Falling Through the Cracks: Child Care Decision Making Among the Working Poor

Session 4: Children. Presenter Amber Moodie-Dyer, Ph.D. University of Missouri (2011)- "Falling Through the Cracks: Child Care Decision Making Among the Working Poor".The Ohio State University College of Social Wor

Falling through the cracks : child care decision-making among the working poor

Title from PDF of title page (University of Missouri--Columbia, viewed on October 19, 2012).The entire thesis text is included in the research.pdf file; the official abstract appears in the short.pdf file; a non-technical public abstract, appears in the public.pdf file.Dissertation advisor: Dr. Colleen GalambosVita.Ph. D. University of Missouri--Columbia 2011."May 2011"The aim of this study was to discover how barriers influence working poor parents' child care selection criteria, satisfaction with child care choice, and continuity of care for their young children. In order to empower working poor families to make the best child care decisions for their young children, the barriers facing parents when choosing care must be better understood. Factors which may act as barriers include: lack of work, family and caregiver flexibility; transportation and affordability challenges; and lack of social support and financial assistance with child care. Data were collected from parents by survey distribution at local community agencies in one Mid-Missouri county. Data from 154 surveys were analyzed using logistic regression and study hypotheses were supported: Parents with more barriers were more likely to report imperfect satisfaction and continuity of care, as well as a discrepancy in the importance of quality and logistical characteristics when choosing care in an ideal versus real world setting. The two barriers that most predicted negative outcomes were lack of social support and financial assistance. Implications for social work practice, policy and future research are discussed.Includes bibliographical reference

Understanding the Impact Of A Property Tax Levy on Provision of Senior Services and Quality of Life for Missouri Seniors

Property tax levies or mill taxes have been increasingly relied upon to support senior services due to inadequate federal and state funding (Payne & Applebaum, 2008). Analysis of the effects of property tax levies on service availability, provision and access for seniors is in its infancy. Given the growing population of seniors and the aging out of the baby-boomer population, needs will continue to grow (Payne & Applebaum). The importance of effective funding techniques is paramount to the adequate provision of services to meet the needs of seniors in their communities. This study is based on a similar study conducted in the state of Ohio, the only other of its kind, in which counties with a senior service tax levy were surveyed about the number of seniors served, types of services, and amount of the levies (Payne, Applebaum, Molea & Ross, 2007). Ohio and Missouri are two of eight states which use county property tax levies to help fund senior services. Results of the Ohio survey indicated that levy funds are very popular and generally pass at a 65 to 35 percent margin. In addition, funds are most often spent on nutrition, transportation and in-home services (Payne et al.)

Navigating Autism: Parent Experiences with Coping and Service Connection

This presentation shares findings from a qualitative study exploring the experiences of parents of youth and young adults with ASD and service providers. Themes from interviews and focus groups are discussed. The presenters explore the implications of the study for providing services to individuals with ASD in relation to research, policy and practice

Virtual teaching kitchen classes and cardiovascular disease prevention counselling among medical trainees

Background: Hands-on culinary medicine education for medical trainees has emerged as a promising tool for cardiovascular health promotion. Purpose: To determine whether virtual culinary medicine programming associates with Mediterranean diet (MedDiet) adherence and lifestyle medicine competencies among medical trainees across the USA. Method: A total of 1433 medical trainees across 19 sites over a 12-month period were included. The Cooking for Health Optimisation with Patients-Medical Trainees survey composed of 61 questions regarding demographics, nutritional attitudes, dietary habits including MedDiet score and lifestyle medicine counselling competencies. Multivariable logistic regression assessed the association of virtual culinary medicine education with MedDiet intake and nutritional attitudes. Results: There were 519 medical trainees who participated in virtual culinary medicine education and 914 medical trainees who participated in their standard nutrition curricula. More than one-half of participants were women (n=759) and the mean age was 27 years old. Compared with students enrolled in traditional nutrition curricula, participants in virtual culinary medicine education were 37% more likely to adhere to MedDiet guidelines for fruit intake (OR 1.37, 95% CI 1.03 to 1.83, p=0.03). Virtual culinary medicine education was associated with higher proficiency in lifestyle medicine counselling categories, notably recommendations involving fibre (OR 4.03; 95% CI 3.05 to 5.34), type 2 diabetes prevention (OR 4.69; 95% CI 3.51 to 6.27) and omega fatty acids (OR 5.21; 95% CI 3.87 to 7.02). Virtual culinary medicine education had a similar, although higher magnitude association with MedDiet counselling competency (OR 5.73, 95% CI 4.26 to 7.70) when compared with historical data previously reported using hands-on, in-person culinary medicine courseware (OR 4.97, 95% CI 3.89 to 6.36). Conclusions: Compared with traditional nutritional educational curricula, virtual culinary medicine education is associated with higher MedDiet adherence and lifestyle medicine counselling competencies among medical trainees. Both virtual and hands-on culinary medicine education may be useful for cardiovascular health promotion

Effects of a high-dose 24-h infusion of tranexamic acid on death and thromboembolic events in patients with acute gastrointestinal bleeding (HALT-IT): an international randomised, double-blind, placebo-controlled trial

Background: Tranexamic acid reduces surgical bleeding and reduces death due to bleeding in patients with trauma. Meta-analyses of small trials show that tranexamic acid might decrease deaths from gastrointestinal bleeding. We aimed to assess the effects of tranexamic acid in patients with gastrointestinal bleeding. Methods: We did an international, multicentre, randomised, placebo-controlled trial in 164 hospitals in 15 countries. Patients were enrolled if the responsible clinician was uncertain whether to use tranexamic acid, were aged above the minimum age considered an adult in their country (either aged 16 years and older or aged 18 years and older), and had significant (defined as at risk of bleeding to death) upper or lower gastrointestinal bleeding. Patients were randomly assigned by selection of a numbered treatment pack from a box containing eight packs that were identical apart from the pack number. Patients received either a loading dose of 1 g tranexamic acid, which was added to 100 mL infusion bag of 0·9% sodium chloride and infused by slow intravenous injection over 10 min, followed by a maintenance dose of 3 g tranexamic acid added to 1 L of any isotonic intravenous solution and infused at 125 mg/h for 24 h, or placebo (sodium chloride 0·9%). Patients, caregivers, and those assessing outcomes were masked to allocation. The primary outcome was death due to bleeding within 5 days of randomisation; analysis excluded patients who received neither dose of the allocated treatment and those for whom outcome data on death were unavailable. This trial was registered with Current Controlled Trials, ISRCTN11225767, and ClinicalTrials.gov, NCT01658124. Findings: Between July 4, 2013, and June 21, 2019, we randomly allocated 12 009 patients to receive tranexamic acid (5994, 49·9%) or matching placebo (6015, 50·1%), of whom 11 952 (99·5%) received the first dose of the allocated treatment. Death due to bleeding within 5 days of randomisation occurred in 222 (4%) of 5956 patients in the tranexamic acid group and in 226 (4%) of 5981 patients in the placebo group (risk ratio [RR] 0·99, 95% CI 0·82–1·18). Arterial thromboembolic events (myocardial infarction or stroke) were similar in the tranexamic acid group and placebo group (42 [0·7%] of 5952 vs 46 [0·8%] of 5977; 0·92; 0·60 to 1·39). Venous thromboembolic events (deep vein thrombosis or pulmonary embolism) were higher in tranexamic acid group than in the placebo group (48 [0·8%] of 5952 vs 26 [0·4%] of 5977; RR 1·85; 95% CI 1·15 to 2·98). Interpretation: We found that tranexamic acid did not reduce death from gastrointestinal bleeding. On the basis of our results, tranexamic acid should not be used for the treatment of gastrointestinal bleeding outside the context of a randomised trial

Finishing the euchromatic sequence of the human genome

The sequence of the human genome encodes the genetic instructions for human physiology, as well as rich information about human evolution. In 2001, the International Human Genome Sequencing Consortium reported a draft sequence of the euchromatic portion of the human genome. Since then, the international collaboration has worked to convert this draft into a genome sequence with high accuracy and nearly complete coverage. Here, we report the result of this finishing process. The current genome sequence (Build 35) contains 2.85 billion nucleotides interrupted by only 341 gaps. It covers ∼99% of the euchromatic genome and is accurate to an error rate of ∼1 event per 100,000 bases. Many of the remaining euchromatic gaps are associated with segmental duplications and will require focused work with new methods. The near-complete sequence, the first for a vertebrate, greatly improves the precision of biological analyses of the human genome including studies of gene number, birth and death. Notably, the human enome seems to encode only 20,000-25,000 protein-coding genes. The genome sequence reported here should serve as a firm foundation for biomedical research in the decades ahead

Dipeptidyl peptidase-1 inhibition in patients hospitalised with COVID-19: a multicentre, double-blind, randomised, parallel-group, placebo-controlled trial

Background Neutrophil serine proteases are involved in the pathogenesis of COVID-19 and increased serine protease activity has been reported in severe and fatal infection. We investigated whether brensocatib, an inhibitor of dipeptidyl peptidase-1 (DPP-1; an enzyme responsible for the activation of neutrophil serine proteases), would improve outcomes in patients hospitalised with COVID-19. Methods In a multicentre, double-blind, randomised, parallel-group, placebo-controlled trial, across 14 hospitals in the UK, patients aged 16 years and older who were hospitalised with COVID-19 and had at least one risk factor for severe disease were randomly assigned 1:1, within 96 h of hospital admission, to once-daily brensocatib 25 mg or placebo orally for 28 days. Patients were randomly assigned via a central web-based randomisation system (TruST). Randomisation was stratified by site and age (65 years or ≥65 years), and within each stratum, blocks were of random sizes of two, four, or six patients. Participants in both groups continued to receive other therapies required to manage their condition. Participants, study staff, and investigators were masked to the study assignment. The primary outcome was the 7-point WHO ordinal scale for clinical status at day 29 after random assignment. The intention-to-treat population included all patients who were randomly assigned and met the enrolment criteria. The safety population included all participants who received at least one dose of study medication. This study was registered with the ISRCTN registry, ISRCTN30564012. Findings Between June 5, 2020, and Jan 25, 2021, 406 patients were randomly assigned to brensocatib or placebo; 192 (47·3%) to the brensocatib group and 214 (52·7%) to the placebo group. Two participants were excluded after being randomly assigned in the brensocatib group (214 patients included in the placebo group and 190 included in the brensocatib group in the intention-to-treat population). Primary outcome data was unavailable for six patients (three in the brensocatib group and three in the placebo group). Patients in the brensocatib group had worse clinical status at day 29 after being randomly assigned than those in the placebo group (adjusted odds ratio 0·72 [95% CI 0·57–0·92]). Prespecified subgroup analyses of the primary outcome supported the primary results. 185 participants reported at least one adverse event; 99 (46%) in the placebo group and 86 (45%) in the brensocatib group. The most common adverse events were gastrointestinal disorders and infections. One death in the placebo group was judged as possibly related to study drug. Interpretation Brensocatib treatment did not improve clinical status at day 29 in patients hospitalised with COVID-19

An Exploration of Fiscal Resources and Systems Needs related to Autism Spectrum Disorder Services and Supports in Ohio: Fiscal Analysis and Parent/Caregiver Interview Results

In order to advocate for policies that align and leverage funding streams in service to the needs of families and individuals affected by autism spectrum disorders (ASD), the Educational Service Center of Central Ohio (ESCCO) and the Center for Systems Change at the Ohio Center for Autism and Low Incidence disorders (OCALI) commissioned the College of Social Work at The Ohio State University to conduct a fiscal analysis of ASD funds and to explore parent / caregiver perceptions of the ASD service delivery system in Ohio. There were two purposes of this work: To identify federal and state funding streams that are available or may be used to support autism spectrum disorders in Ohio and To explore stakeholder (particularly parents / caregivers) experiences with the ASD service delivery system and related informal social supports. The findings from both research components provide insights into ways in which the ASD service delivery system might be improved, as fiscal mapping data inform resource investments and consumer perspectives’ drive continuous improvements