The Impact of the Los Angeles Healthy Kids Program on Access to Care, Use of Services, and Health Status

Presents survey results on the impact of the Healthy Kids program, which provides uninsured children with comprehensive coverage, on access to care, unmet needs, use of specialty and dental services, health status, and parental satisfaction

Final Report of the Evaluation of the San Mateo County Children's Health Initiative

Summarizes key findings from a five-year evaluation of the county's Children's Health Initiative -- its outreach and enrollment efforts, the impact on children enrolled in the Healthy Kids program, areas for improvement, and financing challenges

A study into the relationship between dental development and cervical vertebral maturation in UK subjects

Aim: To examine relationships between dental and skeletal maturity in White British and Asian UK subjects. Methods: Ninety subjects per ethnic group, with digital panoramic and lateral cephalometric radiographs, were selected from the records of Birmingham Dental Hospital. Dental maturity was assessed from the development stage of the left mandibular canine, first and second premolar, and second molar using the Demirjian Index (DI). Skeletal maturity was determined from cervical vertebral maturation (CVM) stage using the method of Baccetti. Spearman rank-order correlation coefficients were calculated to measure the association between DI and CVM. Results: Females reached each CVM stage at an earlier age than males. There was no statistically significant difference in the mean age of White British and Asian subjects at each CVM stage. The mandibular canine had the highest correlation with CVM stage in White British males (r = 0.568). The mandibular second molar demonstrated the highest correlation to CVM stage in White British females and in Asian males and females (r = 0.533; r = 0.752; r = 0.569 respectively). Conclusion: Moderate statistically significant correlations were observed between DI and CVM stages, suggesting that dental development stage can be considered as a method for determining skeletal maturity in UK subjects during orthodontic treatment planning

Fynbos: research & education centre

This document is submitted in partial fulfilment for the degree: Master of Architecture [Professional] at the University of the Witwatersrand, Johannesburg, South Africa, in the year 2014.‘Unless someone like you cares an awful lot, nothing is going to get better, it’s not.’ (The Lorax, Dr Seuss) How can architecture play a role to make us understand and realise the vulnerability of Fynbos? The Western Cape is the habitat for one of the six species of the floral kingdom, Fynbos. This botanical treasure is in danger of becoming extinct. There are thousands of types of Fynbos, each endemic to a specific region within the Western Cape and it is important to raise awareness of this unique species as creating a familiarity and deeper personal connection with the plant can help to protect this endangered flora. I propose a Fynbos Research and Education Centre set in Clanwilliam, a historical area within the Cederberg Mountain Range. The centre will be created to allow a deeper understanding of Fynbos and to this effect, aims to educate people about Fynbos so as to give them a better knowledge about sustainable living and the value of this plant species. It will be a place of calm and learning and the landscape will have a fundamental effect on the form. A vital part of the work to be carried out by this centre will be research into methods of conservation as well as into possible medical and cosmetic uses inherent in this species. Looking to plant structure, organic architecture and the analogy of nature, and its influence on architecture from both the geology of the region and the natural landscape setting, to discover what this then means for the architecture of the centre. The idea of Nature’s constant generation and degeneration, life coming from death and the influence of ruins on architectural imaginations will be fundamental in this building. Fynbos is endangered but this centre will aim to prevent it from becoming a memory and perhaps once it has been saved the structure will be left for nature to take over once again. The relationship between Fynbos and the landscape will shape and determine the architecture and materiality. Organic rammed earth walls will rise out of the sandstone formations which are the foundation of the Cederberg, to create this centre. The walls, made up of the very sand that sustains the Fynbos will exemplify it as at one with nature. As fire reignites life within the Fynbos seeds which lie dormant beneath the soil, so too can the building and the garden ignite passion to save this species, incorporating various design mechanisms into the architecture representing fire and its giving of life, in the case of the Fynbos, or preventing destruction in terms of the building. The creation of an education centre, restaurant and research facility will encourage a steady stream of visitors to Clanwilliam throughout the year. This will help to build tourism and eco-tourism to the town and surrounding areas, giving a much needed economic injection by creating job opportunities. Importantly, it will also increase awareness and exposure to the Fynbos species, with the building encouraging the visitor to linger and get involved with the plants and site and to develop a deeper affinity with this dwindling flora. This thesis aims to take its visitors on a journey, by means of architecture, creating a human experience and therefore a connection with their surroundings, exploring and uncovering the landscape of the Cederberg and its local identity and heritage, creating a bond forged by a new understanding

‘Licking the snake’: the i'khothane and contemporary township youth identities in South Africa

The i’khothane youth subculture is a relatively new phenomenon that has emerged in some of South Africa’s townships. Characterised by the rampant consumption of certain goods, such as expensive clothing, the subculture is unique in that it is also defined by the destruction of these goods in performances known as ‘battles’. Demonised by the media, we set out to explore what makes these practices meaningful to the participants themselves. On the basis of in-depth interviews conducted with the members of one group, we bring to the academic literature a scarcely analysed phenomenon that is nevertheless an acknowledged element of popular youth culture in contemporary South Africa. We attempt to place the practice of i’khothane within the context of the patterns of conspicuous consumption that have emerged in (a highly unequal) post-apartheid South Africa. While the practice of burning expensive consumer goods in public may seem alien, especially in contrast to the impoverished surroundings within which the i’khothane live, there are discernable and understandable reasons why the subculture has gained both popularity and notoriety. We show how the practice of i’khothane is a potent means of articulating youth identity in settings seemingly left behind by the ‘new’ South Africa

An examination of sample length and reliability of the Interactional Network Tool, a new measure of group interactions in acquired brain injury

Background: Conversation is challenging to measure. Quantitative and qualitative measures need to be sensitive to the conversation context, the purpose and the variable contributions of participants in order to capture meaningful change. Measurements also need to be consistent across independent raters. The reliability of global observational rating scales across differing sample lengths has previously been investigated. An investigation into the effects of sample length on inter-rater reliability using a behavioural frequency measure is a new field of research. Aims: This study reports on the inter-rater reliability of the Interactional Network Tool (INT), a behavioural coding system for use with group interaction data. It examines the effects of sample length on reliability using a refined coding system designed to improve the speed and efficiency of use in clinical settings. Methods: Fourteen video samples of group interactions for people with acquired brain injury were prepared for analysis. Two raters independently coded the films using the INT coding system. Individual code reliability was calculated using intra-class correlations (ICCs). Codes were combined to form a new coding structure. Reliability of the new codes was calculated using intra-class correlations across four sample lengths (5,10,15 and 20 minutes). A one-way analysis of variance was used to compare the means of the four sample lengths. Outcomes and Results: Acceptable inter-rater reliability was achieved using the refined INT coding system. There was no difference between the four sample lengths. Conclusions: These findings indicate that trained clinicians using the INT in clinical practice can achieve a reliable measure of participation in a group interaction from short samples. Validation with other clinical groups is now indicated

Breast Cancer Risk Assessment and Primary Prevention Advice in Primary Care: A Systematic Review of Provider Attitudes and Routine Behaviours

Implementing risk-stratified breast cancer screening is being considered internationally. It has been suggested that primary care will need to take a role in delivering this service, including risk assessment and provision of primary prevention advice. This systematic review aimed to assess the acceptability of these tasks to primary care providers. Five databases were searched up to July–August 2020, yielding 29 eligible studies, of which 27 were narratively synthesised. The review was pre-registered (PROSPERO: CRD42020197676). Primary care providers report frequently collecting breast cancer family history information, but rarely using quantitative tools integrating additional risk factors. Primary care providers reported high levels of discomfort and low confidence with respect to risk-reducing medications although very few reported doubts about the evidence base underpinning their use. Insufficient education/training and perceived discomfort conducting both tasks were notable barriers. Primary care providers are more likely to accept an increased role in breast cancer risk assessment than advising on risk-reducing medications. To realise the benefits of risk-based screening and prevention at a population level, primary care will need to proactively assess breast cancer risk and advise on risk-reducing medications. To facilitate this, adaptations to infrastructure such as integrated tools are necessary in addition to provision of education

A study of the effectiveness of teaching methods used in a college course in food selection and preparation

The purpose of the study was to measure knowledge in various subject matter areas and to measure the ability of the student to apply knowledge to the solution of problems met at a subsequent date. Objectives for the course were set up and a tasting program inaugurated. Analyses of results of the measurement program show that there la not a significant difference in achievement in subject matter areas, but in all situations in which the students were tested either formally or observed, there is evidence of the student's inability to apply knowledge. Therefore a method of attack which will give the student more activities and experiences in applying knowledge is recommended

"...they should be offering it": a qualitative study to investigate young peoples' attitudes towards chlamydia screening in GP surgeries

<p>Abstract</p> <p>Background</p> <p>Despite the known health and healthcare costs of untreated chlamydia infection and the efforts of the National Chlamydia Screening Programme (NCSP) to control chlamydia through early detection and treatment of asymptomatic infection, the rates of screening are well below the 2010-2011 target rate of 35%. General Practitioner (GP) surgeries are a key venue within the NCSP however; previous studies indicate that GP surgery staff are concerned that they may offend their patients by offering a screen. This study aimed to identify the attitudes to, and preferences for, chlamydia screening in 15-24 year old men and women attending GP surgeries (the target group).</p> <p>Methods</p> <p>We undertook 36 interviews in six surgeries of differing screening rates. Our participants were 15-24 year olds attending a consultation with a staff member. Data were analysed thematically.</p> <p>Results</p> <p>GP surgeries are acceptable to young people as a venue for opportunistic chlamydia screening and furthermore they think it is the duty of GP surgery staff to offer it. They felt strongly that it is important for surgery staff to have a non-judgemental attitude and they did not want to be singled out as 'needing' a chlamydia screen. Furthermore, our sample reported a strong preference for being offered a screen by staff and providing the sample immediately at the surgery rather than taking home a testing kit. The positive attitude and subjective norms demonstrated by interviewees suggest that young peoples' behaviour would be to accept a screen if it was offered to them.</p> <p>Conclusion</p> <p>Young people attending GP surgeries have a positive attitude towards chlamydia screening and given the right environment are likely to take up the offer in this setting. The right environment involves normalising screening by offering a chlamydia screen to all 15-24 year olds at every interaction with staff, offering screening with a non-judgemental attitude and minimising barriers to screening such as embarrassment. The GP surgery is the ideal place to screen young people for chlamydia as it is not a threatening place for them and our study has shown that they think it is the normal place to go to discuss health matters.</p