric psychopharmacology program were assessed with…

Health education lessons learned: the H.A.P.I. Kids Program.

PubMed

Sworts, V D; Riccitelli, C N

1997-09-01

Challenges exist for effective health communication and health education within diverse populations of the United States. This article addresses the development process for educational materials and lessons learned from the Healthy Asian and Pacific Islander (H.A.P.I.) Kids Program, a vaccination demonstration project funded by the Centers for Disease Control and Prevention to promote catch-up hepatitis B vaccination for older American Asian and Pacific Islander children. Simplicity and a common message were incorporated in multiple strategies to disseminate information to a diverse population. Community representatives from the Cambodian, Hmong, Filipino, Lao, and Vietnamese communities were instrumental in the material development process, which included needs assessment, design, and translation. By making the target community part of the development process, important health messages can be disseminated effectively, carrying great impact to an otherwise hard-to-reach community.

Incorporating shared savings programs into primary care: from theory to practice.

PubMed

Hayen, Arthur P; van den Berg, Michael J; Meijboom, Bert R; Struijs, Jeroen N; Westert, Gert P

2015-12-30

In several countries, health care policies gear toward strengthening the position of primary care physicians. Primary care physicians are increasingly expected to take accountability for overall spending and quality. Yet traditional models of paying physicians do not provide adequate incentives for taking on this new role. Under a so-called shared savings program physicians are instead incentivized to take accountability for spending and quality, as the program lets them share in cost savings when quality targets are met. We provide a structured approach to designing a shared savings program for primary care, and apply this approach to the design of a shared savings program for a Dutch chain of primary care providers, which is currently being piloted. Based on the literature, we defined five building blocks of shared savings models that encompass the definition of the scope of the program, the calculation of health care expenditures, the construction of a savings benchmark, the assessment of savings and the rules and conditions under which savings are shared. We apply insights from a variety of literatures to assess the relative merits of alternative design choices within these building blocks. The shared savings program uses an econometric model of provider expenditures as an input to calculating a casemix-corrected benchmark. The minimization of risk and uncertainty for both payer and provider is pertinent to the design of a shared savings program. In that respect, the primary care setting provides a number of unique opportunities for achieving cost and quality targets. Accountability can more readily be assumed due to the relatively long-lasting relationships between primary care physicians and patients. A stable population furthermore improves the confidence with which savings can be attributed to changes in population management. Challenges arise from the institutional context. The Dutch health care system has a fragmented structure and providers are typically small in size. Shared savings programs fit the concept of enhanced primary care. Incorporating a shared savings program into existing payment models could therefore contribute to the financial sustainability of this organizational form.

Potential for human immunodeficiency virus parenteral transmission in the Middle East and North Africa: An analysis using hepatitis C virus as a proxy biomarker

PubMed Central

Mohamoud, Yousra A; Miller, F DeWolfe; Abu-Raddad, Laith J

2014-01-01

The Middle East and North Africa (MENA) region has endured several major events of infection parenteral transmission. Recent work has established the utility of using hepatitis C virus (HCV) as a proxy biomarker for assessing the epidemic potential for human immunodeficiency virus (HIV) parenteral transmission. In this review, we use data on the prevalence of HCV infection antibody (seroprevalence) among general population and high risk population groups to assess the potential for HIV parenteral transmission in MENA. Relatively low prevalence of HCV infection in the general population groups was reported in most MENA countries indicating that parenteral HIV transmission at endemic levels does not appear to be a cause for concern. Nonetheless, there could be opportunities for localized HIV outbreaks and transmission of other blood-borne infections in some settings such as healthcare facilities. Though there have been steady improvements in safety measures related to parenteral modes of transmission in the region, these improvements have not been uniform across all countries. More precautions, including infection control training programs, surveillance systems for nosocomial infections and wider coverage and evaluation of hepatitis B virus immunization programs need to be implemented to avoid the unnecessary spread of HIV, HCV, and other blood-borne pathogens along the parenteral modes of transmission. PMID:25278675

Implementing the Community Health Worker Model within Diabetes Management: Challenges and Lessons Learned from Programs across the U.S.

PubMed Central

Cherrington, Andrea; Ayala, Guadalupe X.; Amick, Halle; Allison, Jeroan; Corbie-Smith, Giselle; Scarinci, Isabel

2018-01-01

Introduction/objectives The Community Health Worker (CHW) model has gained popularity as a method for reaching vulnerable populations with diabetes mellitus (DM), yet little is known about its actual role in program delivery. The purpose of this qualitative study was to examine methods of implementation as well as related challenges and lessons learned. Methods Semi-structured interviews were conducted with program managers. Four databases (PubMed, CINAHL, ISI Web of Knowledge, PsycInfo), the CDC’s 1998 directory of CHW programs and Google Search Engine and were used to identify CHW programs. Criteria for inclusion were: DM program; used CHW strategy; occurred in United States. Two independent reviewers performed content analyses to identify major themes and findings. Results Sixteen programs were assessed, all but three focused on minority populations. Most CHWs were recruited informally; six programs required CHWs to have diabetes. CHW roles and responsibilities varied across programs; educator was the most commonly identified role. Training also varied in terms of both content and intensity. All programs gave CHWs remuneration for their work. Common challenges included difficulties with CHW retention, intervention fidelity and issues related to sustainability. Cultural and gender issues also emerged. Examples of lessons learned included the need for community buy-in and the need to anticipate non-diabetes related issues. Conclusions Lessons learned from these programs may be useful to others as they apply the CHW model to diabetes management within their own communities. Further research is needed to elucidate the specific features of this model necessary to positively impact health outcomes. PMID:18832287

Indian social safety net programs as platforms for introducing wheat flour fortification: a case study of Gujarat, India.

PubMed

Fiedler, John L; Babu, Sunil; Smitz, Marc-Francois; Lividini, Keith; Bermudez, Odilia

2012-03-01

Micronutrient deficiencies exact an enormous health burden on India. The release of the National Family Health Survey results--showing the relatively wealthy state of Gujarat having deficiency levels exceeding national averages--prompted Gujarat officials to introduce fortified wheat flour in their social safety net programs (SSNPs). To provide a case study of the introduction of fortified wheat flour in Gujarat's Public Distribution System (PDS), Integrated Child Development Scheme (ICDS), and Mid-Day Meal (MDM) Programme to assess the coverage, costs, impact, and cost-effectiveness of the initiative. India's 2004/05 National Sample Survey data were used to identify beneficiaries of each of Gujarat's three SSNPs and to estimate usual intake levels of vitamin A, iron, and zinc. Comparing age- and sex-specific usual intakes to Estimated Average Requirements, the proportion of the population with inadequate intakes was estimated. Postfortification intake levels and reductions in inadequate intake were estimated. The incremental cost of fortifying wheat flour and the cost-effectiveness of each program were estimated. When each program was assessed independently, the proportion of the population with inadequate vitamin A intakes was reduced by 34% and 74% among MDM and ICDS beneficiaries, respectively. Both programs effectively eliminated inadequate intakes of both iron and zinc. Among PDS beneficiaries, the proportion with inadequate iron intakes was reduced by 94%. CONCLUSIONS. Gujarat's substitution of fortified wheat flour for wheat grain is dramatically increasing the intake of micronutrients among its SSNP beneficiaries. The incremental cost of introducing fortification in each of the programs is low, and, according to World Health Organization criteria, each program is "highly cost-effective." The introduction of similar reforms throughout India would largely eliminate the inadequate iron intake among persons participating in any of the three SSNPs and would have a significant impact on the global prevalence rate of inadequate iron intake.

Assessing demographic and epidemiologic parameters of rural dog populations in India during mass vaccination campaigns.

PubMed

Belsare, Aniruddha V; Gompper, Matthew E

2013-08-01

Mass vaccination of dogs is a mainstay for efforts to control rabies and other viral pathogens. The success of such programs is a function of the ability to vaccinate sufficient proportions of animals to develop herd immunity. However, fully assessing success in reaching target vaccination-levels and in understanding the outcome of mass vaccination efforts is hindered if insufficient information is available on the demographics of dog populations and the prevalence of the targeted pathogens. While such information can sometimes be gained from questionnaire surveys, greater precision requires direct assessment of the dog populations. Here we show how such information can be gained from surveys of dogs conducted in association with mass-vaccination programs. We conducted surveys of dogs in six villages in rural Maharashtra, India, between February and July 2011 as part of an effort to reduce the risk of human rabies and virus transmission from dogs to wildlife. Mass vaccination efforts were conducted in each village, and paired with blood sample collection and photographic mark-recapture approaches to gain epidemiologic and demographic data. This data in turn facilitated estimates of dog abundance, population density and structure, vaccination coverage, and seroprevalence of antibodies against canine adenovirus (CAV), canine parvovirus (CPV), and canine distemper virus (CDV). The median dog population size for the six villages was 134 (range 90-188), the median dog population density was 719 dogs per km(2) (range 526-969), and the median human:dog ratio for these six villages was 34 (range 30-47). The median household:dog ratio for the six villages was 6 (range 5-8). Following vaccination efforts, the median vaccination coverage achieved was 34% (range 24-42%). The dog populations consisted mostly of adult dogs (67-86%) and the median sex ratio for the study area was male biased (1.55 males per female; range 0.9-2.5). The seroprevalence of antibodies against CAV, CPV and CDV was 68, 88 and 73%, respectively. Mass vaccination campaigns provide an opportunity to obtain vital epidemiological and demographic data, and develop a clearer understanding of the threats and impacts of diseases and disease control measures. Copyright © 2013 Elsevier B.V. All rights reserved.

Dynamics of a deep-water seagrass population on the Great Barrier Reef: annual occurrence and response to a major dredging program.

PubMed

York, Paul H; Carter, Alex B; Chartrand, Kathryn; Sankey, Tonia; Wells, Linda; Rasheed, Michael A

2015-08-17

Global seagrass research efforts have focused on shallow coastal and estuarine seagrass populations where alarming declines have been recorded. Comparatively little is known about the dynamics of deep-water seagrasses despite evidence that they form extensive meadows in some parts of the world. Deep-water seagrasses are subject to similar anthropogenic threats as shallow meadows, particularly along the Great Barrier Reef lagoon where they occur close to major population centres. We examine the dynamics of a deep-water seagrass population in the GBR over an 8 year period during which time a major capital dredging project occurred. Seasonal and inter-annual changes in seagrasses were assessed as well as the impact of dredging. The seagrass population was found to occur annually, generally present between July and December each year. Extensive and persistent turbid plumes from a large dredging program over an 8 month period resulted in a failure of the seagrasses to establish in 2006, however recruitment occurred the following year and the regular annual cycle was re-established. Results show that despite considerable inter annual variability, deep-water seagrasses had a regular annual pattern of occurrence, low resistance to reduced water quality but a capacity for rapid recolonisation on the cessation of impacts.

Dynamics of a deep-water seagrass population on the Great Barrier Reef: annual occurrence and response to a major dredging program

PubMed Central

York, Paul H.; Carter, Alex B.; Chartrand, Kathryn; Sankey, Tonia; Wells, Linda; Rasheed, Michael A.

2015-01-01

Global seagrass research efforts have focused on shallow coastal and estuarine seagrass populations where alarming declines have been recorded. Comparatively little is known about the dynamics of deep-water seagrasses despite evidence that they form extensive meadows in some parts of the world. Deep-water seagrasses are subject to similar anthropogenic threats as shallow meadows, particularly along the Great Barrier Reef lagoon where they occur close to major population centres. We examine the dynamics of a deep-water seagrass population in the GBR over an 8 year period during which time a major capital dredging project occurred. Seasonal and inter-annual changes in seagrasses were assessed as well as the impact of dredging. The seagrass population was found to occur annually, generally present between July and December each year. Extensive and persistent turbid plumes from a large dredging program over an 8 month period resulted in a failure of the seagrasses to establish in 2006, however recruitment occurred the following year and the regular annual cycle was re-established. Results show that despite considerable inter annual variability, deep-water seagrasses had a regular annual pattern of occurrence, low resistance to reduced water quality but a capacity for rapid recolonisation on the cessation of impacts. PMID:26279474

Technologies for participatory medicine and health promotion in the elderly population

PubMed Central

Nieto-Riveiro, Laura; Groba, Betania; Miranda, M. Carmen; Concheiro, Patricia; Pazos, Alejandro; Pousada, Thais; Pereira, Javier

2018-01-01

Abstract Introduction: The progressive aging of the population is a socio-demographic phenomenon experienced by most countries in the world in recent decades, especially in Japan and in many European Union countries. During this process, so-called “geriatric syndromes” frequently occur. The focus of this study is the quality of life of the elderly in relation to these 3 factors: risk of falls, urinary incontinence, and insomnia. Objective: The main purpose is to determine the impact of a multifactorial intervention program implemented with institutionalized elderly people. The program is focused on the treatment of the aforementioned factors. Methods and Analysis: The study will be carried out with elderly people living in three residences for the elderly in A Coruña Province (Galicia, Spain).It is a prospective and longitudinal study, with a temporary series design of a “quasi-experimental” type that evaluates the effect of an intervention in 1 given population by doing assessments pre- and post-intervention, but there is no comparison with a control group. The intervention will be based on a multifactorial program, including the following phases: the use of wearable devices (wearable fitness trackers to register physical activity and sleep), the use of an App on a Tablet to record the participants’ occupations and activities, counseling about performance in activities of daily living, the implementation of a physical activity program, and the treatment of the pelvic floor (according to each research line). The Quality of Life (QoL) will be assessed before and after the intervention, with the use of the questionnaire EuroQol-5D-5L. Data analysis will be applied with all registered variables through a quantitative perspective. Ethics and Dissemination: The protocol has been approved by the host institution's ethics committee (Research Ethics Committee of Galicia) under the number 2017/106. Results will be disseminated via peer-reviewed journal articles and conferences. This clinical trial is registered at ClinicalTrials.gov identifier: NCT03504813. PMID:29768372

Technologies for participatory medicine and health promotion in the elderly population.

PubMed

Nieto-Riveiro, Laura; Groba, Betania; Miranda, M Carmen; Concheiro, Patricia; Pazos, Alejandro; Pousada, Thais; Pereira, Javier

2018-05-01

The progressive aging of the population is a socio-demographic phenomenon experienced by most countries in the world in recent decades, especially in Japan and in many European Union countries. During this process, so-called "geriatric syndromes" frequently occur. The focus of this study is the quality of life of the elderly in relation to these 3 factors: risk of falls, urinary incontinence, and insomnia. The main purpose is to determine the impact of a multifactorial intervention program implemented with institutionalized elderly people. The program is focused on the treatment of the aforementioned factors. The study will be carried out with elderly people living in three residences for the elderly in A Coruña Province (Galicia, Spain).It is a prospective and longitudinal study, with a temporary series design of a "quasi-experimental" type that evaluates the effect of an intervention in 1 given population by doing assessments pre- and post-intervention, but there is no comparison with a control group.The intervention will be based on a multifactorial program, including the following phases: the use of wearable devices (wearable fitness trackers to register physical activity and sleep), the use of an App on a Tablet to record the participants' occupations and activities, counseling about performance in activities of daily living, the implementation of a physical activity program, and the treatment of the pelvic floor (according to each research line). The Quality of Life (QoL) will be assessed before and after the intervention, with the use of the questionnaire EuroQol-5D-5L. Data analysis will be applied with all registered variables through a quantitative perspective. The protocol has been approved by the host institution's ethics committee (Research Ethics Committee of Galicia) under the number 2017/106. Results will be disseminated via peer-reviewed journal articles and conferences. This clinical trial is registered at ClinicalTrials.gov identifier: NCT03504813.

Building Analytic Capacity and Statistical Literacy Among Title IV-E MSW Students

PubMed Central

LERY, BRIDGETTE; PUTNAM-HORNSTEIN, EMILY; WIEGMANN, WENDY; KING, BRYN

2016-01-01

Building and sustaining effective child welfare practice requires an infrastructure of social work professionals trained to use data to identify target populations, connect interventions to outcomes, adapt practice to varying contexts and dynamic populations, and assess their own effectiveness. Increasingly, public agencies are implementing models of self-assessment in which administrative data are used to guide and continuously evaluate the implementation of programs and policies. The research curriculum described in the article was developed to provide Title IV-E and other students interested in public child welfare systems with hands-on opportunities to become experienced and “statistically literate” users of aggregated public child welfare data from California’s administrative child welfare system, attending to the often missing link between data/research and practice improvement. PMID:27429600

From rhetoric to reality: consumer engagement in 16 multi-stakeholder alliances.

PubMed

Greene, Jessica; Farley, Diane C; Christianson, Jon B; Scanlon, Dennis P; Shi, Yunfeng

2016-08-01

A key component of the Aligning Forces for Quality (AF4Q) program was engaging consumers in their health and healthcare. We examined the extent to which the alliances embraced 4 areas of consumer engagement: self-management, consumer friendliness of reports of healthcare provider quality, involvement of consumers in alliance governance, and the integration of consumers into quality improvement teams. We used a largely qualitative approach. The evaluation team conducted 1100 in-depth interviews with alliance stakeholders. Two authors reviewed the consumer engagement data for each alliance to assess its level of embrace in the 4 consumer engagement areas. For consumer friendliness of public reporting websites, we also assessed alliance public reports for reading level, technical language, and evaluable displays. Population-level effects were also examined for self-management and public reporting. Consumer engagement was new to most alliances, and few had staff with consumer engagement expertise or existing consumer constituencies. For each area of consumer engagement, some alliances enthusiastically embraced the work, other alliances made a concerted but limited effort to develop programs, and a third group of alliances did the minimum work required. Integrating consumers into governance was the area most often embraced, followed by making public reports consumer friendly. Two alliances strongly embraced both self-management and integrating patients into quality improvement efforts. The AF4Q program did not have greater population level effects from self-management or public reporting than were those observed in a national comparison sample. The AF4Q program sparked a few alliances to develop robust consumer engagement programming, while most alliances tried consumer engagement efforts for the first time and developed an appreciation for integrating consumer perspectives into their work.

Distance learning and the internet in respiratory therapy education.

PubMed

Varekojis, Sarah M; Sergakis, Georgianna G; Dunlevy, Crystal L; Foote, Elbie; Clutter, Jill

2011-11-01

The profession of respiratory therapy (RT) continues to grow both in number, due to population growth and an ever-increasing aging population, and scope of practice, due to both new and expanded roles and responsibilities in divergent areas of clinical practice. Instructional technology, including distance learning, will probably play a key role in training, educating, and assessing RT students to meet the increasing demand for practitioners. To assess current uses of distance learning and opinions concerning the appropriate use of distance education in RT education programs nationwide. A 13-item on-line survey was designed to collect information about the frequency of use of various types of distance education typically utilized in RT education programs. The survey was sent to directors of 343 Committee on Accreditation for Respiratory Care accredited programs of RT education that offer entry-level or advanced courses of study. The response rate was 50% (169 respondents). Fifty-two percent of the respondents indicated that their courses included some form of on-line learning component. Most directors anticipated that the distance composition of their course offerings will remain unchanged or increase in the near future. Our results indicate that, while distance education plays an important supportive role in RT education, there is still a preference for face-to-face instruction and Internet-facilitated courses among program directors. Program directors continue to view the laboratory and clinical settings as hands-on environments that require instructor supervision in order for students to demonstrate proficiency and critical thinking skills. When used appropriately, distance learning may be an efficient and effective approach to address the many barriers to education faced by the health workforce in general, including budget constraints, overloaded schedules, the need for on-the-job learning opportunities, and lack of access.

HealthNavigator: a mobile application for chronic disease screening and linkage to services at an urban Primary Health Network.

PubMed

Seneviratne, Martin G; Hersch, Fred; Peiris, David P

2018-03-26

Mobile applications (apps) are promising tools to support chronic disease screening and linkage to health services. They have the potential to increase healthcare access for vulnerable populations. The HealthNavigator app was developed to provide chronic disease risk assessments, linkage to local general practitioners (GPs) and lifestyle programs, and a personalised health report for discussion with a GP. Assessments were either self-administered or facilitated by community health workers through a Primary Health Network (PHN) initiative targeting ethnically diverse communities. In total, 1492 assessments (80.4% self-administered, 19.6% facilitated) were conducted over a 12-month period in Queensland, Australia. Of these, 26% of people screened came from postcodes representing the lowest quartile of socioeconomic disadvantage. When compared against self-administered assessments, subjects screened by the facilitated program were more likely to be born outside Australia (80.5 v. 33.2%, P<0.001), and to fall within a high risk category based on cardiovascular risk scores (19.8 v. 13.7%, P<0.01) and type 2 diabetes mellitus risk scores (58.0 v. 40.1%, P<0.001). Mobile apps embedded into PHN programs may be a useful adjunct for the implementation of community screening programs. Further research is needed to determine their effect on health service access and health outcomes.

National Dissemination of StrongWomen–Healthy Hearts: A Community-Based Program to Reduce Risk of Cardiovascular Disease Among Midlife and Older Women

PubMed Central

Seguin, Rebecca A.; Chui, Kenneth K. H.; Clark, Valerie; Corbin, Marilyn A.; Goldberg, Jeanne P.; Heidkamp-Young, Eleanor; Lichtenstein, Alice H.; Wiker, Nancy; Nelson, Miriam E.

2015-01-01

Objectives. We describe the national dissemination of an evidence-based community cardiovascular disease prevention program for midlife and older women using the RE-AIM (reach effectiveness adoption implementation maintenance) framework and share key lessons learned during translation. Methods. In a 2010 to 2014 collaboration between the StrongWomen program and the National Extension Association of Family and Consumer Sciences, we assessed reach, adoption, implementation, and maintenance using survey methods, and we assessed effectiveness using a pretest–posttest within-participants design, with weight change as the primary outcome. Results. Overall reach into the population was 15 per 10 000. Of 85 trained leaders, 41 (48%) adopted the program. During the 12-week intervention, weight decreased by 0.5 kilograms, fruit and vegetable intake increased by 2.1 servings per day, and physical activity increased by 1238 metabolic equivalent (MET)-minutes per week (all P < .001). Average fidelity score was 4.7 (out of possible 5). Eleven of 41 adopting leaders (27%) maintained the program. Conclusions. The StrongWomen–Healthy Hearts program can be implemented with high fidelity in a variety of settings while remaining effective. These data provide direction for program modification to improve impact as dissemination continues. PMID:26469644

Comparing protein and energy status of winter-fed white-tailed deer

USGS Publications Warehouse

Page, B.D.; Underwood, H.B.

2006-01-01

Although nutritional status in response to controlled feeding trials has been extensively studied in captive white-tailed deer (Odocoileus virginianus), there remains a considerable gap in understanding the influence of variable supplemental feeding protocols on free-ranging deer. Consequently, across the northern portion of the white-tailed deer range, numerous property managers are investing substantial resources into winter supplemental-feeding programs without adequate tools to assess the nutritional status of their populations. We studied the influence of a supplemental winter feeding gradient on the protein and energy status of free-ranging white-tailed deer in the Adirondack Mountains of New York. We collected blood and fecal samples from 31 captured fawns across 3 sites that varied considerably in the frequency, quantity, and method of supplemental feed distribution. To facilitate population-wide comparisons, we collected fresh fecal samples off the snow at each of the 3 sites with supplemental feeding and 1 reference site where no feeding occurred. Results indicated that the method of feed distribution, in addition to quantity and frequency, can affect the nutritional status of deer. The least intensively fed population showed considerable overlap in diet quality with the unfed population in a principal components ordination, despite the substantial time and financial resources invested in the feeding program. Data from fecal samples generally denoted a gradient in diet quality and digestibility that corresponded with the availability of supplements. Our results further demonstrated that fecal nitrogen and fecal fiber, indices of dietary protein and digestibility, can be estimated using regressions of fecal pellet mass, enabling a rapid qualitative assessment of diet quality.

The First National Study of Neighborhood Parks

PubMed Central

Cohen, Deborah A.; Han, Bing; Nagel, Catherine; Harnik, Peter; McKenzie, Thomas L.; Evenson, Kelly R.; Marsh, Terry; Williamson, Stephanie; Vaughan, Christine; Katta, Sweatha

2016-01-01

Introduction An extensive infrastructure of neighborhood parks supports leisure time physical activity in most U.S. cities; yet, most Americans do not meet national guidelines for physical activity. Neighborhood parks have never been assessed nationally to identify their role in physical activity. Methods Using a stratified multistage sampling strategy, a representative sample of 174 neighborhood parks in 25 major cities (population >100,000) across the U.S. was selected. Park use, park-based physical activity, and park conditions were observed during a typical week using systematic direct observation during spring/summer of 2014. Park administrators were interviewed to assess policies and practices. Data were analyzed in 2014–2015 using repeated-measure negative binomial regressions to estimate weekly park use and park-based physical activity. Results Nationwide, the average neighborhood park of 8.8 acres averaged 23 users/hour or an estimated 1,533 person hours of weekly use. Walking loops and gymnasia each generated 221 hours/week of moderate to vigorous physical activity. Seniors represented 4% of park users, but 20% of the general population. Parks were used less in low-income than in high-income neighborhoods, largely explained by fewer supervised activities and marketing/outreach efforts. Programming and marketing were associated with 37% and 63% more hours of moderate to vigorous physical activity/week in parks, respectively. Conclusions The findings establish national benchmarks for park use, which can guide future park investments and management practices to improve population health. Offering more programming, using marketing tools like banners and posters, and installing facilities like walking loops may help currently underutilized parks increase population physical activity. PMID:27209496

The Role of Dog Population Management in Rabies Elimination—A Review of Current Approaches and Future Opportunities

PubMed Central

Taylor, Louise H.; Wallace, Ryan M.; Balaram, Deepashree; Lindenmayer, Joann M.; Eckery, Douglas C.; Mutonono-Watkiss, Beryl; Parravani, Ellie; Nel, Louis H.

2017-01-01

Free-roaming dogs and rabies transmission are integrally linked across many low-income countries, and large unmanaged dog populations can be daunting to rabies control program planners. Dog population management (DPM) is a multifaceted concept that aims to improve the health and well-being of free-roaming dogs, reduce problems they may cause, and may also aim to reduce dog population size. In theory, DPM can facilitate more effective rabies control. Community engagement focused on promoting responsible dog ownership and better veterinary care could improve the health of individual animals and dog vaccination coverage, thus reducing rabies transmission. Humane DPM tools, such as sterilization, could theoretically reduce dog population turnover and size, allowing rabies vaccination coverage to be maintained more easily. However, it is important to understand local dog populations and community attitudes toward them in order to determine whether and how DPM might contribute to rabies control and which DPM tools would be most successful. In practice, there is very limited evidence of DPM tools achieving reductions in the size or turnover of dog populations in canine rabies-endemic areas. Different DPM tools are frequently used together and combined with rabies vaccinations, but full impact assessments of DPM programs are not usually available, and therefore, evaluation of tools is difficult. Surgical sterilization is the most frequently documented tool and has successfully reduced dog population size and turnover in a few low-income settings. However, DPM programs are mostly conducted in urban settings and are usually not government funded, raising concerns about their applicability in rural settings and sustainability over time. Technical demands, costs, and the time necessary to achieve population-level impacts are major barriers. Given their potential value, we urgently need more evidence of the effectiveness of DPM tools in the context of canine rabies control. Cheaper, less labor-intensive tools for dog sterilization will be extremely valuable in realizing the potential benefits of reduced population turnover and size. No one DPM tool will fit all situations, but if DPM objectives are achieved dog populations may be stabilized or even reduced, facilitating higher dog vaccination coverages that will benefit rabies elimination efforts. PMID:28740850

Estimating site occupancy and detection probability parameters for meso- and large mammals in a coastal eosystem

USGS Publications Warehouse

O'Connell, Allan F.; Talancy, Neil W.; Bailey, Larissa L.; Sauer, John R.; Cook, Robert; Gilbert, Andrew T.

2006-01-01

Large-scale, multispecies monitoring programs are widely used to assess changes in wildlife populations but they often assume constant detectability when documenting species occurrence. This assumption is rarely met in practice because animal populations vary across time and space. As a result, detectability of a species can be influenced by a number of physical, biological, or anthropogenic factors (e.g., weather, seasonality, topography, biological rhythms, sampling methods). To evaluate some of these influences, we estimated site occupancy rates using species-specific detection probabilities for meso- and large terrestrial mammal species on Cape Cod, Massachusetts, USA. We used model selection to assess the influence of different sampling methods and major environmental factors on our ability to detect individual species. Remote cameras detected the most species (9), followed by cubby boxes (7) and hair traps (4) over a 13-month period. Estimated site occupancy rates were similar among sampling methods for most species when detection probabilities exceeded 0.15, but we question estimates obtained from methods with detection probabilities between 0.05 and 0.15, and we consider methods with lower probabilities unacceptable for occupancy estimation and inference. Estimated detection probabilities can be used to accommodate variation in sampling methods, which allows for comparison of monitoring programs using different protocols. Vegetation and seasonality produced species-specific differences in detectability and occupancy, but differences were not consistent within or among species, which suggests that our results should be considered in the context of local habitat features and life history traits for the target species. We believe that site occupancy is a useful state variable and suggest that monitoring programs for mammals using occupancy data consider detectability prior to making inferences about species distributions or population change.

Education for all draws upon population education messages.

PubMed

1991-01-01

In May 1991, UNESCO and the Ministry of Education of Pakistan sponsored a Regional Workshop for the Integration of Population Education in Asia-Pacific Programme of Education for All in Islamabad, Pakistan. Prior to the workshop, resource persons and experts met to develop guidelines for participants that were geared towards curriculum and material needs and core population education messages. 1 workshop group addressed integration of population education messages into primary education and the other into literacy programs. All participants observed and analyzed the problems and needs of a Muslim community and Saidpur village. The 1st group visited primary schools and spoke to teachers. The participants agreed that population education messages should be integrated into social studies, science, languages, and religion subjects at grade levels 3-5. The messages should include population related beliefs and values, problems of population growth, small family size, responsible parenthood, sex preference, population and development, the role of elders, and improving the status of women. They tested 4 of 11 developed lesson plans. Both teachers and students were generally pleased, but believed that posters and illustrations would better the plans. The other group conducted a needs assessment survey among 27 Muslim families. Participants found 100 population related issues that needed to be addressed in literacy programs. These issues fit into 6 categories and the group focused on social and cultural values and beliefs. Participants developed materials that highlighted several topics, such as early marriage and preference for males. They used puppet shows, puzzle games, posters and discussions, and story telling with pictures to communicate the messages. Puppet shows were the most popular method among housewives.

Population trends and survival of nesting green sea turtles Chelonia mydas on Aves Island, Venezuela

USGS Publications Warehouse

Garcia-Cruz, Marco A.; Lampo, Margarita; Peñaloza, Claudia L.; Kendall, William L.; Solé, Genaro; Rodriguez-Clark, Kathryn M.

2015-01-01

Long-term demographic data are valuable for assessing the effect of anthropogenic impacts on endangered species and evaluating recovery programs. Using a 2-state open robust design model, we analyzed mark-recapture data from green turtles Chelonia mydas sighted between 1979 and 2009 on Aves Island, Venezuela, a rookery heavily impacted by human activities before it was declared a wildlife refuge in 1972. Based on the encounter histories of 7689 nesting females, we estimated the abundance, annual survival, and remigration intervals for this population. Female survival varied from 0.14-0.91, with a mean of 0.79, which is low compared to survival of other populations from the Caribbean (mean = 0.84) and Australia (mean = 0.95), even though we partially corrected for tag loss, which is known to negatively bias survival estimates. This supports prior suggestions that Caribbean populations in general, and the Aves Island population in particular, may be more strongly impacted than populations elsewhere. It is likely that nesters from this rookery are extracted while foraging in remote feeding grounds where hunting still occurs. Despite its relatively low survival, the nesting population at Aves Island increased during the past 30 years from approx. 500 to >1000 nesting females in 2009. Thus, this population, like others in the Caribbean and the Atlantic, seems to be slowly recovering following protective management. Although these findings support the importance of long-term conservation programs aimed at protecting nesting grounds, they also highlight the need to extend management actions to foraging grounds where human activities may still impact green turtle populations.

1980 ASEAN programme roundup: a model in the making.

PubMed

1981-01-01

Association of Southeast Asian Nations (ASEAN) experts and heads of national population programs held their 4th meeting in Singapore from November 24-28, 1980. Program heads resolved to take steps to link their national activities in the population field with those of the ASEAN Population Program and carry out studies and a joint programming exercise in 1981. Progress reports on the following Phase 1 projects were given: 1) integration of population and rural development policies and programs in ASEAN countries including Indonesia, Malaysia, Philippines, Singapore, and Thailand; 2) development of an inter-country modular training program for personnel in population and rural development; 3) multi-media support for population programs in the context of rural development in ASEAN countries; 4) utilization of research findings in population and family planning for policy formulation and program management in ASEAN countries; and 5) migration in relation to rural development. Phase 2 projects approved by ASEAN country participants were also discussed: 1) institutional development and exchange of personnel, 2) women in development, 3) developing and strengthening national population information systems and networks in ASEAN countries, 4) population and development dynamics and the man/resource balance, 5) studies on health and family planning in ASEAN countries, 6) population migration movement and development, and 7) development of ASEAN social indicators.

Framework for a ground-water quality monitoring and assessment program for California

USGS Publications Warehouse

Belitz, Kenneth; Dubrovsky, Neil M.; Burow, Karen; Jurgens, Bryant C.; John, Tyler

2003-01-01

The State of California uses more ground water than any other State in the Nation. With a population of over 30 million people, an agricultural economy based on intensive irrigation, large urban industrial areas, and naturally elevated concentrations of some trace elements, there is a wide range of contaminant sources that have the potential to contaminate ground water and limit its beneficial uses. In response to the many-and different-potential sources of ground-water contamination, the State of California has evolved an extensive set of rules and programs to protect ground-water quality, and agencies to implement the rules and programs. These programs have in common a focus on compliance with regulations governing chemical use and (or) ground-water quality. Although appropriate for, and successful at, their specific missions, these programs do not at present provide a comprehensive view of ground-water quality in the State of California. In October 2001, The California Assembly passed a bill, AB 599, establishing the Ground-Water- Quality Monitoring Act of 2001.' The goal of AB 599 is to improve Statewide comprehensive ground-water monitoring and increase availability of information about ground-water quality to the public. AB 599 requires the State Water Resources Control Board (SWRCB), in collaboration with an interagency task force (ITF) and a public advisory committee (PAC), to develop a plan for a comprehensive ground-water monitoring program. AB 599 specifies that the comprehensive program should be capable of assessing each ground-water basin in the State through direct and other statistically reliable sampling approaches, and that the program should integrate existing monitoring programs and design new program elements, as necessary. AB 599 also stresses the importance of prioritizing ground-water basins that provide drinking water. The United States Geological Survey (USGS), in cooperation with the SWRCB, and in coordination with the ITF and PAC, has developed a framework for a comprehensive ground-water-quality monitoring and assessment program for California. The proposed framework relies extensively on previous work conducted by the USGS through its National Water-Quality Assessment (NAWQA) program. In particular, the NAWQA program defines three types of ground-water assessment: (1) status, the assessment of the current quality of the ground-water resource; (2) trends, the detection of changes in water quality, and (3) understanding, assessing the human and natural factors that affect ground-water quality. A Statewide, comprehensive ground-water quality-monitoring and assessment program is most efficiently accomplished by applying uniform and consistent study-design and data-collection protocols to the entire State. At the same time, a comprehensive program should be relevant at a variety of scales, and therefore needs to retain flexibility to address regional and local issues. Consequently, many of the program components include a predominant element that will be consistently applied in all basins, and a secondary element that may be applied in specific basins where local conditions warrant attention.

Economic interventions to improve population health: a scoping study of systematic reviews.

PubMed

Khan, Mishal S; Guan, Bernie Y; Audimulam, Jananie; Cervero Liceras, Francisco; Coker, Richard J; Yoong, Joanne

2016-07-07

Recognizing the close relationship between poverty and health, national program managers, policy-makers and donors are increasingly including economic interventions as part of their core strategies to improve population health. However, there is often confusion among stakeholders about the definitions and operational differences between distinct types of economic interventions and financial instruments, which can lead to important differences in interpretation and expectations. We conducted a scoping study to define and clarify concepts underlying key economic interventions - price interventions (taxes and subsidies), income transfer programs, incentive programs, livelihood support programs and health-related financial services - and map the evidence currently available from systematic reviews. We identified 195 systematic reviews on economic interventions published between 2005 and July 2015. Overall, there was an increase in the number of reviews published after 2010. The majority of reviews focused on price interventions, income transfer programs and incentive programs, with much less evidence available from systematic reviews on livelihood support programs and health-related financial services. We also identified a lack of evidence on: health outcomes in low income countries; unintended or perverse outcomes; implementation challenges; scalability and cost-effectiveness of economic interventions. We conclude that while more research is clearly needed to assess suitability and effectiveness of economic interventions in different contexts, before interventions are tested and further systematic reviews conducted, a consistent and accurate understanding of the fundamental differences in terminology and approaches is essential among researchers, public health policy makers and program planners.

Physical activity promotion among underserved adolescents: "make it fun, easy, and popular".

PubMed

Louise Bush, Paula; Laberge, Suzanne; Laforest, Sophie

2010-05-01

There is a paucity of studies regarding noncurricular physical activity promotion interventions among adolescents, and even less such research pertaining to underserved youth. This article describes the development and implementation of a noncurricular, school-based physical activity promotion program designed for a multiethnic, underserved population of adolescents. The program's impact on leisure-time physical activity (LTPA) and on physical activity enjoyment (PAE) is also presented. The 16-week program, named FunAction, utilizes social marketing principles. Control (n = 90) and intervention (n = 131) students are assessed pre- and postintervention for levels of LTPA and PAE. Results indicate that although the program did not contribute to an increase in LTPA or PAE among intervention group students, participation in the program was elevated. This study offers preliminary evidence that noncurricular physical activity promotion programs that apply social marketing principles can be effective in engaging multiethnic, underserved adolescents in physical activity.

Training Medical Students for Rural, Underserved Areas: A Rural Medical Education Program in California.

PubMed

Eidson-Ton, W Suzanne; Rainwater, Julie; Hilty, Donald; Henderson, Stuart; Hancock, Christine; Nation, Cathryn L; Nesbitt, Thomas

2016-01-01

The Association of American Medical Colleges projects an increasing shortage of physicians in rural areas. Medical schools have developed specialty track programs to improve the recruitment and retention of physicians who can serve rural populations. One such program in California includes a variety of unique elements including outreach, admissions, rural clinical experiences, focused mentorship, scholarly and leadership opportunities, and engagement with rural communities. Preliminary outcomes demonstrate that this rural track program has achieved some success in the recruitment, retention, and training of students interested in future rural practice and in the placement of students in primary care residencies. Long-term outcomes, such as graduates entering rural practice, are still unknown, but will be monitored to assess the impact and sustainability of the rural program. This article illustrates the opportunities and challenges of training medical students for rural practice and provides lessons learned to inform newly-established and long standing rural medical education programs.

Prompt Assessment of Global Earthquakes for Response (PAGER): A System for Rapidly Determining the Impact of Earthquakes Worldwide

USGS Publications Warehouse

Earle, Paul S.; Wald, David J.; Jaiswal, Kishor S.; Allen, Trevor I.; Hearne, Michael G.; Marano, Kristin D.; Hotovec, Alicia J.; Fee, Jeremy

2009-01-01

Within minutes of a significant earthquake anywhere on the globe, the U.S. Geological Survey (USGS) Prompt Assessment of Global Earthquakes for Response (PAGER) system assesses its potential societal impact. PAGER automatically estimates the number of people exposed to severe ground shaking and the shaking intensity at affected cities. Accompanying maps of the epicentral region show the population distribution and estimated ground-shaking intensity. A regionally specific comment describes the inferred vulnerability of the regional building inventory and, when available, lists recent nearby earthquakes and their effects. PAGER's results are posted on the USGS Earthquake Program Web site (http://earthquake.usgs.gov/), consolidated in a concise one-page report, and sent in near real-time to emergency responders, government agencies, and the media. Both rapid and accurate results are obtained through manual and automatic updates of PAGER's content in the hours following significant earthquakes. These updates incorporate the most recent estimates of earthquake location, magnitude, faulting geometry, and first-hand accounts of shaking. PAGER relies on a rich set of earthquake analysis and assessment tools operated by the USGS and contributing Advanced National Seismic System (ANSS) regional networks. A focused research effort is underway to extend PAGER's near real-time capabilities beyond population exposure to quantitative estimates of fatalities, injuries, and displaced population.

Challenges to Native American health care.

PubMed

Noren, J; Kindig, D; Sprenger, A

1998-01-01

Native American health care programs face complex and unprecedented challenges resulting from the increased assumption of clinical operations by tribal authorities, shortfalls in Federal funding, modifications in state and Federal health and welfare programs, and intensifying involvement with managed care organizations. These challenges are further complicated by service populations that are increasing at a faster rate than the growth in funding. The authors conducted onsite surveys of 39 Native American health programs in 10 states in order to assess the organizational and management problems they faced. The trend toward transfer of health programs from the Indian Health Service to tribal operation seems likely to continue and accelerate. The survey results indicate that in order for programs to be effective in the long run, they will need to be guided by skilled managers able to adapt to these powerful changes in the health care environment.

Programmatic management of multidrug-resistant tuberculosis: models from three countries.

PubMed

Furin, J; Bayona, J; Becerra, M; Farmer, P; Golubkov, A; Hurtado, R; Joseph, J K; Keshavjee, S; Ponomarenko, O; Rich, M; Shin, S

2011-10-01

Although multidrug-resistant tuberculosis (MDR-TB) is a major global health problem, there is a gap in programmatic treatment implementation. This study describes MDR-TB treatment models in three countries--Peru, Russia and Lesotho-- using qualitative data collected over a 13-year period. A program analysis is presented for each country focusing on baseline medical care, initial implementation and program evolution. A pattern analysis revealed six overarching themes common to all three programs: 1) importance of baseline assessments, 2) early identification of key collaborators, 3) identification of initial locus of care, 4) minimization of patient-incurred costs, 5) targeted interventions for vulnerable populations and 6) importance of technical assistance and funding. Site commonalities and differences in each of these areas were analyzed. It is recommended that all programs providing MDR-TB treatment address these six areas during program development and implementation.

Computer-Guided Deep Brain Stimulation Programming for Parkinson's Disease.

PubMed

Heldman, Dustin A; Pulliam, Christopher L; Urrea Mendoza, Enrique; Gartner, Maureen; Giuffrida, Joseph P; Montgomery, Erwin B; Espay, Alberto J; Revilla, Fredy J

2016-02-01

Pilot study to evaluate computer-guided deep brain stimulation (DBS) programming designed to optimize stimulation settings using objective motion sensor-based motor assessments. Seven subjects (five males; 54-71 years) with Parkinson's disease (PD) and recently implanted DBS systems participated in this pilot study. Within two months of lead implantation, the subject returned to the clinic to undergo computer-guided programming and parameter selection. A motion sensor was placed on the index finger of the more affected hand. Software guided a monopolar survey during which monopolar stimulation on each contact was iteratively increased followed by an automated assessment of tremor and bradykinesia. After completing assessments at each setting, a software algorithm determined stimulation settings designed to minimize symptom severities, side effects, and battery usage. Optimal DBS settings were chosen based on average severity of motor symptoms measured by the motion sensor. Settings chosen by the software algorithm identified a therapeutic window and improved tremor and bradykinesia by an average of 35.7% compared with baseline in the "off" state (p < 0.01). Motion sensor-based computer-guided DBS programming identified stimulation parameters that significantly improved tremor and bradykinesia with minimal clinician involvement. Automated motion sensor-based mapping is worthy of further investigation and may one day serve to extend programming to populations without access to specialized DBS centers. © 2015 International Neuromodulation Society.

Cardiovascular Health Awareness Program (CHAP): a community cluster-randomised trial among elderly Canadians.

PubMed

Kaczorowski, Janusz; Chambers, Larry W; Karwalajtys, Tina; Dolovich, Lisa; Farrell, Barbara; McDonough, Beatrice; Sebaldt, Rolf; Levitt, Cheryl; Hogg, William; Thabane, Lehana; Tu, Karen; Goeree, Ron; Paterson, J Michael; Shubair, Mamdouh; Gierman, Tracy; Sullivan, Shannon; Carter, Megan

2008-06-01

High blood pressure is an important and modifiable cardiovascular disease risk factor that remains under-detected and under-treated. Community-level interventions that address high blood pressure and other modifiable risk factors are a promising strategy to improve cardiovascular health in populations. The present study is a community cluster-randomised trial testing the effectiveness of CHAP (Cardiovascular Health Awareness Program) on the cardiovascular health of older adults. Thirty-nine mid-sized communities in Ontario, Canada were stratified by geographic location and size of the population aged >or=65 years and randomly allocated to receive CHAP or no intervention. In CHAP communities, residents aged >or=65 years were invited to attend cardiovascular risk assessment sessions held in pharmacies over 10 weeks in Fall, 2006. Sessions included blood pressure measurement and feedback to family physicians. Trained volunteers delivered the program with support from pharmacists, community nurses and local organisations. The primary outcome measure is the relative change in the mean annual rate of hospital admission for acute myocardial infarction, congestive heart failure and stroke (composite end-point) among residents aged >or=65 years in intervention and control communities, using routinely collected, population-based administrative health data. This paper highlights considerations in design, implementation and evaluation of a large-scale, community-wide cardiovascular health promotion initiative.

White-tailed deer harvest from the chronic wasting disease eradication zone in south-central Wisconsin

USGS Publications Warehouse

Blanchong, Julie A.; Joly, D.O.; Samuel, M.D.; Langenberg, J.A.; Rolley, R.E.; Sausen, J.F.

2006-01-01

Chronic wasting disease (CWD) was discovered in free-ranging white-tailed deer (Odocoileus virginianus) in south-central Wisconsin in 2002. The current control method for CWD in the state is the harvest of deer from affected areas to reduce population density and lower CWD transmission. We used spatial regression methods to identify factors associated with deer harvest across south-central Wisconsin. Harvest of deer by hunters was positively related to deer density (slope=0.003, 95% CI=0.0001-0.006), the number of landowners that requested harvest permits (slope=0.071, 95% CI=0.037-0.105), and proximity to the area of highest CWD infection (slope=-0.041, 95% CI=-0.056- -0.027). Concomitantly, harvest was not impacted in areas where landowners signed a petition protesting intensive deer reduction (slope=-0.00006, 95% CI=-0.0005-0.0003). Our results suggest that the success of programs designed to reduce deer populations for disease control or to reduce overabundance in Wisconsin are dependent on landowner and hunter participation. We recommend that programs or actions implemented to eradicate or mitigate the spread of CWD should monitor and assess deer population reduction and evaluate factors affecting program success to improve methods to meet management goals.

Randomized Trial of a Family-based, Automated, Conversational Obesity Treatment Program for Underserved Populations

PubMed Central

Wright, J. A.; Phillips, B.D.; Watson, B.L.; Newby, P.K.; Norman, G. J.; Adams, W.G.

2013-01-01

Objective To evaluate the acceptability and feasibility of a scalable obesity treatment program integrated with pediatric primary care and delivered using interactive voice technology (IVR) to families from underserved populations. Design and Methods Fifty parent-child dyads (child 9–12 yrs, BMI >95th percentile) were recruited from a pediatric primary care clinic and randomized to either an IVR or a wait-list control (WLC) group. The majority were lower-income, African-American (72%) families. Dyads received IVR calls for 12 weeks. Call content was informed by two evidenced-based interventions. Anthropometric and behavioral variables were assessed at baseline and 3 mo follow-up. Results Forty-three dyads completed the study. IVR parents ate 1 cup more fruit than WLC (p < .05). No other groups differences were found. Children classified as high users of the IVR decreased weight, BMI and BMI z-score compared to low users (p<.05). Mean number of calls for parents and children were 9.1 (5.2 SD) and 9.0 (5.7 SD), respectively. Of those who made calls, >75% agreed that the calls were useful, made for people like them, credible, and helped them eat healthy foods. Conclusion An obesity treatment program delivered via IVR may be an acceptable and feasible resource for families from underserved populations. PMID:23512915

Mixed-Methods for Comparing Tobacco Cessation Interventions.

PubMed

Momin, Behnoosh; Neri, Antonio; Zhang, Lei; Kahende, Jennifer; Duke, Jennifer; Green, Sonya Goode; Malarcher, Ann; Stewart, Sherri L

2017-03-01

The National Comprehensive Cancer Control Program (NCCCP) and National Tobacco Control Program (NTCP) are both well-positioned to promote the use of population-based tobacco cessation interventions, such as state quitlines and Web-based interventions. This paper outlines the methodology used to conduct a comparative effectiveness research study of traditional and Web-based tobacco cessation and quitline promotion approaches. A mixed-methods study with three components was designed to address the effect of promotional activities on service usage and the comparative effectiveness of population-based smoking cessation activities across multiple states. The cessation intervention component followed 7,902 smokers (4,307 quitline users and 3,595 Web intervention users) to ascertain prevalence of 30-day abstinence rates 7 months after registering for smoking cessation services. User characteristics and quit success was compared across the two modalities. In the promotions component, reach and use of traditional and innovative promotion strategies were assessed for 24 states, including online advertising, state Web sites, social media, mobile applications, and their effects on quitline call volume. The partnership intervention component studied the extent of collaboration among six selected NCCCPs and NTCPs. This study will guide program staff and clinicians with evidence-based recommendations and best practices for implementation of tobacco cessation within their patient and community populations and establish an evidence base that can be used for decision making.

Population movement can sustain STI prevalence in remote Australian indigenous communities.

PubMed

Hui, Ben B; Gray, Richard T; Wilson, David P; Ward, James S; Smith, Anthony M A; Philip, David J; Law, Matthew G; Hocking, Jane S; Regan, David G

2013-04-25

For almost two decades, chlamydia and gonorrhoea diagnosis rates in remote Indigenous communities have been up to 30 times higher than for non-Indigenous Australians. The high levels of population movement known to occur between remote communities may contribute to these high rates. We developed an individual-based computer simulation model to study the relationship between population movement and the persistence of gonorrhoea and chlamydia transmission within hypothetical remote communities. Results from our model suggest that short-term population movement can facilitate gonorrhoea and chlamydia persistence in small populations. By fixing the number of short-term travellers in accordance with census data, we found that these STIs can persist if at least 20% of individuals in the population seek additional partners while away from home and if the time away from home is less than 21 days. Periodic variations in travel patterns can contribute to increased sustainable levels of infection. Expanding existing STI testing and treatment programs to cater for short-term travellers is shown to be ineffective due to their short duration of stay. Testing and treatment strategies tailored to movement patterns, such as encouraging travellers to seek testing and treatment upon return from travel, will likely be more effective. High population mobility is likely to contribute to the high levels of STIs observed in remote Indigenous communities of Australia. More detailed data on mobility patterns and sexual behaviour of travellers will be invaluable for designing and assessing STI control programs in highly mobile communities.

Church-based health programs for mental disorders among African Americans: a review.

PubMed

Hankerson, Sidney H; Weissman, Myrna M

2012-03-01

African Americans underutilize traditional mental health services, compared with white Americans. The authors conducted a systematic review of studies involving church-based health promotion programs for mental disorders among African Americans to assess the feasibility of utilizing such programs to address racial disparities in mental health care. A literature review of MEDLINE, PsycINFO, CINAHL, and ATLA Religion databases was conducted to identify articles published between January 1, 1980, and December 31, 2009. Inclusion criteria were as follows: studies were conducted in a church; the primary objective involved assessment, perceptions and attitudes, education, prevention, group support, or treatment for DSM-IV mental disorders or their correlates; number of participants was reported; qualitative or quantitative data were reported; and African Americans were the target population. Of 1,451 studies identified, only eight met inclusion criteria. Five studies focused on substance-related disorders, six were designed to assess the effects of a specific intervention, and six targeted adults. One study focused on depression and was limited by a small sample size of seven participants. Although church-based health promotion programs have been successful in addressing racial disparities for several chronic medical conditions, the literature on such programs for mental disorders is extremely limited. More intensive research is needed to establish the feasibility and acceptability of utilizing church-based health promotion programs as a possible resource for screening and treatment to improve disparities in mental health care for African Americans.

Setting priorities for teaching and learning: an innovative needs assessment for a new family medicine program in Lao PDR.

PubMed

Kanashiro, Jeanie; Hollaar, Gwen; Wright, Bruce; Nammavongmixay, Khamphong; Roff, Sue

2007-03-01

Lao People's Democratic Republic (Lao PDR) is a small, tropical, landlocked country in southeast Asia. It is one of the least developed countries in the region, and its socioeconomic indicators are among the lowest 25% in the world. The World Health Organization has long called for increased equity in primary health care access around the world. To meet this need in Lao PDR, the Family Medicine Specialist Program was developed, a Lao-generated postgraduate training program designed to produce community-oriented primary care practitioners to serve the rural, remote areas of Lao PDR, where 80% of the population lives. An innovative method of needs assessment was required to determine the health care priorities to be met by this new program. Through the use of a modified Delphi technique, local key leaders in medical education, clinical specialists, and teachers were consulted to develop prioritized objectives for the hospital-based curriculum of the program. By setting priorities for teaching and learning in the unique and needy circumstances of Lao PDR, a novel approach to curriculum planning in a low-income country was explored and ultimately formed the foundation of the new curriculum. This process served to direct the allocation of scarce resources during implementation of this groundbreaking program. More importantly, this model of needs assessment could potentially be used to customize medical curricula in other low-income countries facing challenges similar to those in Lao PDR.

Mortality of American alligators attributed to cannibalism

USGS Publications Warehouse

Delany, Michael F.; Woodward, Allan R.; Kiltie, Richard A.; Moore, Clinton T.

2011-01-01

Mortality of juvenile (Alligator mississippiensis) attributed to cannibalism on Orange Lake, Florida was examined. Alligator web tags used in mark–recapture studies were found in 12% of 267 stomachs sampled from alligators ≥168 cm TL. Captive alligators retained 76% of force-fed tags during a 588-d tag-retention trial. Models relating the probability of tag recovery to the annual probabilities of juvenile survival, cannibalism, tag retention, adult survival, and adult harvest suggested that cannibalism may on average remove 6–7% of the juvenile alligator population annually. Vulnerability continued to 140 cm TL (age 6–8 yr). Cannibalism of juveniles may serve to regulate the alligator population on Orange Lake. Alligator cannibalism may vary widely among populations, depending on demography and environmental conditions. The role and importance of cannibalism in alligator population dynamics should be more fully assessed and environmental and population factors that influence cannibalism identified to better evaluate management programs.

[Nutritional status of beneficiaries of the ¨Bolsa Família¨ Program in Brazil - a systematic review].

PubMed

Wolf, Miriam Regina; Barros Filho, Antonio de Azevedo

2014-05-01

Various programs to combat malnutrition have been implemented over the years in Brazil. Since 2001, it has been the responsibility of the Bolsa Família Program (BFP). Despite the expansion of BFP, to date there has been little coverage charting the advances and challenges to be faced as well as the impacts on health and nutrition of the population. Although the monitoring of nutritional status is one of the conditions for continuing to receive the benefit, when searching for this data, there is great difficulty in obtaining them. The scope of this systematic review is to obtain information on the nutritional status of the beneficiaries of the PBF, to grasp the national reality with regard to this situation, and assess whether the program had an impact on the nutritional status of the population served. A search was conducted online via Medline, Bireme, SciELO, Lilacs, University Libraries System (ULS) and Google. The search includes original articles and theses from March 2002 through May 2012 and approximately100 works were located. After excluding the title there were 23 articles, and after reading the abstracts, 13 articles remained. The studies reviewed suggest that the Program is not modifying the nutritional status of the beneficiaries.

Health benefits of aerobic training programs in adults aged 70 and over: a systematic review.

PubMed

Bouaziz, Walid; Vogel, Thomas; Schmitt, Elise; Kaltenbach, Georges; Geny, Bernard; Lang, Pierre Olivier

Aging is intrinsically associated with a progressive decline in muscle strength and mass, and aerobic capacity. This contributes to reduced mobility and impaired quality of life (QoL) among seniors. Regular physical activity, and more particularly aerobic training (AT), has demonstrated benefits on adults' health. The aim of this review was to assess the current level of evidence regarding the health benefits of AT in the population aged 70 years and over. A comprehensive, systematic database search for manuscripts was performed. Two reviewers independently assessed interventional studies for potential inclusion. Cardiovascular, metabolic, functional, cognitive, and QoL outcomes were targeted. Fifty-three studies were included totalling 2051 seniors aged 70 years and over. Studies selected were divided into 5 categories according to their main outcomes: cardiovascular function (34 studies), metabolic outcomes (26 studies), functional fitness (19 studies), cognitive functions (8 studies), and QoL (3 studies). With a good level of evidence but a wide heterogeneity between study designs, a significant and beneficial effect of AT was measured on the 5 outcomes. For QoL results showed a significant but slighter improvement. This systematic review highlights the benefits of AT on seniors' health outcome such as cardiovascular, functional, metabolic, cognitive, and QoL outcomes although the optimal program remains unclear. When more studies regarding this specific population are needed to determine the most favourable exercise program, clinicians should nevertheless encourage older adults over 70 to participate in AT programs to favour active and healthy ageing. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Effectiveness of a combination prevention strategy for HIV risk reduction with men who have sex with men in Central America: a mid-term evaluation.

PubMed

Firestone, Rebecca; Rivas, Jorge; Lungo, Susana; Cabrera, Alejandra; Ruether, Susan; Wheeler, Jennifer; Vu, Lung

2014-12-04

Despite over a decade of research and programming, little evidence is available on effective strategies to reduce HIV risks among Central American men who have sex with men (MSM). The Pan-American Social Marketing Organization (PASMO) and partners are implementing a HIV Combination Prevention Program to provide key populations with an essential package of prevention interventions and services: 1) behavioral, including interpersonal communications, and online outreach; 2) biomedical services including HIV testing and counseling and screening for STIs; and 3) complementary support, including legal support and treatment for substance abuse. Two years into implementation, we evaluated this program's effectiveness for MSM by testing whether exposure to any or a combination of program components could reduce HIV risks. PASMO surveyed MSM in 10 cities across Guatemala, El Salvador, Nicaragua, Costa Rica, and Panama in 2012 using respondent-driven sampling. We used coarsened exact matching to create statistically equivalent groups of men exposed and non-exposed to the program, matching on education, measures of social interaction, and exposure to other HIV prevention programs. We estimated average treatment effects of each component and all combined to assess HIV testing and condom use outcomes, using multivariable logistic regression. We also linked survey data to routine service data to assess program coverage. Exposure to any program component was 32% in the study area (n = 3531). Only 2.8% of men received all components. Men exposed to both behavioral and biomedical components were more likely to use condoms and lubricant at last sex (AOR 3.05, 95% CI 1.08, 8.64), and those exposed to behavioral interventions were more likely to have tested for HIV in the past year (AOR 1.76, 95% CI 1.01, 3.10). PASMO's strategies to reach MSM with HIV prevention programming are still achieving low levels of population coverage, and few men are receiving the complete essential package. However, those reached are able to practice HIV prevention. Combination prevention is a promising approach in Central America, requiring expansion in coverage and intensity.

Development of a self-report questionnaire designed for population-based surveillance of gingivitis in adolescents: assessment of content validity and reliability

PubMed Central

QUIROZ, Viviana; REINERO, Daniela; HERNÁNDEZ, Patricia; CONTRERAS, Johanna; VERNAL, Rolando; CARVAJAL, Paola

2017-01-01

Abstract The major infectious diseases in Chile encompass the periodontal diseases, with a combined prevalence that rises up to 90% of the population. Thus, the population-based surveillance of periodontal diseases plays a central role for assessing their prevalence and for planning, implementing, and evaluating preventive and control programs. Self-report questionnaires have been proposed for the surveillance of periodontal diseases in adult populations world-wide. Objective This study aimed to develop and assess the content validity and reliability of a cognitively adapted self-report questionnaire designed for surveillance of gingivitis in adolescents. Material and Methods Ten predetermined self-report questions evaluating early signs and symptoms of gingivitis were preliminary assessed by a panel of clinical experts. Eight questions were selected and cognitively tested in 20 adolescents aged 12 to 18 years from Santiago de Chile. The questionnaire was then conducted and answered by 178 Chilean adolescents. Internal consistency was measured using the Cronbach’s alpha and temporal stability was calculated using the Kappa-index. Results A reliable final self-report questionnaire consisting of 5 questions was obtained, with a total Cronbach’s alpha of 0.73 and a Kappa-index ranging from 0.41 to 0.77 between the different questions. Conclusions The proposed questionnaire is reliable, with an acceptable internal consistency and a temporal stability from moderate to substantial, and it is promising for estimating the prevalence of gingivitis in adolescents. PMID:28877279