Alabama\u27s Women in Agriculture: The Road to GAPs Harmonization and Global Addendum - Tuskegee\u27s Walmart Initiative

This paper shares challenges faced and overcome by four African American women on their 2013 journey to secure USDA’s Produce Good Agricultural Practices (GAPs) Harmonized Food Safety Standards with the Global Addendum (Global Markets Primary Production Assessments: GMPPA). Collaboration, consistent training, and technical support from the Tuskegee University Extension and Research staff, and the Small Farmers Agricultural Cooperative undergirded the preparation of the farms for GAPs Certification. The timely sharing of staff expertise and experience from commercial partners (Walmart, Purivida, C.H. Robinson, W.P. Rawls), and support from the USDA (Strike Force Initiative) were important contributors to the positive outcomes described. The outcomes elucidate the adaptability, accountability, and professionalism each participant displayed to prepare her farm for audits; maintain food safety records, and achieve GAPs certification in marketable crops. Key Words: Socially Disadvantaged Women Farmers, Food Safety, GAPs certificatio

The real-world problem of care coordination: a longitudinal qualitative study with patients living with advanced progressive illness and their unpaid caregivers.

OBJECTIVES: To develop a model of care coordination for patients living with advanced progressive illness and their unpaid caregivers, and to understand their perspective regarding care coordination. DESIGN: A prospective longitudinal, multi-perspective qualitative study involving a case-study approach. METHODS: Serial in-depth interviews were conducted, transcribed verbatim and then analyzed through open and axial coding in order to construct categories for three cases (sites). This was followed by continued thematic analysis to identify underlying conceptual coherence across all cases in order to produce one coherent care coordination model. PARTICIPANTS: Fifty-six purposively sampled patients and 27 case-linked unpaid caregivers. SETTINGS: Three cases from contrasting primary, secondary and tertiary settings within Britain. RESULTS: Coordination is a deliberate cross-cutting action that involves high-quality, caring and well-informed staff, patients and unpaid caregivers who must work in partnership together across health and social care settings. For coordination to occur, it must be adequately resourced with efficient systems and services that communicate. Patients and unpaid caregivers contribute substantially to the coordination of their care, which is sometimes volunteered at a personal cost to them. Coordination is facilitated through flexible and patient-centered care, characterized by accurate and timely information communicated in a way that considers patients' and caregivers' needs, preferences, circumstances and abilities. CONCLUSIONS: Within the midst of advanced progressive illness, coordination is a shared and complex intervention involving relational, structural and information components. Our study is one of the first to extensively examine patients' and caregivers' views about coordination, thus aiding conceptual fidelity. These findings can be used to help avoid oversimplifying a real-world problem, such as care coordination. Avoiding oversimplification can help with the development, evaluation and implementation of real-world coordination interventions for patients and their unpaid caregivers in the future

Astronometry with the Hubble Space Telescope : trigonometric parallaxes of planetary nebula nuclei NGC 6853, NGC 7293, Abell 31 and DeHt 5

Original article can be found at: http://www.iop.org/EJ/journal/1538-3881 Copyright American Astronomical Society. DOI: 10.1088/0004-6256/138/6/1969We present absolute parallaxes and relative proper motions for the central stars of the planetary nebulae NGC 6853 (The Dumbbell), NGC 7293 (The Helix), Abell 31, and DeHt 5. This paper details our reduction and analysis using DeHt 5 as an example. We obtain these planetary nebula nuclei (PNNi) parallaxes with astrometric data from Fine Guidance Sensors FGS 1r and FGS 3, white-light interferometers on the Hubble Space Telescope. Proper motions, spectral classifications and VJHKT2M and DDO51 photometry of the stars comprising the astrometric reference frames provide spectrophotometric estimates of reference star absolute parallaxes. Introducing these into our model as observations with error, we determine absolute parallaxes for each PNN. Weighted averaging with previous independent parallax measurements yields an average parallax precision, σπ/π = 5%. Derived distances are: d NGC 6853 = 405+28 –25 pc, d NGC 7293 = 216+14 –12 pc, d Abell 31 = 621+91 –70 pc, and d DeHt 5 = 345+19 –17 pc. These PNNi distances are all smaller than previously derived from spectroscopic analyses of the central stars. To obtain absolute magnitudes from these distances requires estimates of interstellar extinction. We average extinction measurements culled from the literature, from reddening based on PNNi intrinsic colors derived from model SEDs, and an assumption that each PNN experiences the same rate of extinction as a function of distance as do the reference stars nearest (in angular separation) to each central star. We also apply Lutz-Kelker bias corrections. The absolute magnitudes and effective temperatures permit estimates of PNNi radii through both the Stefan-Boltzmann relation and Eddington fluxes. Comparing absolute magnitudes with post-AGB models provides mass estimates. Masses cluster around 0.57 , close to the peak of the white dwarf mass distribution. Adding a few more PNNi with well-determined distances and masses, we compare all the PNNi with cooler white dwarfs of similar mass, and confirm, as expected, that PNNi have larger radii than white dwarfs that have reached their final cooling tracks.Peer reviewe

New paradigms for BRCA1/BRCA2 testing in women with ovarian cancer: results of the Genetic Testing in Epithelial Ovarian Cancer (GTEOC) study.

BACKGROUND: Over recent years genetic testing for germline mutations in BRCA1/BRCA2 has become more readily available because of technological advances and reducing costs. OBJECTIVE: To explore the feasibility and acceptability of offering genetic testing to all women recently diagnosed with epithelial ovarian cancer (EOC). METHODS: Between 1 July 2013 and 30 June 2015 women newly diagnosed with EOC were recruited through six sites in East Anglia, UK into the Genetic Testing in Epithelial Ovarian Cancer (GTEOC) study. Eligibility was irrespective of patient age and family history of cancer. The psychosocial arm of the study used self-report, psychometrically validated questionnaires (Depression Anxiety and Stress Scale (DASS-21); Impact of Event Scale (IES)) and cost analysis was performed. RESULTS: 232 women were recruited and 18 mutations were detected (12 in BRCA1, 6 in BRCA2), giving a mutation yield of 8%, which increased to 12% in unselected women aged <70 years (17/146) but was only 1% in unselected women aged ≥70 years (1/86). IES and DASS-21 scores in response to genetic testing were significantly lower than equivalent scores in response to cancer diagnosis (p<0.001). Correlation tests indicated that although older age is a protective factor against any traumatic impacts of genetic testing, no significant correlation exists between age and distress outcomes. CONCLUSIONS: The mutation yield in unselected women diagnosed with EOC from a heterogeneous population with no founder mutations was 8% in all ages and 12% in women under 70. Unselected genetic testing in women with EOC was acceptable to patients and is potentially less resource-intensive than current standard practice.This work was supported by Target Ovarian Cancer grant number T005MT.This is the author accepted manuscript. It is currently under an indefinite embargo pending publication by the BMJ Group