Geospatial Variation in Caesarean Delivery

Aim: The purpose of this study was to evaluate the variation in caesarean delivery rates across counties in Georgia and to determine whether county-level characteristics were associated with clusters. Design: This was a retrospective, observational study. Methods: Rates of primary and repeat caesarean by maternal county of residence were calculated for 2008 through 2012. Global Moran\u27s I (Spatial Autocorrelation) was used to identify geographic clustering. Characteristics of high and low-rate counties were compared using student\u27s t test and chi squared test. Results: Spatial analysis of both primary and repeat caesarean rate identified the presence of clusters (Moran\u27s I = 0.375; p \u3c .001). Counties in high-rate clusters had significantly lower access to midwives, more deliveries paid by Medicaid, higher proportion of births for women belonging to racial/ethnic minority groups and were more likely to be rural

Relational Agency in Professional Practice: A CHAT Analysis

Cultural Historical Activity Theory (CHAT)is a useful framework for examining learning to become a professional. This is particularly the case when professional practice is seen to be developed within specific institutional settings. However, new forms of practice are being required which call for a capacity to work with other practitioners and draw on resources that may be distributed across systems to support professional actions. In this paper the concept of relational agency is described and illustrated with reference to a series of research studies. It is argued that relational agency leads to an enhanced form of professional agency and that there are implications for the development of CHAT

Should I Say Something? Dating and Sexual Aggression Bystander Intervention Among High School Youth

Using data from a sample of 218 high school youth from three high schools in New England (one rural, two urban), this brief discusses dating and sexual aggression bystander intervention among high school youth. Authors Katie Edwards, Robert Eckstein, and Kara Anne Rodenhizer-Stämpfli report that an overwhelming majority (93.6 percent) of high school students reported having the opportunity to intervene during the past year in situations of dating aggression or sexual aggression; however, in over one-third of the episodes (37.4 percent) students reported not intervening. Girls were more likely to intervene in situations of dating and sexual aggression than boys, and youth with histories of dating and sexual aggression were more likely to intervene than youth without these histories. Focus group data revealed that barriers to bystander intervention included avoidance of drama or a desire to fuel drama, social status and personal repercussions, closeness with the victim and/or perpetrator, the victim being male and the perpetrator female, the failure of the dating or sexual aggression to meet a certain threshold, the dating and sexual aggression occurring online, anticipated negative reactions from the perpetrator or victim, and an inability to relate to the situation. Given the mounting evidence that bystander education is a critical component of dat­ing and sexual aggression prevention, the authors urge policy makers and educators to enhance the presence of this type of education in high school health curricula and related course curricula

Resourceful leadership: how directors of children’s services improve outcomes for children, full report

Leading for Outcomes is a unique study into senior leadership in children’s services in England, drawing on in-depth primary research with leaders in eight local authorities, and 22 directors of children’s services. The eight local authorities were selected on a range of factors but primarily to represent existing high performers or rapidly improving authorities in terms of outcomes. The research was commissioned by the National College in partnership with C4EO, and completed by a team comprising Deloitte, Navigate and the University of Oxford. The study was completed during 2010. The key concept the Leading for Outcomes research has uncovered is that of the resourceful leader1. This report sets out a definition of resourcefulness and the eight core behaviours of resourceful leaders. It then discusses resourcefulness within three specific contexts that emerged as part of the research: leading change, leading in a time of shock, and managing the corporate and political landscape

Consumer and processor methods to control Salmonella and Listeria in shrimp

A common method used by consumers to determine if shrimp are thoroughly cooked when boiling, is to wait until the shrimp float to the top of the water and are pink in color. The purpose of this study was to determine whether the current floating and color cooking method is adequate to ensure the elimination of Listeria and Salmonella species. Furthermore, to determine if processing and storage methods reduce the effectiveness of this method. Shrimp samples were submerged into bacterial suspensions for 30 min then allowed to air dry for 1 hr and color parameters were measured using a colorimeter. Shrimp samples were separated into three groups; day 0, 1, or 2, and stored at 4ºC. The shrimp samples were then treated by placing into boiling water (100°C) on days 0 (inoculation day), 1 and 2. The shrimp were immediately removed from the boiling water once they started floating and color parameters were measured. Bacterial counts were determined by making serial dilutions, spread plating, incubating plates at 37°C for 24 h and calculating Log CFU/g. Typical storage conditions, the use of the additive sodium tripolyphosphate and freezing methods were then tested for their effect on the control of these pathogens in boiled shrimp. Initial bacterial counts ranged from 3.0 to 5.4 Log CFU/g of shrimp. On day 0, 1, and 2 all bacterial counts were reduced to non-detectable levels for shrimp samples that floated in the boiling water. The bacterial counts remained at non-detectable levels during refrigerated (4°C) storage. The redness (a*), yellowness (b*) and lightness (L*) were significantly higher (p\u3c0.0001) in the cooked shrimp compared to uncooked for all days tested. However, the standard deviation for the redness (a*) in the cooked shrimp was large indicating a wide range of pink coloration for all days tested. The flash freezing method led to development of heat resistance in Listeria monocytogenes. Brine freezing was determined to be a better method for microbial reduction. Our results suggest that boiling shrimp until they float will significantly reduce Listeria species and Salmonella species but color change will not and color variation can occur

Successful Integration of Internet Technology in the K-12 Classroom: Trends Perceptions and Successful Practices.

In 1994, the Federal Government made a commitment to link all classrooms, libraries, businesses, and industries to the information highway by the year 2000. President Clinton mandated that all classrooms in America be connected to the Internet by the year 2000. While many say this commitment and mandate have successfully occurred, there is still concern and questions about what successful integration of the Internet looks like and what specific practices can tap the bountiful resources available on the Internet. School systems have spent billions of dollars investing in hardware, software, and connection to the World Wide Web. Stakeholders demand accountability for time and money spent connecting our classrooms to the World Wide Web. Until educators fully understand what successful integration looks like in the K-12 schools, there will continue to be a digital divide for learners. In this qualitative study, which covers K-12 school systems in a three state area, the researcher interviewed system level supervisors of technology, building level administrators, and classroom teachers. The teachers selected for participation in this study were nominated by the administrators as teachers who demonstrate successful integration of Internet technology in the classroom. This study is an attempt to determine if there are trends, characteristics, or successful practices that other teachers could employ. Findings of the study include the importance of re-evaluating staff development related to the Internet and other technology issues. The results indicate that teachers are most receptive to learning from their peers and other teacher leaders when learning how to integrate the Internet into their classroom curricula. The importance of a planned vision, created by the stakeholders, concerning integration of Internet technology also emerged during the study. In addition, the study addresses the need for building level administrators to be better prepared in order to lead their schools in successful practices concerning integration of the Internet into school curricula

Doctor of Philosophy

dissertationNA22598A1 is a unique carbamoylated cyclic guanidine with a diol skipped diamine dipeptide. It was shown to have antimetastatic activity against DLD-1 colon cancer cells with an IC50 of 0.32 µM, but the absolute stereochemistry has yet to be confirmed. Guadinomine B is also a carbamoylated cyclic guanidine with a diol skipped diamine dipeptide. It was shown to inhibit the T3SS virulence system of Gram-negative bacteria with an IC50 of 0.014 µM. We endeavored to synthesize NA22598A1 and determine if it was mischaracterized at isolation. In addition, we investigated a potential mechanism of action that could produce both of the phenotypes exhibited by NA22598A1 and guadinomine B

Using a virtual cortical module implementing a neural field model to modulate brain rhythms in Parkinson’s disease

We propose a new method for selective modulation of cortical rhythms based on neural field theory, in which the activity of a cortical area is extensively monitored using a two-dimensional microelectrode array. The example of Parkinson’s disease illustrates the proposed method, in which a neural field model is assumed to accurately describe experimentally recorded activity. In addition, we propose a new closed-loop stimulation signal that is both space- and time- dependent. This method is especially designed to specifically modulate a targeted brain rhythm, without interfering with other rhythms. A new class of neuroprosthetic devices is also proposed, in which the multielectrode array is seen as an artificial neural network interacting with biological tissue. Such a bio-inspired approach may provide a solution to optimize interactions between the stimulation device and the cortex aiming to attenuate or augment specific cortical rhythms. The next step will be to validate this new approach experimentally in patients with Parkinson’s disease

Emergency Department Use for Nontraumatic Dental Conditions and Adult Oral Health

Nontraumatic dental-related emergency department visits has resulted in a financial burden to hospitals across the United States. This study investigated whether there is a relationship between adult preventive dental care and emergency department visits for nontraumatic dental conditions by comparing specific states. Guided by Andersen\u27s behavioral model of health services utilization, this retrospective quantitative study also investigated associations between state-specific community water fluoridation and dental-related emergency department visits. The population of interest was adult Medicaid enrollees who visited the emergency department for non-trauma-related dental conditions in the top 5 most populous states as identified in the 2012 NHAMCS survey. These top 5 states represented 52% of emergency department visits. Among these visits, 2.4% were for adults with nontraumatic dental conditions. Two binary regression models were constructed, and statistically significant relationships were found between emergency department visits and age, gender, race/ethnicity, and Medicaid as a payment source (n=18,112). State-specific community water fluoridation did not emerge as a statistically significant predictor of emergency department visits. Social change implication may allow taxpayers and public health policy leaders to identify new strategies in promoting oral health. New approaches include reeducating the public on policies in support of community water fluoridation as a preventive strategy and understanding how to encourage adult Medicaid enrollees to use preventive dental care in their community and avoid the emergency department for dental care