Early Childhood Councils: Effective Planning Processes for Health Systems Integration

The Colorado Trust launched its Early Childhood Council Health Integration grant strategy in 2008. Through this effort, the Early Childhood Councils developed strategies to better integrate health practitioners and health care services into their work, along with their already-established focus on early care and education, and family supports. The goal of this grant strategy was to support sustainable efforts by the Councils to change the way local resources were coordinated, reduce service duplication, increase access to health care services and contribute to improved health outcomes for children (ages 0-12 years) across the state. To realize this goal, The Colorado Trust provided the Councils with grant support and technical assistance to engage in the development of plans to achieve integrated childhood development systems in their communities. This case study discusses the successes, challenges and lessons learned from the Early Childhood Council Health Integration planning grant process. Using qualitative data collected through focus groups and key informant interviews, the report details how the planning process was structured, what worked and didn't work as the Councils developed their systems-building plans, and provides recommendations for funders to consider when conducting a systems-building planning process. Key themes include:Grantees learned about systems change and developed plans to achieve such change. The planning process provided Councils with the time, resources and guidance necessary to learn about and develop well-thought-out plans to build connections and develop the infrastructure to help support and sustain programs for children and families across multiple systems. Community-level data is essential in fostering collaboration and planning. Even as it was difficult to access key data for certain populations or geographic regions, many Councils were able to use local data as a tool to coalesce new partnerships and develop a shared vision for change. Integrating new partners into an established system requires planning. For many Councils, the planning process timeframe was essential in conducting outreach to local health partners, especially with regard to developing a shared vision and common language.Funders need to require and support systemic change. It was important that The Colorado Trust explicitly required grantees to engage in activities that supported effective implementation of high-quality programs and connections across systems as opposed to solely focusing the funding on individual programs. While this work was new to most of the Councils, they reported that having a funder willing to support systems-building was a welcome change that better enabled them to tackle a complex scope of work and to address unanticipated challenges

Identifying spatial efficiency-equity tradeoffs in territorial development policies : evidence from Uganda

In many countries, place specific investments in infrastructure are viewed as integral components of territorial development policies. But are these policies fighting market forces of concentration? Or are they adding net value to the national economy by tapping underexploited resources? This paper contributes to the debate on the spatial allocation of infrastructure investments by examining where these investments will generate the highest economic returns"spatial efficiency", and identifying whether there re tradeoffs when infrastructure coverage is made more equitable across regions"spatial equity". The empirical analysis focuses on Uganda and is based on estimating models of firm location choice, drawing on insights from the new economic geography literature. The main findings show that establishments in the manufacturing industry gain from being in areas that offer a diverse mix of economic activities. In addition, availability of power supply, transport links connecting districts to markets, and the supply of skilled workers attract manufacturing activities. Combining all these factors gives a distinct advantage to existing agglomerations along leading areas around Kampala and Jinja. Infrastructure investments in these areas are likely to produce the highest returns compared with investments elsewhere. Public infrastructure investments in other locations are likely to attract fewer private investors, and will pose a spatial efficiencyequity tradeoff. To better integrate lagging regions with the national economy, lessons from the WDR2009"Reshaping Economic Geography"calling for investments in health and education in lagging areas are likely to be more beneficial.Transport Economics Policy&Planning,E-Business,Banks&Banking Reform,Non Bank Financial Institutions,Economic Theory&Research

Does WBT for the HER Meet the Needs of the Medical Surgical Nurse?

Healthcare organizations are beginning to implement the tools needed to receive government stimulus money for meaningful use. The use of electronic health records is directly related to the amount of stimulus funding available to each healthcare organization. Nurse educators are examining innovative training tools to implement in order to meet the needs of the organizations. The purpose of this paper is to examine the question is web-based training an effective model for training nurses on the electronic health record. A pilot study was created to examine the question. The focus group included medical surgical nurses that had taken web-based training. The paper will address the educational gaps related to this topic and provide recommendations from the pilot study and literature

An Investigation of the Developmental Growth of Preschool Children with Disabilities Being Served in Inclusive Settings in Comparison with Noninclusive Settings in California

The purpose of this study was to perform a secondary data analysis to investigate the relationship between preschool setting and the developmental growth of all children receiving state-funded preschool special-education services in California in inclusive settings compared with all children receiving state-funded preschool special-education services in California in noninclusive settings. To accomplish this purpose, a secondary data analysis of a longitudinal data set was conducted using the Desired Results Developmental Profile (DRDP, 2015) to measure progress across eight domains of child development over a 2-year time span and four assessment time points. This study used individual growth modeling to analyze developmental growth; more specifically, this study used hierarchical linear modeling (HLM). The study included all children receiving preschool special-education services in California (N = 78,999), in both inclusive and noninclusive settings and investigated differences between groups based on preschool setting. The response variables for the study included eight domains scores that are combined into three Office of Special Education Programs (OSEP) outcome measures. Statistically significant differences were found between the developmental-growth trajectories of preschool children receiving special-education services in inclusive settings versus noninclusive settings. The results indicated that children served in inclusive settings have a higher developmental-growth trajectory over time across all three OSEP outcome measures. In addition, statistically significant differences were found between the developmental-growth trajectories of preschool children receiving special-education services in inclusive setting versus noninclusive for seven of the eight domains on the DRDP (2015). The only domain that was statistically significant was the English Language Development domain. For preschool children diagnosed as having other health impairments, there is a statistically significant difference in developmental-growth trajectories between the two groups based on setting for the OSEP 1 and OSEP 3 scores. Overall, these results indicate that children served in inclusive settings have a slightly higher developmental-growth trajectory than children served in noninclusive settings. Future studies may be conducted to build upon the HLM models that were used in the analyses as well as include additional information about severity of disability and other outcome measures in order to improve upon the present results

Maladaptive Behaviors within the Context of Play

Play-based assessment is an observational technique used to evaluate young children\u27s development. The Play Assessment/Intervention System (PLAIS) is one of the most widely researched play-based assessment models and assesses domains such as exploratory play, simple pretend play, complex pretend play, and non-play. One of the criticisms of early childhood assessments and screening instruments is they neglect to evaluate the social and emotional development of young children. The PLAIS codes for aggressive behavior, but not within the context of play. Given that aggression is typical among young children, this study created an observational supplement to the PLAIS that allows observers to code disruptive and aggressive behavior within the context of play. In addition, pilot data will be presented to determine whether disruptive and aggressive behavior can in fact be observed within the context of play. Implications for future research will be provided

Effects of a Raised Surface on Lower Extremity Kinematics, Kinetics, and Muscle Activation During a Sidecut in Recreational Female Softball Players

Noncontact anterior cruciate ligament (ACL) injury is a common sports-related injury. “High-risk” dynamic movements, such as a sidecut, have been associated with increasing the risk of noncontact ACL injury. Certain biomechanical abnormalities, specifically at the hip and knee, and neuromuscular abnormalities, such as unbalanced quadriceps-to-hamstrings activation ratios and certain activation patterns prior to initial contact and after initial contact, have also been associated with an increased likelihood of noncontact ACL injuries occurring. Approximately 78% of all NCAA Division I softball game-day injuries are classified as noncontact where there is no direct contact to a player. Internal derangement of the knee accounted for 221 game day injuries, and 31% of these injuries were noncontact ACL injuries. The base runner was at the greatest risk of injury, with 28.8% of athletes base running at the time of injury. Additionally, 9% of base runners, or 187 athletes, were injured while contacting the base. The purpose of this study was to determine the effects of a raised surface on lower extremity kinematics, kinetics, and muscle activation patterns during a sidecut, simulating rounding first base. Participants completed two base conditions – with a base present (WB) and no base (NB) present with a controlled entrance and exit speed. Results indicated the only biomechanical difference between base conditions was greater peak knee adduction moments in the NB condition compared to the WB condition. These findings suggest that the body may be in a better position when a raised surface is present during a sidecut and decrease the risk of noncontact ACL injury. Therefore, examining movement patterns at the ankle may provide a better explanation for noncontact ACL injuries that occur during this time. Regarding muscle activation, there was significantly greater quadriceps activation post-contact compared to pre-contact. Significantly greater quadriceps activation creates a large anterior shear force on the ACL, increasing risk of injury

Move-minimizing puzzles, diamond-colored modular and distributive lattices, and poset models for Weyl group symmetric functions

The move-minimizing puzzles presented here are certain types of one-player combinatorial games that are shown to have explicit solutions whenever they can be encoded in a certain way as diamond-colored modular and distributive lattices. Such lattices can also arise naturally as models for certain algebraic objects, namely Weyl group symmetric functions and their companion semisimple Lie algebra representations. The motivation for this paper is therefore both diversional and algebraic: To show how some recreational move-minimizing puzzles can be solved explicitly within an order-theoretic context and also to realize some such puzzles as combinatorial models for symmetric functions associated with certain fundamental representations of the symplectic and odd orthogonal Lie algebras