Standardizing Discharge Practices for Pediatric Urology Outpatient Procedures: A Quality Improvement Project

Background: Standard discharge instructions of verbal and written methods are only understood by about 45-50% of caregivers. Video discharge instructions (VDIs) in addition to standard methods of verbal and written instructions can be very effective for caregiver comprehension (CC), retaining discharge education information and improving patient outcomes. Problem: In an outpatient surgery department in a Midwestern Children’s hospital, 100% of the discharge instructions for pediatric urology outpatient procedures are different than the instructions given to caregivers by the surgeon. Methods: The study utilizes a descriptive evaluation of change in how discharge instructions were written and provided. Interventions: Updated discharge handouts and corresponding VDIs were created and replaced outdated, standard methods (verbal and written) of discharge teaching for pediatric urology outpatient surgeries. Data was collected via two surveys, one completed prior to discharge on the day of the procedure and the second completed by a phone call two weeks after the procedure. Results: All videos were highly effective in providing consistent instructions among providers, high levels of CC, and low levels of adverse events after discharge. There were no statistically significant differences between the four videos when comparing consistency of discharge information among providers, CC, and adverse events after discharge. Conclusions: In pediatric patients having urological outpatient procedures, standardized discharge instructions with educational videos are highly effective in providing consistent discharge information, high levels of CC, and preventing adverse events during a two-week period after hospital discharge

Collective Thinking for Extension Practice: A Time and Place for World Café

World café (WC) is a structured methodology that provides an opportunity for collective thinking through open dialogue. The WC concept affords the opportunity for individuals to engage in the sharing of ideas and knowledge. Participants rotate through timed discussions on different themes with different groups of individuals, providing for an intermixing of ideas. Facilitators benefit from accessing dialogue output and ideas related to chosen topics of discussion as a result of collective input. Extension professionals should consider WC for increasing communication and generating shared knowledge. Our approach to WC was implemented at the 2016 National Health Outreach Conference

Implications of new economic policy instruments for tuna management in the Western and Central Pacific

Tuna management in the Western and Central Pacific is complicated by the conflicting interests of countries and agents exploiting tuna resources in the region. Historically, regulatory attempts by Pacific Island Countries to control fishing effort within their Exclusive Economic Zones (EEZs) have met with limited success. The introduction of new economic policy instruments by the Parties to the Nauru Agreement (PNA), such as the Vessel Day Scheme (VDS) and Marine Stewardship Council (MSC) certi- fication, has supported and complemented existing conservation and management measures. By bringing in new incentives for the PNA states, greater control over fishing effort and the formulation of perceptibly new sustainable fishing practices have emerged. Using a new institutional economic framework, this paper analyses the shift from regulatory policy to new economic policy instruments through the lens of New Institutional Economics. The results show how the adoption of the VDS and MSC certification program has brought new changes and improvements to tuna negotiations, to agreements, and to outcomes amongst parties. Investing in these new instruments has elucidated ways in which new economic institutions strengthen de jure political control over transboundary fish resources and fishing fleets

Moving Towards Market Based and Incentive Based Approaches for Tuna Management in the Western and Central Pacific - The Case of the Parties to the Nauru Agreement (PNA)

Tuna management in the Western and Central Pacific (WCP) is complicated given the dynamic and sometimes conflicting interests of participating countries and actors exploiting the tuna resource in the region. Pacific Island Countries (PICs) through the Fisheries Forum Agency (FFA) and the Parties to the Nauru Agreement (PNA) have developed a number of institutional and regulatory arrangements to control tuna fishing efforts within the Exclusive Economic Zones (EEZs) but with minimal success. In more recent times market and incentive based approaches are being adopted to support and complement existing conservation and management measures (CMMs). Market and incentive based approaches provide fishers with the motivation and incentive to practice sustainable fishing by creating economic advantages for states and actors involved. This paper aims to analyse this shift within the context of PNA by investigating why PNA shifted from regulatory policies to New Institutional Economics (NIEs) or economics policy instruments by adopting market and incentive based mechanisms. The paper i) provides an overview of tuna regional treaties, regimes and agreements in the pacific, ii) highlights the shift in regional treaties and regimes with NIEs, and iii) examines implications of economic policy instruments on the level of cooperation. The paper concludes that market based mechanisms have brought in changes and much improvements to tuna negotiations and agreements among parties and actors compared to past experiences.

Reframing the sustainable seafood narrative

The dominant sustainable seafood narrative is one where developed world markets catalyze practice improvements by fisheries and aquaculture producers that enhance ocean health. The narrow framing of seafood sustainability in terms of aquaculture or fisheries management and ocean health has contributed to the omission of these important food production systems from the discussion on global food system sustainability. This omission is problematic. Seafood makes critical contributions to food and nutrition security, particularly in low income countries, and is often a more sustainable and nutrient rich source of animal sourced-food than terrestrial meat production. We argue that to maximize the positive contributions that seafood can make to sustainable food systems, the conventional narratives that prioritize seafood's role in promoting ‘ocean health’ need to be reframed and cover a broader set of environmental and social dimensions of sustainability. The focus of the narrative also needs to move from a producer-centric to a ‘whole chain’ perspective that includes greater inclusion of the later stages with a focus on food waste, by-product utilization and consumption. Moreover, seafood should not be treated as a single aggregated item in sustainability assessments. Rather, it should be recognized as a highly diverse set of foods, with variable environmental impacts, edible yield rates and nutritional profiles. Clarifying discussions around seafood will help to deepen the integration of fisheries and aquaculture into the global agenda on sustainable food production, trade and consumption, and assist governments, private sector actors, NGOs and academics alike in identifying where improvements can be made.Until 15 December 2019, this article can be freely accessed online at: https://authors.elsevier.com/c/1ZyqC3Q8oP-AK

Brass Happenings

Presenting a student recital for brass students in USU\u27s Music Department.https://digitalcommons.usu.edu/music_programs/1107/thumbnail.jp

City of El Campo Downtown Revitalization Plan

The Revitalization Plan for Downtown El Campo is a planning document that provides guidance for the development of Downtown El Campo. This planning document includes an overview and analysis of the existing conditions in the City of El Campo and the El Campo Downtown Revitalization Area, a design proposal with vision, goals, and objectives for enhancing Downtown El Campo and a detailed implementation chapter for successful execution of the plan.This planning document presents the revitalization plan for downtown El Campo, Texas. This document was developed by Texas Target Communities (TTC) in partnership with the City of El Campo. The City of El Campo collaborated with Texas Target Communities in fall 2016 through the summer of 2017 to create a plan for revitalization of downtown El Campo. The purpose of the collaboration was to assess current community conditions, develop goals, objectives, and implementation strategies related to future development & growth strategies, through a public participatory process, in order to help guide the future growth of the City

City of El Campo Downtown Revitalization Plan

The Revitalization Plan for Downtown El Campo is a planning document that provides guidance for the development of Downtown El Campo. This planning document includes an overview and analysis of the existing conditions in the City of El Campo and the El Campo Downtown Revitalization Area, a design proposal with vision, goals, and objectives for enhancing Downtown El Campo and a detailed implementation chapter for successful execution of the plan.This planning document presents the revitalization plan for downtown El Campo, Texas. This document was developed by Texas Target Communities (TTC) in partnership with the City of El Campo. The City of El Campo collaborated with Texas Target Communities in fall 2016 through the summer of 2017 to create a plan for revitalization of downtown El Campo. The purpose of the collaboration was to assess current community conditions, develop goals, objectives, and implementation strategies related to future development & growth strategies, through a public participatory process, in order to help guide the future growth of the City

New genetic loci link adipose and insulin biology to body fat distribution.

Body fat distribution is a heritable trait and a well-established predictor of adverse metabolic outcomes, independent of overall adiposity. To increase our understanding of the genetic basis of body fat distribution and its molecular links to cardiometabolic traits, here we conduct genome-wide association meta-analyses of traits related to waist and hip circumferences in up to 224,459 individuals. We identify 49 loci (33 new) associated with waist-to-hip ratio adjusted for body mass index (BMI), and an additional 19 loci newly associated with related waist and hip circumference measures (P < 5 × 10(-8)). In total, 20 of the 49 waist-to-hip ratio adjusted for BMI loci show significant sexual dimorphism, 19 of which display a stronger effect in women. The identified loci were enriched for genes expressed in adipose tissue and for putative regulatory elements in adipocytes. Pathway analyses implicated adipogenesis, angiogenesis, transcriptional regulation and insulin resistance as processes affecting fat distribution, providing insight into potential pathophysiological mechanisms