Rural Child Care in Missouri: How to Improve it

Includes bibliographical references.During 1997 and 1998, a large study called Project REACH (Rural EArly CHildhood Professional Development Initiative), was conducted in a series of interventions over a 16 month period in rural Missouri. The training and follow up was intensive, continuous and individualized. An overview of the results are provided

Fashion and passion: marketing sex to women

Against a backdrop of a ‘pornographication’ of mainstream media and the emergence of a more heavily sexualized culture, women are increasingly targeted as sexual consumers. In the UK, the success of TV shows like Sex and the City and the ‘fashion ‘n’ passion’ of sex emporia like Ann Summers suggests that late twentieth century discourses which foregrounded female pleasure have crystallised in a new form of sexual address to women. This article examines how sex products are being marketed for female consumers, focussing on the websites of sex businesses such as Myla, Babes n Horny, Beecourse, tabooboo and Ann Summers. It asks how a variety of existing discourses – of fashion, consumerism, bodily pleasure and sexuality - are drawn on in the construction of this new market, how they negotiate the dangers and pleasures of sexuality for women, and what they show about the construction of ‘new’ female sexualities.</p

The Integrated Medical Model: A Risk Assessment and Decision Support Tool for Space Flight Medical Systems

The Integrated Medical Model (IMM) is a decision support tool that is useful to mission planners and medical system designers in assessing risks and designing medical systems for space flight missions. The IMM provides an evidence based approach for optimizing medical resources and minimizing risks within space flight operational constraints. The mathematical relationships among mission and crew profiles, medical condition incidence data, in-flight medical resources, potential crew functional impairments, and clinical end-states are established to determine probable mission outcomes. Stochastic computational methods are used to forecast probability distributions of crew health and medical resource utilization, as well as estimates of medical evacuation and loss of crew life. The IMM has been used in support of the International Space Station (ISS) medical kit redesign, the medical component of the ISS Probabilistic Risk Assessment, and the development of the Constellation Medical Conditions List. The IMM also will be used to refine medical requirements for the Constellation program. The IMM outputs for ISS and Constellation design reference missions will be presented to demonstrate the potential of the IMM in assessing risks, planning missions, and designing medical systems. The implementation of the IMM verification and validation plan will be reviewed. Additional planned capabilities of the IMM, including optimization techniques and the inclusion of a mission timeline, will be discussed. Given the space flight constraints of mass, volume, and crew medical training, the IMM is a valuable risk assessment and decision support tool for medical system design and mission planning

Co-production of the quality of patient-centered outcomes research partnerships instrument for people with mental health conditions

Mounting scientific evidence over the past decades in the field of psychiatry has shown community engagement in research produces more relevant research, increased uptake of research findings, and better clinical outcomes. Despite the need for the integration of community engagement methodologies into the scientific method, doctoral and master\u27s level competencies in the field of psychiatry commonly do not include dedicated training or coursework on community engagement methodologies. Without appropriate training or research experience, attempts to facilitate community engagement are often ineffective and burdensome and leave stakeholders feeling disenfranchised. The goal of this study was to co-produce an instrument designed to improve the quality of community engagement research practices by measuring the degree to which researchers have partnered with psychiatric patient stakeholders. The development of the Quality of Patient-Centered Outcomes Research Partnerships Instrument included an iterative co-production process with psychiatric patient stakeholders and scientists, including item formulation, followed by two phases of cognitive interviews with psychiatric patient stakeholders to assess and refine instrument items. A pilot study was conducted to assess acceptability and feasibility. The pilot study of the Patient-Centered Outcomes Research Partnerships Instrument suggested feasibility and acceptability among psychiatric patient stakeholders. The Quality of Patient-Centered Outcomes Research Partnerships Instrument may be a valuable tool to enhance the quality of community engagement research practices within the field of psychiatry. Experience Framework This article is associated with the Innovation & Technology lens of The Beryl Institute Experience Framework (https://www.theberylinstitute.org/ExperienceFramework). Access other PXJ articles related to this lens. Access other resources related to this len

Addressing the sample size problem in behavioural operational research: simulating the newsvendor problem

Laboratory-based experimental studies with human participants are beneficial for testing hypotheses in behavioural operational research. However, such experiments are not without their problems. One specific problem is obtaining a sufficient sample size, not only in terms of the number of participants but also the time they are willing to devote to an experiment. In this paper, we explore how agent-based simulation (ABS) can be used to address the sample size problem and demonstrate the approach in the newsvendor setting. The decision-making strategies of a small sample of individual decision-makers are determined through laboratory experiments. The interactions of these suppliers and retailers are then simulated using an ABS to generate a large sample set of decisions. With only a small number of participants, we demonstrate that it is possible to produce similar results to previous experimental studies that involved much larger sample sizes. We conclude that ABS provides the potential to extend the scope of experimental research in behavioural operational research

Establishing priorities on the range of conditions managed by UK community practitioner nurse prescribers: A modified Delphi consensus study

Aim: To provide national consensus on the range of conditions community practitioner nurse prescribers manage, and for which it is considered important that they can prescribe. Background: Around 35,000 community practitioner nurse prescribers in the UK are able to prescribe from a limited formulary. Although prescribing is a key role for these nurses, there has been a decline in the numbers of community practitioner nurse prescribers who prescribe. It is evident that changing patterns of client and service delivery, changes the role of community nurses and the conditions they manage, however, little is known about the conditions community practitioner nurse prescribers manage. Design and methods: A modified Delphi approach comprising three on-line surveys delivered to a national Expert Panel of eighty-nine qualified community practitioner prescribers. Data collection took place between January and March 2017. Results: Panelists reached a consensus, with consistent high levels of agreement reached, on nineteen conditions for which it is believed community practitioner nurse prescribers should be able to prescribe. Conditions identified by school nurses (n=12) and health visitors (n=7) were mainly acutely focused, whereas those identified by district nurses (n=9) and community staff nurses (n=6) included both long-term and acute conditions. Conclusion: Given the high degree of consensus, this list of conditions should influence any decisions about the items community and public health nurses should be able to prescribe. The findings should also influence the education and training of these nurses

Let\u27s talk about antibiotics: A randomised trial of two interventions to reduce antibiotic misuse

BACKGROUND: Children with acute respiratory tract infections (ARTIs) receive ≈11.4 million unnecessary antibiotic prescriptions annually. A noted contributor is inadequate parent-clinician communication, however, efforts to reduce overprescribing have only indirectly targeted communication or been impractical. OBJECTIVES: Compare two feasible (higher vs lower intensity) interventions for enhancing parent-clinician communication on the rate of inappropriate antibiotic prescribing. DESIGN: Multisite, parallel group, cluster randomised comparative effectiveness trial. Data collected between March 2017 and March 2019. SETTING: Academic and private practice outpatient clinics. PARTICIPANTS: Clinicians (n=41, 85% of eligible approached) and 1599 parent-child dyads (ages 1-5 years with ARTI symptoms, 71% of eligible approached). INTERVENTIONS: All clinicians received 20 min ARTI diagnosis and treatment education. Higher intensity clinicians received an additional 50 min communication skills training. All parents viewed a 90 second antibiotic education video. MAIN OUTCOMES AND MEASURES: Inappropriate antibiotic treatment was assessed via blinded medical record review by study clinicians and a priori defined as prescriptions for the wrong diagnosis or use of the wrong agent. Secondary outcomes were revisits, adverse drug reactions (both assessed 2 weeks after the visit) and parent ratings of provider communication, shared decision-making and visit satisfaction (assessed at end of the visit on Likert-type scales). RESULTS: Most clinicians completed the study (n=38, 93%), were doctors (n=25, 66%), female (n=30, 78%) and averaged 8 years in practice. All parent-child dyad provided data for the main outcome (n=855 (54%) male, n=1043 (53%) CONCLUSIONS AND RELEVANCE: Rate of inappropriate prescribing was low in both arms. Clinician education coupled with parent education may be sufficient to yield low inappropriate antibiotic prescribing rates. The absence of a significant difference between groups indicates that communication principles previously thought to drive inappropriate prescribing may need to be re-examined or may not have as much of an impact in practices where prescribing has improved in recent years. TRIAL REGISTRATION NUMBER: NCT03037112

The Integrated Medical Model

The goals of the Integrated Medical Model (IMM) are to develop an integrated, quantified, evidence-based decision support tool useful to crew health and mission planners and to help align science, technology, and operational activities intended to optimize crew health, safety, and mission success. Presentation slides address scope and approach, beneficiaries of IMM capabilities, history, risk components, conceptual models, development steps, and the evidence base. Space adaptation syndrome is used to demonstrate the model's capabilities

Journey with Ting-Peng Liang in Pacific Asia Information Systems Field

Our respectful old friend Professor Ting-Peng Liang (in short, TP) whom we loved suddenly passed away on May 20, 2021. But we cannot forget his smile and passion, and his inerasable footprints in PACIS, PAJAIS, and AIS Community. He was the founder of PACIS, founding editor-in-chief of PAJAIS, and past president of AIS to list just a few. He was the pioneer who received the first AIS Fellow and the first LEO Award from Asia Pacific. That is why the leaders of the information systems field organized the first ever special tribute session in PACIS 2021 in memory of TP (https://aisel.aisnet.org/pacis2021/253/

Expressions 1993-1994

https://openspace.dmacc.edu/expressions/1015/thumbnail.jp