Web-based Nutrition Education in Georgia Senior Centers: Pilot Test of a Dietary Approaches to Stopping Hypertension (DASH) Diet Website Prototype

As increasing numbers of baby boomers enter retirement age, Georgia senior centers will be inundated with more computer-savvy seniors than ever before. Web-based nutrition education is a pragmatic option to complement the traditional classroom nutrition education sometimes hindered by the centers’ limited monetary and personnel resources. This exploratory observational study sought to pilot test a companion to classroom nutrition education, a prototype Dietary Approaches to Stopping Hypertension (DASH) diet website, for future implementation in Georgia senior centers. Classroom DASH diet lessons were designed and pilot tested on a convenience sample of community dwelling older adults in 6 metropolitan area centers (n=109). Next, the same lessons were incorporated into a senior-friendly DASH diet website specially designed to meet the needs of older adults and pilot tested on a second convenience sample in one center (n=5). Descriptive and analytical statistics were used to compare baseline and post-website blood pressures, body weights, and DASH-related nutrition knowledge. There was a significant difference in the scores for systolic blood pressure at baseline (M=145.60, SD=8.385) and post-website (M=136.40, SD=9.607) conditions; t(4)=3.74, p =.020. Diastolic blood pressure and weight showed no significant change. A survey of DASH-related knowledge, behaviors, and beliefs showed movement towards desired responses on 44% of survey questions after the intervention. An opinion survey collected seniors’ perspectives on their website experience. 100% of participants reported satisfaction with the website and willingness to continue using it. Refinements to the alpha-prototype website are recommended before further testing with a larger pilot study group. Although expanded research is necessary, results from this limited pilot test suggest that web-based nutrition education is a promising method to reinforce classroom lessons teaching dietary and lifestyle management of hypertension in Georgia senior centers. Multi-component nutrition education holds potential to address diversity in cultures, learning preferences, and functional limitations of Georgia seniors

Developing an integrated national simulation-based educational programme for Scottish junior doctors through structured, multi-step action research cycles

OBJECTIVES: Simulation is widely employed to teach a range of skills, across healthcare professions and is most effective when embedded within a standarised curriculum. Although recommended by many governing bodies, establishing a national programme of simulation presents many challenges. Successful implementation requires a clear understanding of the priorities and needs of those it seeks to serve yet there are limited examples of how best to do this. This study aimed to develop an integrated national simulation-based educational programme for junior doctors in Scotland through a structed, multistep prioritisation process. DESIGN: A series of action research cycles were undertaken to develop and evaluate a national simulation programme. This paper describes cycle 1, which employed a six-step structured approach to understand and prioritise learner needs. SETTING: The study considered the educational needs of Scottish junior doctors in the UK Foundation Programme (UKFP). PARTICIPANTS: Multiple stakeholder groups were involved in each stage of the process including recent Scottish UKFP graduates, clinical educators, UKFP programme directors and postgraduate deans. RESULTS: Key stakeholders reviewed the 370 competencies in the UKFP curriculum and identified 18 initial competency areas. These 18 areas were subsequently prioritised through the analytical hierarchy process, resulting in a carefully ordered list of 12 competencies from which a targeted simulation-based educational programme could be developed. CONCLUSIONS: To our knowledge, this is the first study to outline the methods of competency prioritisation to create a simulation curriculum that is integrated within a national curriculum in the medical education context. As well as demonstrating the practical steps of such a process, key implications for practice are identified. This robust approach to educational design also resulted in unexpected benefits, including educator and clinician acceptance and programme funding sustainability

All-optical processing using cross-phase modulation

The following thesis presents results obtained from both numerical simulation and laboratory experimentation (both of which were carried out by the author). When data is propagated along an optical transmission line some timing irregularities can occur such as timing jitter and phase wander. Traditionally these timing problems would have been corrected by converting the optical signal into the electrical domain and then compensating for the timing irregularity before converting the signal back into the optical domain. However, this thesis posses a potential solution to the problem by remaining completely in the optical domain, eliminating the need for electronics. This is desirable as not only does optical processing reduce the latency effect that their electronic counterpart have, it also holds the possibility of an increase in overall speed. A scheme was proposed which utilises the principle of wavelength conversion to dynamically convert timing irregularities (timing jitter and phase wander) into a change in wavelength (this occurs on a bit-by-bit level and so timing jitter and phase wander can be compensated for simultaneously). This was achieved by optically sampling a linearly chirped, locally generated clock source (the sampling function was achieved using a nonlinear optical loop mirror). The data, now with each bit or code word having a unique wavelength, is then propagated through a dispersion compensation module. The dispersion compensation effectively re-aligns the data in time and so thus, the timing irregularities are removed. The principle of operation was tested using computer simulation before being re-tested in a laboratory environment. A second stage was added to the device to create 3R regeneration. The second stage is used to simply convert the timing suppressed data back into a single wavelength. By controlling the relative timing displacement between stage one and stage two, the wavelength that is finally produced can be controlled

Book Reviews

Reviews of: Agriculture in Zambia: Past, Present, and Future, Antony Chapoto and Nicholas J. Sitko eds., 2015 and: Forced to leave: Commercial farming and displacement in Zambia, by Human Rights Watch, 2017

Book Reviews

Reviews of: Agriculture in Zambia: Past, Present, and Future, Antony Chapoto and Nicholas J. Sitko eds., 2015 and: Forced to leave: Commercial farming and displacement in Zambia, by Human Rights Watch, 2017

The Relative Value of AER P&P Economic Education Papers

The CEE had been allocated one session in the AER Papers and Proceedings (P&P) since 1964. In 2008, the American Economic Association evaluated the allocation of AER Papers and Proceedings sessions to various AEA Committees. In response, the CEE was asked to prepare a one-page rationale for keeping that session. Their response (Committee on Economic Education, 2008) made several important defenses of the session, including that the quality of the papers published in these sessions must speak for itself. In this paper, we propose to evaluate the relative quality of AER P&P papers through citation analysis. Using the Social Science Citation Index, the citation counts of CEE AER P&P papers are compared to other papers included in the issue

Local Health Departments’ Costs of Providing Environmental Health Services

Background: A detailed understanding of the costs that local health departments (LHDs) incur in the provision of public health services plays an important role in their efforts to provide services in an effective and efficient manner. However, surprisingly little evidence exists about the key cost components that LHDs incur in the provision of services. Purpose: The purpose of this report was to provide empirical estimates of LHDs’ cost structure. Methods: Using cost information for 2012 from 15 LHDs in North Carolina for two public health services—food and lodging and onsite water—this report first presents estimates of the total costs per service provided. In a second step, total costs are decomposed into key components, including direct and indirect costs. Both data collection and analysis were conducted in 2014. Results: For the LHDs examined in this report, median cost per service amounted to $145 for food and lodging and$82 for onsite water. Service costs, however, varied widely across agencies. Decomposition showed that direct labor costs represented more than 80% of total costs. Other direct costs accounted for 10% to 15% of total costs, while indirect costs represented 5% to 6% of total costs. Implications: The finding that labor costs represent a majority of the total costs of service provision has important implications for public health practitioners. Perhaps most importantly, for the purpose of costing public health services, estimation procedures may be simplified by focusing primarily on the cost of labor required to provide any given service

A Tool to Cost Environmental Health Services in North Carolina Local Health Departments

Introduction: The cost of providing a basic set of public health services necessary not been well-described. Recent work suggests public health practitioners are unlikely to have the empirically-based financing information necessary to make informed decisions regarding practice. The purpose of this paper is to describe the development of a costing tool used to collect primary data on the number of services provided, staff employed, and costs incurred for two types of mandated environmental health services: food and lodging inspections and onsite water services. Methods: The tool was iteratively reviewed, revised, and piloted with local health department (LHD) environmental health and finance managers. LHDs (n=15) received technical support to estimate costs for fiscal year 2012. Results: The tool contained the following sections: Agency/Respondent Information, Service Counts, Direct Labor Costs, Direct Non-Labor Costs, and Indirect/Overhead Costs. The time required to complete the tool ranged from 2 to 12 hours (median = 4). Implications: LHDs typically did not track costs by program area, nor did they acknowledge indirect costs or costs absorbed by the county. Nonetheless, this costing tool is one of the first to estimate costs associated with environmental health programs at the LHD level and has important implications for practitioners and researchers, particularly when these limitations are recognized