Communication with Infants: Power and Practices

Presenter will Provide

Behavioral Intervention Teams: A Campus Wide Collaboration

Campus behavioral intervention teams vary greatly from campus to campus, guided by their institution’s mission statement, ensuring a safe, educational environment for all members of the campus community. Assessments and interventions of distressed students and students exhibiting disturbing behavior provide a unique opportunity to collaborate with constituents of the campus community. This collaborative approach will assist in eliminating information silos and allow meaningful student interventions to take place

Modern methods in the treatment of certain acute diseases: with special reference to (1) the specific treatment of typhoid fever; (2) the chemo-therapy of erysipelas

Recent advances in the treatment of typhoid fever and erysipelas have been made the subjects of this thesis. In the first section, an evaluation of the serum treatment of enteric fever with the new serum devised by Felix is presented, and the significance of the results obtained is discussed in detail. In the second part, an analysis of the treatment of a large series of cases of erysipelas with the recently introduced drugs belonging to the sulphanilamide group is given. Both studies, it is believed, enable certain conclusions to be drawn which are of very great practical importance.1. A series of seventy -seven cases of erysipelas treated by the sulphanilamide drugs is presented.2. An analysis of the cases in relation to the behaviour of the rash, the toxaemia, and the pyrexia, the incidence of complications and of relapse, and the fatality rate, indicates that the results obtained are significantly superior to those derived from symptomatic or serum treatment.3. So consistent are the results prevailing that sulphanilamide may be regarded as specific in erysipelas.4. Although certain toxic effects are known due to the administration of sulphmsriide, the latter is to be regarded on the whole as a safe and not unpleasant means of treatment.5. It may be that in infants the response is not so good as in older individuals, but the numbers in this series are too few to be decisive on this point.6. The exact mode of action of sulphonamide in the body is unknown. In the light of experimental knowledge and clinical observation however, a directly bactericidal action in the tissues is probably supplemented by an increased activity of the normal defence forces

Evaluation of factors that influence participation in a federal tree planting program

The vast majority of nonindustrial private forestland in Tennessee, and much of the nation, is currently unmanaged. This results in a reduction of the quality of timber and other forest resources such as wildlife habitat and water quality. In the 1990 Farm Bill, Congress instituted the Stewardship Incentive Program, believing that management of these types of lands would be greatly beneficial to the nation as a whole. Apparently, owners do not perceive enough personal benefit from this type of forest management. Therefore, incentives may be necessary to induce landowners to practice management of their land. Historically, the federal government has concentrated its efforts to promote improved farm practices on the use of monetary incentives. Consistent with past programs, the major incentive offered in the Stewardship Incentive Program for a landowner is that the government will share a percentage of the startup costs. However, participation in previous forestry programs using similar incentives has been chronically low, as evidenced by data from the Forestry Incentives Program and the Conservation Reserve Program. It is the purpose of this study to determine the likely effect of cost-share incentives on participation in the Stewardship Incentive Program as well as to identify other factors that may contribute to participation. This information may prove useful in considering the most effective implementation strategy of the Stewardship Incentive Program. In this study an indirect utility function is used to determine the probability an individual will choose to participate as well as to identify the relationship between that choice and certain attributes of the individual. Analysis of this choice as a function of economic, physical, and behavioral factors results in a qualitative model, specifically, a binary choice model since the dependent variable is dichotomous in nature and represents the participate - not participate decision. In order to determine the landowner\u27s willingness to participate in a stewardship program in Tennessee, 4000 surveys were mailed to randomly selected owners of 100 acres or more. In the survey, participation is directly determined in a hypothetical situation and various cost share amounts were offered to different individuals. In addition to the effect of cost on participation the questionnaire was designed to identify owner characteristics in the following three categories: 1. demographic, socioeconomic; 2. attitudes and beliefs regarding conservation, information, and various goals of the program including timber, wildlife/fisheries, water quality, recreation, wetlands, aesthetic value; 3. attributes of the farm; A logit procedure is used to estimate the model. Measures of the goodness of fit indicate the model fit the data fairly well. Cost to the owner of participating is found to be significant, however, the variables representing the attitudes and opinions of the respondent toward the goals of the program prove substantially more influential per unit on the probability of participating. This information may be valuable to decision makers faced with deciding the most effective method of implementing programs such as the Stewardship Incentive Program

Socioeconomic Status and Study Abroad: Participation, Academic Performance, and Graduation

Research into retention, academic performance, and degree completion of study abroad program participants positively correlates with the assertion of Kuh, Kinzie, Schuh, Whitt, and Associates (2005) that study abroad is a high-impact educational activity. Literature on study abroad participation, academic performance, and graduation status is limited. This quantitative study adds to the literature on study abroad, and specifically examines to what extent participation, academic performance, and graduation at four and six years for study abroad students differ by socioeconomic status

Electronic health information exchange in underserved settings: examining initiatives in small physician practices & community health centers.

BackgroundHealth information exchange (HIE) is an important tool for improving efficiency and quality and is required for providers to meet Meaningful Use certification from the United States Centers for Medicare and Medicaid Services. However widespread adoption and use of HIE has been difficult to achieve, especially in settings such as smaller-sized physician practices and federally qualified health centers (FQHCs). We assess electronic data exchange activities and identify barriers and benefits to HIE participation in two underserved settings.MethodsWe conducted key-informant interviews with stakeholders at physician practices and health centers. Interviews were recorded, transcribed, and then coded in two waves: first using an open-coding approach and second using selective coding to identify themes that emerged across interviews, including barriers and facilitators to HIE adoption and use.ResultsWe interviewed 24 providers, administrators and office staff from 16 locations in two states. They identified barriers to HIE use at three levels-regional (e.g., lack of area-level exchanges; partner organizations), inter-organizational (e.g., strong relationships with exchange partners; achieving a critical mass of users), and intra-organizational (e.g., type of electronic medical record used; integration into organization's workflow). A major perceived benefit of HIE use was the improved care-coordination clinicians could provide to patients as a direct result of the HIE information. Utilization and perceived benefit of the exchange systems differed based on several practice- and clinic-level factors.ConclusionsThe adoption and use of HIE in underserved settings appears to be impeded by regional, inter-organizational, and intra-organizational factors and facilitated by perceived benefits largely at the intra-organizational level. Stakeholders should consider factors both internal and external to their organization, focusing efforts in changing modifiable factors and tailoring HIE efforts based on all three categories of factors. Collective action between organizations may be needed to address inter-organizational and regional barriers. In the interest of facilitating HIE adoption and use, the impact of interventions at various levels on improving the use of electronic health data exchange should be tested

A conceptual framework and protocol for defining clinical decision support objectives applicable to medical specialties.

BackgroundThe U.S. Centers for Medicare and Medicaid Services established the Electronic Health Record (EHR) Incentive Program in 2009 to stimulate the adoption of EHRs. One component of the program requires eligible providers to implement clinical decision support (CDS) interventions that can improve performance on one or more quality measures pre-selected for each specialty. Because the unique decision-making challenges and existing HIT capabilities vary widely across specialties, the development of meaningful objectives for CDS within such programs must be supported by deliberative analysis.DesignWe developed a conceptual framework and protocol that combines evidence review with expert opinion to elicit clinically meaningful objectives for CDS directly from specialists. The framework links objectives for CDS to specialty-specific performance gaps while ensuring that a workable set of CDS opportunities are available to providers to address each performance gap. Performance gaps may include those with well-established quality measures but also priorities identified by specialists based on their clinical experience. Moreover, objectives are not constrained to performance gaps with existing CDS technologies, but rather may include those for which CDS tools might reasonably be expected to be developed in the near term, for example, by the beginning of Stage 3 of the EHR Incentive program. The protocol uses a modified Delphi expert panel process to elicit and prioritize CDS meaningful use objectives. Experts first rate the importance of performance gaps, beginning with a candidate list generated through an environmental scan and supplemented through nominations by panelists. For the highest priority performance gaps, panelists then rate the extent to which existing or future CDS interventions, characterized jointly as "CDS opportunities," might impact each performance gap and the extent to which each CDS opportunity is compatible with specialists' clinical workflows. The protocol was tested by expert panels representing four clinical specialties: oncology, orthopedic surgery, interventional cardiology, and pediatrics