Fostering cultural competency: The Pennsylvania Action Coalition\u27s exemplar

This presentation will discuss opportunities presented by changing demographics and the long-standing disparities in health care. Presenters will share strategies employed by members of the PA-AC Nursing Diversity Council to increase proportion of traditionally underrepresented nurses in the workforce and the implementation of the Pennsylvania statewide cultural competency program

Leading change: The power of vision and collaborative-partnership

This presentation will discuss how leadership vision and commitment to quality healthcare for vulnerable populations served as a catalyst for change. Leveraging the qualities of visionary leadership, a team of thought leaders collaborated to lead a statewide initiative that enhanced cultural competence services across the state of Pennsylvania

Homeostatic Relationships of Single- and Double-crosses of Corn

The inherent homeostatic properties of single- and double- cross corn hybrids were studied by growing the plant materials in six locations over three years. Measurements of plant height and ear weight were recorded and used to calculate means and variances. Variances were pooled over locations and years and confidence intervals for the variance estimates were computed by use of the chi-square method. A lower variance for an entry, when compared with other entries grown in the same environment, was considered to be the result of relatively better homeostatic properties. Comparisons of entries were made by the use of confidence intervals for the variance estimates, with overlapping of intervals for the variance estimates, with overlapping of intervals indicative of no significant difference in variability. The theory that single-cross hybrids are more variable between locations and double-cross hybrids more variable within locations was partially substantiated. It was concluded that more diverse environmental conditions, either more locations and/or more years, would be required to more accurately detect differences in the relative homeostatic properties of the entries used

Providing Comprehensive Care to Underserved Communities

This panel shares the history, vision and programs of Philadelphia FIGHT Community Health Centers, charting their growth from 1990 to today. Originally formed as a clinical research organization committed to ending the AIDS epidemic, FIGHT expanded into an AIDS Service Organization (ASO) and has since become a large Federally Qualified Health Center (FQHC) incorporating dental care, behavioral health and recovery programs, and pediatric, adolescent, and adult primary care, with a special focus on treating HIV and curing Hep C. FIGHT is unique because the health services are embedded in an organization that prioritizes digital access and digital literacy while addressing the needs of formerly incarcerated persons, homeless and unstably housed individuals, and anyone at risk of HIV. In addition, the panel discusses the relationship between the Jefferson College of Population Health and Philadelphia FIGHT, particularly with the JCPH MPH students. Learning Objectives: Describe FIGHT’s history in community research and how the type of programs they offer positively affect underserved communities. Explain various successes and challenges of building a multi-disciplinary practice servicing some of Philadelphia\u27s most vulnerable citizens. List ways Federally Qualified Health Centers impact populations and how they play an important role in population health. Presentation: 56:4

Aquatic therapy for children with Duchenne muscular dystrophy: a pilot feasibility randomised controlled trial and mixed-methods process evaluation.

BACKGROUND: Duchenne muscular dystrophy (DMD) is a rare disease that causes the progressive loss of motor abilities such as walking. Standard treatment includes physiotherapy. No trial has evaluated whether or not adding aquatic therapy (AT) to land-based therapy (LBT) exercises helps to keep muscles strong and children independent. OBJECTIVES: To assess the feasibility of recruiting boys with DMD to a randomised trial evaluating AT (primary objective) and to collect data from them; to assess how, and how well, the intervention and trial procedures work. DESIGN: Parallel-group, single-blind, randomised pilot trial with nested qualitative research. SETTING: Six paediatric neuromuscular units. PARTICIPANTS: Children with DMD aged 7-16 years, established on corticosteroids, with a North Star Ambulatory Assessment (NSAA) score of 8-34 and able to complete a 10-m walk without aids/assistance. Exclusions: > 20% variation between baseline screens 4 weeks apart and contraindications. INTERVENTIONS: Participants were allocated on a 1 : 1 ratio to (1) optimised, manualised LBT (prescribed by specialist neuromuscular physiotherapists) or (2) the same plus manualised AT (30 minutes, twice weekly for 6 months: active assisted and/or passive stretching regime; simulated or real functional activities; submaximal exercise). Semistructured interviews with participants, parents (n = 8) and professionals (n = 8) were analysed using Framework analysis. An independent rater reviewed patient records to determine the extent to which treatment was optimised. A cost-impact analysis was performed. Quantitative and qualitative data were mixed using a triangulation exercise. MAIN OUTCOME MEASURES: Feasibility of recruiting 40 participants in 6 months, participant and therapist views on the acceptability of the intervention and research protocols, clinical outcomes including NSAA, independent assessment of treatment optimisation and intervention costs. RESULTS: Over 6 months, 348 children were screened - most lived too far from centres or were enrolled in other trials. Twelve (30% of target) were randomised to AT (n = 8) or control (n = 4). People in the AT (n = 8) and control (n = 2: attrition because of parental report) arms contributed outcome data. The mean change in NSAA score at 6 months was -5.5 [standard deviation (SD) 7.8] for LBT and -2.8 (SD 4.1) in the AT arm. One boy suffered pain and fatigue after AT, which resolved the same day. Physiotherapists and parents valued AT and believed that it should be delivered in community settings. The independent rater considered AT optimised for three out of eight children, with other children given programmes that were too extensive and insufficiently focused. The estimated NHS costs of 6-month service were between £1970 and £2734 per patient. LIMITATIONS: The focus on delivery in hospitals limits generalisability. CONCLUSIONS: Neither a full-scale frequentist randomised controlled trial (RCT) recruiting in the UK alone nor a twice-weekly open-ended AT course delivered at tertiary centres is feasible. Further intervention development research is needed to identify how community-based pools can be accessed, and how families can link with each other and community physiotherapists to access tailored AT programmes guided by highly specialised physiotherapists. Bayesian RCTs may be feasible; otherwise, time series designs are recommended. TRIAL REGISTRATION: Current Controlled Trials ISRCTN41002956. FUNDING: This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 21, No. 27. See the NIHR Journals Library website for further project information

Agricultural Districts and Land Use: A Pilot Study

A.E. Res. 80-2

Views of Soil and Water Conservation District Directors Regarding Development and Implementation of Farm Conservation Plans and Implications for Water Quality Management Planning in New York State

A.E. Res. 79-