Development of an educational overburden index for New Mexico schools

The purpose of this study was to develop an educational overburden index (EOI) as a component in the New Mexico Public School Funding Formula. This is part of an ongoing research effort to develop a methodology for the distribution of funds based on the unique characteristics and needs of individual school districts. Research indicated that measuring and predicting populations containing at-risk students can be accomplished through application of multiple variables which reflect home, school, and community concerns. The study initially began with a selection of indicators from data provided by the New Mexico State Department of Education and the U.S. Census Bureau. According to current literature, these indicators supported predictions of students most likely to be at-risk. A total of 11 variables were analyzed for eighty-nine school districts. The variables were: Chapter 1 funds, free and reduced price lunch participation, dropout rate, ITBS and High School Competency Exam scores, pupils per square miles, teacher salary, training and experience, student mobility, limited English proficiency, special education, and gifted and talented; School districts were classified into clusters based on relative need using an unsupervised learning neural network computer analysis that recognized patterns of variables of need across districts. The clusters were verified through a feedforward neural net computing program and the districts were assigned a numerical weight ordering them from districts with highest to lowest need. The numerical weights comprised the Educational Overburden Index (EOI) that was applied in a simulation to each New Mexico school district\u27s share of the state funding formula. Use of the EOI in funding programs fosters local program flexibility, avoids labeling students and targets funds for districts with the highest incidence of youth in need

Making a difference: how health visitors understand the social processes of leadership

Leadership has become a pre-requisite for all health professionals working at every level in healthcare. The need to strengthen leadership in health visiting has been voiced in health care policy for the past eighteen years (Department of Health (DH), 1999 & 2006; National Health Service (NHS) England, 2016). Yet there is still a lack of research examining how health visitors understand leadership, with, much of the existing research on leadership focusing on leaders “per se” as opposed to leadership as a social process. This study sought to understand how health visitors perceive their leadership role, and how leadership is demonstrated in the delivery of the health visiting service in the context of the NHS. The aim being to enable the researcher to examine how health visitors understand leadership as a social process. The research focused on 17 participants, 16 of whom came from a health visiting background. The participants consisted of three groups: a focus group comprising health visitors in clinical practice taken from one NHS Trust, a further group consisted of team leaders, managers and practice teachers, drawn from the same NHS Trust. The third group comprised of national, strategic leaders in health visiting. The latter two groups were interviewed individually. A constructivist grounded theory approach was used to ascertain the participants’ main concerns in relation to leadership (Charmaz, 2014). A conceptual framework of making a difference: how health visitors understand the social processes of leadership has been constructed to explain how health visitors understand leadership through their professional ideology (Whittaker et al, 2013). The conceptual framework demonstrates how the categories, context of leadership, the purpose of leadership and leadership behavior emerged. These were constructed from the comparative analysis, of the data and encapsulate the participants’ main concerns. The findings support the construction of a conceptual leadership development framework for health visitors. This framework identifies the need to incorporate education based on the three categories and the core category “making a difference” and there is a need to focus on leadership development as a continuous process. In addition, the findings recognize the importance of establishing both a health visitor and leadership identity (Lord & Hall, 2005; Day & Harrison, 2007). This study has provided a framework for leadership development that can be used as a structural framework in health visiting education in both academic and clinical practice settings, and as a way of articulating how health visitors understand leadership. This study sheds light on the importance of building not only health visiting identity but also leadership identity when delivering health visitor education. It provides an interpretive perspective instead of the more common positivist approach to leadership research reported in the literature

Prevention and lifestyle behaviour change : a competence framework

Prevention, Health and Wellbeing and Health Inequalities are key national and regional priorities for the future of our nation and for the NHS. This was highlighted in recent ‘Fair Society, Healthy Lives’ Marmot review. The ‘Prevention and Lifestyle Behaviour Change: A Competence Framework’, has been developed to support NHS Yorkshire and the Humber’s key Public Health strategy ‘Making Every Contact Count’, to which there has already been an excellent response. Delivery on this subject has always been challenging and with this in mind we are aiming to support all involved in every way possible. The Framework will support all staff and organisations in the delivery of this important agenda. This framework will enable a common approach across all elements as everyone will be able to use the same base. We would encourage everyone in the workforce to engage with this framework to establish their current knowledge and skills on this subject. This will in turn support Service and Education commissioners and Education and Service providers with the measurable base line of their current workforce and identify what additional learning, new ways of working or service redesign may be required and what services can be commissioned now and in the future. We would like to thank the Faculty of Health and Wellbeing at Sheffield Hallam University. The development of this Framework has also been supported by collaboration with NHS Yorkshire and the Humber and the staff and organisations within Yorkshire and the Humber who have given of their time and knowledge to deliver this excellent product

A propensity score-matched, real-world comparison of ustekinumab vs vedolizumab as a second-line treatment for Crohn's disease. The Cross Pennine study II

BackgroundThe optimal choice of biological agents after failure of anti-tumour-necrosis-factor-(TNF)α agent in Crohn's disease (CD) is yet to be defined.AimsTo assess the effectiveness and safety of ustekinumab compared to vedolizumab as second-line treatment in CD patients who failed anti-TNFα therapy.MethodsRetrospective analysis of clinical response and remission at 14 and 52 weeks to ustekinumab by physician global assessment (PGA). A propensity score-matched analysis with a cohort treated with vedolizumab was performed.ResultsOf 282 patients (mean age 40 ± 15, F:M ratio 1.7:1) treated with ustekinumab, clinical response or remission was reached by 200/282 patients (70.9%) at 14 weeks, and 162/259 patients (62.5%) at 52 weeks. Overall, 74 adverse events occurred, of which 26 were labelled as serious (8.3 per 100 person-year). After exclusion of patients without prior anti-TNFα exposure and patients previously exposed to vedolizumab or ustekinumab, we analysed 275/282 patients (97.5%) on ustekinumab and 118/135 patients (87.4%) on vedolizumab. Propensity score analysis revealed that at 14 weeks, patients treated with ustekinumab were 38% (95% CI 25%-50%; P ConclusionsUstekinumab was effective and well tolerated in this real-world cohort. While ustekinumab proved more effective at 14-weeks, we found no statistically significant differences at 52 weeks compared to vedolizumab

International genome-wide meta-analysis identifies new primary biliary cirrhosis risk loci and targetable pathogenic pathways.

Primary biliary cirrhosis (PBC) is a classical autoimmune liver disease for which effective immunomodulatory therapy is lacking. Here we perform meta-analyses of discovery data sets from genome-wide association studies of European subjects (n=2,764 cases and 10,475 controls) followed by validation genotyping in an independent cohort (n=3,716 cases and 4,261 controls). We discover and validate six previously unknown risk loci for PBC (Pcombined<5 × 10(-8)) and used pathway analysis to identify JAK-STAT/IL12/IL27 signalling and cytokine-cytokine pathways, for which relevant therapies exist

Relapse after withdrawal from anti-TNF therapy for inflammatory bowel disease: an observational study, plus systematic review and meta-analysis.

Infliximab and adalimumab have established roles in inflammatory bowel disease (IBD) therapy. UK regulators mandate reassessment after 12 months' anti-TNF therapy for IBD, with consideration of treatment withdrawal. There is a need for more data to establish the relapse rates following treatment cessation.This article is freely available via Open Access. Click on the 'Additional Link' above to access the full-text from the publisher's site.Publishe

Hearts and Minds: Mental Health Support for schools

Hearts and Minds is a collection of generic mental health case studies written by students at the University of Southern Queensland. The mental health concerns focus on those typically experienced within schools and include Anxiety, Autism Spectrum Disorder, Attention Deficit Hyperactivity Disorder, Depression, Post-Traumatic Stress Disorder and Suicidal Ideation

Variations in risk and protective factors for life satisfaction and mental wellbeing with deprivation: a cross-sectional study

Abstract Background Improving life satisfaction (LS) and mental wellbeing (MWB) is important for better public health. Like other health issues, LS and MWB are closely related to deprivation (i.e. lack of resources). Developing public health measures that reduce inequalities in wellbeing requires an understanding of how factors associated with high and low LS and MWB vary with deprivation. Here, we examine such variations and explore which public health measures are likely to improve wellbeing while reducing related inequalities. Methods A self-administered questionnaire measuring LS and MWB was used with a cross-sectional sample of adults from the North West of England (n = 15,228). Within deprivation tertiles, analyses examined how demographics, health status, employment, relationships and behaviours (alcohol, tobacco, physical exercise) were associated with LS and MWB. Results Deprivation was strongly related to low LS and MWB with, for instance, 17.1 % of the most deprived tertile having low LS compared to 8.9 % in the most affluent. After controlling for confounders, across all deprivation tertiles, better self-assessed health status and being in a relationship were protective against low LS and MWB. Unemployment increased risks of low LS across all tertiles but only risks of low MWB in the deprived tertile. For this tertile, South Asian ethnicity and higher levels of exercise were protective against low MWB. In the middle tertile retired individuals had a reduced risk of low MWB and an increased chance of high LS even in comparison to those in employment. Alcohol’s impact on LS was limited to the most deprived tertile where heavy drinkers were at most risk of poor outcomes. Conclusions In this study, positive outcomes for LS and MWB were strongly associated with lower deprivation and good health status. Public health measures already developed to promote these issues are likely to improve LS and MWB. Efforts to increase engagement in exercise are also likely to have positive impacts, particularly in deprived communities. The development of future initiatives that address LS and MWB must take account of variations in their risk and protective factors at different levels of deprivation.</p