Implementation of a Quality Improvement (QI) intervention to increase influenza vaccination uptake in a pediatric primary care setting.

Background: Internal and external evidence demonstrates that there is a suboptimal uptake of influenza vaccination (flu vaccine) in all settings, despite national objectives to achieve 80%- 90% immunization rates across all populations. In 2002, the Advisory Committee on Immunization Practices (ACIP) issued a recommendation that all children 6 months of age and older be immunized annually with the influenza vaccine. Despite these recommendations, influenza vaccination is not required for school entry in the Commonwealth of Kentucky and immunization rates continue to fall below local, state, and national targets. Being considered an optional vaccine leaves the decision to vaccinate (or not) up to the discretion of the parent(s). Many parents choose not to vaccinate their child(ren) with the flu vaccine, leaving those children vulnerable to infection during flu season (approximately October – May). Setting: This project will take place at a private pediatric practice located in Louisville, KY. This practice currently has three providers: one physician (MD) and two physician assistants (PA). The target population will be all pediatric patients eligible to receive influenza vaccination (6 months – 17 years of age) that present to the clinic during the QI project period. All interventions will take place within the current flu season, a designated time block between October and May. Purpose: The purpose of this quality improvement (QI) project is to increase influenza vaccination uptake among all pediatric patients eligible to receive the vaccine. Measures to enhance uptake will include: providing all parents with an educational piece addressing influenza infection and vaccination, addressing erroneous attitudes and beliefs surrounding the vaccine, and targeted provider communication to vaccine-hesitant parents. Methods: This 6-week quality improvement (QI) project is separated into a 3-week preintervention period and a 3-week intervention period. Upon checking into the clinic, patients will be screened for flu vaccine eligibility and given an educational pamphlet regarding influenza infection and vaccination. Vaccine-eligible patients will be prompted for intent to vaccinate during current visit, tracked during the visit, and marked for further intervention by providers (during intervention period). Vaccination rates will be recorded and compared between pre-intervention period (does not include provider-prompted intervention) and intervention period. Measures: Outcomes measured in this project will include number of patients that received the flu vaccine (subdivided by intent to vaccinate at check-in) during intervention and preintervention periods. Statistics will be tracked as an aggregate and also by provider

Methods to Develop a Crediting Strategy for Transportation and Metropolitan Planning Agencies: White Paper

The focus of this paper is to identify the ways in which the Ecosystem Services Crediting methodology, part of the Integrated Ecological Framework (IEF), could be developed to make it easily usable and meaningful to transportation agencies. IEF is an ecological assessment process and framework to integrate conservation planning and transportation planning

Elementary Principals\u27 Behaviors and Collaborative Professional Learning Communities

Principals need to possess leadership skills and behaviors that help set expectations for collaborative work. The problem in this case study was that little was known about the collaboration-building behaviors principals use that promote effective collaboration between members of the school community. The purpose of this qualitative study was to explore and describe the behaviors principals exhibit when building collaboration through the implementation of Professional Learning Communities (PLCs). The conceptual framework was based on 3 elements: leadership styles and approaches, collaboration, and the implementation of effective PLCs. The primary research question explored how principal behaviors contribute to collaborative professional learning communities. Purposeful sampling was used to recruit 6 elementary principals from a Mid-Atlantic State. Data were collected through semistructured interviews and document review of PLC structures. Data were coded using a Microsoft Word Doc Data Extract tool and analyzed for themes using an inductive process. Emergent themes for building collaboration were identified as leadership traits, vision, time, collaborative structures, culture, and the need for professional learning. Results suggest that shared leadership, vision, collective learning, and supportive conditions influence the effective development of PLCs. As a result, professional learning opportunities are recommended for school leaders on strategies that successfully develop supportive and collaborative structures in schools. Implications for social change are that PLCs may strengthen professional practice in classrooms, schools, districts, and communities

Adding climate change to the mix: using climate futures in conservation planning for Oregon’s oak-dominated habitats - Eugene, Oregon April 26-27, 2011 - Workshop Summary

In 2009, the Oregon Department of Fish and Wildlife initiated a process to incorporate information about climate change and its effects on fish, wildlife, and habitats into the Oregon Conservation Strategy. The agency acknowledged that climate change is already affecting Oregon’s species and habitats and that future climate change represents one of the most serious long-term challenges to sustaining healthy populations of fish and wildlife. This workshop brought together representatives of the research, land and resource management, and conservation communities to contribute to the update and implementation of the Oregon Conservation Strategy. Participants were asked to help ODFW identify climate change impacts and high-priority climate change adaptation strategies for Oregon’s oak-dominated habitats. The meeting was also intended to build and strengthen partnerships in the research and management communities

Workshop on Estuaries, Climate Change, and Conservation Planning Oregon Coast Aquarium, Newport, Oregon, November 18-19, 2010 - Workshop Summary

In 2009, the Oregon Department of Fish and Wildlife initiated a process to incorporate information about climate change and its effects on fish, wildlife, and habitats into the Oregon Conservation Strategy. The agency acknowledged that climate change is already affecting Oregon’s species and habitats and that future climate change represents one of the most serious long-term challenges to sustaining healthy populations of fish and wildlife. This workshop brought together representatives of the research, land and resource management, and conservation communities to contribute to the update and implementation of the Oregon Conservation Strategy. Participants were asked to help ODFW identify high-priority climate change adaptation strategies for Oregon’s estuaries. A secondary goal of the meeting was to build and strengthen partnerships in the research and management communities

Evidence Based Review Workshop for Forestry: Introduction & practical guidance on systematic reviews

Systematic Evidence Based Review Workshop, May 7-9, 2013 (Corvallis, OR). Workshop materials and presentations.This workshop was held in 107 Richardson Hall on the Corvallis campus of Oregon State University with the intended goal of introducing participants to the skills required for evidence-based natural resource analysis. These skills include: framing answerable questions to address policy & practice concerns, finding the best available evidence to answer the question, recognizing the limitations of available studies and problems of bias, critically appraising the evidence for its validity and usefulness, planning a systematic review, and forming a systematic review team. The workshop explored guidance from a variety of fields that utilize an evidence-based approach, and related this to issues of high priority for natural resources regionally. The workshop was facilitated by Dr. Gillian Petrokofsky of Oxford University who has worked on related training programs for researchers at CIFOR. Files attached to this record include speakers’ presentation slides, handouts and the registration webpage with contact information. These are preserved as PDFs. Additional information is available on the OSU Library Guide created for this workshop at: http://guides.library.oregonstate.edu/2013serworksho

Identifying environmental and management factors that may be associated with the quality of life of kennelled dogs (Canis familiaris)

Abstract This paper describes the use of a validated quality of life assessment tool (described elsewhere) to identify environmental and management factors that may affect quality of life in dogs kennelled in rehoming centres. Dogs were allocated to one of four treatment groups, all of which had a positive (0.0 - 1.0) average quality of life score: long stay dogs with an enriched routine had a mean score of 0.477; long stay dogs with a standard routine had a mean score of 0.453; newly admitted dogs with an enriched routine had a mean score of 0.399; and newly admitted dogs with a standard routine had a mean score of 0.362. Only 2 of the dogs had a negative score (-1.0 - 0.0). Thirteen rehoming centre managers completed a questionnaire relating to the kennel environment and management practices of their rehoming centres. The environmental and management factorsâ�� associations with quality of life scores, collected from 202 dogs from the 13 rehoming centres using this scoring system, were analysed as fixed factors in a linear mixed-effect model, with rehoming centre fitted as a random factor, and a multiple linear regression model. There was a statistically significant association between quality of life scores and rehoming centre (H(12) = 54.153, p <0.001), however, the fitted linear mixed-effect model did not improve upon the null model and therefore cannot be used to explain the 29 variance in quality of life scores attributed to rehoming centre. The multiple linear regression model explained 42 of the variation in quality of life scores (F(10,131) = 9.318, p < 0.001): the provision of bunk beds increased quality of life scores by 0.3 (t = 3.476, p < 0.001); provision of 30 minutes or more of staff or volunteer interaction increased scores by 0.26 (t = -2.551, p = 0.012); grooming dogs decreased scores by 0.404 (t = 3.326, p = 0.001); exercising dogs more than once a day decreased scores by 0.173 (t = -3.644, p = <0.001), whereas exercising dogs for 30 minutes or more increased quality of life scores by 0.213 (t = -2.374, p = 0.019) and the provision of less common types of exercise increased scores by 0.504 (t = 5.120, p < 0.001); training dogs for 30 minutes or more every day increased scores by 0.688 (t = 3.040, p = 0.003) and training dogs less than daily decreased scores by 0.393 (t = -4.245, p < 0.001); feeding a diet of dry and wet food compared to dry food alone decreased scores by 0.08 (t = -2.331, p = 0.021); and a quiet environment increased scores by 0.275 (t = -3.459, p < 0.001). These results suggest that environmental design and kennel management have an impact on the quality of life of kennelled dogs and should be considered carefully in decision-making processes. However, further study may be required as grooming and exercising dogs more than once per day decreased quality of life scores, which are not obviously intuitive results

Cocaine-Induced Locomotor Activation Differs Across Inbred Mouse Substrains

Cocaine use disorders (CUD) are devastating for affected individuals and impose a significant societal burden, but there are currently no FDA-approved therapies. The development of novel and effective treatments has been hindered by substantial gaps in our knowledge about the etiology of these disorders. The risk for developing a CUD is influenced by genetics, the environment and complex interactions between the two. Identifying specific genes and environmental risk factors that increase CUD risk would provide an avenue for the development of novel treatments. Rodent models of addiction-relevant behaviors have been a valuable tool for studying the genetics of behavioral responses to drugs of abuse. Traditional genetic mapping using genetically and phenotypically divergent inbred mice has been successful in identifying numerous chromosomal regions that influence addiction-relevant behaviors, but these strategies rarely result in identification of the causal gene or genetic variant. To overcome this challenge, reduced complexity crosses (RCC) between closely related inbred mouse strains have been proposed as a method for rapidly identifying and validating functional variants. The RCC approach is dependent on identifying phenotypic differences between substrains. To date, however, the study of addiction-relevant behaviors has been limited to very few sets of substrains, mostly comprising the C57BL/6 lineage. The present study expands upon the current literature to assess cocaine-induced locomotor activation in 20 inbred mouse substrains representing six inbred strain lineages (A/J, BALB/c, FVB/N, C3H/He, DBA/2 and NOD) that were either bred in-house or supplied directly by a commercial vendor. To our knowledge, we are the first to identify significant differences in cocaine-induced locomotor response in several of these inbred substrains. The identification of substrain differences allows for the initiation of RCC populations to more rapidly identify specific genetic variants associated with acute cocaine response. The observation of behavioral profiles that differ between mice generated in-house and those that are vendor-supplied also presents an opportunity to investigate the influence of environmental factors on cocaine-induced locomotor activity

Meaning in Life as a Mediator of Ethnic Identity and Adjustment Among Adolescents from Latin, Asian, and European American Backgrounds

Establishing a sense of life meaning is a primary facet of well-being, yet is understudied in adolescent development. Using data from 579 adolescents (53% female) from Latin American, Asian, and European backgrounds, demographic differences in meaning in life, links with psychological and academic adjustment, and the role of meaning in explaining associations between ethnic identity and adjustment were examined. Although no generational or gender differences were found, Asian Americans reported higher search for meaning than Latin and European Americans. Presence of meaning was positively associated with self-esteem, academic adjustment, daily well-being, and ethnic belonging and exploration, whereas search for meaning was related to lower self-esteem and less stability in daily well-being. Presence of meaning mediated associations between ethnic identity and adjustment, explaining 28–52% of ethnic identity’s protective effect on development. Ethnic identity thus appears to affect adjustment, in part, through its role in fostering a positive sense of meaning in adolescents’ lives