Economic evaluation of a group-based exercise program for falls prevention among the older community-dwelling population

BACKGROUND: Falls among older people are of growing concern globally. Implementing cost-effective strategies for their prevention is of utmost importance given the ageing population and associated potential for increased costs of fall-related injury over the next decades. The purpose of this study was to undertake a cost-utility analysis and secondary cost-effectiveness analysis from a healthcare system perspective, of a group-based exercise program compared to routine care for falls prevention in an older community-dwelling population. METHODS: A decision analysis using a decision tree model was based on the results of a previously published randomised controlled trial with a community-dwelling population aged over 70. Measures of falls, fall-related injuries and resource use were directly obtained from trial data and supplemented by literature-based utility measures. A sub-group analysis was performed of women only. Cost estimates are reported in 2010 British Pound Sterling (GBP). RESULTS: The ICER of GBP£51,483 per QALY for the base case analysis was well above the accepted cost-effectiveness threshold of GBP£20,000 to £30,000 per QALY, but in a sensitivity analysis with minimised program implementation the incremental cost reached GBP£25,678 per QALY. The ICER value at 95% confidence in the base case analysis was GBP£99,664 per QALY and GBP£50,549 per QALY in the lower cost analysis. Males had a 44% lower injury rate if they fell, compared to females resulting in a more favourable ICER for the women only analysis. For women only the ICER was GBP£22,986 per QALY in the base case and was below the cost-effectiveness threshold for all other variations of program implementation. The ICER value at 95% confidence was GBP£48,212 in the women only base case analysis and GBP£23,645 in the lower cost analysis. The base case incremental cost per fall averted was GBP£652 (GBP£616 for women only). A threshold analysis indicates that this exercise program cannot realistically break even. CONCLUSIONS: The results suggest that this exercise program is cost-effective for women only. There is no evidence to support its cost-effectiveness in a group of mixed gender unless the costs of program implementation are minimal. Conservative assumptions may have underestimated the true cost-effectiveness of the program

General Education and Special Education Elementary School Teachers\u27 Understanding of Professional Learning Communities

The purpose of this study was to identify general and special education teachers\u27 understanding of professional learning communities (PLCs) at 2 public suburban elementary schools in the western United States. Both schools were in the second year of implementation of PLCs but seemed to be using PLC time to plan lessons. This quantitative descriptive survey sought to to identify the teachers\u27 overall understanding of the 6 dimensions of the Professional Learning Communities Assessment - Revised (PLCA-R) and to determine if there was a difference between general and special education teachers\u27 perceptions of PLCs. This survey was administered to general and special education teachers who had at least 3 years of teaching experience and at least 1 year of participation in a PLC. A total of 23 general education teachers and 10 special education teachers participated. Descriptive statistics were used to analyze the data from the 6 dimensions and the PLCA-R. The results indicated that both groups understood the PLC process and had favorable perceptions of PLCs. The results of the ANOVA for each of the 7 hypotheses showed that there was no significant difference between general and special education teachers\u27 perceptions of PLCs. The dissemination of results will help administrators focus on the 6 dimensions of a PLC to provide teachers with an in-depth understanding of PLCs, which can help students to achieve their potential

Paper Prototyping Comfortable VR Play for Diverse Sensory Needs

We co-designed paper prototype dashboards for virtual environments for three children with diverse sensory needs. Our goal was to determine individual interaction styles in order to enable comfortable and inclusive play. As a first step towards an inclusive virtual world, we began with designing for three sensory-diverse children who have labels of neurotypical, ADHD, and autism respectively. We focused on their leisure interests and their individual sensory profiles. We present the results of co-design with family members and paper prototyping sessions conducted by family members with the children. The results contribute preliminary empirical findings for accommodating different levels of engagement and empowering users to adjust environmental thresholds through interaction design

Leveling the Playing Field: Supporting Neurodiversity via Virtual Realities

Neurodiversity is a term that encapsulates the diverse expression of human neurology. By thinking in broad terms about neurological development, we can become focused on delivering a diverse set of design features to meet the needs of the human condition. In this work, we move toward developing virtual environments that support variations in sensory processing. If we understand that people have differences in sensory perception that result in their own unique sensory traits, many of which are clustered by diagnostic labels such as Autism Spectrum Disorder (ASD), Sensory Processing Disorder, Attention-Deficit/Hyperactivity Disorder, Rett syndrome, dyslexia, and so on, then we can leverage that knowledge to create new input modalities for accessible and assistive technologies. In an effort to translate differences in sensory perception into new variations of input modalities, we focus this work on ASD. ASD has been characterized by a complex sensory signature that can impact social, cognitive, and communication skills. By providing assistance for these diverse sensory perceptual abilities, we create an opportunity to improve the interactions people have with technology and the world. In this paper, we describe, through a variety of examples, the ways to address sensory differences to support neurologically diverse individuals by leveraging advances in virtual reality

Direct and mediated effects of a social-emotional and character development program on adolescent substance use

Mitigating and preventing substance use among adolescents requires approaches that address the multitude of factors that influence this behavior. Such approaches must be tested, not only for evidence of empirical effectiveness, but also to determine the mechanisms by which they are successful. The aims of the present study were twofold: 1) To determine the effectiveness of a school-based social-emotional and character development (SECD) program, Positive Action (PA), in reducing substance use (SU) among a sample of U.S. youth living in a low-income, urban environment, and 2) to test one mechanism by which the program achieves its success. We used longitudinal mediation analysis to test the hypotheses that: 1) students attending PA intervention schools engage in significantly less SU than students attending control schools, 2) students attending PA intervention schools show significantly better change in SECD than students attending control schools, and 3) the effect of the PA intervention on SU is mediated by the change in SECD. Analyses revealed program effects on both SECD and SU, a relationship between SECD and SU, and the effects of PA on SU were completely mediated by changes in SECD. Future research directions and implications for schoolbased social-emotional and character development efforts and substance use prevention are addressed.peer-reviewe

A Virtual Reality System for Practicing Conversation Skills for Children with Autism

We describe a virtual reality environment, Bob’s Fish Shop, which provides a system where users diagnosed with Autism Spectrum Disorder (ASD) can practice social interactions in a safe and controlled environment. A case study is presented which suggests such an environment can provide the opportunity for users to build the skills necessary to carry out a conversation without the fear of negative social consequences present in the physical world. Through the repetition and analysis of these virtual interactions, users can improve social and conversational understanding

Effects of the Positive Action Program on Indicators of Positive Youth Development Among Urban Youth

This study evaluated effects of Positive Action, a school-based social-emotional and character development (SECD) intervention, on indicators of positive youth development (PYD) among a sample of low-income, ethnic minority youth attending 14 urban schools. The study used a matched-pair, cluster-randomized controlled design at the school level. A multiple-measure self-report protocol assessed four key strengths and resources for PYD: self-concept, peer affiliations, ethics, and social skills. Students (n=1170) were assessed from grades 3 to 8, the duration of the intervention, with drop-outs and late entrants included in analyses. Growth curve analyses revealed evidence of favorable program effects on each of the four types of resources. The study contributes to PYD research by providing evidence for school-based interventions in low-income, urban contexts for ethnic minority youth.Keywords: positive youth development, social-emotional and character development, longitudinal, adolescenc

Chitosan in Plant Protection

Chitin and chitosan are naturally-occurring compounds that have potential in agriculture with regard to controlling plant diseases. These molecules were shown to display toxicity and inhibit fungal growth and development. They were reported to be active against viruses, bacteria and other pests. Fragments from chitin and chitosan are known to have eliciting activities leading to a variety of defense responses in host plants in response to microbial infections, including the accumulation of phytoalexins, pathogen-related (PR) proteins and proteinase inhibitors, lignin synthesis, and callose formation. Based on these and other proprieties that help strengthen host plant defenses, interest has been growing in using them in agricultural systems to reduce the negative impact of diseases on yield and quality of crops. This review recapitulates the properties and uses of chitin, chitosan, and their derivatives, and will focus on their applications and mechanisms of action during plant-pathogen interactions

A Virtual Reality System for Practicing Conversation Skills for Children with Autism

We describe a virtual reality environment, Bob’s Fish Shop, which provides a system where users diagnosed with Autism Spectrum Disorder (ASD) can practice social interactions in a safe and controlled environment. A case study is presented which suggests such an environment can provide the opportunity for users to build the skills necessary to carry out a conversation without the fear of negative social consequences present in the physical world. Through the repetition and analysis of these virtual interactions, users can improve social and conversational understanding