AN ASSESSMENT OF OUTPATIENT CLINIC ROOM VENTILATION SYSTEMS AND POSSIBLE RELATIONSHIP TO DISEASE TRANSMISSION

The delivery of healthcare in the United States is shifting from a largely inpatient model to an outpatient services model, but the physical infrastructure for outpatient clinics or medical offices may not be as robust as inpatient hospitals regarding whole room ventilation requirements. Guidelines for the design of healthcare facilities and national standards for ventilation establish generally acceptable ventilation rates for outpatient clinics, but it is unclear if these standards are actually being integrated into these settings. Published peer reviewed literature indicates that inadequate ventilation rates can be a risk factor in airborne transmission of infectious diseases in outpatient clinics, hospitals and residential buildings. This study examined whether outpatient clinics operating in a business occupancy setting were conducting procedures in rooms with ventilation rates above, at, or below thresholds defined in ANSI/ASHRAE/ASHE Standard 170 for Ventilation in Health Care Facilities, and whether lower ventilation rate and building characteristics increase the risk of transmission of infectious disease. Ventilation rates were measured in outpatient clinic rooms categized by services rendered (general exam, treatment or procedure room; aerosol-generating or minor surgical procedures) to compare against national standards. Analysis included evaluation of the building characteristics (where the clinic resides) as determinants of ventilation rates and estimated risk of infectious disease transmission based on the measured ventilation rates. The results of this study suggest that a subset of clinics operating in business occupancy settings may be conducting procedures in rooms with ventilation rates that are below those defined in national standards for healthcare settings. When compared to the ANSI/ASHRAE/ASHE Standard 170 for Ventilation in Health Care Facilities standards, 11 of the 105 (10%) clinic rooms assessed did not meet the minimum requirement for general exam rooms, 41 of 105 (39%) did not meet the requirement for treatment rooms, 87 of 105 (83%) did not meet the requirement for aerosol-generating procedures, and 92 of 105 (88%) did not meet the requirement for procedure rooms or minor surgical procedures. While lower air change rates were observed in all building types, newer constructed one-story stand-alone buildings exhibited higher air change rates as compared to the other building types. Based on the measured ventilation rates and the procedures being performed, these outpatient clinic rooms could possibly facilitate transmission of infectious disease rather than protect workers and patients. National ventilation standards should be considered for all healthcare settings and factored into clinic design and clinic lease agreements, which is currently not the case, as suggested by the evidence in this study

The Relationship between Participation in Goal Setting, Company Size and Performance, Commitment, Acceptance and Job Satisfaction in the United States and Macedonia.

While some researchers have suggested that participative goal setting increases performance, acceptance, commitment, and satisfaction, others have suggested that it does not. Additionally, much research on goal setting has been done in the US while none has been done in Macedonia. The purpose of this study was to clarify the relationship between participation in goal setting and company size on these variables and to determine if there are differences in the effects of participation in goal setting in the US and Macedonia. The independent variables were country, company size, and type of participation and dependent variables were performance, commitment, acceptance, and satisfaction. Participants also completed Hofstede’s (1994) VSM and demographic questions. Workers from the US scored significantly higher on all dependent variables. There were no significant differences in participation verses assigned goal setting on the four dependent variables. Multiple regressions revealed that some VSM questions predicted the four dependent variables

Workforce Data Quality Initiative

Texas’ Workforce Data Quality Initiative aimed to develop a comprehensive system for analysis of workforce and education participation and outcomes. In partnership with the Texas Workforce Commission, the Ray Marshall Center (RMC) is working to build, test, improve, and expand data linkages across linked individual-level, longitudinal education, and workforce records. Through this project, researchers would be able to identify and assess postsecondary pathways and transitions between education, employment, and other outcomes for students exiting the public school system as well as analyze the performance of the human capital development system in Texas, spanning secondary education through postsecondary education, and workforce training and employment.This report seeks to examine and analyze the postsecondary labor market outcomes of Texas high school graduates from the classes of 2008 and 2009. One advantage of looking at these two particular cohorts stems from differences in when they encountered the Great Recession: the class of 2008 graduated prior to the start of the recession in Texas and the class of 2009 graduated immediately after the start of the recession. It is likely that class of 2009 graduates factored in the regional changes in availability of employment as they weighed whether or not to apply for and enroll in college.Texas Workforce CommissionRay Marshall Center for the Study of Human Resource

Summer and Winter Spatial Habitat Use by the Lake Erie Watersnake

In an effort to provide information to guide habitat management for the Lake Erie watersnake Nerodia sipedon insularum, a federally threatened and Ohio state endangered species, we used radiotelemetry to obtain spatial habitat data for adult snakes during the summer active season and during winter hibernation. During the summer active season, terrestrial habitat use was limited to a narrow band of shoreline. Among individuals, maximum distance inland from shore ranged from 1 to 50 m (mean = 8 m) and linear extent of shoreline ranged from 30 to 1,360 m (mean = 261 m). Winter hibernation occurred at varying distances inland with individual hibernation sites ranging from 1 to 580 m (mean = 29 m) from shore. Habitat use did not differ between males and females. Existing U.S. Fish and Wildlife Service habitat management guidelines suggest that ground-disturbing activities within potential hibernation areas (defined as terrestrial habitat within 161 m of shore) should be avoided in winter to prevent harm to hibernating snakes. They suggest further that excavation and removal of shrubs, standing or downed trees, root masses, animal burrows, piled rocks, cliffs, or bedrock within 21 m of shore should be avoided in summer to prevent harm to active snakes. Given that Lake Erie watersnakes have recovered to the point where delisting is being proposed, these habitat guidelines appear to be sufficient. However, maintaining voluntary compliance with habitat guidelines and meeting the need for continued public outreach will be vital to ensure long-term persistence

The Practice Of Teaching Therapeutic Songwriting: A Survey Of Educators And Internship Directors

The purpose of this study was to determine how therapeutic songwriting is currently being taught within American Music Therapy Association-approved music therapy programs and national roster internship sites. An online questionnaire was distributed to determine if songwriting is being taught, where within the curricula it is included, what methods educators employ, and what specific songwriting techniques are being taught to students. Respondents (n = 84) included music therapy program directors and music therapy faculty from AMTA approved schools, and internship supervisors and internship directors from AMTA roster internship sites. Results indicated that songwriting is being taught to some extent by the majority of university programs and internship sites through a variety of methods that cover a range of methods and techniques. Open-ended responses demonstrated a need for clarification of the expected songwriting competence of students, and that respondents believe a greater emphasis should be placed on songwriting education. The study also addressed recommendations for future research and considerations for university programs and internship sites

The mediating role of visuospatial planning skills on adaptive function among young adult survivors of childhood brain tumors

The Boston Qualitative Scoring System (BQSS) was used as a method to examine executive skills on the Rey-Osterrieth complex figure (ROCF). Young adult survivors of childhood brain tumor (N = 31) and a demographically-matched comparison group (N = 33) completed the ROCF copy version and Grooved Pegboard, and informants were administered the Scales of Independent Behavior-Revised (SIB-R) and Behavior Rating Inventory of Executive Function (BRIEF). Survivors had significantly lower BQSS planning and SIB-R community living skills and greater perseveration. Mediation analyses found that BQSS planning skills mediate the relationship between group and community living skills. Convergent findings of the BRIEF Planning, and discriminant findings with the BQSS Fragmentation, BRIEF Emotional Control, and Grooved Pegboard support the planning construct as the specific mediator in this model. Together, these findings highlight the role of planning skills in adaptive functions of young adult survivors of childhood brain tumor

Canine Support Program: Student perceptions and preferences at a regional university and implications for health, well-being, and student support enhancements

Issue Addressed: Canine Support Programs (CSPs) are a potential solution to growing university student support demands. While current studies focus on the impacts of CSPs, there is limited understanding of the views and expectations of tertiary students about CSPs. This study explored the perceptions and preferences of students in an Australian regional university about CSPs. Methods: A questionnaire with multiple choice and open-ended questions surveyed residential students' perspectives about CSP. Data were analysed using descriptive statistical tests and thematic analysis for open responses. Results: Majority (98%) of participants (sample n = 48) would support a CSP on campus. Frequent, small-group interactions of ≥15 min involving physical contact were preferred. Dog disposition, welfare-trained handlers, and veterinary certification were important aspects of program safety. Participants strongly agreed a CSP would improve mental health and well-being, relieve stress, reduce feelings of homesickness, provide support, comfort, and enable social interactions. Conclusion: There is strong support among the study population for CSP to be established on campus. This study supports earlier research that CSP has benefit potential for new, stressed, and/or students who love dogs. The preferences of students should inform program design to enhance utility and impact. This aligns with Health Promoting Universities and College's Okanagan Charter principle of ‘engaging student voices’. More institutional awareness and support for CSPs will be necessary for integration. So What?: This study reveals the need for tailored and creative student support beyond traditional offerings including those that focus on student well-being and social initiatives. CSPs can be utilised as an advocate, enabler, and medium for mental health promotion action and well-being support for tertiary students; thereby, contributing to the ‘Health Promoting University’ agenda in Australia. It also reinforces the need for a Health in All Policies approach to be incorporated into our tertiary education sector. Future actions should focus on improving institutional awareness, support, and sector implementation

An Exploratory Multiple Case Study of Discipline Practices in a Major Metropolitan Public School District: A Look into the School to Prison Pipeline

The school to prison pipeline is a phenomenon fed by exclusionary discipline practices that increase the likelihood that a student will have an interaction with the juvenile or criminal justice system at some time in their life; this phenomenon disproportionately affects Black students. Understanding the problem is key to slowing down the school to prison pipeline. This study of a school district in Missouri explores questions about how interpersonal relationships, implicit bias awareness, and school policies influence the learning environment, and how those factors relate to school discipline, which ultimately can lead to the school to prison pipeline. Drawing data from exploratory multiple case study interviews, numerous themes emerged. Relationships are important when making changes in schools. Staff were forced to develop plans to support students by building relationships, managing teaching expectations, and developing alternatives to suspension. The new policy positively affected law enforcement officers’ interactions with students. The study has important implications for school practitioners; namely policy change is an effective method to lessen school suspensions thus decreasing the school to prison pipeline. The implications for law enforcement officers working in schools is that they can also work to reduce the school to prison pipeline through improved relationships with students and families. They are an invaluable resource to students, families, and school staff to support students and to prevent them from entering the criminal justice system later in life

Perspectives on credit scoring and fair mortgage lending: article two

Credit scoring systems ; Mortgages

CareerAdvance® Implementation Study Findings Through July 2013

This report examines fundamental changes in the CareerAdvance® program that directly relate to the experience and progress of participants through July 2013 (the end of the fourth program year) and the recruitment of Cohort 8 in April 2013. CareerAdvance® has evolved over time from a single nursing career training pathway in 2009 to four healthcare career pathways in 2013. The evolution of the program has led to many changes and has increased opportunities for program participants.U.S. Department of Health and Human Services’ Administration for Children and FamiliesRay Marshall Center for the Study of Human Resource