A Development Evaluation Study of a Professional Development Initiative to Strengthen Organizational Conditions in Early Education Settings

High quality instruction is essential to producing developmental gains for young children and can mitigate risk factors such as family poverty and low parental education. Even in programs with highly qualified teachers, teacher-child interactions often do not provide the level of instructional support that children need to be well-prepared for success in kindergarten. In order to improve instructional quality, an emerging focus on early childhood professional development involves supporting leaders in creating a web of supports for teacher learning and child growth. The purpose of the 3-year evaluation study was to assess the effectiveness of an Early Childhood Education Professional Development Initiative (ECE PDI) in advancing the knowledge, skills, and dispositions of community-based early childhood leaders and teachers in relation to creating the conditions for superior developmental outcomes for low-income students served by these community-based centers. Findings from the implementation and impact studies are reported

SUMMARY

Cushing’s syndrome is a pathological condition associated with excessive cortisol production, the commonest etiology being Cushing’s disease. Corticosteroids in high doses have been used in the management of Steven Johnson Syndrome (SJS) with favourable outcome. We describe a patient with Cushing’s disease who developed SJS, one week after taking sperulina a product from sea-weed while waiting for transphenoidal surgery. KEY WORDS

Hubungan Antara Kebiasaan Mencuci Tangan Anak Pra Sekolah Dengan Kejadian Diare Di Wilayah Kerja Puskesmas Pajang Surakarta

Penyakit diare masih merupakan masalah kesehatan masyarakat di negara berkembang seperti di Indonesia, karena morbiditas dan mortalitas-nya yang masih tinggi. Penyakit ini banyak menyerang bayi maupun anak usi pra sekolah. Salah satu upaya untuk mencegah terkena diare adalah dengan kebiasaan anak pra sekolah melakukan cuci tangan baik sebelum makan ataupun setelah beraktivitas. Tujuan penelitian ini adalah mengetahui hubungan kebiasaan mencuci tangan anak pra sekolah dengan kejadian diare di wilayah kerja puskesmas Pajang Surakarta. Jenis penelitian ini adalah peneltian kuantitatif. Metode penelitian adalah deskriptif korelasi. Pendekatan penelitian menggunakan crossectional. Sampel penelitian sebanyak 81 ibu yang mempunyai anak usia 3-5 tahun dengan taknik pengambilan sampel menggunakan propotional random sampling. Instrumen penelitian berupa kuesioner baik kebiasaan mencuci tangan pada anak usia pra sekolah maupun kejadian diare pada anak pra sekolah yang dihitung dalam 3 bulan terakhir. Analisis data menggunakan uji Chi Square. Hasil penelitian diperoleh data 17 anak (21%) sudah baik dalam melakukan cuci tangan, 41 anak (50,6%) melakukan cuci tangan cukup baik, dan 23 anak (28,4%) masih kurang dalam melakukan cuci tangan. Kejadian diare pada anak usia pra sekolah diperoleh data 45 anak (55,6%) tidak diare, 29 anak (35,8%) mengalami diare sebanyak 1 kali, 7 anak (8,6%) mengalami 2 kali diare. Hasil uji Chi Square dan diperolah nilai X2 = 6,063 dan p = 0,048 dan disimpulkan hubungan antara kebiasaan mencuci tangan anak pra sekolah dengan kejadian diare di Wilayah Kerja Puskesmas Pajang Surakarta

Development of learning objectives for neurology in a veterinary curriculum: Part II: Postgraduates

Background: Specialization in veterinary medicine in Europe is organized through the Colleges of the European Board of Veterinary Specialization. To inform updating of the curriculum for residents of the European College of Veterinary Neurology (ECVN) job analysis was used. Defining job competencies of diploma holders in veterinary neurology can be used as references for curriculum design of resident training. With the support of the diplomates of the ECVN and the members of the European Society of Veterinary Neurology (ESVN) a mixed-method research, including a qualitative search of objectives and quantitative ranking with 149 Likert scale questions and 48 free text questions in 9 categories in a survey was conducted. In addition, opinions of different groups were subjected to statistical analysis and the result compared. Results: A return rate of 62% (n = 213/341) was achieved. Of the competencies identified by the Delphi process, 75% objectives were expected to attain expert level; 24% attain advanced level; 1% entry level. In addition, the exercise described the 11 highly ranked competencies, the 3 most frequently seen diseases of the central and peripheral nervous systems and the most frequently used immunosuppressive, antiepileptic and chemotherapeutic drugs. Conclusion: The outcomes of this “Delphi job analysis” provide a powerful tool to align the curriculum for ECVN resident training and can be adapted to the required job competencies, based on expectations. The expectation is that for majority of these competencies diplomates should attain an expert level. Besides knowledge and clinical skills, residents and diplomates are expected to demonstrate high standards in teaching and communication. The results of this study will help to create a European curriculum for postgraduate education in veterinary neurology

Translational and Regulatory Challenges for Exon Skipping Therapies

Several translational challenges are currently impeding the therapeutic development of antisense-mediated exon skipping approaches for rare diseases. Some of these are inherent to developing therapies for rare diseases, such as small patient numbers and limited information on natural history and interpretation of appropriate clinical outcome measures. Others are inherent to the antisense oligonucleotide (AON)-mediated exon skipping approach, which employs small modified DNA or RNA molecules to manipulate the splicing process. This is a new approach and only limited information is available on long-term safety and toxicity for most AON chemistries. Furthermore, AONs often act in a mutation-specific manner, in which case multiple AONs have to be developed for a single disease. A workshop focusing on preclinical development, trial design, outcome measures, and different forms of marketing authorization was organized by the regulatory models and biochemical outcome measures working groups of Cooperation of Science and Technology Action: "Networking towards clinical application of antisense-mediated exon skipping for rare diseases." The workshop included participants from patient organizations, academia, and members of staff from the European Medicine Agency and Medicine Evaluation Board (the Netherlands). This statement article contains the key outcomes of this meeting.status: publishe

The Impact of Swallowing Disorders in the Elderly

Abstract Introduction: Swallowing disorders are common in the elderly but its prevalence is often underestimated. They can result in increased morbidity and mortality. Methods: This article summarises the findings of selected published papers in major international journals indexed on Medline on swallowing using the key words-swallowing, dysphagia, aged, geriatrics and deglutition. Results: There are age-related changes in the oral, pharyngeal and oesophageal functions. In the elderly, central nervous system diseases such as stroke, parkinsonism, dementia, medications, local oral and oesophageal factors are common causes of swallowing dysfunction. Swallowing disorders in the elderly are associated with increased mortality and morbidity. Aspiration, dehydration, pneumonia, malnutrition, functional decline and institutionalisation are often encountered in the elderly with dysphagia. There is a choice of different interventions available to reduce morbidity and mortality arising from swallowing impairments, and improving their quality of life. Conclusion: The effective management of swallowing impairment in the elderly requires a multidisciplinary team approach

How equitable is vocational rehabilitation in Sweden? A review of evidence on the implementation of a national policy framework

Purpose. Under the national framework law in Sweden, all eligible people should have equal chances of receiving vocational rehabilitation. We aimed to review the evidence on (1) whether access to vocational rehabilitation is equitable in practice and (2) whether the outcomes vary for different groups in the population. Method. Systematic review of studies in Sweden that reported diagnostic or socio-demographic characteristics of people offered or taking up rehabilitation programmes and outcomes of such programmes for different diagnostic and socio-demographic groups. Searches of 11 relevant electronic databases, 15 organisational websites, citation searching and contact with experts in the field, for the period 1990–2009. Results. A total of 11 studies were included in the final review, six of which addressed review question (1) and seven addressed review question (2). All the six observational studies of access reported biased selection into vocational rehabilitation: greater likelihood for men, younger people, those with longer-term sick leave, those with lower income, employed rather than unemployed people and those with musculoskeletal and mental disorders or alcohol abuse. Having had a rehabilitation investigation also increased the likelihood of receiving vocational rehabilitation. Differential outcome of rehabilitation was reported in seven studies: outcomes were better for men, younger people, employed individuals, those with shorter sick leave and those with higher income. Selection into vocational rehabilitation was perceived as important for successful outcomes, but success also depended on the state of the local labour market. Conclusions. There is evidence of socio-demographic differences in access to and outcomes of vocational rehabilitation in Sweden, even though the national framework law is meant to apply to everyone. Few studies have deliberately measured differential access or outcomes, and there is a need for this kind of equity analysis of population-wide policies. Studies evaluating the effects of vocational rehabilitation must consider selection into the programmes for adequate interpretation of impact results