Nursing Home Implementation of Health Information Technology: Review of the Literature Finds Inadequate Investment in Preparation, Infrastructure, and Training.

Health information technology (HIT) is increasingly adopted by nursing homes to improve safety, quality of care, and staff productivity. We examined processes of HIT implementation in nursing homes, impact on the nursing home workforce, and related evidence on quality of care. We conducted a literature review that yielded 46 research articles on nursing homes' implementation of HIT. To provide additional contemporary context to our findings from the literature review, we also conducted semistructured interviews and small focus groups of nursing home staff (n = 15) in the United States. We found that nursing homes often do not employ a systematic process for HIT implementation, lack necessary technology support and infrastructure such as wireless connectivity, and underinvest in staff training, both for current and new hires. We found mixed evidence on whether HIT affects staff productivity and no evidence that HIT increases staff turnover. We found modest evidence that HIT may foster teamwork and communication. We found no evidence that the impact of HIT on staff or workflows improves quality of care or resident health outcomes. Without initial investment in implementation and training of their workforce, nursing homes are unlikely to realize potential HIT-related gains in productivity and quality of care. Policy makers should consider creating greater incentives for preparation, infrastructure, and training, with greater engagement of nursing home staff in design and implementation

Changing home care aides: Differences between family and non-family care in California Medicaid home and community-based services.

In California Medicaid home-and-community-based services (HCBS), recipients' family members receive payment as home care aides (HCAs). We analyzed data on first-time HCBS recipients to examine factors associated with the likelihood of switching HCAs within the first year of services. Those with family HCAs were less than half as likely to change than those with non-family HCAs and racial/ethnic minorities with non-family HCAs had the highest switching rates. Lower wages and local unemployment were associated with switching of non-family HCAs but not family HCAs. Policymakers can foster continuity of home care by paying family members for home care and raising worker wages

Intra-Project Externality and Layout Variables in Residential Condominium Appraisals

This study examines the impact of intra-project externalities and layout variables on the selling prices of 897 condominium units in the cities of Irvine and Santa Ana in Orange County, California. It documents that, at a micro-level, proximity to intra-project externalities such as greenspace, swimming pools, recreational areas, traffic noise, and the like, and project layout variables representing the location of individual condominium units within multiunit structures, have significant effects on the property values of units within a condominium project. The results indicate that, when cost is not prohibitive, both appraisers and underwriters should take intra-project externalities and layout variables into consideration when estimating property values or underwriting residential mortgages for condominium properties.

Equity for All: Providing Accessible Healthcare for Patients Living with Disabilities

At the end of this activity, students will be able to: Identify relevant resources to assist patients living with disabilities Recommend appropriate patient-specific resources to minimize barriers to health Identify strategies to enhance the healthcare experience of patients living with disabilities Describe the policies that currently exist to enhance care for patients living with disabilitieshttps://digitalcommons.chapman.edu/pharmacy_books/1027/thumbnail.jp

Youtube as an early childhood music education resource parental attitudes, beliefs, usages, and experiences

This descriptive study was designed with two main purposes: (a) to provide researchers and educators with baseline information about current YouTube music usages and practices and (b) to examine parental attitudes and beliefs towards YouTube as a music education resource. One hundred ninety-two (N = 192) parents of toddler-age children (16-to-36 months old) participated in a researcher-constructed survey designed to examine the digital home music environment, digital musical parenting, and parent-child YouTube music experiences. Results indicated that parents accessed YouTube regularly, maintained positive attitudes towards YouTube, and considered YouTube to be an effective resource for children's overall learning and music skills. Data suggested that children engage with and respond to digital music in various ways, and parental beliefs about YouTube were multi-faceted. Findings suggested a need for accessible musical parenting guidelines and resources in this YouTube generation.Includes bibliographical reference

Addressing Barriers to Breast Cancer Care in California: The 2016 - 2017 Landscape for Policy Change

In 2018, over 29,000 women will be diagnosed with breast cancer in California and an estimated 4,500 will die of the disease. While the Affordable Care Act (ACA) has successfully expanded access to health insurance and breast cancer care, numerous population subgroups remain uninsured, and many others may lack adequate coverage for treatment and management of their breast cancer. Although insurance improves breast cancer outcomes compared to those with no insurance, challenges may remain even for the insured. Among those insured, there appear to be significant barriers to cancer care as health insurance premiums are increasing, networks are narrowing, and as the cost of breast cancer drugs is increasing.This report provides a comprehensive assessment of the significant barriers and challenges to accessing breast cancer care in California through the  completion of three key tasks: (1) a synthesis of the peer reviewed literature, news media, reports and policy briefs, (2) completion of a series of key informant/stakeholder interviews, and (3) an analysis of social media. The authors find five categories of barriers: (1) Health System Barriers, (2) Insurance Barriers, (3) High Costs, (4) Individual and Cultural Characteristics, and (5) Language.Although many barriers are shared across insurance types, where possible, this report provides insight on barriers unique to the insurance status of women, specifically for the uninsured, those covered by Medi-Cal, and those covered by commercial insurance. Findings from this report can be used to guide efforts of policymakers to improve timely access to breast cancer care among all women in California

Mechanical Strength Comparison of Hydrated and Dehydrated Pteridium Stems

In this experiment, the mechanical strength of Pteridium stems was tested in two differing conditions: hydrated and dehydrated. It was hypothesized that there would be an increased performance of hydrated stems in the presence of mechanical stress. In order to test this hypothesis, twelve 20 cm pieces of stems were cut in alternation, separating those that would be dehydrated (6) with those that were hydrated (6). The dehydrated specimens were left to dry over a period of 24 hours. The diameters of each individual stem were measured to account for variation in size and remove excess variables. All twelve stems were placed into the Instron individually and their MOE and MOR were measured. Based on the raw data that was obtained from these tests and analysis of the data performed in the form of a paired t-test, it was concluded that there is not a significant difference between the two. Both the MOE’s and MOR’s of the hydrated and dehydrated stems resulted in p values that were more than the significant 0.05 level. Although the data was found not significantly different, it is an important discovery in the scientific community

Effects of PARP inhibitors, SGLT2 inhibitors, and Colchicine on Doxorubicin-induced Premature Senescence Induced-Phenotype

https://openworks.mdanderson.org/sumexp22/1076/thumbnail.jp

Observing secondary school teachers’ effective teaching behavior in the Netherlands, England, and the United States using the ICALT observation instrument

Introduction: The purpose of this study was to examine measurement invariance in observer scoring of effective teaching behavior in three secondary education contexts–the Netherlands, England, and the United States. It also aimed to describe what effective teaching behavior looks like in secondary education across the three education contexts. Methods: A uniform observation measure called International Comparative Analysis of Learning and Teaching (ICALT) was used to observe teachers. Results: Results revealed that the hypothesized factor structure of effective teaching behavior was confirmed for the Dutch and English data, but not for the US data. Teachers in the Netherlands showed higher levels of more basic teaching behaviors, but lower levels of more complex teaching behaviors, compared to teachers in England. Discussion: Implications of the findings are discussed.</p

Neural basis for a heritable phenotype: differences in the effects of apomorphine on startle gating and ventral pallidal GABA efflux in male Sprague–Dawley and Long–Evans rats

Prepulse inhibition (PPI) of startle is a measure of sensorimotor gating that is heritable and deficient in certain psychiatric disorders, including schizophrenia. Sprague–Dawley (SD) rats are more sensitive to PPI disruptive effects of dopamine (DA) agonists at long interstimulus intervals (60–120 ms) and less sensitive to their PPI-enhancing effects at short (10–30 ms), compared with Long–Evans (LE) rats. These heritable strain differences in sensitivity to the PPI disruptive effects of DA agonists must ultimately reflect neural changes "downstream" from forebrain DA receptors. The current study evaluated the effects of the DA agonist, apomorphine (APO), on ventral pallidal (VP) gamma-aminobutyric acid (GABA) and glutamate efflux and PPI in SD and LE rats. PPI was tested in SD and LE rats after vehicle or APO (0.5 mg/kg, subcutaneously (s.c.)) in a within-subject design. In different SD and LE rats, VP dialysate was collected every 10 min for 120 min after vehicle or APO (0.5 mg/kg, s.c.) and analyzed for GABA and glutamate content by capillary electrophoresis (CE) coupled with laser-induced fluorescence (LIF). As predicted, SD rats exhibited greater APO-induced PPI deficits at long intervals and less APO-induced PPI enhancement at short intervals compared to LE rats. APO significantly reduced VP GABA efflux in SD but not in LE rats; glutamate efflux was unaffected in both strains. Heritable strain differences in PPI APO sensitivity in SD vs LE rats parallel, and may be mediated by, strain differences in the VP GABA efflux