2,482 research outputs found
Policy Framework for Outreach, Enrollment, Retention and Utilization for Health Care Coverage in California
Defines a framework that counties in California can use to structure outreach, enrollment, retention, and utilization systems and strategies. Provides specific recommendations, based on local successes, for improving access to health care by children
Approaches to Studying Bacterial Biofilms in the Bioeconomy with Nanofabrication Techniques and Engineered Platforms.
Studies that estimate more than 90% of bacteria subsist in a biofilm state to survive environmental stressors. These biofilms persist on man-made and natural surfaces, and examples of the rich biofilm diversity extends from the roots of bioenergy crops to electroactive biofilms in bioelectrochemical reactors. Efforts to optimize microbial systems in the bioeconomy will benefit from an improved fundamental understanding of bacterial biofilms. An understanding of these microbial systems shows promise to increase crop yields with precision agriculture (e.g. biosynthetic fertilizer, microbial pesticides, and soil remediation) and increase commodity production yields in bioreactors. Yet conventional laboratory methods investigate these micron-scale biofilms with macro-scale vessels and are limited in experimental throughput. This dissertation leverages nanofabrication techniques to engineer novel platforms for the study of bacterial biofilms from the bioeconomy. Nanofabrication can create micron-scale environments for bacterial biofilm studies and gain measurements inaccessible to conventional laboratory methods. Nanofabrication techniques can control physical and chemical influences (e.g. fluid flow, topography, confinement, surface roughness, chemistry, etc.) to mimic features of the natural environment. Platform design can also be aligned with microscopy and custom image processing algorithms to amass large datasets. Silane functionalization, together with image processing, investigated Pantoea YR343 biofilm propagation and enumerated the honeycomb biofilm morphology
Sibling Relationship Quality and Identity Formation: Testing of Gender Characteristics and Birth Order of Sibling as a Moderator
Siblings play a significant role in the process of forming identity among adolescents. Therefore, this research examined the role of sibling characteristics such as gender and order of birth in moderating the quality of relations among siblings and adolescent identity formation. The respondents were adolescents aged 12-21 years, with at least one sibling having a maximum age gap of 4 years. The data collection technique used two measurement scales involving the warmth and closeness subscale in the Sibling Relationship Questionnaire and The Utrecht-Management of Identity Commitments Scale. Additionally, the hypothesis was tested using a tiered regression test. The analysis showed the role of same-gender characteristics and birth order strengthens the relationship between siblings with three aspects of identity formation, including commitment, in-depth exploration, and reconsideration of commitment. This finding indicates that adolescents having same-gender and older siblings have better relationship qualities that contribute to a more optimal identity formation
Composing Information Literacy: A Pedagogical Partnership Between Rhet/Comp and Library Faculty
For more than a decade, the Program for Writing and Rhetoric (PWR) at the University of Colorado Boulder has partnered with teaching and learning librarians to design and deliver Information Literacy learning opportunities in first-year and upper-division composition classes. In recent years, this partnership has grown more robust as we have come to recognize that our two fields have much in common and are making similar pedagogical, theoretical, and practical moves. The guiding documents produced in both our fields (the ACRL’s “Framework for Information Literacy for Higher Education” and the WPA’s “Framework for Success in Post-Secondary Writing”) highlight the shared concerns and complementary values and educational goals of librarians and rhetoric and composition instructors.
Additionally, the dynamic information and media environment in which we and our students live and work requires new kinds of information and digital literacies and thus new literacy curricula. As we began to re-think the PWR’s Information Literacy initiatives, we asked ourselves this question: If we could design a curriculum that no longer treats Information Literacy and Rhetoric and Composition as separate, and that acknowledges the complex information landscapes in which we reside and the multiple modes in which our students compose, what would it look like? For the past year, we have been developing this curriculum. In our presentation, we will provide an overview of this collaborative process, as well as the outcomes and materials developed. We will invite attendees to explore the characteristics of successful pedagogical partnerships dedicated to improving student learning through information literacy initiatives
Health Literacy Introduction
This Health Literacy Introduction is a brief overview of solutions and techniques to support health literacy. Discover practical solutions to support health literacy and resources to learn more, raise awareness, and act now to improve health literacy
Contemporary Asian Art and Exhibitions
This volume draws together essays by leading art experts observing the dramatic developments in Asian art and exhibitions in the last two decades. The authors explore new regional and global connections and new ways of understanding contemporary Asian art in the twenty-first century
Treatments for women with gestational diabetes mellitus: an overview of Cochrane systematic reviews
Background
Successful treatments for gestational diabetes mellitus (GDM) have the potential to improve health outcomes for women with GDM and their babies.
Objectives
To provide a comprehensive synthesis of evidence from Cochrane systematic reviews of the benefits and harms associated with interventions for treating GDM on women and their babies.
Methods
We searched the Cochrane Database of Systematic Reviews (5 January 2018) for reviews of treatment/management for women with GDM. Reviews of pregnant women with pre-existing diabetes were excluded.
Two overview authors independently assessed reviews for inclusion, quality (AMSTAR; ROBIS), quality of evidence (GRADE), and extracted data.
Main results
We included 14 reviews. Of these, 10 provided relevant high-quality and low-risk of bias data (AMSTAR and ROBIS) from 128 randomised controlled trials (RCTs), 27 comparisons, 17,984 women, 16,305 babies, and 1441 children. Evidence ranged from high to very low-quality (GRADE). Only one effective intervention was found for treating women with GDM.
Effective
Lifestyle versus usual care
Lifestyle intervention versus usual care probably reduces large-for-gestational age (risk ratio (RR) 0.60, 95% confidence interval (CI) 0.50 to 0.71; 6 RCTs, N = 2994; GRADE moderate-quality).
Promising
No evidence for any outcome for any comparison could be classified to this category.
Ineffective or possibly harmful
Lifestyle versus usual care
Lifestyle intervention versus usual care probably increases the risk of induction of labour (IOL) suggesting possible harm (average RR 1.20, 95% CI 0.99 to 1.46; 4 RCTs, N = 2699; GRADE moderate-quality).
Exercise versus control
Exercise intervention versus control for return to pre-pregnancy weight suggested ineffectiveness (body mass index, BMI) MD 0.11 kg/m², 95% CI -1.04 to 1.26; 3 RCTs, N = 254; GRADE moderate-quality).
Insulin versus oral therapy
Insulin intervention versus oral therapy probably increases the risk of IOL suggesting possible harm (RR 1.3, 95% CI 0.96 to 1.75; 3 RCTs, N = 348; GRADE moderate-quality).
Probably ineffective or harmful interventions
Insulin versus oral therapy
For insulin compared to oral therapy there is probably an increased risk of the hypertensive disorders of pregnancy (RR 1.89, 95% CI 1.14 to 3.12; 4 RCTs, N = 1214; GRADE moderate-quality).
Inconclusive
Lifestyle versus usual care
The evidence for childhood adiposity kg/m² (RR 0.91, 95% CI 0.75 to 1.11; 3 RCTs, N = 767; GRADE moderate-quality) and
hypoglycaemia was inconclusive (average RR 0.99, 95% CI 0.65 to 1.52; 6 RCTs, N = 3000; GRADE moderate-quality).
Exercise versus control
The evidence for caesarean section (RR 0.86, 95% CI 0.63 to 1.16; 5 RCTs, N = 316; GRADE moderate quality) and perinatal death or serious morbidity composite was inconclusive (RR 0.56, 95% CI 0.12 to 2.61; 2 RCTs, N = 169; GRADE moderate-quality).
Insulin versus oral therapy
The evidence for the following outcomes was inconclusive: pre-eclampsia (RR 1.14, 95% CI 0.86 to 1.52; 10 RCTs, N = 2060),
caesarean section (RR 1.03, 95% CI 0.93 to 1.14; 17 RCTs, N = 1988), large-for-gestational age (average RR 1.01, 95% CI 0.76 to 1.35; 13 RCTs, N = 2352), and perinatal death or serious morbidity composite (RR 1.03; 95% CI 0.84 to 1.26; 2 RCTs, N = 760). GRADE assessment was moderate-quality for these outcomes.
Insulin versus diet
The evidence for perinatal mortality was inconclusive (RR 0.74, 95% CI 0.41 to 1.33; 4 RCTs, N = 1137; GRADE moderate-quality).
Insulin versus insulin
The evidence for insulin aspart versus lispro for risk of caesarean section was inconclusive (RR 1.00, 95% CI 0.91 to 1.09; 3 RCTs, N = 410; GRADE moderate quality).
No conclusions possible
No conclusions were possible for: lifestyle versus usual care (perineal trauma, postnatal depression, neonatal adiposity, number of antenatal visits/admissions); diet versus control (pre-eclampsia, caesarean section); myo-inositol versus placebo (hypoglycaemia); metformin versus glibenclamide (hypertensive disorders of pregnancy, pregnancy-induced hypertension, death or serious morbidity composite, insulin versus oral therapy (development of type 2 diabetes); intensive management versus routine care (IOL, large-for-gestational age); post- versus pre-prandial glucose monitoring (large-for-gestational age). The evidence ranged from moderate-, low- and very low quality.
Authors’ conclusions
Currently there is insufficient high-quality evidence about the effects on health outcomes of relevance for women with GDM and their babies for many of the comparisons in this overview comparing treatment interventions for women with GDM. Lifestyle changes (including as a minimum healthy eating, physical activity and self-monitoring of blood sugar levels) was the only intervention that showed possible health improvements for women and their babies. Lifestyle interventions may result in fewer babies being large. Conversely, in terms of harms, lifestyle interventions may also increase the number of inductions. Taking insulin was also associated with an increase in hypertensive disorders, when compared to oral therapy. There was very limited information on long-term health and health services costs. Further high-quality research is needed
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