Healthcare Provider\u27S Adherence To The Centers For Disease Control And Prevention\u27S Guidelines Regarding The Human Papillomavirus Vaccine In Males

The purpose of this study is to identify how many patients in the primary care setting diagnosed with depression were appropriately screened for suicide and, if screened, were referred to another facility

Next generation software environments : principles, problems, and research directions

The past decade has seen a burgeoning of research and development in software environments. Conferences have been devoted to the topic of practical environments, journal papers produced, and commercial systems sold. Given all the activity, one might expect a great deal of consensus on issues, approaches, and techniques. This is not the case, however. Indeed, the term "environment" is still used in a variety of conflicting ways. Nevertheless substantial progress has been made and we are at least nearing consensus on many critical issues.The purpose of this paper is to characterize environments, describe several important principles that have emerged in the last decade or so, note current open problems, and describe some approaches to these problems, with particular emphasis on the activities of one large-scale research program, the Arcadia project. Consideration is also given to two related topics: empirical evaluation and technology transition. That is, how can environments and their constituents be evaluated, and how can new developments be moved effectively into the production sector

Enhancing Federal-Tribal Coordination of Invasive Species

Invasive species are defined by the United States government to mean “with regard to a particular ecosystem, a non-native organism whose introduction causes or is likely to cause economic or environmental harm, or harm to human, animal, or plant health” (Executive Order [EO] 13751). The ecosystems to which invasive species are introduced or spread are not delimited by jurisdictional boundaries; they intersect with lands managed by federal, tribal, state, territorial, and county governments, as well as properties under private ownership. For this reason, effective coordination and cooperation across jurisdictions is of paramount importance in the prevention, eradication, and control of invasive species. Federally recognized American Indian tribes are second only to the federal government in terms of the amount of land they manage; approximately 56.2 million acres are owned either by individual tribal members or the tribe; the title to which is held in trust by the federal government. Most trust land is within reservation boundaries, but trust land can also be off-reservation, or outside the boundaries of an Indian reservation. A large amount of additional land is owned and/or managed by Native Hawaiians and Alaska Native Corporations. For the purposes of this paper, these native land stewards will hereafter be referred to collectively as indigenous peoples. Since its establishment in 1999, the National Invasive Species Council (NISC) has acknowledged the importance of working with indigenous peoples to address invasive species issues (EO 13112). To date, six representatives of federally recognized American Indian tribes have been appointed members of the non-governmental Invasive Species Advisory Committee (ISAC) which advises NISC. The 2016–2018 NISC Management Plan calls includes a priority action (2.5.1) to: Develop recommendations for coordinating Federal agency activities to implement EO 13112 with Federally-recognized tribes, as well as Native Alaskan and Native Hawaiian communities. Adopted on December 5th, 2016, EO 13751 reiterates that federal agencies are to: Coordinate with and complement similar efforts of States, territories, federally recognized American Indian tribes, Alaska Native Corporations, Native Hawaiians, local governments, nongovernmental organizations, and the private sector. In order to further these goals, a Federal-Tribal Coordination Task Team was established under the auspices of the Invasive Species Advisory Committee (ISAC). This paper reflects the work of that task team, including internal group discussions, informal consultations with other indigenous peoples, and literature review. The task team identified the following needs and recommendations to further strengthen coordination and cooperation between the United States government and indigenous peoples in their efforts to address a shared concern: the devastating impacts of invasive species on the environment and all who depend on it for their survival and quality of life. In order to be successful, coordination efforts between federal agencies and indigenous peoples to address invasive species will need to take into consideration land rights and claims; assure indigenous peoples free, prior, and informed consent; respect and facilitate the application of traditional ecological knowledge; and enable indigenous groups to build their own legal and technical capacities to address invasive species concerns

Capacity for the management of kidney failure in the International Society of Nephrology North America and the Caribbean region:Report from the 2023 ISN Global Kidney Health Atlas (ISN-GKHA)

The International Society of Nephrology Global Kidney Health Atlas charts the availability and capacity of kidney care globally. In the North America and the Caribbean region, the Atlas can identify opportunities for kidney care improvement particularly in Caribbean countries where structures for systematic data collection are lacking. In this third iteration, respondents from 12 of 18 countries from the region reported a 2-fold higher than global median prevalence of dialysis and transplant, and a 3-fold higher than global median prevalence of dialysis centers. Peritoneal dialysis prevalence was lower than global median, and transplantation data was missing from 6 of the 10 Caribbean countries. Government-funded payments predominated for dialysis modalities, with greater heterogeneity in transplantation payor mix. Services for chronic kidney disease (CKD), such as monitoring of anemia and blood pressure, and diagnostic capability relying on serum creatinine and urinalyses were universally available. Notable exceptions in Caribbean countries included non-calcium-based phosphate binders and kidney biopsy services. Personnel shortages were reported across the region. Kidney failure was more commonly identified as a governmental priority than was CKD or acute kidney injury. In this generally affluent region, there is better access to kidney replacement therapy and CKD-related services than in much of the world. Yet clear heterogeneity exists, especially among the Caribbean countries struggling with dialysis and personnel capacity. Important steps to improve kidney care in the region include increased emphasis on preventive care, a focus on home-based modalities and transplantation, and solutions to train and retain specialized allied health professionals

Positive Parenting Approaches and Their Association with Child Eating and Weight: A Narrative Review from Infancy to Adolescence

Parents play a critical role in the development of children\u27s eating behaviours and weight status, serving as providers, models and regulators of the food environment. Many research reviews have focused on the robust body of evidence on coercive control in feeding: how parenting practices such as restriction and pressure to eat increase children\u27s risk for developing undesirable eating behaviours and unhealthy weight outcomes. Fewer reviews adopt a strengths-based perspective focusing on the ways that parents can actively support the development of healthy eating behaviours and weight trajectories. Emerging research on such positive parenting styles and practices offers solutions beyond the avoidance of coercive control, as well as opportunities to highlight parallels between research on food parenting and the broader, well-established developmental literature on positive parenting. The focus of this review is to summarize what is known regarding benefits of positive parenting styles and practices for child eating and weight outcomes and discuss recommendations for future research. Current evidence supports starting with responsive feeding and parenting during infancy and incorporating structure and limit setting in early childhood, with monitoring and mealtime structure remaining important during middle childhood and adolescence. Areas for future research include: (1) further examination of the implications of identified food parenting practices and styles among diverse groups and caregivers; (2) increased consideration of child factors (eg, temperament) as moderators or mediators; and (3) further clarification of the relationship between general parenting and food parenting

An electronic family health history tool to identify and manage patients at increased risk for colorectal cancer: protocol for a randomized controlled trial.

BackgroundColorectal cancer is the fourth most commonly diagnosed cancer in the United States. Approximately 3-10% of the population has an increased risk for colorectal cancer due to family history and warrants more frequent or intensive screening. Yet, < 50% of that high-risk population receives guideline-concordant care. Systematic collection of family health history and decision support may improve guideline-concordant screening for patients at increased risk of colorectal cancer. We seek to test the effectiveness of a web-based, systematic family health history collection tool and decision support platform (MeTree) to improve risk assessment and appropriate management of colorectal cancer risk among patients in the Department of Veterans Affairs primary care practices.MethodsIn this ongoing randomized controlled trial, primary care providers at the Durham Veterans Affairs Health Care System and the Madison VA Medical Center are randomized to immediate intervention or wait-list control. Veterans are eligible if assigned to enrolled providers, have an upcoming primary care appointment, and have no conditions that would place them at increased risk for colorectal cancer (such as personal history, adenomatous polyps, or inflammatory bowel disease). Those with a recent lower endoscopy (e.g. colonoscopy, sigmoidoscopy) are excluded. Immediate intervention patients put their family health history information into a web-based platform, MeTree, which provides both patient- and provider-facing decision support reports. Wait-list control patients access MeTree 12 months post-consent. The primary outcome is the risk-concordant colorectal cancer screening referral rate obtained via chart review. Secondary outcomes include patient completion of risk management recommendations (e.g. colonoscopy) and referral for genetic consultation. We will also conduct an economic analysis and an assessment of providers' experience with MeTree clinical decision support recommendations to inform future implementation efforts if the intervention is found to be effective.DiscussionThis trial will assess the feasibility and effectiveness of patient-collected family health history linked to decision support to promote risk-appropriate screening in a large healthcare system such as the Department of Veterans Affairs.Trial registrationClinicalTrials.gov, NCT02247336 . Registered on 25 September 2014

Biography of Leann L Birch, PhD, 25 June 1946 – 26 May 2019

On 26 May, 2019, the nutrition community lost a visionary ambassador, trusted advisor, and cherished mentor. Leann Birch was a pioneer in bringing a developmental psychology perspective to the study of children\u27s nutrition as a means to respond to real-world questions raised by parents. Leann Elsie Traub was born in Owosso, Michigan 25 June, 1946. She grew up primarily in Southern California and received a bachelor\u27s degree in psychology from California State University, Long Beach, in 1971. She completed her graduate studies at the University of Michigan where she received a master\u27s degree in 1973 and a doctorate in 1975, both in psychology. She subsequently held faculty appointments reflecting affiliations with nutrition as well as human development at the University of Illinois, Urbana-Champaign (1976–1992), the Pennsylvania State University (1992–2014), and the University of Georgia (2014–2019). Over this time, Leann was a prolific scientist, publishing \u3e250 publications (with \u3e51,000 citations) and receiving \u3e$30 million in federal research funding. The public health impact and reach of Leann\u27s work is profound. References to her work can be found everywhere: federal dietary guidance, position statements from leading professional organizations, early-childhood education policies, anticipatory guidance given in the pediatrician\u27s office, and popular books on feeding children

Nonprofits in crisis: How to retain employees in the nonprofit sector

In today\u27s worsening economy more and more people find themselves seeking help through the services of nonprofit groups. Families are in worsening situations and the need for effective and efficient nonprofit human services is growing faster as more people are put out of work. It is clear that the nonprofit organizations must find a way to retain already trained employees to stave off the cost of finding and training replacements. It would be easy to think that nonprofit employees would stay if only their salaries were to increase, however, the literature review and focus group interviews found that is not the case. While more money would be welcomed, most nonprofit employees did not get into the field to become wealthy, instead they joined the nonprofit organization because of the mission and the desire to help people. Thus, nonprofit organizations\u27 managers must find ways to keep their long-tenured employees. The stress levels the frontline workers are feeling continues to increase as more and more people come in for services. The ability to rely on the mission of the organization to keep the employees is quickly eroding. Employees find themselves in a position of not only low wages but also high stress. This combination will lead to people fleeing the nonprofit human services sector for more lucrative positions in private and government sector jobs. Through analyzing a survey of Nevada nonprofit workers and conducting focus group interviews, the nonprofit human services frontline workers showed they are interested in more than just money. They want to help people. To keep those employees, the organizations can give the workers more than just money. The workers desire flexible hours, more training and an understanding of what leads to the burnout, causing them to leave the nonprofit sector. Nonprofit organizations would do well to listen to the concerns of the frontline workers or the groups will be faced with a revolving door of employees and less effective service to their clients