Improving the Quality of Child Care in the Rural South

A collaborative of six social service agencies and a state university determined that the single most pressing need of families in a 14-county, rural area was child care. The Training Resource Center, developed through a W K. Kellogg Foundation grant, worked with day care licensing and early childhood professional groups to develop a plan to address the systemic nature of the problem of how to improve the quality of child care. Programs developed included training, mentoring, NAEYC accreditation, and a resource library. After 15 months, some programs show the possibility of sustainability

The normative source of Kantian Hypothetical Imperatives

This paper offers a critique of Christine Korsgaard’s interpretation of Kantian instrumental reason. Korsgaard understands Kantian hypothetical imperatives to share a common normative source with the categorical imperative – namely self-legislating, human rational agency. However, her reading of Kantian hypothetical imperatives is problematic for three reasons. Firstly, Korsgaard’s agent-centred approach renders incoherent Kant’s analytic-synthetic division. Secondly, by minimising the dualistic framework of Kant’s practical philosophy the dialectical character of practical rationality is lost: norms of instrumental reasoning therefore become confused with those of moral reasoning. Thirdly, this in turn curtails the distinct critical authority of pure practical rationality over instrumental choice. The paper argues that we need to understand the normativity of instrumental rationality through the lens of Kant’s dualisms. An alternative interpretation is offered which highlights how the norms of hypothetical imperatives appeal to standards of theoretical cognition and practical efficiency rather than the self-legislative demands of pure practical reason

Preparing High School Students for College: An Exploratory Study of College Readiness Partnership Programs in Texas

About 40 percent of traditional college students take at least one remedial course to prepare for college-level coursework. According to scholars and policymakers, one cause of this problem is the misalignment of high school graduation standards and college academic expectations. College readiness partnership programs attempt to address this problem by facilitating students’ transition to college. These programs, co-sponsored by a college and K-12 organization (usually a high school), are explicitly designed to prepare high school students to enter college ready to undertake college-level work. The current study examines a number of college readiness partnership programs operating in Texas and identifies their features, targeted students, and intended outcomes. It also examines the partnerships that created these programs. The findings presented here are based on a search and analysis of the relevant research and Texas policy literature, an online scan of college readiness partnership programs in Texas with a web presence, and site visits to high schools, colleges, and community-based organizations in the Houston and Dallas–Fort Worth areas. The authors observed that most college readiness partnership programs could be classified into two types: those that focused on academic subjects and those that focused on college knowledge. The former tended to be intensive, short-term programs that targeted a small group of students and provided a direct experience of college; the latter tended to be light-touch, long-term programs that were open to all students and provided little direct experience of college. Although few rigorous evaluations of these programs have been conducted, their potential to improve college readiness for students in the “academic middle” is generally supported by the literature and the research presented here. The authors identify a number of implications for college readiness partnership programs and the partnerships themselves. It is clear that college readiness partnerships create opportunities for secondary and postsecondary institutions to leverage each other’s services, eliminating redundant services and aligning programming to maximize gains for students. In some cases, college readiness partnership programs also lead to long-lasting relationships between institutions and continued collaboration. College readiness partnership programs may have the best chance of improving outcomes if commonly encountered challenges — such as issues related to student recruitment and program sustainability — are considered early in the planning stages. The authors emphasize the value of choosing interventions that show the greatest promise in a given context and matching students to the interventions that best meet their needs; they also note that building a stronger evidence base would enhance high schools’ and colleges’ ability to make sound decisions about which potential program models to implement

Using surveillance data to monitor entry into care of newly diagnosed HIV-infected persons: San Francisco, 2006–2007

<p>Abstract</p> <p>Background</p> <p>Linkage to care after HIV diagnosis is associated with both clinical and public health benefits. However, ensuring and monitoring linkage to care by public health departments has proved to be a difficult task. Here, we report the usefulness of routine monitoring of CD4 T cell counts and plasma HIV viral load as measures of entry into care after HIV diagnosis.</p> <p>Methods</p> <p>Since July 1, 2006, the San Francisco Department of Public Health (SFDPH) incorporated monitoring initial primary care visit into standard HIV public health investigation for newly diagnosed HIV-infected patients in select clinics. Entry into care was defined as having at least one visit to a primary HIV care provider after the initial diagnosis of HIV infection. Investigators collected reports from patients, medical providers, laboratories and reviewed medical records to determine the date of the initial health care visit after HIV diagnosis. We identified factors associated with increased likelihood of entering care after HIV diagnosis.</p> <p>Results</p> <p>One -hundred and sixty new HIV-infected cases were diagnosed between July 1, 2006 and June 30, 2007. Routine surveillance methods found that 101 of those cases entered HIV medical care and monitoring of CD4 T cell counts and plasma HIV viral load confirmed entry to care of 25 more cases, representing a 25% increase over routine data collection methods. We found that being interviewed by a public health investigator was associated with higher odds of entry into care after HIV diagnosis (OR 18.86 [1.83–194.80], p = .001) compared to cases not interviewed. Also, HIV diagnosis at the San Francisco county hospital versus diagnosis at the county municipal STD clinic was associated with higher odds of entry into care (OR 101.71 [5.29–1952.05], p < .001).</p> <p>Conclusion</p> <p>The time from HIV diagnosis to initial CD4 T cell count, CD4 T cell value and HIV viral load testing may be appropriate surveillance measures for evaluating entry into care, as well as performance outcomes for local public health departments' HIV testing programs. Case investigation performed by the public health department or case management by clinic staff was associated with increased and shorter time to entry into HIV medical care.</p

College 101 Courses for Applied Learning and Student Success

College 101 courses—also called student success, introduction to college, orientation to college, or freshman experience courses—provide students with information about college and campus services, assistance with academic and career planning, and techniques to improve study habits and personal skills. This study investigated College 101 courses at three community colleges in Virginia through interviews with 169 college staff members, faculty members, and students combined with observations of 19 course sections. Although College 101 courses were found to be widely supported by stakeholders, contextual factors made implementation challenging and undermined the courses’ potential to create long-lasting impacts on students’ outcomes. College 101 courses provided students with important information, but they did not offer sufficient opportunities for in-depth exploration and skill-building practice. However, the authors found strong evidence of the worth and promise of College 101 courses and identified ways to optimize them and generate long-term results

Emerging pneumococcal carriage serotypes in a high-risk population receiving universal 7-valent pneumococcal conjugate vaccine and 23-valent polysaccharide vaccine since 2001

<p>Abstract</p> <p>Background</p> <p>In Australia in June 2001, a unique pneumococcal vaccine schedule commenced for Indigenous infants; seven-valent pneumococcal conjugate vaccine (7PCV) given at 2, 4, and 6 months of age and 23-valent pneumococcal polysaccharide vaccine (23PPV) at 18 months of age. This study presents carriage serotypes following this schedule.</p> <p>Methods</p> <p>We conducted cross sectional surveys of pneumococcal carriage in Aboriginal children 0 to 6 years of age living in remote Aboriginal communities (RACs) in 2003 and 2005. Nasal secretions were collected and processed according to published methods.</p> <p>Results</p> <p>902 children (mean age 25 months) living in 29 communities in 2003 and 818 children (mean age 35 months) in 17 communities in 2005 were enrolled. 87% children in 2003 and 96% in 2005 had received two or more doses of 7PCV. From 2003 to 2005, pneumococcal carriage was reduced from 82% to 76% and reductions were apparent in all age groups; 7PCV-type carriage was reduced from 11% to 8%, and 23PPV-non-7PCV-type carriage from 31% to 25% respectively. Thus non-23PPV-type carriage increased from 57% to 67%. All these changes were statistically significant, as were changes for some specific serotypes. Shifts could not be attributed to vaccination alone. The top 10 of 40 serotypes identified were (in descending order) 16F, 19A, 11A, 6C, 23B, 19F, 6A, 35B, 6B, 10A and 35B. Carriage of penicillin non-susceptible (MIC > = 0.12 μg/mL) strains (15% overall) was detected in serotypes (descending order) 19A, 19F, 6B, 16F, 11A, 9V, 23B, and in 4 additional serotypes. Carriage of azithromycin resistant (MIC > = 2 μg/mL) strains (5% overall), was detected in serotypes (descending order) 23B, 17F, 9N, 6B, 6A, 11A, 23F, and in 10 additional serotypes including 6C.</p> <p>Conclusion</p> <p>Pneumococcal carriage remains high (~80%) in this vaccinated population. Uptake of both pneumococcal vaccines increased, and carriage was reduced between 2003 and 2005. Predominant serotypes in combined years were 16F, 19A, 11A, 6C and 23B. Antimicrobial non-susceptibility was detected in these and 17 additional serotypes. Shifts in serotype-specific carriage suggest a need more research to clarify the association between pneumococcal vaccination and carriage at the serotype level.</p

The Setpoint Study (ACTG A5217): Effect of Immediate Versus Deferred Antiretroviral Therapy on Virologic Set Point in Recently HIV-1–Infected Individuals

(See the editorial commentary by Tossonian and Conway, on pages 10–12.