Addressing Barriers to Colorectal Cancer Screening in a Federally Qualified Health Center: A Quality Improvement Project

Abstract Background: Colorectal cancer (CRC) is a leading cause of death from cancer in the United States, despite the availability of several high-quality screening options. Multiple barriers to CRC screening have been identified, including cost (non-insured), younger age, racial or ethnic minority, recent immigration to the U.S. (non-English speaking), fear or distrust of the healthcare system and rural residence. Addressing health equity within underserved populations requires improved access to CRC screenings per evidence-based guidelines. Local Problem: The mean CRC screening rate for the designated Federally Qualified Health Center (FQHC) was 33.7% for the 5 months preceding this quality improvement (QI) project. The Community Health Access Network Unified Data System (CHAN UDS) benchmark target for CRC screening was 60.1%. Methods: Multiple targeted interventions were implemented over a 4-month period that emphasized a strong provider recommendation, a team-based approach to identify and offer CRC screening options to patients who were overdue for testing, and accurate documentation of results in the electronic medical record (EMR). A chart audit was followed by a mailed fecal immunochemical test (FIT) and colonoscopy reminder letter initiative. Results: The CHAN UDS performance metric for CRC screening reached 40% within 4 months. The second chart audit (2 months after the first) confirmed the CRC screening rate improved to 41.5% among FQHC patients aged 50 to 75 years. An overall 55% return rate was achieved with the mailed FIT initiative within 2 months. Conclusions: Despite an improvement in the CRC screening rate, continued quality improvement initiatives are needed to achieve the CHAN UDS benchmark target for this FQHC. The global aim of this QI project, to reduce or remove barriers to CRC screening test completion, was demonstrated in the results. These team-based interventions can be utilized within other underserved patient populations to improve health equity for CRC screening

Explaining non-renewal behaviour : an empirical investigation of recently lapsed NRL club members

This paper reports on a survey of lapsed members of an Australian professional National Rugby League (NRL) Club. Analysis of the 195 useable responses returned suggest that these lapsed members had originally joined as much for intangible aspects, such as seeking a greater level of involvement with the club, as for the functional aspects such as savings on game entry. Overall, these lapsed members were satisfied with the service they received whilst a member, and claimed it had been performed in line with expectations. The main drivers of satisfaction were also a mix of tangible and intangible factors such as feeling valued by the club and receiving discounts on entry costs. The members gave a number of reasons for not rejoining in 2002, but primarily cited an inability to attend games. Despite joining for intangible reasons, it seems that if these members could not get to games, they perceived that membership was not worth maintaining. That said, a large number of members indicated that as their circumstances change they will rejoin the club, supporting the theory that non-renewal is not driven by service failure, but rather the perception that attendance is still the core product (entertainment). The overall level of satisfaction had a weak but positive relationship with the likelihood of members rejoining in the future.<br /

The quality of work dimensions. Results of a multivariate analysis from the Third Isfol Survey on Quality of work in Italy

This paper starts with an overview of the theoretical framework on quality of work and identifies five relevant dimensions, in line with Gallino &amp; La Rosa: ergonomic, complexity, autonomy, control and economic dimensions. The above dimensions are described and measured by means of multivariate analysis to detect differences in terms of the factors affecting the level of the quality of work dimensions achieved. The data set that we use for this purpose is the Third Isfol Survey on Quality of Work (IsfolQdL) that has been carried out in 2010 on a sample of 5,000 workers and operationalizes the five dimensions of the quality of work. The results of the multivariate analysis confirm the worse achievements in terms of quality of work by temporary workers and lower skilled workers and lower level of achievements by women in the economic and autonomy dimensions. Women are also more likely to be found in part-time work positions and the latter show an improvement in the ergonomic dimension (that includes also work life balance) at the expenses of the economic and autonomy dimensions

Design and Analysis Rolling Press Mechanism for producing Banana Stem as Natural Fiber

Materials for structural engineering are divided into four types, including ceramics, polymers, and composites. Composite material is a combination of reinforcement and matrix. Composite technology has progressed so rapidly. The development was mainly triggered by the demand for high quality materials. In its development, the fiber used is not only synthetic fiber (glass fiber) but also natural fiber (natural fiber). The advantage of natural fibers compared to synthetic fibers is that natural fibers are more environmentally friendly because natural fibers are able to decompose naturally, while synthetic fibers are more difficult to decompose. In this paper, banana midrib fiber is used and taken from the kepok banana tree (Musa paradisiaca) is a fiber that has good mechanical properties. Banana midrib fiber has a density of 1.35 g/cm3, the cellulose content is 63-64%, hemicellulose 20%, lignin content is 5%, the average tensile strength is 600 MPa, the tensile modulus is 17.85 GPa and the fracture strain is 3, 36%. Because of the advantages of the banana midrib fiber, hence this paper is made for support the production of the banana midrib fiber by designing and analyzing concept design of the machine for processing natural fibers, especially when the material is banana stems, it is called ZEUS MACHINE: Banana Stem Rolling Press Machine as Natural Fiber by Using Manual Power from Pedaling. This machine can help increase the productivity of natural fiber manufacture and can support the development of technology engaged in industry

Dimensions Underlying Student Ratings of Instruction: A Multidimensional Scaling Analysis

↵MARTHA L. BANZ, Graduate Student, Department of Psychology, University of Oklahoma, Norman, OK 73019.Specializations:Quantitative methods, educational psychology.Yeshttps://us.sagepub.com/en-us/nam/manuscript-submission-guideline

Norming of Student Evaluations of Instruction: Impact of Non-Instructional Factors

Student Evaluations of Instruction (SEIs) from about 6000 sections over four years representing over 100,000 students at the college of business at a large public university are analyzed, to study the impact of non-instructional factors on student ratings. Administrative factors like semester, time of day, location, and instructor attributes like gender and rank are studied. The combined impact of all the non-instructional factors studied is statistically significant. Our study has practical implications for administrators who use SEIs to evaluate faculty performance. SEI scores reflect some inherent biases due to non-instructional factors. Appropriate norming procedures can compensate for such biases, ensuring fair evaluations

Sostenibilità economica e ambientale degli impianti per la produzione di biogas da reflui zootecnici: un caso di studio nel comune di Pontinia

ECONOMIC AND ENVIRONMENTAL SUSTAINABILITY OF PLANTS FOR THEPRODUCTION OF BIOGAS FROM LIVESTOCK WASTE: A CASE STUDY IN THEMUNICIPALITY OF PONTINIA. The presence in the municipality of Pontinia of an intensive livestock activity has led to assess the possibility to realize a biogas production plant, aimed at the generation of electricity and thermal energy. From an economic point of view various process scenarios were analyzed. An economic feasibility analysis was carried out, demonstrating that the maximum economic benefit of the production may be fostered with a biomethane production. The work also addressed the issue of improving the sustainability of biogas production plants, in order to amend their social acceptability

An Empirical Investigation of Student Evaluations of Instruction - The Relative Importance of Factors

We analyzed over 100,000 student evaluations of instruction over four years in the college of business at a major public university. We found that the original instrument that was validated about 20 years ago is still valid, with factor analysis showing that the six underlying dimensions used in the instrument remained relatively intact. Also, we found that the relative importance of those six factors in the overall assessment of instruction changed over the past two decades, reflecting changes in the expectations of the current millennial generation of students. The results were consistent across four subgroups studied – Undergraduate Core, Undergraduate Non-Core, Graduate Core and Graduate Non-Core classes, with minor differences. Student Motivation (the instructor’s ability to motivate students) and grading/assignments (fairness and objectivity of grading practices) have superseded presentation ability in relative importance as indicators of overall teaching effectiveness. Our study has implications for teachers in terms of the appropriate areas to focus on for improving their teaching practices