Gaston Memorial Hospital: Driving Quality Improvement With Data, Guidelines, and Real-Time Feedback

Describes efforts to reduce variance in provider practice patterns through data analysis and benchmarking of process-of-care measures. Discusses strategies such as sharing data, feedback, and best practices in ways physicians can utilize them immediately

Consequences of Community Water Fluoridation Cessation for Medicaid Eligible Children and Adolescents

Oral health impacts general health and well-being throughout the lifespan. Recent trends in the United States towards cessation of community water fluoridation (CWF) may increase disparities in oral health. The purpose of this quantitative retrospective cohort study was to analyze Medicaid dental claims records for caries related procedures among 0 to18-year-old patients during an optimal CWF year 2003 (n = 854) and compare them to claims records from 2012 (n = 1,053), 5 years after CWF was ceased. The theoretical framework of this study was the diffusion of innovations theory. Statistically significant results included higher mean number of caries related procedures among 0 to18 year and \u3c 7-year aged patients in the suboptimal CWF group (2.57 vs. 2.43, p \u3c 0.001; 2.68 vs. 2.01, p = 0.004, respectively). Mean caries related treatment costs per patient was also higher in the 0 to18 year and \u3c 7-year suboptimal CWF groups compared to the optimal CWF group (583.70 vs 344.34 $, p \u3c 0.0001; 692.87 vs. 350.13$, p \u3c 0.0001, respectively). Binary logistic regression analysis results indicated a protective effect from optimal CWF for the 0 to18 and \u3c 7 year age groups ([OR] 0.75, 95% CI [0.62, 0.90], p = 0.002); OR = 0.70, 95% CI [0.52, 0.95], p = 0.02, respectively). The results confirm optimal CWF exposure prevents dental decay, expand the evidence base of caries epidemiology under CWF cessation, and indicate patients without early childhood CWF exposure experience more dental caries procedures and treatment costs. These findings may create opportunities for social change by supplying evidence that can be used to improve equity oriented oral health public policies that protect population health

The Effectiveness of Bilateral Cochlear Implants in Adults and Children: a Critical Review

Unilateral cochlear implants are routinely provided to individuals who present with bilateral severe to profound sensorineural hearing loss. Unilateral implantation is widely accepted as the standard of care by most insurance companies, though bilateral implantation has the potential to restore some of the advantages of binaural listening in these patients. The aim of this literature review is to discuss recent research concerning benefits of bilateral cochlear implantation relative to performance with a single implant in both the pediatric and adult populations. Electronic databases and reference lists were searched using a pre-determined search strategy and were reviewed for relevant information. This critical review focused on the following questions: 1) What are the benefits of bilateral cochlear implantation compared to unilateral CI or bimodal arrangements in the areas of speech perception in quiet and noise, sound localization, and expressive and receptive speech and language acquisition?; 2) What benefits, if any, are provided when simultaneous implantation is performed versus sequential implantation?; and 3) What impact does age at implantation have on the benefits seen with bilateral cochlear implantation in children? Throughout this review, mixed evidence of bilateral benefit was reported for various outcomes including speech perception in quiet and noise, sound localization, and speech and language acquisition. Both sequential and simultaneous implant subjects received bilateral benefit. Continued research regarding benefits observed with earlier age at implantation, the impact of hearing aid use in the non-implanted ear between sequential surgeries, and speech and language outcomes in bilaterally implanted children is necessary

A Sea Change on the Horizon: Transforming Our Students and Campuses through Innovative Conflict Management

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/108333/1/abc21158.pd

The interrelation between collective participation and sustainable decisions – a qualitative assessment approach

The theoretical claim for stakeholder participation in order to achieve sustainable policy outcomes is prominent in the literature. Empirical evidence substantiating this claim is, however, lacking. The complex characteristics of the concepts of sustainability and participation demand a systematic approach in which method develops from theory. We propose a qualitative assessment approach based on theoretical considerations. We deliberately restrict our approach not to prove causalities but to demonstrate tendencies. Our methodological starting point refines the complex interrelation between collective participation and sustainability by qualitatively assessing the value of the two concepts separately before looking for mutual or opposing trends. Based on theory, both concepts are re-split into two dimensions. Collective participation is re-split into 1. inclusion and 2. influence and sustainability is re-split into 1. the external impact of decisions and 2. the internal capacity to face pressures. For each dimension the approach combines an abstracting point-based scaling system with explanatory narratives. This ensures the comparability of different cases and at the same time the transparency and reliability of the assessment. By matching and comparing the previous scaling results in the end, the assessment procedure explores whether the degree of collective participation and the degree of sustainability are rather synchronic or opposite. We exemplify our approach with an example of local level non-governmental neighbourhood governance in India and review primary data on the agitation for green spaces and slum eviction in Hyderabad. This application outlines the disregard for diversity among stakeholders and the cost-benefit assessment of sustainability as remaining theoretical and methodological items for the amendment of our assessment approach in its current version. After refinement the presented approach is intended for the application on diverse cases of direct decision-making and for the meta- analysis and comparison of secondary case-studies as well as for the analysis of primary qualitative data

Graduate Recital:Jennifer Meyer, Trumpet

Kemp Recital Hall Wednesday Evening April 18, 2001 6:00 p.m

Carbon Cycle Science Data and Services at the Goddard Earth Sciences Data Information and Services Center (GES DISC)

The Goddard Earth Sciences Data Information and Services Center (GES DISC) archives and distributes a number of observational and model carbon cycle science data sets. We also provide services that facilitate data discovery, intercomparison, and visualization of these heterogeneous datasets for both research and applications users, such as subsetting, format conversion, How-To documentation, and the Help Desk

Comparative analysis between different flood assessment technologies in HAZUS-MH

Natural disasters devastate the United States through both economic loss and loss of life. The world wide economic damage that results from natural disasters has more than tripled in the last thirty years. Of these natural disasters, floods are the most chronic and costly disasters, comprising an average $5 billion dollars of damage each year. FEMA has released a new software program called HAZUS-MH, which attempts to capture economic losses caused by flooding before losses occur and predict losses from real-time events. This estimate is accomplished through the coupling of flood hazard modeling with local data. FEMA’s goal is that the information constructed within the program will help planners to mitigate and capture flood related losses. This study provides a methodology for assessing the accuracy of HAZUS level one flood loss estimates by examining the extent to which HAZUS default building stock inventory data represents the built local environment. The study area is concentrated in the northwest corner of Livingston Parish, Louisiana. The area is comprised of 200 census blocks that were chosen due to their proximity to the Amite River. Thus it is an area prone to floods. Livingston Parish is located in the Mississippi River and Lake Maurepas Basin, which collectively cover approximately 236,000 acres. 70% of the Parish’s land is located within FEMA’s 100-year flood plain. Building count for structures was obtained using remote sensing technology, processed and used to populate HAZUS ® MH default databases. Flood loss estimations were run for all of the data sets and results were compared for a significant difference. Differences in flood loss between the two analyses were found in isolated areas. This demonstrated the need to incorporate growth and development information into flood loss estimation methodologies