Homeless Veterans: VA Should Improve Reporting on the Benefits Provided by Leases of Unneeded Property

[Excerpt] Federal real property is on GAO’s high risk list partly because some agencies, like VA, have large amounts of underutilized or vacant space. In an effort to develop some of these unneeded properties, VA has worked with private partners to convert its unneeded space into supportive housing for veterans and other purposes using EULs. Congress included a provision in statute for GAO to review VA’s EUL program. This report examines: 1) VA’s authorities for managing unneeded property and providing homeless veteran housing; 2) VA’s internal control design for monitoring EULs and collecting accurate data; and 3) VA’s estimates of the financial effect of EULs. To conduct this work, GAO reviewed federal laws and VA guidance, and analyzed VA models for determining an EUL’s financial effect for two lease types: supportive housing and improved VA operations, since these two lease types had the greatest number of EULs. GAO reviewed two EULs from each lease type, selected based on the dollar amount of net benefits. GAO compared VA’s design of the EUL program’s internal control activities to federal standards and interviewed VA officials. Testing the effectiveness of VA’s internal controls was not within GAO’s scope

The Standards of Success: Tracking Market Capitalization in Companies

Financial metrics are crucial to determine what companies are doing well, what they are doing poorly, and how they should change. It is an ongoing problem of managers to focus on key metrics in order to track their company performance well and be able to focus on how to improve their bottom line. This paper determines which financial metrics best track the performance of a company by evaluating various metrics which companies can use to track their performance measured against their market capitalization. I expect that an increase in the debt to equity ratio will be associated with an increase in a company?s market capitalization. This paper studies ten companies from the biotechnology industry. Utilizing data from the past ten years will allow the study to cover the Great Recession and examine how the financial metrics performed both during the recession and during the recovery of the economy. Knowing which metrics are more telling of a company?s performance allows the company to spend more time in the necessary areas, thus saving a great amount of time and resources. Analyzing what constitutes a healthy performing company is telling of past performance, current performance, and where the performance will likely be in the future

The Institute of Archaeology & Siegfried H. Horn Museum Newsletter Volume 41.1

William Shea Dies, Karen Shea, Rebecca Shea Erdelyi, Gerhard Pfandl, and Paul J. Ray, Jr. Al-Maktába: The Bookstore Random Surveyhttps://digitalcommons.andrews.edu/iaham-news/1081/thumbnail.jp

Collaboration Between Extension and Industry: Coordination and Assessment of Technical Large Animal Emergency Rescue Training

Rescuing large animals from emergency situations can be fraught with dangers not only to the animals but also to the rescuers. People involved at the scene of such an emergency are most likely to include first responders, horse owners, and veterinarians. These groups need to be aware of how they can best work together to effect a safe and efficient rescue as none typically has all the knowledge and skills that are necessary. Extension training programs that bring together such groups can be beneficial in supporting emergency and disaster preparedness in the local community

Characterization of Horse Use in Therapeutic Horseback Riding Programs in the United States: A Pilot Survey

With increasing public scrutiny on animal welfare, it behooves those involved in the equine industry to revisit best management practices to ensure these support healthy horses. There is little published research on how horses are used in the equine industry, particularly in therapeutic horseback riding (THR) programs. Although there is a large amount of information on the benefits of THR programs to the participants, there is little published information available about the horses. Therefore, the objective of this survey was to gather data regarding horse use and care in Professional Association of Therapeutic Horsemanship International (PATH Intl.)–affiliated THR programs in the United States to help establish a foundation for a standard of care. A 20-question survey sent to 659 PATH Intl.–affiliated THR programs returned a 40% response rate. Demographics demonstrated that the median number of horses in each program was 10; geldings outnumbered mares; most horses were between 16 and 20 years of age; and Quarter Horse or stock-type breeds predominated. Median session length was 8 weeks and median lesson length was 45 minutes. Horses were typically ridden by clients 4 days/week and 2 hours/day. Most horses were donated to the programs, participated for approximately 7 years, and left because of aging. Limb lameness and back soreness were the top health issues noted, with only a small percentage of colic and ulcers reported. More horses received nonsteroidal anti-inflammatory drugs for a lameness issue, chiropractic adjustment, and massage than any other supplemental care or complementary therapy. Based on data gathered in this survey, THR horses were not worked excessively. Horses were ridden less than PATH Intl.’s maximum recommendation of 6 hours/day and 6 days/week and less than those used in university programs. Horses in THR programs also appeared to have fewer reported health issues as compared with data in other national reports

Key components of rehabilitation programmes for adults with complex fractures following traumatic injury: A scoping review

Introduction Complex fractures are severe injuries that cause considerable disability, particularly in the working population. Effective rehabilitation is essential to achieve good outcomes, however, it is unclear what the best rehabilitation strategy is for adults with complex fractures, after their discharge from hospital. The aim of this scoping review was to identify and map the breadth of evidence available on this topic. Methods A systematic search was completed on 24th July 2023 using a combination of subject and specialist databases. In addition, a secondary search assessed unpublished literature from trial registries. A citation search was completed on the selected studies. The template for intervention description and replication (TIDieR) checklist was used to extract consistent data on the interventions reported in the studies. The Joanna Briggs Institute methodology for scoping reviews was followed. Results 19,253 studies were identified from the search strategy of which 25 studies met the eligibility criteria. Most interventions were exercise-based and delivered by physiotherapists. Some studies compared manual therapy treatments to other forms of physiotherapy or a placebo, whilst others investigated psychosocial interventions, such as cognitive behavioural therapy, in comparison to usual care. Two studies took a multidisciplinary team approach, incorporating components such as exercise, functional activities and self-management strategies. Discussion The studies included were heterogenous in terms of population (fracture type, location and complexity), intervention content and therapeutic aims. However, commonalities were found with most interventions or comparators including range of movement, strengthening and task specific exercises; functional tasks; gait and balance training; and advice on return to activities as components. Value was attributed to components such as, a coordinated team approach, person-centred rehabilitation, supervised exercise and psychosocial support. Conclusion There is a broad and varied approach to the rehabilitation of complex fractures. The studies differed in population and approach, with a wide range of injuries, interventions and modes of delivery reported. Fidelity was poorly described, with only a third of studies reporting adherence or acceptability. There was inconclusive evidence to inform clinical practice and further research is advised. Qualitative, expert consensus, and coproduction approaches are recommended methods to develop complex interventions and best practice guidance

Toxicological responses of environmental mixtures: Environmental metal mixtures display synergistic induction of metal-responsive and oxidative stress genes in placental cells

Exposure to elevated levels of the toxic metals inorganic arsenic (iAs) and cadmium (Cd) represents a major global health problem. These metals often occur as mixtures in the environment, creating the potential for interactive or synergistic biological effects different from those observed in single exposure conditions. In the present study, environmental mixtures collected from two waste sites in China and comparable mixtures prepared in the laboratory were tested for toxicogenomic response in placental JEG-3 cells. These cells serve as a model for evaluating cellular responses to exposures during pregnancy. One of the mixtures was predominated by iAs and one by Cd. Six gene biomarkers were measured in order to evaluate the effects from the metals mixtures using dose and time-course experiments including: heme oxygenase 1 (HO-1) and metallothionein isoforms (MT1A, MT1F and MT1G) previously shown to be preferentially induced by exposure to either iAs or Cd, and metal transporter genes aquaporin-9 (AQP9) and ATPase, Cu2+ transporting, beta polypeptide (ATP7B). There was a significant increase in the mRNA expression levels of ATP7B, HO-1, MT1A, MT1F, and MT1G in mixture-treated cells compared to the iAs or Cd only-treated cells. Notably, the genomic responses were observed at concentrations significantly lower than levels found at the environmental collection sites. These data demonstrate that metal mixtures increase the expression of gene biomarkers in placental JEG-3 cells in a synergistic manner. Taken together, the data suggest that toxic metals that co-occur may induce detrimental health effects that are currently underestimated when analyzed as single metals

Association of Rideshare-Based Transportation Services and Missed Primary Care Appointments: A Clinical Trial

In a pragmatic trial, offering complimentary ridesharing services broadly to Medicaid patients did not reduce rates of missed primary care appointments. The uptake of free rides was low, and rates of missed appointments remained unchanged at 36%. Efforts to reduce missed appointments due to transportation barriers may require more targeted approaches