A policy analysis of two preschool prevention programs in Ontario

The purpose of this research was to examine issues relevant to best practices for preschooler mental health prevention policy so as to inform future prevention policy. Data were gathered through the examination of two preschool prevention programs, Ontario Early Years Centres (OEYCs) and Healthy Babies, Healthy Children (HBHC). These prevention programs were examined with respect to four major issues: (a) the ideology and origins of the program, (b) theoretical underpinnings, (c) research base, and (d) implementation and adaptation issues. To explore these four issues, qualitative methods were used in the form of document reviews (two documents for the Early Years Centres and two documents for the Healthy Babies, Healthy Children) and key informant interviews (seven informants for the Early Years Centres and six informants for Healthy Babies, Healthy Children). The main finding regarding the ideology and origins of the Early Years Centres and Healthy Babies, Healthy Children is that a mixture of values related to both personal well-being and collective well-being was used in the framing of both the problem(s) and solution(s). Furthermore, informants indicated that centres were created by the government in response to both timing (an influx of federal funding for programs for preschool children) and the influences of key people. A key finding regarding the theoretical underpinnings of both programs is that brain-based development theories were used to explain how the quality of early sensory stimulation during critical early periods influences the brain’s ability to develop properly. The centres were used improve the quality of stimulation for preschool children by assisting parents and children through the use of centre-based programs, whereas Healthy Babies, Healthy Children programs used primarily family-based programs. Findings for the research base were based on evaluations conducted on both programs. While the evaluation reports suggest encouraging conclusions regarding the effectiveness and efficiency of both programs, the methodologies used in the evaluations of both programs have major limitations. As for best practices with regard to the Early Years Centres and Healthy Babies, Healthy Children, key informants noted the lack of comprehensiveness, accessibility, follow-up assessments, and theoretical basis of the programs and the issues of insufficient dosage of the interventions. Cultural sensitivity was deemed by informants to be a strong aspect of both programs. Key informants also noted that centres are struggling to provide consistent programming across Ontario. Additionally, the Healthy Babies, Healthy Children program’s home visitation services lack intensity and may not be effective because this program uses lay home visitors in its primary approach to home visitation. Findings regarding implementation and adaptation for the centres include a clear message from informants that the ease of implementation was dependent on whether the centre began in a pre-established organization. Additionally, key informants asserted that the extent of community ownership and adaptation varied from centre-to-centre across Ontario. The implementation and adaptation issues faced by Healthy Babies, Healthy Children are evidenced in the lack of pilot projects the program undertook before it was implemented province-wide. This approach led to implementation that was not based in teachings from research evidence or community-based knowledge. While informants commended HBHC’s ability to adapt to the community’s needs, the community’s sense of ownership of the program is still questionable. The findings of this research have implications for improving preschool mental health prevention policy in all four categories. These implications include: (a) more thorough framing of the problem(s) and solution(s), (b) a deeper understanding of the research base upon which the greatest program impacts can be achieved, and (c) the need for pilot projects before province-wide implementation

CLINICAL AND DEMOGRAPHIC VARIABLES ASSOCIATED WITH COGNITIVE DEFICITS, SYMPTOM SEVERITY, AND DURATION AFTER CONCUSSIVE INJURY IN ADOLESCENTS: A RETROSPECTIVE STUDY

Background: Concussions in adolescents are a public health concern with the growing popularity of high school sports. Recent legislation mandates that athletes who are suspected of a concussion be cleared to return-to-play by a clinician. More research is needed to develop a concussion predictive model to identify populations at risk for more severe and prolonged symptoms and long-term neurologic deficits. Aims: The aims of this study were to (1) examine the effect of race and gender on neurocognitive and symptom scores and (2) determine which clinical (e.g., number of concussions, migraine history, learning disabilities/ attention deficit disorders) and demographic factors (e.g., age, gender, race/ ethnicity, health insurance, mechanism of injury/ sport, education) predict prolonged recovery times. Methods: This was an observational cohort study of clinical data reviewed retrospectively in adolescents aged 13 to 19 years who were evaluated for an acute concussion (≤ 10 days from injury) at a university-based concussion clinic between January 1, 2012 to August 1, 2015. Multivariate analysis of variance was used to examine the role of gender and race on Immediate Post-concussion Assessment and Cognitive Testing composite scores. Logistic regression, Kaplan-Meier analysis, and Cox regression proportional hazards model were utilized to examine predictors of concussion recovery times. Results: The sample (N = 118) was primarily male (71.2%) with a median age of 16 (range 13-19 years old). Ethnic minorities (Blacks and Hispanics) constituted 40% of the sample. Univariate analyses revealed that females had slower reaction times than males (p = .04) and minority females performed significantly worse on verbal memory (p = .04) than other groups. Predictors of protracted recovery included ADHD (p \u3c .001) and prior concussion history (p = .03). Predictors of shorter recovery times included student athletic insurance (p = .02) and public insurance (Medicaid or Chips) (p = .03) as compared with private or no insurance. Conclusions: The findings showed that there was a gender difference on reaction time and there was an interaction of race and gender on verbal memory after a concussion. This study also identified key risk factors that may be used prognosticate concussion recovery times in adolescents

How Good Is Local Search for Capacitated Facility Location Problem: An Experimental Study

Facility location problems have been widely studied since 1960’s. These problems are known to be strongly NP-hard. In capacitated variant of the problem, a capacity constraint is associated with each facility. Capacitated facility location problem (CFLP) instances can be solved exactly using existing MILP solvers but only for small instance sizes. As the size of the problem instance increases beyond few hundred facilities and few hundred clients, it becomes prohibitive to solve these instances exactly. For large problem instances, therefore, other solution methods are used. One approach is to use heuristic methods. These methods usually give good solutions in reasonable time but they do not provide any guarantee about the quality of the solution. Somewhere between these two extremes exist another class of algorithms called approximation algorithms. They also provide only suboptimal solutions to the problem, like heuristic algorithms, in polynomial time. How ever they guarantee worst case upper bounds on the cost of the solution. So, a solution obtained using an approximation algorithm is guaranteed to have its cost between the optimal cost and the upper bound. We present experimental studies done with a local search based approximation algorithm for CFLP given by Bansal et al. [1] to show that this algorithm performs well in practice

Bicriteria in n x 2 Flow Shop Scheduling Under Specified Rental Policy, Processing Time and Setup Time Each Associated with probabilities Including Job Block

This paper is an attempt to obtains an optimal solution for minimizing the bicriteria taken as minimizing thetotal rental cost of the machines subject to obtain the minimum makespan for n jobs 2 machines flowshopproblem in which the processing times and independent set up times are associated with probabilitiesincluding the job block concept. A heuristic approach method to find optimal or near optimal sequence hasbeen discussed. The proposed method is very simple and easy to understand and also provide an importanttool for the decision makers. A computer programme followed by a numerical illustration is give to clarifythe algorithm.Keywords: Flowshop Scheduling, Heuristic, Processing Time, Set Up Time, Rental Cost and Job Block

PHARMACOGNOSTICAL EVALUATION OF EMBELIA RIBES AND CAMELLIA SINENSIS: COMPARATIVE STUDIES OF THEIR ANTHELMINTIC ACTIVITY

Objective: The present research work deals with the establishment of a standardization parameter for the Pharmacognositical evaluation of the plant Embelia Ribes and Camellia sinensis. Embelia Ribes is widely using in parasitic intestinal infection, however; Camellia sinensis is mainly used in the beverage preparation, for their Antioxidant activity but their anthelmintic effect is unknown. The present study aims to find out the effect of Camellia sinensis against pheritima Posthuma and compare their anthelmintic effect with Embelia Ribes. Methods: The study has been performed under the different parameters 1). The physicochemical parameter includes total Ash value, acid insoluble ash value, water-soluble ash value, moisture content, and foreign organic matter 2). The phytochemical investigation includes the Extraction of Embelia Ribes and Camellia sinensis in different solvents in the increasing order of their polarity with Petroleum ether, chloroform, ethanol, distilled respectively and showed the presence of Alkaloids, carbohydrates, glycosides, tannins, flavonoids, phenolic compounds. 3) The pharmacological studies include the In vitro anthelmintic effect of Embellia Ribes and Camellia sinensis (ethanolic extract) against Pheritima Posthuma. The paralysis time and death time were studied. Results: Shows the physic-chemical parameters such as total Ash value, acid insoluble ash value, water-soluble ash value, moisture content and foreign organic matter, which was determined to be not more than 8.98%, 1.5%, 7.8%, 3.2% and 0.25% in Embelia ribes as well as 7.78%, 1.6%, 8%, 2.2% and 0.21% in Camellia sinensis. Anthelemintic effect of Embellia ribes and Camellia sinensis (ethanolic extract) were investigated by measuring the paralysis time (75+3.76, 60+4.30, 48+4.40 and 73.32+3.80, 53.34+2.50, 38.55+3.45 respectively) and death time (140+2.82, 135+9.95, 97.55+4.25 and 124.85+5.30, 110.82+5.80, 80.30+2.80) at three different concentration 25 mg, 50 mg, 100 mg, against Pheritima posthuma and compares with the standard drug (Albendazole). Conclusion: Camellia sinensis (ethanolic extract) extract and affords protection against helminthes (Pheritima Posthuma) and results show that Camellia sinensis is as effective as embellia ribes

Bicriteria in n x 2 Flow Shop Scheduling Problem under Specified Rental Policy, Processing Time, Setup Time Each Associated with Probabilities Including Job Block Criteria and Weightage of Jobs

This paper is an attempt to obtain an optimal solution for minimizing the bicriteria taken as minimization of the total rental cost of the machines subject to obtain the minimum makespan for n-jobs, 2-machine flow shop scheduling problem in which the processing times and independent set up times are associated with probabilities including job block criteria. Further jobs are attached with weights to indicate their relative importance. The proposed method is very simple and easy to understand and also provide an important tool for the decision makers. A computer programme followed by a numerical illustration is given to justify the algorithm. Keywords: Flowshop Scheduling, Heuristic, Processing Time, Setup Time, Job Block, Weighs of job

Vaginal delivery in a patient with asymptomatic severe aortic stenosis: a case report

Heart disease complicates about 1-4% of all pregnancies of which valvular heart disease is the commonest cause. In developing countries, congenital heart diseases are commonly first detected during pregnancy. Most women do well during pregnancy but severe mitral stenosis or severe aortic stenosis are high-risk conditions that can cause significant morbidity and mortality. Unlike asymptomatic severe mitral stenosis, asymptomatic severe aortic stenosis is mWHO category 3. There is no consensus on the mode of delivery in patients with asymptomatic severe aortic stenosis. Here we describe a case of successful vaginal delivery in a woman with severe aortic stenosis. As the patient was asymptomatic and ejection fraction was preserved, a joint decision for vaginal delivery was taken along with the cardiology team. The patient was induced and delivered with operative vaginal delivery. This case shows that vaginal delivery could be a viable option in patients with asymptomatic severe aortic stenosis given continuous haemodynamic monitoring can be provided

Incipient primary biliary cirrhosis/autoimmune hepatitis overlap or hepatitic form of primary biliary cirrhosis: a case report

A 42 year old asymptomatic female detected as incipient Primary Biliary Cirrhosis/Autoimmune Hepatitis overlap during routine checkup. The biochemical profile showed evolution from a mildly deranged liver function test in 2004 along with increased erythrocyte sedimentation rate to a 4 times elevation of alkaline phosphatase in 2006 with mildly deranged alanine transaminase. Autoimmune markers demonstrable were Anti mitochondrial antibody M2 and sp100. Histopathology showed dual features, dominant findings were of autoimmune heptatitis. Features consistent with Primary Biliary Cirrhosis were minimal with an occasional portal tract showing paucity of bile ducts and occasional bile duct proliferation. Human leucocyte antigen DR/DQ genotype was as follows: DRB1*03, DRB1*07, DQB1*02, DQB1*04

Autophagy induction by Scutellaria flavones in cancer: recent advances

In parallel with a steady rise in cancer incidence worldwide, the scientific community is increasingly focused on finding novel, safer and more efficient modalities for managing this disease. Over the past decades, natural products have been described as a significant source of new structural leads for novel drug candidates. Scutellaria root is one of the most studied natural products because of its anticancer potential. Besides just describing the cytotoxic properties of plant constituents, their molecular mechanisms of action in different cancer types are equally important. Therefore, this review article focuses on the role of the Scutellaria flavones wogonin, baicalein, baicalin, scutellarein and scutellarin in regulating the autophagic machinery in diverse cancer models, highlighting these molecules as potential lead compounds for the fight against malignant neoplasms. The knowledge that autophagy can function as a dual-edged sword, acting in both a pro- and antitumorigenic manner, further complicates the issue, revealing an amazing property of flavonoids that behave either as anti- or proautophagic agents