Assessing the Enhanced Ranch Program of the Santa Clara County Probation Department

In 2006, the Santa Clara County Probation Department (SCCPD) changed its approach to serving youth in two of its juvenile justice programs--the William F. James Boys' Ranch and the Muriel Wright Center. The overarching objectives of the change were to provide specific therapeutic services to youth and families while maintaining a commitment to public safety. The new cognitive-behavioral model marks a vastly different structure and philosophy, patterned after the evidence-based program developed by the Missouri Division of Youth Services. The new model, entitled the Enhanced Ranch Program, targets youth heavily entrenched in the juvenile justice system and emphasizes positive, peer-based group interactions and a holistic approach to developing individual case plans. Specially trained teams of staff work with small groups of youth offenders.Teams function as therapeutic units that share the daily activities of life with youth and focus on their critical thinking, personal development, and group processes. The Enhanced Ranch Program serves high-risk, high- need youth with gang affiliations, substance abuse issues, and significant criminal histories. This model was designed to improve outcomes for youth with extensive criminal histories by ensuring that they receive the most appropriate and purposeful services. The primary focus is to help youth internalize healthy behavior that will help them succeed.In November, 2008, Santa Clara County Chief Probation Officer Sheila Mitchell, commissioned NCCD to evaluate the implementation of the Enhanced Ranch Program. In large part, this report presents the findings of a process evaluation--an analysis of the specific structure and practice instituted by the County. It also presents some preliminary outcomes for youth

Revitalizing Tier 2 Intervention with Graphic Novels

The authors explore the practice of incorporating graphic novels in a Tier 2 Response To Intervention (RTI) program for five elementary-aged struggling readers in an urban school. Using a formative experiment framework, the study found that graphic novels provided a vehicle for the application of word recognition and fluency strategies learned in the RTI intervention program. In addition, graphic novels were used to develop students’ vocabulary and comprehension skills and resulted in increased progress for students’ fluency as measured by DIBELS. Since graphic novels are not grade level specific, they are appropriate for readers across grades. As a genre, graphic novels can also provide a scaffold for students in the development of literacy skills

Caring for parents with neurodegenerative disease: a qualitative description

PURPOSE/OBJECTIVE: The objective of this study was to explore the positive aspects experienced by adult children in providing care to their parent who has either Parkinson's or Alzheimer's disease. DESIGN:A qualitative descriptive approach was used to analyze audiotaped in-depth semistructured interviews that were conducted with 34 adult children who were primary caregivers as part of a larger randomized clinical trial. SETTING: Individual interviews were conducted by trained research assistants in the caregiver's home. SAMPLE: Thirty-four adult children caregivers who were primary caregivers for their respective 34 parents. Seventy-six percent (n = 26) of the caregivers were caring for a parent with Alzheimer's disease. Twenty-four percent (n = 8) were caring for a parent with Parkinson's disease. Eighty-two percent were adult daughters. Mean age of the caregiver was 52 years, and the mean age of the parent was 81 years. Fifty-three percent of caregivers were white, and 47% were black. DATA ANALYSIS: A conventional content analysis was performed to summarize themes. FINDINGS: Results indicated that most caregivers had positive experiences. Three relationship-centered themes were identified: spending and enjoying time together, appreciating each other and becoming closer, and giving back care. A small number of caregivers (n = 6) could not identify positive experiences. CONCLUSION/IMPLICATIONS: Caregivers who had positive experiences in caregiving expressed fewer feelings of being overwhelmed or distressed by their situations. Further study is needed on caregivers who do not experience positive aspects in caring for a parent, and these caregivers potentially may be a group that warrants further intervention by advanced practice nurses

Excessive Infant Mortality: An Exploration of Factors Contributing to South Dakota Indians\u27 Life Chances

The consequences of racial inequality are clearly delineated in an analysis of social indicators between racial groups. Among the more direct indicators of social inequality are infant and general mortality rates (Anderson, 1973:286). Indeed, no cold statistic expresses more eloquently the difference between a society of sufficiency and a society of deprivation than the infant mortality rate (Newland, 1981:5). Societies of deprivation that produce higher rates of infant mortality are characterized by low levels of education (Bertoli at al., 1984; Heoht and Outright, 1979), poor health care (Gortmaker, 1879), lower socioeconomic status (Fordyce, 1977), and other problematic environmental conditions. South Dakota is characterized by racial differences in infant mortality rates. Are these rates significantly different? If so, can the social conditions that are associated with high and low rates be distinguished? These are the general questions addressed by this research. Specifically, this research compares and contrasts pertinent vital statistics of the Native American population in South Dakota with the White population. The nature of differential life chances will also be examined

Audit Committees Oversight of Information Technology Risk

This exploratory study examines the role of the audit committee in overseeing information technology (IT) risk. We address the degree of audit committee oversight of specific IT risks, as well as factors associated with variations in audit committee IT oversight. Based on responses from 39 audit committee members, we found (1) little audit committee emphasis on oversight of IT risks, (2) audit committees involved with IT oversight focus on more traditional risks (e.g., monitoring), while very little attention is devoted to IT acquisition and implementation, and (3) the amount of IT oversight is positively associated with the responding members auditing experience and prior familiarity with the COBIT model for assessing IT risks. Audit committee independence, diligence, and expertise, company size, and industry were not significantly associated with IT oversight

Characterization of microRNA expression profiles in normal human tissues

<p>Abstract</p> <p>Background</p> <p>Measuring the quantity of miRNAs in tissues of different physiological and pathological conditions is an important first step to investigate the functions of miRNAs. Matched samples from normal state can provide essential baseline references to analyze the variation of miRNA abundance.</p> <p>Results</p> <p>We provided expression data of 345 miRNAs in 40 normal human tissues, which identified universally expressed miRNAs, and several groups of miRNAs expressed exclusively or preferentially in certain tissue types. Many miRNAs with co-regulated expression patterns are located within the same genomic clusters, and candidate transcriptional factors that control the pattern of their expression may be identified by a comparative genomic strategy. Hierarchical clustering of normal tissues by their miRNA expression profiles basically followed the structure, anatomical locations, and physiological functions of the organs, suggesting that functions of a miRNA could be appreciated by linking to the biologies of the tissues in which it is uniquely expressed. Many predicted target genes of miRNAs that had specific reduced expression in brain and peripheral blood mononuclear cells are required for embryonic development of the nervous and hematopoietic systems based on database search.</p> <p>Conclusion</p> <p>We presented a global view of tissue distribution of miRNAs in relation to their chromosomal locations and genomic structures. We also described evidence from the <it>cis</it>-regulatory elements and the predicted target genes of miRNAs to support their tissue-specific functional roles to regulate the physiologies of the normal tissues in which they are expressed.</p

A Very Rare Cause of Pancytopenia.

INTRODUCTION: Levetiracetam (Keppra) is a pyrrolidone derivative and acts as an anti-epileptic medication by modulating neurotransmitter release. Pancytopenia is a very rare adverse effect caused by levetiracetam. There are fewer than four case reports in the medical literature discussing the association between levetiracetam and pancytopenia. The pathogenesis behind this relationship is unclear. Therefore, this case will serve to spread awareness of a rare cause of pancytopenia and to hypothesize how this medication causes pancytopenia. CASE REPORT: A brain MRI of a 79-year-old female with a medical history of hypertension, Type II diabetes, and CVA revealed a right temporoparietal mass. She was started on dexamethasone prior to surgery due to the extensive amount of vasogenic edema. She underwent a temporal craniotomy with resection of the mass and was started on levetiracetam as seizure prophylaxis. Postoperatively, her blood count remained stable. She was on levetiracetam, dexamethasone, pantoprazole, and enoxaparin as prophylaxis. She was noted to have an episode of melena and anemia on the fifth day postoperatively, which resulted in a transfusion of two units of blood with an appropriate response. No acute gastroenterological intervention was deemed necessary. The patient was also noted to develop thrombocytopenia and leukopenia. Thrombotic thrombocytopenic purpura, disseminated intravascular coagulation, and heparin-induced thrombocytopenia were ruled out. Pantoprazole and enoxaparin were discontinued without any improvement in cell counts. The patient received a total of five units of platelets due to a platelet count of less than 100,000. Levetiracetam was changed to lacosamide on day ten post-operative, and dexamethasone was continued without change. Within 24 hours of discontinuing levetiracetam, the platelet counts improved and continued to trend upward. A noticeable increase in white blood cells and hemoglobin were seen five days after that. DISCUSSION: Levetiracetam was approved by FDA for partial seizure, myoclonic seizure, and generalized tonic-clonic seizure. It is used off-label as seizure prophylaxis. This medication is associated with a few side effects that include behavioral changes, headache, drowsiness, and weakness. Hematologic adverse effects are rarely caused by this therapy. These effects include anemia, thrombocytopenia, and leukopenia. Our patient developed pancytopenia induced by levetiracetam and was resolved after we discontinued this medication. Her hemolysis profile and blood smear did not reveal any signs of hemolysis. Therefore, we hypothesize that levetiracetam induces pancytopenia by causing bone marrow suppression. CONCLUSION: Clinicians should be aware that levetiracetam induces severe pancytopenia. We should consider changing levetiracetam to lacosamide in patients who develop pancytopenia with negative hemolysis profile. Further studies need to understand how levetiracetam induces bone marrow suppression and to find a blood test for diagnosis

Audit Committees Oversight Of Information Technology Risk

This exploratory study examines the role of the audit committee in overseeing information technology (IT) risk. We address the degree of audit committee oversight of specific IT risks, as well as factors associated with variations in audit committee IT oversight. Based on responses from 39 audit committee members, we found (1) little audit committee emphasis on oversight of IT risks, (2) audit committees involved with IT oversight focus on more traditional risks (e.g., monitoring), while very little attention is devoted to IT acquisition and implementation, and (3) the amount of IT oversight is positively associated with the responding members auditing experience and prior familiarity with the COBIT model for assessing IT risks. Audit committee independence, diligence, and expertise, company size, and industry were not significantly associated with IT oversight

Real time power management strategy for hybrid energy storage systems coupled with variable energy sources in power smoothing applications

Abstract As the renewable energy sources (RES) production is strongly influenced by multiple geographic factors and highly variable, the need for both energy storage integration and robust real-time power management strategies development is obvious. Wind power represents the largest generating capacity among RES, being at the same time the most fluctuant. The capability to overcome the great disadvantage of wind power variability supports rising its penetration while preserving current operation modes of power systems, so new fashions to achieve this target are of great interest. This paper aims to prove the robustness of a recently introduced power management strategy, able to operate in online conditions, based on simultaneous perturbation stochastic approximation (SPSA) algorithm. To this regard, two different real datasets for wind power profiles with different statistical features are employed. The power management strategy is implemented on a hybrid energy storage system comprising a battery and a flywheel, modeled in Simulink/Matlab. The objectives of the proposed strategy are to reduce the instantaneous power ramp of the profile injected to the grid while smoothening the power profile exchanged by the battery in order to preserve it. Simulations are performed in representative conditions selected on statistical basis. It is demonstrated that the SPSA based power management achieves similar performances in all simulation conditions, proving to be robust. As a performance indicator, the reduction of the power ramp in reference to the 90% CDF threshold is evaluated. It is remarked as an 80% power ramp reduction is obtained towards the grid in both sites. Moreover, the further target is achieved in terms of battery lifetime extension; specifically, the fluctuation of the power profile exchanged by the battery is smoothed by 63% in the first site and 48% in the second, with respect to the flywheel one