Rural Health Care as an Economic Engine

Rural areas across the U.S. are experiencing extremely tough economic times. As business layoffs continue, the economy of these rural communities will suffer more and more. One opportunity leaders in rural communities often overlook is health care. Rural leaders know the importance of medical facilities in providing health care but are often unaware of the economic impact and opportunities that health care has on their economic health. The overall objective of this paper is to illustrate and measure the economic impact of critical access hospitals on a medical service area, on a county and at the state level. The paper will discuss how the results can be used to enhance and expand health services at each governmental level. There are nine critical access hospital in Hawaii. Operational data, which include employment, wages and salaries, and revenue were collected from each hospital in 2008. Also, construction data, which reflects capital expenditures, were collected. Then the input-output model, using data from IMPLAN were used to measure the operational economic impact and construction impact at three government levels. These included impacts of a critical access hospital on a community (Hale Ho'ola Hamakua), impact of three critical access hospitals on Hawaii County, and impact of nine critical access hospitals on the state of Hawaii. This section will present economic impacts at each governmental level and discuss how this information can be used at each governmental level. Also included will be a discussion of the community or county engagement process, which provides the community or county leaders a format to assess health needs and gather support and input. From this process, medical services are often expanded or added and in turn, jobs are created. In summary, the provision of medical services in rural areas is critical. The economic impact is huge. Thus, if community leaders desire the provision of health services can be an economic engine. This paper shows how health research and extension professionals can assist rural leaders in enhancing the provision of health services in rural communities

Problem-Based Teacher-Mentor Education: Fostering Literacy Acquisition in Multicultural Classrooms

We designed a professional development (PD) teacher-mentor program that used problem-based learning (PBL) to accomplish two goals. First, teachers explored how PBL could be used effectively in their classrooms to change the way they think about teaching to include literacy development in content areas. Second, PBL was the basis for PD training to help them improve their own knowledge of PBL, become mentors to other teachers, and implement PBL in their schools across content areas. Educators in the United States are challenged to teach linguistically and culturally diverse (LCD) students with differing literacy levels. The demographics of U.S. classrooms require a rigorous attempt to engage LCD students through collaborative, active learning opportunities (McGroarty, 1998; U.S. Department of Education, 2015). Research shows that literacy learning for all students improves in classroom settings that take a cooperative, student-centered approach (McGroarty, 1988, 1989; NCSS, 1991; Shumway, Saunders, Stewardson, & Reeve, 2001). PBL provides opportunities for students to engage in active learning and allows students with multiple learning styles to negotiate contextualized meaning through a variety of collaborative tasks. PBL has also been shown to be an effective method for teaching learners to be self-directed problemsolvers. However, in the absence of PD and ongoing support, teachers are often resistant to the implementation of PBL. In our program, we used PBL to help teachers learn more about literacy and PBL while providing opportunities for PD and support. As a result, the teacher reflections, discussions, presentations, and self-evaluations demonstrated how, by using PBL in their classrooms while immersing themselves in evidence-based content, they observed enhanced student collaboration. Teachers felt that they were better able to foster a learning environment in their classrooms that would allow students to develop literacy skills in a content-rich context both because of the incorporation of PBL and because of the support they provided for each other. This idea can be easily adapted to foster teacher development and mentoring programs in other fields

Memes as Means: Using Popular Culture to Enhance the Study of Literature

Artistic response is the process by which readers create concrete representations of their transactions with a text through artistic means, including visual arts (e.g. drawing, sculpture, and painting), drama, and music. Research has shown that artistic response helps students form meaningful relationships with texts, as it is a tool that encourages students to enter, explore, make connections, and enjoy stories and characters. In this article we describe an artistic response strategy that we developed and implemented. Recognizing that today’s students often know and interact with the world through social media and memes, we draw on this cultural tool to leverage the power of this platform and its familiarity and appeal to our student

Ceftaroline fosamil monotherapy for methicillin-resistant Staphylococcus aureus bacteremia: a comparative clinical outcomes study

OBJECTIVES: Vancomycin is the treatment of choice for methicillin-resistant Staphylococcus aureus (MRSA) bacteremia; however, its use has been subject to scrutiny due to failure in severe infections. Ceftaroline fosamil (CPT-F) is approved for MRSA acute bacterial skin and skin structure infections, but not for bloodstream infections. The clinical outcomes of treatment with CPT-F in patients with MRSA bacteremia were evaluated. METHODS: Patients diagnosed with MRSA bacteremia at Henry Ford Hospital in Detroit, Michigan, USA, involving isolates with a vancomycin minimum inhibitory concentration ≥1.0mg/l and susceptible in vitro to CPT-F, were systematically reviewed retrospectively. Ceftaroline fosamil-treated patients were matched with at least two vancomycin- and/or one daptomycin-treated control patient based on age-patients age 65 years or greater or less than 65 years of age. Outcomes evaluated included the duration of hospitalization, duration of therapy, adverse events, relapse, hospital readmission, and death. RESULTS: Thirty consecutive cases of MRSA bacteremia treated with CPT-F during the period May 2011 to June 2013 were identified; these patients were matched to 56 MRSA bacteremia patients treated with vancomycin and 46 MRSA bacteremia patients treated with daptomycin. The primary source of MRSA bacteremia in the cohort treated with CPT-F was endocarditis (n=7, 23%), skin/wound (n=9, 30%), and bone/joint (n=8, 27%). The MRSA bacteremia in those treated with CPT-F was community-acquired in 43% of cases, healthcare-associated in 43%, and hospital-acquired in 13%. The mean length of hospital stay for these patients was 22 days. The overall 30-day mortality rate was 13% (n=4) in CPT-F patients versus 24% (n=11) in daptomycin patients and 11% (n=6) in vancomycin patients (p=0.188). CONCLUSIONS: CPT-F demonstrated comparable clinical outcomes in MRSA bacteremia patients compared with the other agents, especially as salvage therapy

Pds5p regulates the maintenance of sister chromatid cohesion and is sumoylated to promote the dissolution of cohesion

Pds5p and the cohesin complex are required for sister chromatid cohesion and localize to the same chromosomal loci over the same cell cycle window. However, Pds5p and the cohesin complex likely have distinct roles in cohesion. We report that pds5 mutants establish cohesion, but during mitosis exhibit precocious sister dissociation. Thus, unlike the cohesin complex, which is required for cohesion establishment and maintenance, Pds5p is required only for maintenance. We identified SMT4, which encodes a SUMO isopeptidase, as a high copy suppressor of both the temperature sensitivity and precocious sister dissociation of pds5 mutants. In contrast, SMT4 does not suppress temperature sensitivity of cohesin complex mutants. Pds5p is SUMO conjugated, with sumoylation peaking during mitosis. SMT4 overexpression reduces Pds5p sumoylation, whereas smt4 mutants have increased Pds5p sumoylation. smt4 mutants were previously shown to be defective in cohesion maintenance during mitosis. These data provide the first link between a protein required for cohesion, Pds5p, and sumoylation, and suggest that Pds5p sumoylation promotes the dissolution of cohesion

Evaluating the economic impact of telemedicine in a rural community

The Oklahoma Cooperative Extension Service periodically issues revisions to its publications. The most current edition is made available. For access to an earlier edition, if available for this title, please contact the Oklahoma State University Library Archives by email at [email protected] or by phone at 405-744-6311

The inverse hazard law: Blood pressure, sexual harassment, racial discrimination, workplace abuse and occupational exposures in US low-income black, white and Latino workers

http://dx.doi.org/10.1016/j.socscimed.2008.09.03