29,165 research outputs found
Isoperimetric and stable sets for log-concave perturbations of Gaussian measures
Let be an open half-space or slab in endowed with
a perturbation of the Gaussian measure of the form
, where and is a smooth concave
function depending only on the signed distance from the linear hyperplane
parallel to . In this work we follow a variational approach to
show that half-spaces perpendicular to uniquely minimize the
weighted perimeter in among sets enclosing the same weighted volume.
The main ingredient of the proof is the characterization of half-spaces
parallel or perpendicular to as the unique stable sets with
small singular set and null weighted capacity. Our methods also apply for
, which produces in particular the classification of
stable sets in Gauss space and a new proof of the Gaussian isoperimetric
inequality. Finally, we use optimal transport to study the weighted minimizers
when the perturbation term is concave and possibly non-smooth.Comment: final version, to appear in Analysis and Geometry in Metric Space
Standardizing the Process for Diagnosing Attention Deficit Hyperactivity Disorder (ADHD) in the Primary Care Setting
Standardizing the Process for Diagnosing
Attention Deficit Hyperactivity Disorder (ADHD) in the Primary Care Setting
Louise Moon Rosales, MSN, APRN
Purpose. Attention deficit hyperactivity disorder (ADHD) is a common problem that primary care providers diagnose and treat. Yet, there is a current lack of standardization to diagnose ADHD in many primary care settings. This purpose of this project was to standardize the process of diagnosing ADHD through introduction of screening instruments. Objectives included: assessment of clinician knowledge and attitudes about ADHD, implementation of a clinician-directed educational intervention, and development of a work flow procedure to standardize the diagnostic process.
Methods. Clinicians at a family practice participated in a project to standardize the ADHD diagnostic process. Knowledge and attitude assessments via informal interviews and pre-intervention surveys were conducted with the five practice clinicians; three physicians and two nurse practitioners. An ADHD educational intervention was implemented followed by post-intervention surveys. A work flow procedure was implemented to assist in diagnosing ADHD through the use of psychometrically proven instruments embedded into the electronic health record (EHR). The scales used were the Vanderbilt ADHD Assessment Scale and Wender Utah Rating Scale. To measure clinician and subsequent patient outcomes, a data collection plan was created.
Results. All five clinicians completed the pre and post knowledge and attitudinal surveys. The results demonstrated increased provider knowledge and confidence in diagnosing ADHD. A standardized process to diagnose ADHD was successfully developed, and scales to aid in the diagnosis of ADHD were embedded into the EHR. A data collection plan to monitor ongoing clinician and patient outcomes was implemented.
Conclusions. An educational intervention and standardized workflow procedure by which to diagnose ADHD were successfully implemented in a family practice, thereby laying the foundation for continued quality improvement in the diagnosis of ADHD. To refine the process and gain a better appreciation of the impact of the intervention on clinicians and patients, data collection on established outcome measures continues.
Keywords. Attention deficit hyperactivity disorder, ADHD, diagnosis, rating scales, primary care
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An exploratory analysis of best practices for community resource coordination groups of Texas
During the 70th Legislative Session in 1987, the Texas Legislature mandated the establishment of local county-based Community Resource Coordination Groups (CRCGs) to collaborate on the development of individualized service plans and the service provision for children and youth with complex, multi-agency needs. While this was an unfunded mandate for localities, the State’s budget for the Health and Human Services Commission (HHSC) provided training and technical assistance to local CRCGs from the State CRCG Office. However, the 82nd Texas Legislature reduced HHSC’s budget, which resulted in the defunding of the CRCG program at the state level. During fiscal years 2012 and 2013, county CRCG leaders across Texas were left to sustain local operations, if possible, without state-level support. Although some CRCGs did not remain active, the majority of CRCGs did in the absence of the State Office’s support.
Local CRCG leaders across the state of Texas experience difficulty maintaining adequate representation from CRCG partners from the 11 mandated state agencies, as well as limited funding and resources to meet the needs of individuals served by CRCGs. In light of the unfunded mandate and in an effort to identify strategies to enhance the quality of CRCG agency collaboration and service delivery, the purpose of this report is to explore various models for multi-agency collaboration, identify relevant best practices, and discuss potential funding mechanisms for Texas CRCGs. The report presents program and policy recommendations to increase the capacity that the State CRCG Office and local CRCGs have to serve individuals with complex, multi-agency needs.Public AffairsSocial Wor
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