From Ghost Systems to Host Systems via Transformation Zones

Over the past two centuries social reformers and educators have worked hard to include children from disadvantaged families, girls, racial and ethnic minorities, children with special needs, and young adults into an education system open to all. This was a struggle, and now a free and appropriate public education (FAPE) is available for all children from birth through high school graduation and beyond. As a result of these struggles to include all children, current education systems are legacy systems. They are the fragmented remains of different times and a wide variety of approaches to reforming education. There is no ill will implied in this statement. Systems often have their beginnings in this piecemeal manner. The goals were inclusion and equality, and the effectiveness of the overall system was anticipated but was not the main focus of the reform efforts. In the new millennium, the focus is shifting. Given the lack of improvement in education outcomes in the United States over the past decades, the emphasis now is on a free, appropriate, and effective public education system. The purpose of this Brief is to outline the convergence of advances in implementation, organization change, and system reinvention science and practice. The confluence of these fields is lighting the way for effective and efficient changes in large education and human service systems

Sigma1 Targeting to Suppress Aberrant Androgen Receptor Signaling in Prostate Cancer.

Suppression of androgen receptor (AR) activity in prostate cancer by androgen depletion or direct AR antagonist treatment, although initially effective, leads to incurable castration-resistant prostate cancer (CRPC) via compensatory mechanisms including resurgence of AR and AR splice variant (ARV) signaling. Emerging evidence suggests that Sigma1 (also known as sigma-1 receptor) is a unique chaperone or scaffolding protein that contributes to cellular protein homeostasis. We reported previously that some Sigma1-selective small molecules can be used to pharmacologically modulate protein homeostasis pathways. We hypothesized that these Sigma1-mediated responses could be exploited to suppress AR protein levels and activity. Here we demonstrate that treatment with a small-molecule Sigma1 inhibitor prevented 5α- dihydrotestosterone-mediated nuclear translocation of AR and induced proteasomal degradation of AR and ARV, suppressing the transcriptional activity and protein levels of both full-length and splice-variant AR. Consistent with these data, RNAi knockdown of Sigma1 resulted in decreased AR levels and transcriptional activity. Furthermore, Sigma1 physically associated with ARV7 and A

Evaluating screening colonoscopy quality in an uninsured urban population following patient navigation

Patient navigation (PN) increases screening colonoscopy completion in minority and uninsured populations. However, colonoscopy quality is under-reported in the setting of PN and quality indicators have often failed to meet benchmark standards. This study investigated screening colonoscopy quality indicators after year-one of a PN initiative targeting the medically uninsured. This was a retrospective analysis of 296 outpatient screening colonoscopies. Patients were 45 to 75 years of age with no history of bowel cancer, inflammatory bowel disease, or colorectal surgery. The screening colonoscopy quality indicators: adenoma detection rate (ADR), cecal intubation rate (CIR), and bowel preparation quality were compared in 89 uninsured Federally Qualified Health Center (FQHC) patients who received PN and 207 University Hospital patients who received usual care. The FQHC PN and University Hospital cohorts were similar in female sex (69% vs. 70%; p = 0.861) and African American race (61% vs. 61%; p = 0.920). The FQHC PN cohort was younger (57 years vs. 60 years; p < 0.001). There was no difference in ADR (33% vs. 32%; p = 0.971) or CIR (96% vs. 95%; p = 0.900) comparing the FQHC PN and University Hospital cohorts. The FQHC PN patients had a greater likelihood of an optimal bowel preparation on multivariate logistic regression (odds ratio 4.17; 95% confidence interval 1.07 to 16.20). Uninsured FQHC patients who received PN were observed to have intra-procedure quality indicators that exceeded bench-mark standards for high-quality screening colonoscopy and were equivalent to those observed in an insured University Hospital patient population

The New Tech Effect: Analyzing Juror Credibility In Cases Involving Digital Evidence

Abstract In recent studies, the &quot;Tech-Effect&quot; theory has replaced the &quot;CSI-Effect&quot; theory as a means to explain the potential impact of technology on jurors. In past studies, proponents of the CSI-Effect (Crime Scene Investigation Effect) proposed that jurors tend to acquit suspects when forensic evidence is not as prevalent as it is in television crime dramas. The newer &quot;Tech-Effect&quot; (Technology Effect) proponents argue that crime dramas do not influence jurors; rather, jurors have heightened expectations for technical and scientific evidence simply because technology is so widespread in society. This study surveyed 131 students in a medium-sized, private university to determine if a Tech-Effect truly exists, and if so, could it influence juror credibility. The survey attempted to answer two questions: 1) Will students in IS/IT degree programs demonstrate greater knowledge of forensic technology in cases involving digital evidence?, and 2) Will students in IS/IT programs demonstrate lower acquittal rates in cases involving digital evidence? The study found that students in IS/IT programs do demonstrate greater knowledge of forensic technology. However, the study failed to reveal a relationship between higher levels of digital forensic knowledge and higher rates of acquittal

Les éléments moteurs de l'implémentation : analyse des responsabilités

Ce document, produit par Base & Van Dyke (2021), permet d'identifier quels acteurs ont la responsabilité de quel.s élément.s moteur.s de l'implémentation et ce faisant, de repérer les recouvrements ou les manques

Research utilization among children's mental health providers

Abstract Background Children with emotional and behavioural disorders should be able to count on receiving care that meets their needs and is based on the best scientific evidence available, however, many do not receive these services. Implementation of evidence-based practice (EBP) relies, in part, on the research utilization practices of mental health care providers. This study reports on a survey of research utilization practices among 80 children's mental health (CMH) service provider organizations in Ontario, Canada. Methods A web-based survey was distributed to 80 CMH service provider organizations, to which 51 executive directors and 483 children's mental health practitioners responded. Research utilization was assessed using questions with Likert-type responses based on the Canadian Health Services Research Foundation's Four-A's approach: access, assess, adapt, apply. Results There was general agreement among executive directors and practitioners regarding the capacity of their organizations to use – access, assess, adapt, and apply – research evidence. Overall, both groups rated their organizations as using research information 'somewhat well.' The low response rate to the practitioner survey should be noted. Conclusion These findings provide a useful benchmark from which changes in reported research utilization in the Ontario CMH sector can be tracked over time, as a function of EBP training and implementation initiatives, for instance. The need to improve access to research evidence should be addressed because it relates to the eventual implementation and uptake of evidence-based practices. Communities of practice are recommended as a strategy that would enable practitioners to build capacity in their adaptation and application of research evidence.</p

Research utilization among children's mental health providers

Abstract Background Children with emotional and behavioural disorders should be able to count on receiving care that meets their needs and is based on the best scientific evidence available, however, many do not receive these services. Implementation of evidence-based practice (EBP) relies, in part, on the research utilization practices of mental health care providers. This study reports on a survey of research utilization practices among 80 children's mental health (CMH) service provider organizations in Ontario, Canada. Methods A web-based survey was distributed to 80 CMH service provider organizations, to which 51 executive directors and 483 children's mental health practitioners responded. Research utilization was assessed using questions with Likert-type responses based on the Canadian Health Services Research Foundation's Four-A's approach: access, assess, adapt, apply. Results There was general agreement among executive directors and practitioners regarding the capacity of their organizations to use – access, assess, adapt, and apply – research evidence. Overall, both groups rated their organizations as using research information 'somewhat well.' The low response rate to the practitioner survey should be noted. Conclusion These findings provide a useful benchmark from which changes in reported research utilization in the Ontario CMH sector can be tracked over time, as a function of EBP training and implementation initiatives, for instance. The need to improve access to research evidence should be addressed because it relates to the eventual implementation and uptake of evidence-based practices. Communities of practice are recommended as a strategy that would enable practitioners to build capacity in their adaptation and application of research evidence