Presidential Success in Congress: Factors that Determine the President\u27s Ability to Influcence Congressional Voting

This study examines the factors that contribute to presidential success in Congress. Results show that, overall, presidential popularity, the president’s party’s control of Congress and the misery index positively and significantly affect presidential success in Congress, whereas party is not a significant factor. The study also demonstrates that the honeymoon period does not increase a president’s success rate. The results indicate that these variables interact differently within foreign policy compared to domestic policy and in the Senate compared to the House

'Was it Good for you Darling?' – Intimacy, Sex and Critical Technical Practice

On the basis of forty-two weeks of ethnographic data collected across six pairs of co-habiting partners, we have theorized about the nature of intimacy, developed artifacts for its mediation and explored methods for its study. In this workshop we wish to take this work as our departure point, and reflect on: The importance of problematising intimacy carefully, that is, approaching intimacy critically. The complex and multiple meanings of intimacy in the context of ongoing intimate relationships. The losses and risks attendant on supporting intimacy between distributed couples

FEMA's Integration of Preparedness and Development of Robust Regional Offices

In October 2006, Congress enacted major legislation to reform the function and organization of the Federal Emergency Management Agency (FEMA) in response to the recognized failures in preparation for and response to Hurricane Katrina. The Post-Katrina Emergency Management Reform Act of 2006 (PKEMRA) focused national preparedness responsibilities within FEMA and directed additional resources and responsibilities to FEMA's ten regional offices. Directed by Congress, in October 2008 a National Academy Panel began an independent assessment of FEMA's integration of preparedness functions and progress in development of robust regional offices.Main FindingsOver the past three years, FEMA has taken significant steps in an effort to integrate preparedness and develop more robust regional offices. These efforts, undertaken by both the previous and current Administrations, are documented throughout this report and should be recognized and applauded. However, FEMA has yet to define specific goals and outcomes that would permit it, Congress or the public to determine when preparedness has been fully integrated into all aspects of FEMA's work and whether the development and ongoing operation of robust regional offices has been achieved. In the absence of well-defined, measurable outcome indicators, the National Academy Panel relied upon the assessments of FEMA leaders and staff, documentation provided by FEMA, and a review of secondary sources material to inform its findings and recommendations. Based upon this evidence, the Panel has concluded that, while progress has been made: (1) preparedness is not fully integrated across FEMA, (2) FEMA's regional offices do not yet have the capacity required to ensure the nation is fully prepared, (3) stakeholders are not yet full partners with FEMA in national preparedness, and (4) FEMA has ineffective internal business practices, particularly with regard to human resource management. The Panel made seven recommendations for FEMA:Establish a cross-organizational process, with participation from internal and external stakeholders, to develop a shared understanding of preparedness integrationEstablish a robust set of outcome metrics and standards for preparedness integration, as well as a system to monitor and evaluate progress on an ongoing basisWork to eliminate organizational barriers that are adversely impacting the full integration of preparedness across the agencyContinue to build regional office capacity and monitor implementation consistent with the Administrator's recent policy guidanceUndertake steps to improve the ongoing working relationship between headquarters and the regions in accord with Panel-identified principlesTake steps to improve stakeholder engagement and relationships at all levels in accord with Panel-identified principles; andStrengthen internal business practices, especially in the area of human capital planning

Pulmonary artery pressure and activities in chronic heart failure

AbstractLong-term continuous pulmonary artery pressure monitoring was used to investigate pressure changes during different types of exercise and normal daily activities in patients with chronic heart failure. Nine men (mean age 55 years) with treated chronic heart failure underwent continuous pulmonary artery pressure measurement with use of a micromanometer-tipped catheter with in vivo calibration and frequency-modulated recording.The mean (± SD) maximal systolic pulmonary artery pressure (in mm Hg) was 59.4 ± 26.1 on treadmill exercise, 54.9 ± 30.6 on bicycle exercise, 52.5 ± 26.1 walking up and down state and 43.5 ± 23.9 walking on a flat surface. The mean maximal diastolic pressure (in mm Hg) was 27.8 ± 14.6 on treadmill exercise, 25.5 ± 14.9 on bicycle exercise, 24.9 ± 14.8 walking up and down stairs and 20.4 ± 12.5 walking on a flat surface. The increase in pulmonary artery pressure did not correlate with the severity of the limiting symptoms except during walking on a flat surface.All patients had marked postural changes in pressure, with the systolic pressure difference from lying to standing ranging from 8 to 25 mm Hg and the diastolic pressure difference ranging from 3 to 13 mm Hg. Eating meals caused an increase in pressure in three patients, but less than that when lying flat. There was an increase in pressure during urination in four patients equal to that when walking on a flat surface. None of these activities was associated with symptoms.Neither symptoms nor pulmonary artery pressure during maximal exercise is the same as during daily activities. This may restrict the value of maximal exercise tests in assessing patients with chronic heart failure

An exploratory trial implementing a community-based child oral health promotion intervention for Australian families from refugee and migrant backgrounds: a protocol paper for Teeth Tales

Introduction: Inequalities are evident in early childhood caries rates with the socially disadvantaged experiencing greater burden of disease. This study builds on formative qualitative research, conducted in the Moreland/Hume local government areas of Melbourne, Victoria 2006–2009, in response to community concerns for oral health of children from refugee and migrant backgrounds. Development of the community-based intervention described here extends the partnership approach to cogeneration of contemporary evidence with continued and meaningful involvement of investigators, community, cultural and government partners. This trial aims to establish a model for child oral health promotion for culturally diverse communities in Australia.<p></p> Methods and analysis: This is an exploratory trial implementing a community-based child oral health promotion intervention for Australian families from refugee and migrant backgrounds. Families from an Iraqi, Lebanese or Pakistani background with children aged 1–4 years, residing in metropolitan Melbourne, were invited to participate in the trial by peer educators from their respective communities using snowball and purposive sampling techniques. Target sample size was 600. Moreland, a culturally diverse, inner-urban metropolitan area of Melbourne, was chosen as the intervention site. The intervention comprised peer educator led community oral health education sessions and reorienting of dental health and family services through cultural Competency Organisational Review (CORe).<p></p> Ethics and dissemination: Ethics approval for this trial was granted by the University of Melbourne Human Research Ethics Committee and the Department of Education and Early Childhood Development Research Committee. Study progress and output will be disseminated via periodic newsletters, peer-reviewed research papers, reports, community seminars and at National and International conferences.<p></p&gt

Population-Based Pragmatic Trial of Advance Care Planning in Primary Care in the University of California Health System.

Introduction: Varying intensity of advance care planning (ACP) interventions at the population level has not been compared among seriously ill patients in primary care. This project will implement, test, and disseminate real-world scalable ACP interventions among primary care clinics across three University of California Health systems. The three ACP interventions are (1) distribution of an advance directive (AD) with targeted ACP messaging, (2) the AD, messaging, plus prompting patients to engage with the Prepare For Your Care website (PREPARE), and (3) the AD, messaging, PREPARE, plus Care Coordinator engagement with patients and clinicians. Methods: We will identify a population cohort of seriously ill primary care patients and implement the ACP interventions using electronic health record (EHR) patient portals and postal mailings. Forty-five clinics across the three health systems will be cluster randomized to one of the three ACP interventions. The primary outcome for the population cohort is AD or Physician Orders for Life-Sustaining Treatment documentation in the EHR. A subset of the population cohort will be surveyed to assess patient-centered outcomes, including care consistent with goals at baseline, 12 months, and 24 months. Caregivers will be interviewed if patients are unable to be surveyed or die. ACP documentation, goal concordant care, and among decedents, health care utilization will be compared among intervention arms. Study Implementation: Challenges and Contributions: The project is guided by a Study Advisory Group and Community Advisory Groups at each site to ensure rigorous patient-centered methods and consistency of implementation. Intervention fidelity will be evaluated using the Reach, Efficacy, Adoption, Implementation, and Maintenance (RE-AIM) framework. Challenges to implementation of this three-site health system trial and to intervention fidelity stem from site/clinic/system cultures, increasing attention to end-of-life care from payers and regulators, and growing pressures by health systems to implement ACP interventions. Stakeholder engagement is required to ensure consistent interventions across sites

Assessment from a distance: A case study implementing focus groups at an online library

Assessing library resources and services at a distance holds unique challenges in gathering data needed to make informed decisions. This article describes the complete process of piloting virtual focus groups—from planning and implementation through the analysis of results for a completely online student population. The virtual focus group method proved effective in getting qualitative feedback to spur library improvements, and it is transferable to many different library settings