Model All-Payer Claims Database Legislation

With support from the Gary and Mary West Health Policy Center, the APCD Council has developed model legislation guidance for states to develop all-payer claims database legislation

Alien Registration- Peters, Jo (Andover, Oxford County)

https://digitalmaine.com/alien_docs/18088/thumbnail.jp

Automated design of ligand responsive RNA devices

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Young Children's Mathematics: A supporting document for the "Making Things Count" resource

Making Things Count (Ministry of Education, 1999) is a teaching resource for early childhood educators. This paper expands on the ideas in Making Things Count and is intended as a resource for teachers, parents and caregivers who want to understand and enhance young children's mathematical thinking It provides a framework for looking at children's mathematical thinking and explores why the development of a 'number sense' is so important. Annotated lists of books for children and further reading for adults are included, along with master copies of some games for young children. This is followed by a profile of a fictional early childhood centre where mathematical experiences occur as an integral and natural part of the daily programme. A summary of the early childhood teacher's role in providing mathematical experiences for children, and practical suggestions for mathematics in centres are presented at the end

Sharing Resources: A Bistate Extension Specialist Position

As Extension budgets across the United States continue to tighten, sharing a specialist between states could become an increasingly effective way to provide high-quality programming at a lower total cost. This article describes the working modalities, benefits, challenges, and outputs of an existing two-state Extension consumer food safety specialist position. Overall, this bistate position has been beneficial to both states involved. The model could be implemented in other states, and the descriptions of aspects of the position provided in this article may be instructive for states considering such an option

Are medical educators following General Medical Council guidelines on obesity education: if not why not?

BackgroundAlthough the United Kingdom's (UK's) General Medical Council (GMC) recommends that graduating medical students are competent to discuss obesity and behaviour change with patients, it is difficult to integrate this education into existing curricula, and clinicians report being unprepared to support patients needing obesity management in practice. We therefore aimed to identify factors influencing the integration of obesity management education within medical schools.MethodsTwenty-seven UK and Irish medical school educators participated in semi-structured interviews. Grounded theory principles informed data collection and analysis. Themes emerging directly from the dataset illustrated key challenges for educators and informed several suggested solutions.ResultsFactors influencing obesity management education included: 1) Diverse and opportunistic learning and teaching, 2) Variable support for including obesity education within undergraduate medical programmes, and 3) Student engagement in obesity management education. Findings suggest several practical solutions to identified challenges including clarifying recommended educational agendas; improving access to content-specific guidelines; and implementing student engagement strategies.ConclusionsStudents' educational experiences differ due to diverse interpretations of GMC guidelines, educators' perceptions of available support for, and student interest in obesity management education. Findings inform the development of potential solutions to these challenges which may be tested further empirically

Chest physiotherapy for mechanically ventilated children: a survey of current UK practice

Objectives: Chest physiotherapy is a treatment option for mechanically ventilated children. However, there is a lack of consensus regarding its value and informal discussions suggest variation in practice. This study describes chest physiotherapy practices for mechanically ventilated children in the UK and explores clinical decision making related to its delivery. Design: Cross-sectional study, using an anonymous, electronic survey. Participants: Qualified physiotherapists working in UK NHS paediatric intensive care units (PICUs). Results: The response rate was 61% (72/118), this included physiotherapists from 26/27 (96%) PICUs. All participants reported using manual hyperinflations and position changes ‘always’ or ‘often’. Variation in practice was evident for some techniques, including Metaneb® and percussion. DNase (99%, 71/72) and hypertonic saline (90%, 65/72) were the most frequently used mucoactives: 91% (59/65) of physiotherapists reported only nebulising hypertonic saline and 69% (49/71) use both nebulised and instilled DNase. Use and delivery of N-acetylcysteine was inconsistent (nebulised only 55%, 26/47; instilled only 15%, 7/47; both 30%, 14/47). Chest physiotherapy was most commonly delivered with a nurse (67%, 48/72). Clinical decision making processes were comparable between physiotherapists and encompassed three main elements: individual patient assessment, involvement of the multidisciplinary team, and risk versus benefit analysis. Conclusions: A range of chest physiotherapy treatments and adjuncts were used with ventilated children. Variation was apparent and may be due to individual preferences of those training staff or local policies. Pragmatic, interventional studies are required to determine best practice. Further exploration is necessary to understand the variation in practice and intricacies of decision making