Bioterrorism preparedness at a hospital level in the Southwest Region of the United States -- A systematic review

Since the tragic events of September, 11 2001 the United States bioterrorism and disaster preparedness has made significant progress; yet, numerous research studies of nationwide hospital emergency response have found alarming shortcomings in surge capacity and training level of health care personnel in responding to bioterrorism incidents. The primary goals of this research were to assess hospital preparedness towards the threat of bioterrorist agents in the Southwest Region of the United States and provide recommendations for its improvement. Since little formal research has been published on the hospital preparedness of Oklahoma, Arizona, Texas and New Mexico, this research study specifically focused on the measurable factors affecting the respective states' resources and level of preparedness, such as funding, surge capacity and preparedness certification status.^ Over 300 citations of peer-reviewed articles and 17 Web sites were reviewed, of which 57 reports met inclusion criteria. The results of the systematic review highlighted key gaps in the existing literature and the key targets for future research, as well as identified strengths and weaknesses of the hospital preparedness in the Southwest states compared to the national average. ^ Based on the conducted research, currently, the Southwest states hospital systems are unable fully meet presidential preparedness mandates for emergency and disaster care: the staffed beds to 1,000 population value fluctuated around 1,5 across the states; funding for the hospital preparedness lags behind hospital costs by millions of dollars; and public health-hospital partnership in bioterrorism preparedness is quite weak as evident in lack of joint exercises and training. However, significant steps towards it are being made, including on-going hospital preparedness certification by the Joint Commission of Health Organization. Variations in preparedness levels among states signify that geographic location might determine a hospital level of bioterrorism preparedness as well, tending to favor bigger states such as Texas.^ Suggested recommendations on improvement of the hospital bioterrorism preparedness are consistent with the existing literature and include establishment and maintenance of solid partnerships between hospitals and public health agencies, conduction of joint exercises and drills for the health care personnel and key partners, improved state and federal funding specific to bioterrorism preparedness objectives, as well as on-going training of the clinical personnel on recognition of the bioterrorism agents.^

Returning Texas Senate Bill 530 back to 1100 Congress Avenue: The need for effective surveillance reporting of student fitness levels to Texas house representatives

Every Texas student is required to complete the FITNESSGRAM fitness assessment under legislation outlined in Senate Bill 530. This study described cardiovascular, body mass index (BMI), and overall fitness levels of students (grades 3–12) in the state of Texas during the 2009–2010 school year, and provides examples of how to effectively present results to Texas House Representatives using three unique health communication strategies. Given the Texas legislature mandates FITNESSGRAM collection yet did not require reporting according to their election district, the data were aggregated to 150 Texas House Representative Districts by sex and grade category to facilitate effective fitness data dissemination. Fitness data were also analyzed with results from the Texas Assessment of Knowledge and Skills (TAKS) to provide insight into potential relationships between fitness and academic achievement. ^ The majority of students in Texas need improvement on at least 1 fitness assessment. In general, female students have superior fitness in elementary and middle school but the fitness edge is erased by high school. Female cardiovascular fitness deteriorates faster from elementary to high school compared to male students. Female BMI deteriorates and male BMI improves from elementary to high school. Cardiovascular fitness and overall fitness decreases from elementary to high school for both male and female students. ^ Student fitness was significantly and strongly independently correlated with academic achievement. Further analysis showed that House Representatives with TAKS scores in the top quartile consistently showed superior fitness. Small significant partial correlations remain between fitness and TAKS assessment after controlling for socioeconomic status. In general, correlations were stronger between female BMI and TAKS assessment compared to male students. Cardiovascular fitness was significantly correlated with TAKS assessment for both genders. This paper supports student fitness as a confounder in the relationship between socioeconomic status and academic achievement. Plus, student fitness has a strong correlation with academic that deserves further exploration. ^ Senate Bill 530 fails to organize and implement a health communication strategy that effectively disseminates the health data collected to stakeholders of interest. The lack of a vital health communication strategy results in an incomplete student health surveillance system. This paper outlines three unique strategies tailored to legislators. It is important to disseminate health information using a variety of methods tailored to your targeted audience. The use of interactive mapping technology presented (GIS) uses new technology that has the potential to effectively reach a large audience.^

Changing Tides and Changing Focus: Mapping the Challenges and Successes of One State's Implementation Of the Adoption and Safe Families Act of 1997

In 1997, the Adoption and Safe Families Act shifted from the preservation of families to an emphasis on safety, permanency, and well-being through expediting the termination of parental rights, establishing exceptions to the reasonable efforts clause of preserving the family, and fiscal incentives for finalizing adoptions. The current project assessed the role of a full service array in achieving the outcomes set forth in ASF A. Concept mapping was utilized to elicit information from participants (both urban and rural) regarding the identified research question. Participants recognized family preservation versus safety, community connections, mandates versus reality, and worker recruitment and retention as critical components for meeting ASFA goals. Perceived importance and level of success in implementing these services was also highlighted. Recommendations supported through the data are also provided.

An analysis of the revenue policy -making process of the Texas Legislature

The purpose of this dissertation was to develop a conceptual framework which can be used to account for policy decisions made by the House Ways and Means Committee (HW&MC) of the Texas House of Representatives. This analysis will examine the actions of the committee over a ten-year period with the goal of explaining and predicting the success of failure of certain efforts to raise revenue.^ The basis framework for modelling the revenue decision-making process includes three major components--the decision alternatives, the external factors and two competing contingency theories. The decision alternatives encompass the particular options available to increase tax revenue. The options were classified as non-innovative or innovative. The non-innovative options included the sales, franchise, property and severance taxes. The innovative options were principally the personal and corporate income taxes.^ The external factors included political and economic constraints that affected the actions of the HW&MC. Several key political constraints on committee decision-making were addressed--including public attitudes, interest groups, political party strength and tradition and precedents. The economic constraints that affected revenue decisions included court mandates, federal mandates and the fiscal condition of the nation and the state.^ The third component of the revenue decision-making framework included two alternative contingency theories. The first alternative theory postulated that the committee structure, including the individual member roles and the overall committee style, resulted in distinctive revenue decisions. This theory will be favored if evidence points to the committee acting autonomously with less concern for the policies of the Speaker of the House. The Speaker assignment theory, postulated that the assignment of committee members shaped or changed the course of committee decision-making. This theory will be favored if there was evidence that the committee was strictly a vehicle for the Speaker to institute his preferred tax policies.^ The ultimate goal of this analysis is to develop an explanation for legislative decision-making about tax policy. This explanation will be based on the linkages across various tax options, political and economic constraints, member roles and committee style and the patterns of committee assignment. ^

Behavioral decision making and the levels of change: An application of the transtheoretical model to prenatal smoking in low -income women

Despite continued research and public health efforts to reduce smoking during pregnancy, prenatal cessation rates in the United States have decreased and the incidence of low birth weight has increased from 1985 to 1991. Lower socioeconomic status women who are at increased risk for poor pregnancy outcomes may be resistant to current intervention efforts during pregnancy. The purpose of this dissertation was to investigate the determinants of continued smoking and quitting among low-income pregnant women.^ Using data from cross-sectional surveys of 323 low-income pregnant smokers, the first study developed and tested measures of the pros and cons of smoking during pregnancy. The original decisional balance measure for smoking was compared with a new measure that added items thought to be more salient to the target population. Confirmatory factor analysis using structural equation modeling showed neither the original nor new measure fit the data adequately. Using behavioral science theory, content from interviews with the population, and statistical evidence, two 7-item scales representing the pros and cons were developed from a portion (n = 215) of the sample and successfully cross-validated on the remainder of the sample (n = 108). Logistic regression found only pros were significantly associated with continued smoking. In a discriminant function analysis, stage of change was significantly associated with pros and cons of smoking.^ The second study examined the structural relationships between psychosocial constructs representing some of the levels of and the pros and cons of smoking. The cross-sectional design mandates that statements made regarding prediction do not prove causation or directionality from the data or methods analysis. Structural equation modeling found the following: more stressors and family criticism were significantly more predictive of negative affect than social support; a bi-directional relationship was found between negative affect and current nicotine addiction; and negative affect, addiction, stressors, and family criticism were significant predictors of pros of smoking.^ The findings imply reversing the trend of decreasing smoking cessation during pregnancy may require supplementing current interventions for this population of pregnant smokers with programs addressing nicotine addiction, negative affect, and other psychosocial factors such as family functioning and stressors. ^

Open Access Influence on Argentinean Scientific Community's Publishing Patterns

Este estudio tiene como objetivo estimar la influencia del acceso abierto en los patrones de publicación de la comunidad científica argentina en diferentes campos temáticos (Medicina; Física y Astronomía; Agricultura y Ciencias biológicas y Ciencias sociales y Humanidades), a partir del análisis del modelo de acceso de las revistas elegidas para comunicar los resultados de investigación en el período 2008-2010. La producción fue recogida de la base de datos SCOPUS y los modelos de acceso de las revistas determinados a partir de la consulta a las fuentes DOAJ, e-revist@s, SCielo, Redalyc, PubMed, Romeo-Sherpa y Dulcinea. Se analizó la accesibilidad real y potencial de la producción científica nacional por las vías dorada y verde, respectivamente, así como también por suscripción a través de la Biblioteca Electrónica de Ciencia y Tecnología del Ministerio de Ciencia, Tecnología e Innovación Productiva de la Nación Argentina. Los resultados muestran que en promedio, y para el conjunto de las temáticas estudiadas, el 70 de la producción científica argentina visible en SCOPUS se publica en revistas que adhieren de una u otra forma al movimiento de acceso abierto, en una relación del 27 para la vía dorada y del 43 para las que permiten el autoarchivo por la vía verde. Entre el 16 y el 30 (según las áreas temáticas) de los artículos publicados en revistas que permiten el autoarchivo se accede vía suscripción. El porcentaje de revistas sin acceso es del orden del 30 en Ciencias Sociales y Humanidades, y alcanza cerca del 45 en el resto de las áreas. Se concluye que Argentina presenta condiciones muy favorables para liberar un alto porcentaje de la literatura científica generada en el país bajo la modalidad del acceso abierto a través de repositorios institucionales y de mandatos para el auto-archivo, contribuyendo además a incrementar la accesibilidad y la preservación a largo plazo de la producción científica y tecnológica nacional

Nacimiento y evolución de los partidos políticos bonaerenses

El peso político de los hombres de la provincia de Buenos Aires dentro del concierto nacional, ha sido y es de significación. A partir de 1880, pese a las íntimas relaciones que tuvieron los partidos provinciales con sus respectivas conducciones nacionales, los primeros tomaron varias veces, caminos no siempre coincidentes con las segundas. Gran parte de los hombres que habrían de tener principal participación en el manejo político de la provincia y la nación en los últimos años del siglo XIX y primeros treinta del XX, se formaron, como así también su ideología y moral política, en el devenir de las tres presidencias posteriores a Pavón. El presente trabajo pretende estudiar básicamente las ideas y acciones de un grupo de aquellos que integraron el autonomismo y que habrían de descollar en los años posteriores a 1880.

Nacimiento y evolución de los partidos políticos bonaerenses

El peso político de los hombres de la provincia de Buenos Aires dentro del concierto nacional, ha sido y es de significación. A partir de 1880, pese a las íntimas relaciones que tuvieron los partidos provinciales con sus respectivas conducciones nacionales, los primeros tomaron varias veces, caminos no siempre coincidentes con las segundas. Gran parte de los hombres que habrían de tener principal participación en el manejo político de la provincia y la nación en los últimos años del siglo XIX y primeros treinta del XX, se formaron, como así también su ideología y moral política, en el devenir de las tres presidencias posteriores a Pavón. El presente trabajo pretende estudiar básicamente las ideas y acciones de un grupo de aquellos que integraron el autonomismo y que habrían de descollar en los años posteriores a 1880.

Open Access Influence on Argentinean Scientific Community's Publishing Patterns

Este estudio tiene como objetivo estimar la influencia del acceso abierto en los patrones de publicación de la comunidad científica argentina en diferentes campos temáticos (Medicina; Física y Astronomía; Agricultura y Ciencias biológicas y Ciencias sociales y Humanidades), a partir del análisis del modelo de acceso de las revistas elegidas para comunicar los resultados de investigación en el período 2008-2010. La producción fue recogida de la base de datos SCOPUS y los modelos de acceso de las revistas determinados a partir de la consulta a las fuentes DOAJ, e-revist@s, SCielo, Redalyc, PubMed, Romeo-Sherpa y Dulcinea. Se analizó la accesibilidad real y potencial de la producción científica nacional por las vías dorada y verde, respectivamente, así como también por suscripción a través de la Biblioteca Electrónica de Ciencia y Tecnología del Ministerio de Ciencia, Tecnología e Innovación Productiva de la Nación Argentina. Los resultados muestran que en promedio, y para el conjunto de las temáticas estudiadas, el 70 de la producción científica argentina visible en SCOPUS se publica en revistas que adhieren de una u otra forma al movimiento de acceso abierto, en una relación del 27 para la vía dorada y del 43 para las que permiten el autoarchivo por la vía verde. Entre el 16 y el 30 (según las áreas temáticas) de los artículos publicados en revistas que permiten el autoarchivo se accede vía suscripción. El porcentaje de revistas sin acceso es del orden del 30 en Ciencias Sociales y Humanidades, y alcanza cerca del 45 en el resto de las áreas. Se concluye que Argentina presenta condiciones muy favorables para liberar un alto porcentaje de la literatura científica generada en el país bajo la modalidad del acceso abierto a través de repositorios institucionales y de mandatos para el auto-archivo, contribuyendo además a incrementar la accesibilidad y la preservación a largo plazo de la producción científica y tecnológica nacional

Nacimiento y evolución de los partidos políticos bonaerenses

El peso político de los hombres de la provincia de Buenos Aires dentro del concierto nacional, ha sido y es de significación. A partir de 1880, pese a las íntimas relaciones que tuvieron los partidos provinciales con sus respectivas conducciones nacionales, los primeros tomaron varias veces, caminos no siempre coincidentes con las segundas. Gran parte de los hombres que habrían de tener principal participación en el manejo político de la provincia y la nación en los últimos años del siglo XIX y primeros treinta del XX, se formaron, como así también su ideología y moral política, en el devenir de las tres presidencias posteriores a Pavón. El presente trabajo pretende estudiar básicamente las ideas y acciones de un grupo de aquellos que integraron el autonomismo y que habrían de descollar en los años posteriores a 1880.

A qualidade da regulação estatal no Brasil: uma análise a partir de indicadores de qualidade

As primeiras agências reguladoras foram criadas a partir da segunda metade dos anos 1990, e a mais recente delas, em 2005. Com as agências surgiram também os atores privados regulados, os usuários e consumidores, e uma nova forma de interação entre os Poderes Executivo, Legislativo e Judiciário. Esses atores participam e dão forma ao processo de aprendizagem institucional das agências. Passado o período de criação e após quase duas décadas de existência, é necessária uma visão crítica sobre as agências. Propõe-se, então, um método de avaliação regulatória a partir de três variáveis que serão decompostas em diversas subvariáveis (quesitos a serem respondidos objetivamente). A primeira variável, institucionalização, mede as regras aplicáveis à própria agência: características dos mandatos dos dirigentes, autonomia decisória, autonomia financeira e de gestão de pessoal. A segunda, procedimentalização, ocupa-se do processo de tomada de decisão da agência e de sua transparência. Ambas as variáveis procuram medir as agências do ponto de vista formal, a partir de normas aplicáveis (leis, decretos, resoluções, portarias etc.), e pela prática regulatória, com base nos fatos ocorridos demonstrados por meio de documentos oficiais (decretos de nomeação, decisões, relatórios de atividade das próprias agências etc.). A última variável, judicialização, aponta as várias vezes em que a decisão administrativa muda de status e o nível de confirmação dessas decisões pelo Poder Judiciário. O modelo teórico de avaliação das agências ora apresentado é aplicado e testado em três setores que são submetidos à regulação econômica e contam com forte presença de atores sociais e empresa estatal federal. Assim, as agências analisadas foram: Agência Nacional de Energia Elétrica ANEEL, Agência Nacional de Telecomunicações ANATEL e Agência Nacional de Aviação Civil ANAC. Em termos gerais, não é possível garantir a existência de um isoformismo entre essas agências, nem mesmo entre agências criadas em momentos diferentes e por presidentes distintos. Também não foi possível demonstrar que a interferência política seja uma marca de um único governo. A ANATEL, a melhor avaliada das três agências, destaca-se pelo rigor de suas normas que seu processo decisório reflete. A ANEEL e a ANAC tiveram uma avaliação mediana já que apresentaram avaliação sofrível quanto ao processo, mas mostraram ter instituições (regras) um pouco melhores.

The Museum/School Partnership: A New Role for Art Museums in K-5 Art Education

For nearly thirty years, the arts have been poorly represented in public school classrooms due to tight budgets, state mandates, and a belief that the arts are not essential to education. In this paper, I will investigate the absence of focused art education curriculum in K-5 classrooms across the United States’ public school system, explain the advantages of reinstating art as a basic subject in the classroom curriculum, and advocate for a more active art museum role in public school elementary art education. The art museum may be in the ideal position to help develop and facilitate programming in K-5 classrooms. By placing teams of art museum professionals in public school classrooms, art museums can establish a prominent role in the museum/school relationship and can help ensure that children have adequate access to art education. The outcome would be children who have greater academic and personal successes throughout their lives.

Construction de l’image organisationnelle réfractée par les journaux et les groupes de pression : le cas du gouvernement fédéral canadien dans la mise en œuvre du projet de loi C-38

Ce mémoire s’est attaché à comprendre les dimensions émergentes de la constitution de l’image d’une organisation. A l’issue de l’étude de la littérature de recherche existante, nous nous sommes intéressée à l’image réfractée, qui est l’image d’une organisation construite par une catégorie de publics nommés arbitres externes. Ce sont les organisations mandatées qui diffusent de l’information au grand public. En adoptant l’approche qualitative, nous avons réalisé une étude du processus de travail des journalistes travaillant pour des journaux différents et des membres des organismes environnementaux dans le cas de la mise en œuvre du projet de loi C-38 du gouvernement fédéral canadien. L’étude empirique nous a permis de proposer un modèle conceptuel du phénomène de la construction de l’image réfractée. Nous avons pu ainsi suggérer d’observer ce phénomène à travers les pratiques de travail des acteurs pour appréhender les dynamiques d’émergence de l’image. Aussi, nous avons insisté sur la pertinence de considérer des paramètres qui constituent le cadre dans lequel se déroule le processus de travail des acteurs appartenant à des communautés de publics différentes. Car ce sont ces paramètres qui engendrent des dynamiques régulant la construction de l’image organisationnelle au sein de chaque communauté de public.

Restoring Order in Global Health Governance: Do Metagovernance Norms Affect Interorganizational Convergence? CES Open Forum Series #23, 2014-2015

This paper theorizes about the convergence of international organizations in global health governance, a field of international cooperation that is commonly portrayed as particularly hit by institutional fragmentation. Unlike existing theories on interorganizationalism that have mainly looked to intra- and extraorganizational factors in order to explain why international organizations cooperate with each other in the first place, the paper is interested in the link between causes and systemic effects of interorganizational convergence. The paper begins by defining interorganizational convergence. It then proceeds to discuss why conventional theories on interorganizational- ism fail to explain the aggregate effects of convergence between IOs in global (health) governance which tend to worsen rather than cushion fragmentation — so-called "hypercollective action" (Severino & Ray 2010). In order to remedy this explanatory blind-spot the paper formulates an alternative sociological institutionalist theory on interorganizational convergence that makes two core theoretical propositions: first that emerging norms of metagovernance are a powerful driver behind interorganizational convergence in global health governance, and secondly that IOs are engaged in a fierce meaning-struggle over these norms which results in hypercollective action. In its empirical part, the paper’s core theoretical propositions are corroborated by analyzing discourses and practices of interorganizational convergence in global health. The empirical analysis allows drawing two far-reaching conclusions. On the one hand, interorganizational harmonization has emerged as a largely undisputed norm in global health which has been translated into ever more institutionalized forms of interorganizational cooperation. On the other, discourses and practices of interorganizational harmonization exhibit conflicts over the ordering principles according to which the policies and actions of international organizations with overlapping mandates and missions should be harmonized. In combination, these two empirical findings explain why interorganizational convergence has so far failed to strengthen the global health architecture.

E-commerce in Europe: parcel delivery prices in a digital single market. Bruegel Policy Contribution ISSUE 2016/09 May 2016

Highlights • In its Digital Single Market strategy, the European Commission has rightly noted the importance of reducing the price paid for basic cross-border parcel delivery by consumers and by small and medium size retail senders. • The payment flows for cross-border parcel delivery are strikingly similar to those for telecommunications. Comparisons with roaming can be instructive. As with roaming, it is clear that the links between wholesale payments between the national postal operators and retail prices need to be properly understood in order to craft good policy. Another useful lesson is that national postal regulatory authorities are unlikely to address cross-border problems because of limitations in their respective mandates and because they have no incentive to take measures to benefit residents of other countries. • There are also significant differences between roaming and parcel delivery.While high wholesale charges were a major driver of high retail prices for international mobile roaming, the wholesale payments for cross-border parcel delivery appear to be below cost.This implies that it is the ‘spread’ between retail price and thewholesale payment that is inflated, at least for small retail senders and for consumers. • Comprehensive statistics gathering, coordinated at European level, is indispensable.