Providing Disadvantaged Workers with Skills to Succeed in the Labor Market

Millions of Americans cannot obtain jobs that pay enough to lift them out of poverty. For many, the principal barrier to obtaining these good jobs is their lack of specialized occupational skills increasingly sought by employers. Research has shown that vocational training can be effective in boosting the earnings of disadvantaged adult workers. This proposal argues that, by helping workers acquire the skills that employers demand, vocational training could be wielded as an effective anti-poverty tool.This paper outlines why Congress should increase funding for vocational training for disadvantaged adult workers. Specifically, we argue that Congress should increase funding for the Workforce Investment Act (WIA) Adult program. We also argue, however, that Congress, and the state and local workforce investment boards that administer the WIA Adult program, should explore ways to improve the vocational training that is available to adult disadvantaged workers

The Nature of Religious Melancholy: Edward Taylor\u27s Poetic Treatments of a 17th Century Epidemic

Edward Taylor indicates an awareness of 17th century religious melancholy in his Preparatory Meditations, but the minister is largely excluded from current discourse surrounding religious melancholy in Puritan communities. Taylor\u27s presence in this conversation serves to further understanding of religious melancholy in America and also of the complex nature of the condition that is of interest at the present time. Through an analysis of dominant images of the conversion experience from Edward Taylor\u27s poetry, this thesis argues that Taylor provides intimate knowledge of the nature of religious melancholy and also offers a treatment option for the ailing Puritan in the form of hope for salvation

Managing workplace stress in community pharmacy organisations:Lessons from a review of the wider stress management and prevention literature

Abstract Background Workplace stress in community pharmacy is increasing internationally due, in part, to pharmacists’ expanding roles and escalating workloads. Whilst the business case for preventing and managing workplace stress by employers is strong, there is little evidence for the effectiveness of organisational stress management interventions in community pharmacy settings. Aim To identify and synthesise existing evidence for the effectiveness of organisational solutions to workplace stress from the wider organisational literature which may be adaptable to community pharmacies. Method A secondary synthesis of existing reviews. Publications were identified through keyword searches of electronic databases and the internet; inclusion and exclusion criteria were applied; data about setting, intervention, method of evaluation, effectiveness and conclusions (including factors for success) were extracted and synthesised. Findings Eighteen reviews of the stress management and prevention literature were identified. A comprehensive list of organisational interventions to prevent or manage workplace stress, ordered by prevalence of evidence of effectiveness, was produced, together with an ordered list of the benefits both to the individual and employing organisation. An evidence-based model of best practice was derived specifying eight factors for success: top management support, context-specific interventions, combined organisational and individual interventions, a participative approach, clearly delineated tasks and responsibilities, buy-in from middle management, change agents as facilitators and change in organisational culture. Conclusions This literature review provides community pharmacy organisations with evidence from which to develop effective and successful stress management strategies to support pharmacists and pharmacy staff. Well-designed trials of stress management interventions in community pharmacy organisations are still required. </jats:sec

Improvements to the production of ZIF-94; a case study in MOF scale-up

The authors acknowledge the financial support of the European Research Council under the European Union’s Seventh Framework Programme (FP/2007-2013), under grant agreement no. 608490, M4CO2 project.The ability to produce large scale quantities of MOF materials is essential for the commercialisation of these frameworks to continue. Herein we report how the production of ZIF-94 can be improved from a ∼1 g laboratory preparation to a scalable procedure allowing for large scale production of the desired framework. The synthesis of ZIF-94 was completed at room temperature, atmospheric pressure and without the use of DMF as a solvent. This method offers improvements over the current literature synthesis routes and affords a product at 18 wt% solids. To demonstrate the robustness of the derived methodology a 60 g, large scale, batch of this framework was produced which possessed a surface area of 468 m2 g−1. This large scale sample has superior CO2 uptake of 3.3 mmol g−1 at 1 bar, an improvement of 30% over literature reports.Publisher PDFPeer reviewe

Virtual Reality, Ultrasound-guided Liver Biopsy Simulator: Development and Performance Discrimination

International audienceObjectives: Identify and prospectively investigate simulated ultrasound-guided targeted liver biopsy performance metrics as differentiators between levels of expertise in interventional radiology. Methods: Task analysis produced detailed procedural step documentation allowing identification of critical procedure steps and performance metrics for use in a virtual reality ultrasound-guided targeted liver biopsy procedure. Consultant (n 5 14, male 5 11, female 5 3) and trainee (n 5 26, male 5 19, female 5 7) scores on the performance metrics were compared. Ethical approval was granted by the Liverpool Research Ethics Committee (UK). Independent t-tests and analysis of variance (ANOVA) investigated differences between groups. Results: Independent t-tests revealed significant differences between trainees and consultants on 3 performance metrics: targeting, p 5 0.018, t 5 22.487 (22.040 to 20.207); probe usage time, p 5 0.040, t 5 2.132 (11.064 to 427.983); mean needle length in beam, p 5 0.029, t 5 22.272 (20.028 to 20.002). ANOVA reported significant differences across years of experience (0-1, 1-2, 3+ years) on seven performance metrics: no-go area touched, p 5 0.012; targeting, p 5 0.025; length of session, p 5 0.024; probe usage time, p 5 0.025; total needle distance moved, p 5 0.038; number of skin contacts, p , 0.001; total time in no-go area, p 5 0.008. More experienced participants consistently received better performance scores on all 19 performance metrics. Conclusion: It is possible to measure and monitor performance using simulation, with performance metrics providing feedback on skill level and differentiating levels of expertise. However, a transfer of training study is required

Maternal and perinatal health research priorities beyond 2015 : an international survey and prioritization exercise

Background: Maternal mortality has declined by nearly half since 1990, but over a quarter million women still die every year of causes related to pregnancy and childbirth. Maternal-health related targets are falling short of the 2015 Millennium Development Goals and a post-2015 Development Agenda is emerging. In connection with this, setting global research priorities for the next decade is now required. Methods. We adapted the methods of the Child Health and Nutrition Research Initiative (CHNRI) to identify and set global research priorities for maternal and perinatal health for the period 2015 to 2025. Priority research questions were received from various international stakeholders constituting a large reference group, and consolidated into a final list of research questions by a technical working group. Questions on this list were then scored by the reference working group according to five independent and equally weighted criteria. Normalized research priority scores (NRPS) were calculated, and research priority questions were ranked accordingly. Results: A list of 190 priority research questions for improving maternal and perinatal health was scored by 140 stakeholders. Most priority research questions (89%) were concerned with the evaluation of implementation and delivery of existing interventions, with research subthemes frequently concerned with training and/or awareness interventions (11%), and access to interventions and/or services (14%). Twenty-one questions (11%) involved the discovery of new interventions or technologies. Conclusions: Key research priorities in maternal and perinatal health were identified. The resulting ranked list of research questions provides a valuable resource for health research investors, researchers and other stakeholders. We are hopeful that this exercise will inform the post-2015 Development Agenda and assist donors, research-policy decision makers and researchers to invest in research that will ultimately make the most significant difference in the lives of mothers and babies.</p

The Role of Simulation in Medical Training and Assessment

An overview to medical simulation has been provided. In the context of procedural interventional radiology training, we start with the definition and history of simulation, address its increasing importance in medicine reflect on its theoretical basis and current evidence and finally review its advantages/ limitations and prospects for the future

Pre-exposure prophylaxis to prevent the acquisition of HIV-1 infection (PROUD) : effectiveness results from the pilot phase of a pragmatic open-label randomised trial

Background Randomised placebo-controlled trials have shown that daily oral pre-exposure prophylaxis (PrEP) with tenofovir-emtricitabine reduces the risk of HIV infection. However, this benefit could be counteracted by risk compensation in users of PrEP. We did the PROUD study to assess this effect. Methods PROUD is an open-label randomised trial done at 13 sexual health clinics in England. We enrolled HIV-negative gay and other men who have sex with men who had had anal intercourse without a condom in the previous 90 days. Participants were randomly assigned (1:1) to receive daily combined tenofovir disoproxil fumarate (245 mg) and emtricitabine (200 mg) either immediately or after a deferral period of 1 year. Randomisation was done via web-based access to a central computer-generated list with variable block sizes (stratified by clinical site). Follow-up was quarterly. The primary outcomes for the pilot phase were time to accrue 500 participants and retention; secondary outcomes included incident HIV infection during the deferral period, safety, adherence, and risk compensation. The trial is registered with ISRCTN (number ISRCTN94465371) and ClinicalTrials.gov (NCT02065986). Findings We enrolled 544 participants (275 in the immediate group, 269 in the deferred group) between Nov 29, 2012, and April 30, 2014. Based on early evidence of effectiveness, the trial steering committee recommended on Oct 13, 2014, that all deferred participants be offered PrEP. Follow-up for HIV incidence was complete for 243 (94%) of 259 patient-years in the immediate group versus 222 (90%) of 245 patient-years in the deferred group. Three HIV infections occurred in the immediate group (1·2/100 person-years) versus 20 in the deferred group (9·0/100 person-years) despite 174 prescriptions of post-exposure prophylaxis in the deferred group (relative reduction 86%, 90% CI 64-96, p=0·0001; absolute difference 7·8/100 person-years, 90% CI 4·3-11·3). 13 men (90% CI 9-23) in a similar population would need access to 1 year of PrEP to avert one HIV infection. We recorded no serious adverse drug reactions; 28 adverse events, most commonly nausea, headache, and arthralgia, resulted in interruption of PrEp. We detected no difference in the occurrence of sexually transmitted infections, including rectal gonorrhoea and chlamydia, between groups, despite a suggestion of risk compensation among some PrEP recipients. Interpretation In this high incidence population, daily tenofovir-emtricitabine conferred even higher protection against HIV than in placebo-controlled trials, refuting concerns that effectiveness would be less in a real-world setting. There was no evidence of an increase in other sexually transmitted infections. Our findings strongly support the addition of PrEP to the standard of prevention for men who have sex with men at risk of HIV infection. Funding MRC Clinical Trials Unit at UCL, Public Health England, and Gilead Sciences