A Collaborative Project to Increase the Participation of Women and Minorities In Higher Level Mathematics Courses

In this article, the authors describe a program developed to encourage women and minorities to continue their study of mathematics in high schools until graduation. The 3- year program was a collaborative effort by professors and students from Bryant University, local businesses, and local high schools. During the 3 years, the program evolved from the development and presentation of reality-based mathematical modules taught in the high school classrooms to an interdisciplinary enrichment activity at Bryant University. The university students acted as mentors or tutors to the high school students. Throughout the program, the business representatives, university personnel, and high school teachers collaborated to bring mathematics alive to the students through real-world applications

Young Children’s Access and Use of Computers in Family Child Care and Child Care Centers

Forty eight family child care providers and 37 center-based providers completed surveys about the availability and use of computers for children in their care. In addition, the providers were asked about their attitudes towards technology and their own computer skills. The impact of setting type on computer placement and rules about their use did not differ very much by setting type. Several factors were associated with the amount of time children were reported to use the computers. Overall, it appears that child care providers had developmentally sensitive guidelines for fostering computer use in both child care settings

Antiretroviral therapy uptake and coverage in four HIV community cohort studies in sub-Saharan Africa

OBJECTIVE: To compare socio-demographic patterns in access to antiretroviral therapy (ART) across four community HIV cohort studies in Africa. METHODS: Data on voluntary counselling and testing and ART use among HIV-infected persons were analysed from Karonga (Malawi), Kisesa (Tanzania), Masaka (Uganda) and Manicaland (Zimbabwe), where free ART provision started between 2004 and 2007. ART coverage was compared across sites by calculating the proportion on ART among those estimated to need treatment, by age, sex and educational attainment. Logistic regression was used to identify socio-demographic characteristics associated with undergoing eligibility screening at an ART clinic within 2 years of being diagnosed with HIV, for three sites with information on diagnosis and screening dates. RESULTS: Among adults known to be HIV-infected from serological surveys, the proportion who knew their HIV status was 93% in Karonga, 37% in Kisesa, 46% in Masaka and 25% in Manicaland. Estimated ART coverage was highest in Masaka (68%) and lowest in Kisesa (2%). The proportion of HIV-diagnosed persons who were screened for ART eligibility within 2 years of diagnosis ranged from 14% in Kisesa to 84% in Masaka, with the probability of screening uptake increasing with age at diagnosis in all sites. CONCLUSIONS: Higher HIV testing rates among HIV-infected persons in the community do not necessarily correspond with higher uptake of ART, nor more equitable treatment coverage among those in need of treatment. In all sites, young adults tend to be disadvantaged in terms of accessing and initiating ART, even after accounting for their less urgent need

Feasibility of an ED-to-Home Intervention to Engage Patients: A Mixed-Methods Investigation

Introduction: Older, chronically ill patients with limited health literacy are often under-engagedin managing their health and turn to the emergency department (ED) for healthcare needs. Wetested the impact of an ED-initiated coaching intervention on patient engagement and follow-updoctor visits in this high-risk population. We also explored patients’ care-seeking decisions. Methods: We conducted a mixed-methods study including a randomized controlled trial andindepth interviews in two EDs in northern Florida. Participants were chronically ill older EDpatients with limited health literacy and Medicare as a payer source. Patients were assignedto an evidencebased coaching intervention (n= 35) or usual post-ED care (n= 34). Qualitativeinterviews (n=9) explored patients’ reasons for ED use. We assessed average between-groupdifferences in patient engagement over time with the Patient Activation Measure (PAM) tool,using logistic regression and a difference-in-difference approach. Between-group differences infollow-up doctor visits were determined. We analyzed qualitative data using open coding andthematic analysis. Results: PAM scores fell in both groups after the ED visit but fell signi ficantly more in “usualcare” (average decline -4.64) than “intervention” participants (average decline -2.77) (β=1.87,p=0.043). There were no between-group differences in doctor visits. Patients described wellinformedreasons for ED visits including onset and severity of symptoms, lack of timely provideraccess, and immediate and comprehensive ED care. Conclusion: The coaching intervention significantly reduced declines in pati ent engagementobserved after usual post-ED care. Patients reported well-informed reasons for ED use andwill likely continue to make ED visits unless strategies, such as ED-initiated coaching, areimplemented to help vulnerable patients better manage their health and healthcare

Child Life Specialists’ Evaluation of Hospital Playroom Design: A Mixed Method Inquiry

This study uses the expertise of child life specialists to identify which elements support child life goals for hospitalized children. This study can be used to inform those interested in the optimal design of hospital playrooms. Ninety child life specialists were surveyed using a photograph methodology showing five actual child life playrooms from different hospitals. The participants were asked the following: rate each playroom on 14 dimensions; describe what was liked best about each playroom; and finally, rank order the playrooms based on their ability to support child life goals. Findings show that child life specialists were able to detect fine distinctions among hospital playrooms; thus, highlighting the important role that child life specialists can play in the design or modification of these spaces. Notably, using both Likert ratings and open-response questions, the value of biophilia in child life play spaces, specifically windows, light, and nature themes were revealed. In addition to biophilic attributes, the playrooms rated most favorably were those that contain pleasing color and décor and plenty of open space. Playrooms that promote sensory-motor and pretend play were also preferred

Did national HIV prevention programs contribute to HIV decline in eastern Zimbabwe? Evidence from a prospective community survey. Sexually Transmitted Diseases

Abstract Objective: To add to the evidence on the impact of national HIV prevention programmes in reducing HIV risk in sub-Saharan African countries. Methods: Statistical analysis of prospective data on exposure to HIV prevention programmes, relatives with AIDS and unemployment, and sexual behaviour change and HIV incidence, in a population cohort of 4,047 adults, collected over a period (1998)(1999)(2000)(2001)(2002)(2003) when HIV prevalence and risk-behaviour declined in eastern Zimbabwe. Results: Exposure to HIV prevention programmes and relatives with AIDS -but not unemployment -increased from 1998-2003. Men and women exposed to media campaigns and HIV/AIDS meetings had greater knowledge and self-efficacy, attributes that were concomitantly protective against HIV infection. Women attending community HIV/AIDS meetings before recruitment were more likely than other women to adopt lower-risk behaviour (96.4% versus 90.8%; aOR 3.09; 95% CI, 1.27-7.49) and had lower HIV incidence (0.9% versus 1.8%; aIRR 0.63; 95% CI, 0.32-1.24) during the inter-survey period. Prior exposure to relatives with AIDS was not associated with differences in behaviour change. More newly unemployed men than employed men adopted lowerrisk behaviour (84.2% versus 76.0%; aOR 2.13; 95% CI, 0.98-4.59). Conclusion: Community-based HIV/AIDS meetings reduced risk-behaviour amongst women who attended contributing to HIV decline in eastern Zimbabwe

Household-based cash transfer targeting strategies in Zimbabwe: are we reaching the most vulnerable children?

Census data, collected in July 2009, from 27,672 children were used to compare the effectiveness, coverage and efficacy of three household-based methods for targeting cash transfers to vulnerable children in eastern Zimbabwe: targeting the poorest households using a wealth index; targeting HIVaffected households using socio-demographic information (households caring for orphans, chronicallyill or disabled members; child-headed households); and targeting labour-constrained households using dependency ratios. All three methods failed to identify large numbers of children with poor social and educational outcomes. The wealth index approach was the most efficient at reaching children with poor outcomes whilst socio-demographic targeting reached more vulnerable children but was less efficient.publishedVersio

Effects of unconditional and conditional cash transfers on child health and development in Zimbabwe: a cluster-randomised trial

SummaryBackgroundCash-transfer programmes can improve the wellbeing of vulnerable children, but few studies have rigorously assessed their effectiveness in sub-Saharan Africa. We investigated the effects of unconditional cash transfers (UCTs) and conditional cash transfers (CCTs) on birth registration, vaccination uptake, and school attendance in children in Zimbabwe.MethodsWe did a matched, cluster-randomised controlled trial in ten sites in Manicaland, Zimbabwe. We divided each study site into three clusters. After a baseline survey between July, and September, 2009, clusters in each site were randomly assigned to UCT, CCT, or control, by drawing of lots from a hat. Eligible households contained children younger than 18 years and satisfied at least one other criteria: head of household was younger than 18 years; household cared for at least one orphan younger than 18 years, a disabled person, or an individual who was chronically ill; or household was in poorest wealth quintile. Between January, 2010, and January, 2011, households in UCT clusters collected payments every 2 months. Households in CCT clusters could receive the same amount but were monitored for compliance with several conditions related to child wellbeing. Eligible households in all clusters, including control clusters, had access to parenting skills classes and received maize seed and fertiliser in December, 2009, and August, 2010. Households and individuals delivering the intervention were not masked, but data analysts were. The primary endpoints were proportion of children younger than 5 years with a birth certificate, proportion younger than 5 years with up-to-date vaccinations, and proportion aged 6–12 years attending school at least 80% of the time. This trial is registered with ClinicalTrials.gov, number NCT00966849.Findings1199 eligible households were allocated to the control group, 1525 to the UCT group, and 1319 to the CCT group. Compared with control clusters, the proportion of children aged 0–4 years with birth certificates had increased by 1·5% (95% CI −7·1 to 10·1) in the UCT group and by 16·4% (7·8–25·0) in the CCT group by the end of the intervention period. The proportions of children aged 0–4 years with complete vaccination records was 3·1% (−3·8 to 9·9) greater in the UCT group and 1·8% (−5·0 to 8·7) greater in the CCT group than in the control group. The proportions of children aged 6–12 years who attended school at least 80% of the time was 7·2% (0·8–13·7) higher in the UCT group and 7·6% (1·2–14·1) in the CCT group than in the control group.InterpretationOur results support strategies to integrate cash transfers into social welfare programming in sub-Saharan Africa, but further evidence is needed for the comparative effectiveness of UCT and CCT programmes in this region.FundingWellcome Trust, the World Bank through the Partnership for Child Development, and the Programme of Support for the Zimbabwe National Action Plan for Orphans and Vulnerable Children