Barriers to Accessing Early Intervention and Early Childhood Special Education: Professionals\u27 Perspectives

Supervised by the Maine Department of Education, Child Development Services (CDS) provides Early Intervention (EI) for children from birth through age 2 and Early Childhood Special Education (ECSE) for children ages 3-5 through a network of regional sites. Access to EI and ECSE services educates and empowers families to understand and respond to their children’s developmental needs and supports improved cognition, language, communication, social-emotional skills, and school readiness. These early gains can lead to better outcomes later in childhood and into adulthood

Implementation and Evaluation of a Neonatal Chest Tube Simulation Lab for App Competency

Pneumothorax in the neonatal period is a potentially life threatening condition that requires Neonatal Advanced Practice Providers to respond rapidly and competently in order to prevent complications of morbidity and mortality. It has become increasingly difficult to establish initial competency as well as maintain competency in low volume high acuity emergency procedures such as chest tube placement. The purpose of this practice based quality improvement project was to implement a simulation based training program in chest tube placement for the Neonatal Advanced Practice Providers within Norton Children’s Neonatology. The goal was to have all Advanced Practice Providers (APP) be able to demonstrate competency in chest tube placement for initial and ongoing clinical practice privileges within the Norton Healthcare System. Participants in the project included five APP within Norton Children’s Neonatology. Data included collecting responses asking the number of chest tubes the APP had placed in the previous two years and collecting APP demographic data through a questionnaire. This was followed by subject participation in a chest tube simulation lab exercise involving chest tube placement for pneumothorax using a high-fidelity mannequin. Post simulation descriptive statistical means and standard deviations were used to assess satisfaction and self-confidence in learning. Mean scores and standard deviations for each participating provider were calculated for each performance point on the Evaluation of the Neonatal Nurse Practitioner Procedural Competency Checklist published by the National Association of Neonatal Nurse Practitioners. It is important for healthcare organizations to employ professionals who can provide timely, effective and safe care. Establishing a continued performance competency stimulation lab in chest tube placement was a evidence based strategy to support Neonatal APP to maintain competency and privileges within the Norton Healthcare system and ultimately improved outcomes for its neonatal population

Clinical psychology in a general hospital : conflicts and paradoxes

Includes bibliography.Over the past decade clinical psychologists have increasingly begun to work in general hospital settings, but little published research has dealt in depth with the adjustments and negotiations that need to occur at the interface of clinical psychology and medicine. In this dissertation, the relationship of the psychosocial to medicine and the professional relationships of psychologists and doctors are discussed. Consultation- liaison psychiatry and multidisciplinary treatment teams are presented as two ways in which medicine has attempted to deal with the psychosocial, and which provide potentially useful models of practice for psychologists. Four cases that were referred to the author while working as an intern clinical psychologist in a Neurosurgery unit are discussed in terms of the insight they provide in understanding implicit assumptions about and expectations of psychology. In addition, the head of this Department of Neurosurgery and the two clinical psychologists working in this department were interviewed, and these interviews, together with the cases, provide the material for a discussion of various issues which face clinical psychologists in this unit. These include: the power structures and relationships in the unit; the use of consultation-liaison psychiatry and multidisciplinary treatment team models of practice; the inability of psychologists to fulfil present demands for their services; and the issue of reactive or proactive definition of psychological functions. Finally, some suggestions for enhancing the psychological contribution to patient care in Neurosurgery are made, based on the principles that arise out of the discussion

Evaluation of the Aphidius colemani-Rhopalosiphum padi banker plant system in greenhouse biological control

Banker plants are mobile habitats that provide alternate hosts or food for commercially available natural enemies. As a biological control strategy, banker plants offer a novel non-chemical approach to managing commonly encountered pests in the greenhouse. Most banker plants that target aphids consist of a graminaceous plant, a nonpest cereal grain aphid, and a parasitoid that attacks both the non-pest and pest aphids occurring on crop plants. Use of banker plants may provide more effective, long-term pest control than pesticide applications, but both can be combined. Banker plant systems have been used commercially in areas of the United States, Canada, Europe, and Asia. One of my goals was to ascertain if banker plants are a viable aphid pest management technique in the southwestern United States. The following study is an overview of the history of biological control in enclosed environments, the Aphidius colemani-Rhopalosiphum padi banker plant system in Oklahoma, pesticides compatible with A. colemani natural enemies, the costs and benefits of the Aphidius colemani-Rhopalosiphum padi system to manage aphid pests, and alternative species of grasses for potential use as banker plants

A retrospective study of preschool handicapped children

The hypothesis of this study is that preschool handicapped programs are indicative of what type of educational setting a child will be placed in during his future years of education. The data for this study was collected from three different school districts of varying size and socio-economic backgrounds. Children who were classified preschool handicapped during the 1989-90 school year were followed during their kindergarten and fourth grade years of school. It was found that it is difficult to predict where a child will be placed throughout his educational career by looking at his reasons for classification during preschool. Data from this study shows that children classified with only speech, language, and communication concerns have more of a likelihood of being declassified and participating primarily in regular education programs, while children classified with cognitive and perceptual delays have a greater likelihood of remaining classified and participating in special education programs

HB 69 Grocery Investment Program and Fund

In the 2018 session of the Virginia General Assembly, multiple pieces of legislation were brought to committee, proposing the creation of a fund to catalyze public-private partnerships to expand access to Virginians residing in food deserts. Through the creation of the fund, underserved communities would see the construction, rehabilitation and expansion of food retailers in their communities ameliorate food desserts

Constructing multiple unique input/output sequences using metaheuristic optimisation techniques

Multiple unique input/output sequences (UIOs) are often used to generate robust and compact test sequences in finite state machine (FSM) based testing. However, computing UIOs is NP-hard. Metaheuristic optimisation techniques (MOTs) such as genetic algorithms (GAs) and simulated annealing (SA) are effective in providing good solutions for some NP-hard problems. In the paper, the authors investigate the construction of UIOs by using MOTs. They define a fitness function to guide the search for potential UIOs and use sharing techniques to encourage MOTs to locate UIOs that are calculated as local optima in a search domain. They also compare the performance of GA and SA for UIO construction. Experimental results suggest that, after using a sharing technique, both GA and SA can find a majority of UIOs from the models under test

Older Teen Attitudes Towards Birth Control Access in Pharmacies: A Qualitative Study

Objectives To examine adolescent attitudes toward accessing contraception through a new pharmacist prescribing model in the State of California. Study design In-depth telephone interviews were conducted in summer 2015 with 30 females ages 18 to 19 in California. Participants were recruited using a social media advertisement. Semi-structured interviews utilized open-ended questions to understand teens' experiences with pharmacies, experiences obtaining contraception, and views on pharmacist prescribing of contraception. Responses were transcribed and qualitatively analyzed using an independent-coder method to identify salient themes. Results Participants were ethnically diverse and primarily living in suburban areas. All participants had completed high school and many had completed one year of college. Nearly all participants were supportive of California's new law allowing pharmacist prescribing of contraception. Thematic analyses revealed that while participants were satisfied with traditional service providers and valued those relationships, they appreciated the benefit of increased access and convenience of going directly to a pharmacy. Participants expected increased access to contraception in pharmacies would lead to both personal and societal benefits. They expressed concerns regarding parental involvement, as well as confidentiality in the pharmacy environment and with insurance disclosures. Conclusion Older teens in California are very supportive of pharmacies and pharmacists as direct access points for contraception, but confidentiality concerns were noted. Policy makers and pharmacies can incorporate study findings when designing policies, services, and physical pharmacy spaces to better serve teens. Further research is warranted after pharmacies implement this new service to assess teen utilization and satisfaction as well as outcomes. Implication statement Several states recently passed legislation enabling pharmacists to prescribe contraception and other states are considering similar legislation. Older teens are interested in this additional method of contraceptive access and understanding their perspectives can help guide implementation by states and in individual pharmacies

Access to Emergency Contraception After Removal of Age Restrictions

BACKGROUND: Levonorgestrel emergency contraception (EC) is safe and effective for postcoital pregnancy prevention. Starting in 2013, the US Food and Drug Administration removed age restrictions, enabling EC to be sold over the counter to all consumers. We sought to compare the availability and access for female adolescents with the 2012 study, using the same study design. METHODS: Female mystery callers posing as 17-year-old adolescents in need of EC used standardized scripts to telephone 979 pharmacies in 5 US cities. Using 2015 estimated census data and the federal poverty level, we characterized income levels of pharmacy neighborhoods. RESULTS: Of 979 pharmacies, 827 (83%) indicated that EC was available. This proportion did not vary by pharmacy neighborhood income level, nor was significantly different from the 2012 study (P = .78). When examining access, 8.3% of the pharmacies reported it was impossible to obtain EC under any circumstances, which occurred more often in low-income neighborhoods (10.3% vs 6.3%, adjusted odds ratio 1.5; 95% confidence interval 1.20-1.94). This was not significantly different from 2012 (P = .66). Correct information regarding over-the-counter access was conveyed only 51.6% of the time; accuracy did not differ by pharmacy's neighborhood income (47.9% vs 55.3%, adjusted odds ratio 0.89; 95% confidence interval 0.71-1.11) and was not significantly different from 2012 (P = .37). CONCLUSIONS: A majority of pharmacies have EC available; however, barriers to and disparities in access for adolescents persist and have not changed since the previous study despite regulatory changes that were designed to improve access to EC