Adolescent Sexual Health and the Dynamics of Oppression: A Call for Cultural Competency

This paper encourages those who work with youth to understand the impact of prejudice and discrimination on vulnerable adolescents, to assess and address their needs, and to build on their assets. In prevention programming, it is essential to empower young participants by involving them in all aspects of designing and running programs for youth. It is equally essential to provide culturally appropriate interventions, with culturally competent adult and youth staff

Quality Improvement for Well Child Care

Presented to the Faculty of University of Alaska Anchorage in Partial Fulfillment of Requirements for the Degree of MASTER OF SCIENCEThe American Academy of Pediatrics (AAP) Bright Futures (BF) guidelines for well child care were designed to provide quality pediatric care. Adherence to AAP-BF guidelines improves: screenings, identification of developmental delay, immunization rates, and early identification of children with special healthcare needs. The current guideline set is comprehensive and includes thirty one well child exams, thirty three universal screening exams and one hundred seventeen selective screening exams. Many providers have difficulty meeting all guideline requirements and are at risk of committing Medicaid fraud if a well exam is coded and requirements are not met. The goal of this quality improvement project was to design open source and adaptable templates for each pediatric age group to improve provider adherence to the BF guidelines. A Plan-Do-Study-Act (PDSA) quality improvement model was used to implement the project. Templates were created for ages twelve months to eighteen years and disseminated to a pilot clinic in Anchorage, Alaska. The providers were given pre-implementation and postimplementation surveys to determine the efficacy and usefulness of the templates. Templates were determined to be useful and efficient means in providing Bright Futures focused well child care. The templates are in the process of being disseminated on a large scale to assist other providers in meeting BF guideline requirements.Title Page / Table of Contents / List of Tables / List of Appendices / Abstract / Introduction / Background / Clinical Significance / Current Clinical Practice / Research Question / Literature Review / Framework: Evidence Based Practice Model/ Ethical Considerations and Institutional Review Board / Methods / Implementation Barriers / Findings / Discussion / Disseminatio

The interplanetary magnetic field

Large-scale properties of the interplanetary magnetic field as determined by the solar wind velocity structure are examined. The various ways in which magnetic fields affect phenomena in the solar wind are summarized. The dominant role of high and low velocity solar wind streams that persist, with fluctuations and evolution, for weeks or months is emphasized. It is suggested that for most purposes the sector structure is better identified with the stream structure than with the magnetic polarity and that the polarity does not necessarily change from one velocity sector to the next. Several mechanisms that might produce the stream structure are considered. The interaction of the high and low velocity streams is analyzed in a model that is steady state when viewed in a frame that corotates with the sun

An Economic Analysis of a Dairy Anaerobic Digestion (A.D.) System: Will Dairy Producers Invest in A.D. Technology to Reduce Potential Litigation Suits?

In many areas of the United States, dairy and livestock farmers are facing lawsuits due to a variety of externalities, such as odor and other forms of non-point source pollution, caused by Confined animal feeding operations (CAFO's). Complaints include: general illness, unpleasant odor, headaches, and property devaluation. However, state and national law requires all CAFO's to have some form of waste storage facility. These facilities, mainly lagoons, increase the potential of pollution and run-off into streams and other water sources. As a result, large producers are beginning to install anaerobic digestive (A.D.) systems, which are a new form of waste management practices that reduces negative environmental effects. Therefore, the purpose of this study is to determine the future value of an ordinary annuity of an anaerobic digestive system by analyzing the joint probability of being sued and losing a litigation case. The analysis will also factor in potential policy incentives such as 100% grants with guaranteed electric buy-back premiums to determine a producer's joint probability of losing a litigation case.Anaerobic Digestion, Dairy Litigation suits, Dairy production, Livestock Production/Industries,

Crawler Transporter Steering and Jel Systems

The transporter weighing 2.8 million kilograms (6.3 million pounds) was used to lift a 5.7-million-kilogram (12.6-million-pound) combination of mobile launcher and space vehicle, transfer this load approximately 5.6 kilometers (3.5 miles) from its point of assembly, negotiate curves of 152-meter (500-foot) mean radius, climb a 5-percent grade while maintaining the 122-meter (400-foot) structure in a vertical position within 10 minutes of arc, and smoothly position this huge structure to within plus or minus 5.1 centimeters (plus or minus 2 inches) on support pedestals at the launch pad. The crawler-transporter is described in detail