The Sponsorship Model: Leveraging Extension Program Funds, Building Local Community Collaborations

Garnering alternative Extension programming funds has become a fact of life. A group of University of Minnesota Extension educators use what they call the Sponsorship Model to accomplish this. Selected programs are not marketed to program participants but are marketed to potential local community sponsors. Sponsors pay a flat sponsorship fee and are responsible for participant recruitment and selecting the meeting date, location, start time, and any costs such as meeting facility, refreshments, and meals. This process has resulted in greater participant attendance, less management work for the Extension educators, and the ability to generate revenue to sustain and grow programming

Long-Term Health Care Planning: A Subset of Farm Transition Programming

Farm transition programming has been a valuable addition to Extension programming efforts. An often overlooked subset of farm transition programming is a discussion regarding long-term health care planning. Research supports the need for long-term health care planning. The probability of having some sort of long-term health care issue in one\u27s lifetime is high. This includes a large percentage of people under the age of 65. Health care costs, including long-term care, are increasing at alarming rates. These costs can potentially cripple a farm business financially as well as impede the transition of the business to the next generation

Unique Multiorganizational Collaborative Proves Effective in Delivering 2014 Farm Bill Education

The Agricultural Act of 2014 is critical to the economic safety net for U.S. producers. This act represented a major change in philosophy, requiring producers to make key decisions about their options on the basis of risk management. To add to the complexity of the issue, the time period for delivering applicable education to landowners before sign-up deadlines was relatively short. This article highlights a unique multiorganizational statewide approach to delivering the applicable education. It involved University of Minnesota Extension, the Center for Farm Financial Management, the U.S. Department of Agriculture, and banks and resulted in substantive evaluative outcomes

Rigel: An interactive structured grid generation system

An interactive structured grid generation application that facilitates the construction of complex, discretized, simulation models directly from the original CAD geometry specifications is presented. The application, named Rigel, reads physical model descriptions generated by modern CAD packages. Rigel includes a suite of interactive geometry editing functions to assist the user in the construction of a topologically correct geometry from the original CAD specification. Once a topologically correct geometry is created, an interactively steered grid generation capability is provided to facilitate the construction of an appropriate discretization for the simulation. Grid quality enhancement is supported with the application of user-directed elliptic smoothing, refinement, and coarsening operators. After a grid is completed, various output filters are supplied to write an input file for the target simulation code. This paper is intended to provide an overview of the mechanics of this process and to highlight some of the novel algorithms and techniques employed

Does menopause transition influence viral suppression and adherence in Women living with HIV?

BACKGROUND Increasing numbers of women living with HIV transition through menopause. It is unclear if this transition has an impact on treatment adherence, viral suppression, psychiatric comorbidities or drug use. We aimed at examining adherence and viral suppression during the perimenopausal period and explored the influence of psychiatric comorbidities and active injection drug use (IDU). SETTING Retrospective Swiss HIV Cohort Study analysis from 01/2010 to 12/2018. METHODS We explored peri- and postmenopausal trends of viral blips, low-level viremia, viral failure, adherence, psychiatric comorbidities and IDU using interrupted time series (ITS) models. RESULTS Rates of depression and psychiatric care increased during perimenopause before decreasing afterwards. Negative treatment outcomes such as viral blips, low-level viremia, viral failure and low adherence steadily declined while transitioning through menopause - this was also true for subgroups of women with depression, psychiatric treatment and active IDU. CONCLUSIONS Increased rates of depression and psychiatric care while transitioning through menopause do not result in lower rates of adherence or viral suppression in women living with HIV in Switzerland

Women with HIV transitioning through menopause: Insights from the Swiss HIV Cohort Study (SHCS)

OBJECTIVES We aimed to assess prevalence and age at menopause, identify factors associated with early menopause and explore the provision and utilization of healthcare in women living with HIV in Switzerland. METHODS This was a retrospective Swiss HIV Cohort Study analysis from January 2010 to December 2018. Descriptive statistics to characterise the population and menopause onset. Logistic regression analysis to identify risk factors for early menopause. RESULTS Of all women in the SHCS, the proportion of postmenopausal women tripled from 11.5% (n = 274) in 2010 to 36.1% (n = 961) in 2018. The median age at menopause was 50 years. Early menopause (< 45 years) occurred in 115 (10.2%) women and premature ovarian insufficiency (POI) (< 40 years) in 23 (2%) women. Early menopause was associated with black ethnicity (52.2% vs. 21.6%, p < 0.001), but not with HIV acquisition mode, CDC stage, viral suppression, CD4 cell count, hepatitis C, smoking or active drug use. While 92% of the postmenopausal women underwent a gynaecological examination during the 36 months before menopause documentation, only 27% received a bone mineral density measurement within 36 months after the last bleed and 11% were on hormone replacement therapy at the time of menopause documentation. CONCLUSIONS The median age of women living with HIV at menopause is around 2 years lower than that reported for HIV-negative women in Switzerland. HIV care providers need to adapt their services to the requirements of the increasing number of women living with HIV transitioning through menopause. They should be able to recognize menopause-associated symptoms and improve access to bone mineral density measurement as well as hormone replacement therapy

Brief Report: Does Menopause Transition Influence Viral Suppression and Adherence in Women Living With HIV?

BACKGROUND: Increasing numbers of women living with HIV transition through menopause. It is unclear whether this transition has an impact on treatment adherence, viral suppression, psychiatric comorbidities, or drug use. We aimed at examining adherence and viral suppression during the perimenopausal period and explored the influence of psychiatric comorbidities and active injection drug use (IDU). SETTING: Retrospective Swiss HIV Cohort Study analysis from January 2010 to December 2018. METHODS: We explored perimenopausal and postmenopausal trends of viral blips, low-level viremia, viral failure, adherence, psychiatric comorbidities, and IDU using interrupted time series models. RESULTS: Rates of depression and psychiatric care increased during perimenopause before decreasing afterward. Negative treatment outcomes such as viral blips, low-level viremia, viral failure, and low adherence steadily declined while transitioning through menopause-this was also true for subgroups of women with depression, psychiatric treatment, and active IDU. CONCLUSIONS: Increased rates of depression and psychiatric care while transitioning through menopause do not result in lower rates of adherence or viral suppression in women living with HIV in Switzerland

Preschool Teachers’ Perspectives About the Engagement of Immigrant and Non-Immigrant Parents in Their Children’s Early Education

The present study explores the perceptions of teachers about the engagement of immigrant and non-immigrant parents in preschool. Data were drawn from a larger evaluation study of a government initiative for preschools in Germany, which was designed to foster inclusive pedagogy and parent cooperation. In these analyses, teachers’ perceptions of the engagement of immigrant parents and non-immigrant parents were rated for each parent group, on a 10-item measure, to identify how teacher ratings varied for the different parent groups. Data from 1397 preschool teachers, employed across 203 preschools, were analyzed using multilevel modeling. This statistical approach takes account of the clustered nature of the data. Teacher ratings of engagement for immigrant and non-immigrant parent groups differed between preschools. Most variability in the ratings could be ascribed to preschool characteristics. In preschools, in which staff held a shared understanding of dealing with cultural diversity and in which the director of the preschool had a multicultural mindset, teachers perceived engagement of parents more positively, especially for immigrant parents. Overall, the findings identified the importance of self-efficacy for inclusion and more positive beliefs about multiculturalism among preschool teachers. Such qualities are important for working with all parents. However, unfavorable social structures, such as those found in disadvantaged areas, may present major challenges for parent cooperation and engagement

Sex and gender in infection and immunity: addressing the bottlenecks from basic science to public health and clinical applications

Although sex and gender are recognized as major determinants of health and immunity, their role is rarely considered in clinical practice and public health. We identified six bottlenecks preventing the inclusion of sex and gender considerations from basic science to clinical practice, precision medicine and public health policies. (i) A terminology-related bottleneck, linked to the definitions of sex and gender themselves, and the lack of consensus on how to evaluate gender. (ii) A data-related bottleneck, due to gaps in sex-disaggregated data, data on trans/non-binary people and gender identity. (iii) A translational bottleneck, limited by animal models and the underrepresentation of gender minorities in biomedical studies. (iv) A statistical bottleneck, with inappropriate statistical analyses and results interpretation. (v) An ethical bottleneck posed by the underrepresentation of pregnant people and gender minorities in clinical studies. (vi) A structural bottleneck, as systemic bias and discriminations affect not only academic research but also decision makers. We specify guidelines for researchers, scientific journals, funding agencies and academic institutions to address these bottlenecks. Following such guidelines will support the development of more efficient and equitable care strategies for all

Sex and gender in infection and immunity: addressing the bottlenecks from basic science to public health and clinical applications

Although sex and gender are recognized as major determinants of health and immunity, their role israrely considered in clinical practice and public health. We identified six bottlenecks preventing theinclusion of sex and gender considerations from basic science to clinical practice, precision medicineand public health policies. (i) A terminology-related bottleneck, linked to the definitions of sex andgender themselves, and the lack of consensus on how to evaluate gender. (ii) A data-relatedbottleneck, due to gaps in sex-disaggregated data, data on trans/non-binary people and genderidentity. (iii) A translational bottleneck, limited by animal models and the underrepresentation ofgender minorities in biomedical studies. (iv) A statistical bottleneck, with inappropriate statisticalanalyses and results interpretation. (v) An ethical bottleneck posed by the underrepresentation ofpregnant people and gender minorities in clinical studies. (vi) A structural bottleneck, as systemicbias and discriminations affect not only academic research but also decision makers. We specifyguidelines for researchers, scientific journals, funding agencies and academic institutions to addressthese bottlenecks. Following such guidelines will support the development of more efficient andequitable care strategies for all