Creating Choices Before Making Choices: One Family Foundation’s Journey to Finding a Strategic Focus

Rooted in business principles, philanthropic study, and reflective practice, this article examines the journey of the Marion I. & Henry J. Knott Foundation, a small family foundation established in 1977, toward a strategic grantmaking focus. This article examines a foundation’s first step toward building a grantmaking strategy – finding an issue or problem to address – alongside a three-part model for creating choices that reflect donor intent, organizational talents and resources, and broader community needs. The study adds to the body of knowledge about the value, process, and challenges of finding a strategic grantmaking focus, whether that focus is for all or simply one portion of a foundation’s giving portfolio. It might be of significant benefit to foundations that are programmatically broad, those trying to clarify or formalize the intent of their original donors, those with large multigenerational boards, and those questioning why, where, or how to begin

An Educational Resource for Young Adults with Disabilities, Their Caregivers, and Clinicians in the Driver Learning Environment

Driving and community mobility are essential occupations for growing independence and identity. Young adults who are transitioning into adulthood have a desire to engage in their community, and it is at this time that an interest in driving begins. Driving is a complex occupation that requires in-depth education and experience to safely participate in. Learning to drive can be challenging, especially for a person with a disability. Young adults with disabilities confront several community concerns that limit their ability to participate in the meaningful activity of driving. Those with disabilities often rely on their support systems to help guide their decision-making and learning. Caregivers, specifically, play a significant role as a primary support system by preparing their young adults for this occupation. Unfortunately, there is an absence of educational resources on driver education that highlights the role of the caregiver. As a result, there is a lack of awareness on the caregiver’s role in driver education and a feeling of unpreparedness when creating a supportive learning environment for their young adult. For this capstone project, an online advocacy and educational resource was developed for caregivers responsible for young adults with disabilities who are interested in learning the occupation of driving.https://soar.usa.edu/otdcapstonessummer2021/1005/thumbnail.jp

A randomised controlled feasibility trial to investigate the effects of a functional standing frame programme versus usual physiotherapy to improve function and quality of life and reduce neuromuscular impairment in people with severe sub-acute stroke

Background Task-related training can aid functional recovery post-stroke but has not been investigated in people with severe stroke. Orthostatic hypotension (OH) may limit rehabilitation, therefore, the effects of undertaking prolonged standing and sit to stand repetitions (functional standing frame programme) early after severe stroke during inpatient sub-acute rehabilitation is unknown. Methods A systematic review of non-pharmacological interventions to treat OH in people with neurological conditions was undertaken to inform a protocol for the management of OH during the functional standing frame programme. The feasibility of a blinded randomised controlled trial (RCT) investigating the effects of a functional standing frame programme compared to usual physiotherapy for people with severe stroke was conducted. Primary (Barthel Index, Edmans ADL Index for Stroke) and secondary outcomes (including lower limb joint range of movement, knee extensor strength, and quality of life) were assessed at baseline, post-intervention and 15-, 29- and 55-weeks post-randomisation. Semi-structured interviews were conducted with a subset of participants, relatives and physiotherapists to explore experiences of the intervention and trial procedures. Data were analysed using thematic analysis and descriptive analysis. Results The systematic review included randomised controlled trials (n=13), quasiexperimental (n=27), case control (n=1) and case report (n=2). A meta-analysis of seven studies concluded electrical stimulation, lower limb compression and resistance exercise training were favourable in treating or reducing OH. Forty-five participants (51-96 years; 42% male, mRS 4=80% 5=20%) were recruited; n=22 randomised to intervention, n=23 to control. Twenty-seven participants completed the trial: n=12 died (n=7 intervention), n=2 moved out of area, n=4 withdrawn. Adherence to the intervention was low: 38-51% of possible sessions being completed; average session duration 39.40 minutes (±18.8); standing duration 12.52 minutes (±8.8); and mean sit-to-stand repetitions 4.64 (±3.9 SD) per session. 91% of sessions were enjoyed. Adherence was affected by patient, physiotherapist and organisational factors. Conclusion A definitive RCT of a functional standing frame programme is feasible for people with severe stroke. However, intervention adherence need to be addressed before progressing to a definitive trial, which will investigate clinical and cost effectiveness.National Institute for Health Researc

Attendant Care for Children and Youth with EBD/SED: Part II Attendant Care in Kansas

Attendant Care (AC) services provided to youth who experience Severe Emotional Disturbances (SED) are individualized support provided in the least restrictive community settings. AC has been identified as a valuable piece of the system of care in Kansas and elsewhere. Service utilization continues to dramatically increase, yet very little knowledge about AC is available in the literature. This is the first known study of mental health AC evaluating the standards of AC practices in the state of Kansas, stakeholders’ perspective on the usefulness of AC, and the policies and practices that support integration of AC into the system of care.c. 2004 State of Kansas Department of Social and Rehabilitation Services May be reproduced in original form Prepared under grant No. KAN23373; and contract No. 0702-HCP-0603-07

Feasibility of Podcasts and City by City Analysis for Upside.FM

The objective of the project is to conduct a feasibility study for Upside, with regard to their underlying business model. We then hope to make recommendations for other cities and complementary products that can fit under the Upside umbrella

Efficacy of High-performance Vision Training on Improving the Reaction Time of Collegiate Softball Athletes: A Randomized Trial

Purpose. A well-developed visual system is integral to the dynamic nature of sport performance among collegiate athletes. Occupational therapists play an important role in addressing an athlete’s visual skills through incorporating meaningful occupation, in this case sport, into interventions while addressing specific client factors. The aim of the study was to examine the efficacy of occupational therapist led high-performance visual training in improving the reaction time of collegiate softball athletes. Method. A mixed method approach was used to collect both qualitative and quantitative data. Qualitative data were collected to assess athlete perceptions of sport, and quantitative data were collected using a mixed within group and between group design. Twenty-one participants were randomly allocated into two groups, each receiving a 6-week intervention which followed an evidence-based protocol. Group A consisted of Dynavision™ D2 training, and Group B of non-machine, therapist-led, visual training, twice weekly for 10-15 minutes each. Results. Results of the study highlight perceived meaningfulness of sport and display that both theory-based protocols were effective, as Group A and Group B experienced significant decreases in reaction time. However, decreases in reaction time were more significant for Group A in both proactive and reactive Dynavision™ D2 training modes. Conclusion. Results suggest that both the Dynavision™ D2 and alternative vision training as led by occupational therapists may be beneficial in improving the proactive and reactive reaction times of collegiate athletes, enhancing their abilities to participate in meaningful sports, but the Dynavision™ D2 may be a more effective training tool, especially related to proactive reaction time training

Estimating the distribution of morbidity and mortality of childhood diarrhea, measles, and pneumonia by wealth group in low- and middle-income countries

__Background:__ Equitable access to vaccines has been suggested as a priority for low- and middle-income countries (LMICs). However, it is unclear whether providing equitable access is enough to ensure health equity. Furthermore, disaggregated data on health outcomes and benefits gained across population subgroups are often unavailable. This paper develops a model to estimate the distribution of childhood disease cases and deaths across socioeconomic groups, and the potential benefits of three vaccine programs in LMICs. __Methods:__ For each country and for three diseases (diarrhea, measles, pneumonia), we estimated the distributions of cases and deaths that would occur across wealth quintiles in the absence of any immunization or treatment programs, using both the prevalence and relative risk of a set of risk and prognostic factors. Building on these baseline estimates, we examined what might be the impact of three vaccines (first dose of measles, pneumococcal conjugate, and rotavirus vaccines), under five scenarios based on different sets of quintile-specific immunization coverage and disease treatment utilization rates. __Results:__ Due to higher prevalence of risk factors among the poor, disproportionately more disease cases and deaths would occur among the two lowest wealth quintiles for all three diseases when vaccines or treatment are unavailable. Country-specific context, including how the baseline risks, immunization coverage, and treatment utilization are currently distributed across quintiles, affects how different policies translate into changes in cases and deaths distribution. __Conclusions:__ Our study highlights several factors that would substantially contribute to the unequal distribution of childhood diseases, and finds that merely ensuring equal access to vaccines will not reduce the health outcomes gap across wealth quintiles. Such information can inform policies and planning of programs that aim to improve equitable delivery of healthcare services

Complex I deficiency due to selective loss of Ndufs4 in the mouse heart results in severe hypertrophic cardiomyopathy.

Mitochondrial complex I, the primary entry point for electrons into the mitochondrial respiratory chain, is both critical for aerobic respiration and a major source of reactive oxygen species. In the heart, chronic dysfunction driving cardiomyopathy is frequently associated with decreased complex I activity, from both genetic and environmental causes. To examine the functional relationship between complex I disruption and cardiac dysfunction we used an established mouse model of mild and chronic complex I inhibition through heart-specific Ndufs4 gene ablation. Heart-specific Ndufs4-null mice had a decrease of ∼ 50% in complex I activity within the heart, and developed severe hypertrophic cardiomyopathy as assessed by magnetic resonance imaging. The decrease in complex I activity, and associated cardiac dysfunction, occurred absent an increase in mitochondrial hydrogen peroxide levels in vivo, accumulation of markers of oxidative damage, induction of apoptosis, or tissue fibrosis. Taken together, these results indicate that diminished complex I activity in the heart alone is sufficient to drive hypertrophic cardiomyopathy independently of alterations in levels of mitochondrial hydrogen peroxide or oxidative damage

Laboratory and Experimental Hut Evaluation of a Long-lasting Insecticide Treated blanket for Protection against Mosquitoes.

Long-lasting insecticide treated blankets (LLIBs) may provide additional protection against malaria where use of long lasting insecticidal nets (LLIN) is low or impractical such as in disaster or emergency situations. Initial efficacy testing of a new candidate LLIB was carried out at LSHTM and KCMUCo, before and after washing, in cone and ball bioassays and arm-in-cage tests against pyrethroid susceptible Anopheles gambiae. A small scale field trial was conducted using veranda-trap experimental huts in northern Tanzania against wild An. arabiensis and Culex quinquefasciatus mosquitoes. Treatments included unwashed and 5 times washed permethrin treated LLIB and blankets hand-treated with permethrin (ITB), untreated blankets, and a holed unwashed Olyset net. Cone test mortality was 75% for LLIB when unwashed, but decreased to 32% after 5 washes and <10% after 10 washes. In arm-in-cage tests protection against biting was 100% for LLIBs regardless of the number of washes while reduction in landings was 79% when unwashed, 75% after 5 washes, but declined to 41% after 10 and 33% after 20 washes. In ball bioassays using pyrethroid resistant An. arabiensis, mortality was low in all treatments (<35%) and there was no significant difference in mortality between Olyset net, LLIB or ITB (p > 0.05). Percentage mortality of An. arabiensis in huts with LLIB unwashed (26%) was not statistically different to Olyset net (31%, p = 0.5). The 5 times washed LLIB reduced blood-feeding by 49% which was equivalent to Olyset net (p > 0.086). There was no significant difference in percentage blood-feeding between LLIB and ITB unwashed or 5 times washed (p = 0.147 and p = 0.346 respectively). The 5 times washed LLIB reduced blood-feeding of Culex quinquefasciatus by 40%, although the Olyset provided the greatest protection with 85% inhibition. ELISA analysis of a sub-sample of blood fed mosquitoes showed that not all had fed on humans in the huts, therefore blood-feeding inhibition may have been underestimated. This trial demonstrated the potential of LLIBs to provide substantial personal protection even against pyrethroid resistant mosquitoes. LLIBs may prove particularly useful where LLINs are unsuitable or net usage is low