Selecting the 'invisible' user interface development tool

Developers of interactive software are confronted by an increasing variety of software tools to help engineer the interactive aspects of software applications. Typically resorting to ad hoc means of tool selection, developers are often dissatisfied with their chosen tool on account of the fact that the tool lacks required functionality or does not fit seamlessly within the context in which it is to be used. This paper describes a system for evaluating the suitability of user interface development tools for use in software development organisations and projects such that the selected tool appears ‘invisible’ within its anticipated context of use. The paper also outlines and presents the results of an informal empirical study and a series of observational case studies of the system.

Thiazolidinediones

Thiazolidinediones (TZDs), also termed "glitazones", are used as antidiabetic agents for the treatment of type 2 (non-insulin dependent) diabetes mellitus. They activate the nuclear peroxisome proliferator-activated receptor-gamma (PPAR-gamma). This increases the transcription of various insulin-sensitive genes, improving insulin action and lowering blood glucose concentrations. TZDs currently in clinical use for the treatment of type 2 diabetes are rosiglitazone and pioglitazone. Troglitazone was withdrawn due to hepatotoxicity. Other TZDs (e.g. ciglitazone) have been studied preclinically, but not introduced into clinical use. TZDs do not cause severe hypoglycemia, hence they are regarded as antihyperglycemic (rather than hypoglycemic) agents .... © 2007 Elsevier Inc. All rights reserved..

Women-led community development organizations (CDOs) in Miami-Dade County: A model of community development efforts impacting the economic security of women

Recent studies on the economic status of women in Miami-Dade County (MDC) reveal an alarming rate of economic insecurity and significant obstacles for women to achieve economic security. Consistent barriers to women's economic security affect not only the health and wellbeing of women and their families, but also economic prospects for the community. A key study reveals in Miami-Dade County, "Thirty-nine percent of single female-headed families with at least one child are living at or below the federal poverty level" and "over half of working women do not earn adequate income to cover their basic necessities" (Brion 2009, 1). Moreover, conventional measures of poverty do not adequately capture women's struggles to support themselves and their families, nor do they document the numbers of women seeking basic self-sufficiency. Even though there is lack of accurate data on women in the county, which is a critical problem, there is also a dearth of social science research on existing efforts to enhance women's economic security in Miami-Dade County. My research contributes to closing the information gap by examining the characteristics and strategies of women-led community development organizations (CDOs) in MDC, working to address women's economic insecurity. The research is informed by a framework developed by Marilyn Gittell, who pioneered an approach to study women-led CDOs in the United States. On the basis of research in nine U.S. cities, she concluded that women-led groups increased community participation and "by creating community networks and civic action, they represent a model for community development efforts" (Gittell, et al. 2000, 123). My study documents the strategies and networks of women-led CDOs in MDC that prioritize women's economic security. Their strategies are especially important during these times of economic recession and government reductions in funding towards social services. The focus of the research is women-led CDOs that work to improve social services access, economic opportunity, civic participation and capacity, and women's rights. Although many women-led CDOs prioritize building social infrastructures that promote change, inequalities in economic and political status for women without economic security remain a challenge (Young 2004). My research supports previous studies by Gittell, et al., finding that women-led CDOs in Miami-Dade County have key characteristics of a model of community development efforts that use networking and collaboration to strengthen their broad, integrated approach. The resulting community partnerships, coupled with participation by constituents in the development process, build a foundation to influence policy decisions for social change. In addition, my findings show that women-led CDOs in Miami-Dade County have a major focus on alleviating poverty and economic insecurity, particularly that of women. Finally, it was found that a majority of the five organizations network transnationally, using lessons learned to inform their work of expanding the agency of their constituents and placing the economic empowerment of women as central in the process of family and community development.

Os usos do território e a economia solidária no Rio Grande do Norte

The solidary economy as the organization of production, alternative to the capitalist economy provides new forms of organization and social behavior, that, in the sight of geography, it is shown by the different territory uses. The territory assume new meanings that, influenced by the Solidary Economy movement, tries to reach for new ways of acting that differ from social order already stablished. However, the different uses show themselves in a more complex and contradictory way, given that, in solidary undertakings, different corporative agents start to act, the State being a last resource on this process. Given this reality, our goal on the present paper is to analyze the different uses of the territory from the rural economic solidary undertakings and the relationship it establishes to the different agents involved on the socio-territorial dynamics on Rio Grande do Norte. Starting from a study that contemplates the territorial organization forms and contents of the analyzed phenomena, the methodology utilized for this research is based on a bibliographic review, with authors from the geography and areas related to the Solidary Economy, besides the use of secondary data, acquired from official offices such as SIES and IBGE, from the documented research, SENAES and field interviews conducted with local solidary undertakings. The results obtained in the study reveal the complexity of the agricultural use of the territory by Solidary Economy on the RN, while a resource of intensified use, from the state actions and important economical agents, and regulating the use while shelter, that marginalize solidary workers, making them subdued to the hegemonic logic. Therefore, we can infer that the solidary economy, despite its image of new form of organization between agricultural workers, given the expressivity of the rural solidary undertakings presented on RN, it hasn’t shown a full social development as an instrument of reproduction and emancipation of the associates. Nevertheless, the undertakings articulated in nets excel, even when considering its punctual and residual form. The given contradictions show that it is necessary to fortify the building of the solidary economy as being horizontal and popular based for it to have strength to surpass the regulative actions of the capitalist state and ownership created by the Capital.

A Brief Chronicle of CD4 as a Biomarker for HIV/AIDS: A Tribute to the Memory of John L. Fahey.

Foundational cellular immunology research of the 1960s and 1970s, together with the advent of monoclonal antibodies and flow cytometry, provided the knowledge base and the technological capability that enabled the elucidation of the role of CD4 T cells in HIV infection. Research identifying the sources and magnitude of variation in CD4 measurements, standardized reagents and protocols, and the development of clinical flow cytometers all contributed to the feasibility of widespread CD4 testing. Cohort studies and clinical trials provided the context for establishing the utility of CD4 for prognosis in HIV-infected persons, initial assessment of in vivo antiretroviral drug activity, and as a surrogate marker for clinical outcome in antiretroviral therapeutic trials. Even with sensitive HIV viral load measurement, CD4 cell counting is still utilized in determining antiretroviral therapy eligibility and time to initiate therapy. New point of care technologies are helping both to lower the cost of CD4 testing and enable its use in HIV test and treat programs around the world.

Protected Areas' Impacts on Brazilian Amazon Deforestation: Examining Conservation-Development Interactions to Inform Planning.

Protected areas are the leading forest conservation policy for species and ecoservices goals and they may feature in climate policy if countries with tropical forest rely on familiar tools. For Brazil's Legal Amazon, we estimate the average impact of protection upon deforestation and show how protected areas' forest impacts vary significantly with development pressure. We use matching, i.e., comparisons that are apples-to-apples in observed land characteristics, to address the fact that protected areas (PAs) tend to be located on lands facing less pressure. Correcting for that location bias lowers our estimates of PAs' forest impacts by roughly half. Further, it reveals significant variation in PA impacts along development-related dimensions: for example, the PAs that are closer to roads and the PAs closer to cities have higher impact. Planners have multiple conservation and development goals, and are constrained by cost, yet still conservation planning should reflect what our results imply about future impacts of PAs.

The Use of a Pressure-Indicating Sensor Film to Provide Feedback upon Hydrogel-Forming Microneedle Array Self-Application In Vivo

PURPOSE:
To evaluate the combination of a pressure-indicating sensor film with hydrogel-forming microneedle arrays, as a method of feedback to confirm MN insertion in vivo.
METHODS:
Pilot in vitro insertion studies were conducted using a Texture Analyser to insert MN arrays, coupled with a pressure-indicating sensor film, at varying forces into excised neonatal porcine skin. In vivo studies involved twenty human volunteers, who self-applied two hydrogel-forming MN arrays, one with a pressure-indicating sensor film incorporated and one without. Optical coherence tomography was employed to measure the resulting penetration depth and colorimetric analysis to investigate the associated colour change of the pressure-indicating sensor film.
RESULTS:
Microneedle insertion was achieved in vitro at three different forces, demonstrating the colour change of the pressure-indicating sensor film upon application of increasing pressure. When self-applied in vivo, there was no significant difference in the microneedle penetration depth resulting from each type of array, with a mean depth of 237 μm recorded. When the pressure-indicating sensor film was present, a colour change occurred upon each application, providing evidence of insertion.
CONCLUSIONS:
For the first time, this study shows how the incorporation of a simple, low-cost pressure-indicating sensor film can indicate microneedle insertion in vitro and in vivo, providing visual feedback to assure the user of correct application. Such a strategy may enhance usability of a microneedle device and, hence, assist in the future translation of the technology to widespread clinical use.

A 'before and after' study of nursing students' self-assessed competence in identifying the needs of older patients in hospital using an educational workbook.

Background: A core component of nurse education is clinical practice in order to support the development of clinical skills and competence. Assessment and measurement of the clinical competence of nursing students is important to gauge their professional development and educational needs.

Aim: To evaluate the impact of an Older Persons’ Assessment Educational Workbook (OPAEW) and explore second year nursing students’ competence and their opinions and use of the workbook.

Methods: A ‘before and after’ pre-experimental design was undertaken with n=6 second year nursing students. Outcome measures were the Nursing Competencies Questionnaire and the Self-efficacy in Clinical Performance Scale. Content analysis of workbooks and a survey (n=5) of opinions regarding the workbook was undertaken.

Findings: Pre and post test results for the study (n=5) were tested to determine if there was a relationship between changes in the NCQ and SECP repeated measures and use of an OPAEW. Testing identified evidence of a statistically significant difference for both SECP measures (SECP28 p=0.043; SECP7 p=0.042), with no clear statistical evidence of a difference for the NCQ (p=0.08). A weak negative association (NCQ ρ=-0.600 p=0.285; SECP28 ρ=-0.300 p=0.624; SECP7 ρ=-0.205 p=0.741), was found indicating that those participants who scored the lowest scores at the start of the study, benefited most from the workbook.

Content analysis of the OPAEW (n=5) found that 3 of the 5 participants completed all components of the workbook, with a mean of 1051 words used (SD 281.8). Through the survey (n=5) students reported the workbook as a useful guide when undertaking a patient assessment.

Conclusions: The OPAEW showed potential as an intervention to support the development of nursing students’ competence in older person assessment skills.

A 'before and after' study of nursing students' self-assessed competence in identifying the needs of older patients in hospital using an educational workbook.

Background: A core component of nurse education is clinical practice in order to support the development of clinical skills and competence. Assessment and measurement of the clinical competence of nursing students is important to gauge their professional development and educational needs.

Aim: To evaluate the impact of an Older Persons’ Assessment Educational Workbook (OPAEW) and explore second year nursing students’ competence and their opinions and use of the workbook.

Methods: A ‘before and after’ pre-experimental design was undertaken with n=6 second year nursing students. Outcome measures were the Nursing Competencies Questionnaire and the Self-efficacy in Clinical Performance Scale. Content analysis of workbooks and a survey (n=5) of opinions regarding the workbook was undertaken.

Findings: Pre and post test results for the study (n=5) were tested to determine if there was a relationship between changes in the NCQ and SECP repeated measures and use of an OPAEW. Testing identified evidence of a statistically significant difference for both SECP measures (SECP28 p=0.043; SECP7 p=0.042), with no clear statistical evidence of a difference for the NCQ (p=0.08). A weak negative association (NCQ ρ=-0.600 p=0.285; SECP28 ρ=-0.300 p=0.624; SECP7 ρ=-0.205 p=0.741), was found indicating that those participants who scored the lowest scores at the start of the study, benefited most from the workbook.

Content analysis of the OPAEW (n=5) found that 3 of the 5 participants completed all components of the workbook, with a mean of 1051 words used (SD 281.8). Through the survey (n=5) students reported the workbook as a useful guide when undertaking a patient assessment.

Conclusions: The OPAEW showed potential as an intervention to support the development of nursing students’ competence in older person assessment skills.

Testing the psychometric properties of two self-report clinical competence scales for nursing students.

Background: It is important to assess the clinical competence of nursing students to gauge their educational needs. Competence can be measured by self-assessment tools; however, Anema and McCoy (2010) contend that currently available measures should be further psychometrically tested.
Aim: To test the psychometric properties of Nursing Competencies Questionnaire (NCQ) and Self-Efficacy in Clinical Performance (SECP) clinical competence scales.
Method: A non-randomly selected sample of n=248 2nd year nursing students completed NCQ, SECP and demographic questionnaires (June and September 2013). Mokken Scaling Analysis (MSA) was used to investigate structural validity and scale properties; convergent and discriminant validity and reliability were also tested for each scale.
Results: MSA analysis identified that the NCQ is a unidimensional scale with strong scale scalability coefficients Hs =0.581; but limited item rankability HT =0.367. The SECP scale MSA suggested that the scale could be potentially split into two unidimensional scales (SECP28 and SECP7), each with good/reasonable scalablity psychometric properties as summed scales but negligible/very limited scale rankability (SECP28: Hs = 0.55, HT=0.211; SECP7: Hs = 0.61, HT=0.049). Analysis of between cohort differences and NCQ/SECP scores produced evidence of discriminant and convergent validity; good internal reliability was also found: NCQ α = 0.93, SECP28 α = 0.96 and SECP7 α=0.89.

Discussion: In line with previous research further evidence of the NCQ’s reliability and validity was demonstrated. However, as the SECP findings are new and the sample small with reference to Straat and colleagues (2014), the SECP results should be interpreted with caution and verified on a second sample.
Conclusions: Measurement of perceived self-competence could start early in a nursing programme to support students’ development of clinical competence. Further testing of the SECP scale with larger nursing student samples from different programme years is indicated.

References:
Anema, M., G and McCoy, JK. (2010) Competency-Based Nursing Education: Guide to Achieving Outstanding Learner Outcomes. New York: Springer.
Straat, JH., van der Ark, LA and Sijtsma, K. (2014) Minimum Sample Size Requirements for Mokken Scale Analysis Educational and Psychological Measurement 74 (5), 809-822.

Comparação de materiais usados na confeção de facetas dentárias

A demanda na procura da reabilitação estética é um dos focos da história da humanidade ao longo das eras, mas que teve a sua acentuação nestes últimos dois séculos. Sendo a face um dos pontos que nos permite avaliar esteticamente uma pessoa, cabe ao médico dentista, como um dos profissionais que trabalha nessa zona do corpo humano, avaliar e procurar satisfazer as necessidades estéticas da população. Assim, por parte dos profissionais de Medicina Dentária, tem de haver uma procura constante para a satisfação das exigências estéticas, não só no conhecimento como no aprimoramento da técnica. Nos últimos tempos, com a necessidade de desenvolvimento de materiais para colmatar a cada vez maior busca para a perfeição estética, as facetas surgiram como tratamento de excelência. O presente trabalho teve como objectivo a comparação entre resina composta e cerâmica, na elaboração de restaurações estéticas. Para os dois tipos de materiais foram avaliados a estética e o comportamento biomecânico. Foram comparados benefícios e desvantagens, contra-indicações, indicações, plano de tratamento, diagnóstico e procedimentos clínicos dos dois materiais, utilizados na confecção das facetas cerâmicas e de resina composta. Foram utilizados os seguintes parâmetros de comparação: biocompatibilidade, adaptação marginal, preparação, resistência, cor, acabamento, potencial de reparação, custo e estética. A utilização de facetas cerâmicas tem sido um dos principais focos de desenvolvimento da Medicina Dentária no âmbito científico. A sua utilização permite uma maior predictibilidade e uma maior longevidade clínica. A sua qualidade estética, resistência à fractura, biodisponibilidade e estabilidade de cor, são as suas maiores vantagens na utilização clínica. Em sentido inverso, as facetas de resina composta apresentam menor custo, maior resistência à abrasão, possibilidade de reparação fácil e menor desgaste de estrutura dentária durante a sua preparação. Contudo apresentam menor estabilidade de cor. Portanto, torna-se esclarecedor que a escolha do material a utilizar na confecção de facetas, deve ser adaptada às especificidades de cada caso.

A medida e as escalas de avaliação da saúde das populações neonatais e pediátricas : estudo de simulação de Monte Carlo com variáveis ordinais

A investigação na área da saúde e a utilização dos seus resultados tem funcionado como base para a melhoria da qualidade de cuidados, exigindo dos profissionais de saúde conhecimentos na área específica onde desempenham funções, conhecimentos em metodologia de investigação que incluam as técnicas de observação, técnicas de recolha e análise de dados, para mais facilmente serem leitores capacitados dos resultados da investigação. Os profissionais de saúde são observadores privilegiados das respostas humanas à saúde e à doença, podendo contribuir para o desenvolvimento e bem-estar dos indivíduos muitas vezes em situações de grande vulnerabilidade. Em saúde infantil e pediatria o enfoque está nos cuidados centrados na família privilegiando-se o desenvolvimento harmonioso da criança e jovem, valorizando os resultados mensuráveis em saúde que permitam determinar a eficácia das intervenções e a qualidade de saúde e de vida. No contexto pediátrico realçamos as práticas baseadas na evidência, a importância atribuída à pesquisa e à aplicação dos resultados da investigação nas práticas clínicas, assim como o desenvolvimento de instrumentos de mensuração padronizados, nomeadamente as escalas de avaliação, de ampla utilização clínica, que facilitam a apreciação e avaliação do desenvolvimento e da saúde das crianças e jovens e resultem em ganhos em saúde. A observação de forma sistematizada das populações neonatais e pediátricas com escalas de avaliação tem vindo a aumentar, o que tem permitido um maior equilíbrio na avaliação das crianças e também uma observação baseada na teoria e nos resultados da investigação. Alguns destes aspetos serviram de base ao desenvolvimento deste trabalho que pretende dar resposta a 3 objetivos fundamentais. Para dar resposta ao primeiro objetivo, “Identificar na literatura científica, os testes estatísticos mais frequentemente utilizados pelos investigadores da área da saúde infantil e pediatria quando usam escalas de avaliação” foi feita uma revisão sistemática da literatura, que tinha como objetivo analisar artigos científicos cujos instrumentos de recolha de dados fossem escalas de avaliação, na área da saúde da criança e jovem, desenvolvidas com variáveis ordinais, e identificar os testes estatísticos aplicados com estas variáveis. A análise exploratória dos artigos permitiu-nos verificar que os investigadores utilizam diferentes instrumentos com diferentes formatos de medida ordinal (com 3, 4, 5, 7, 10 pontos) e tanto aplicam testes paramétricos como não paramétricos, ou os dois em simultâneo, com este tipo de variáveis, seja qual for a dimensão da amostra. A descrição da metodologia nem sempre explicita se são cumpridas as assunções dos testes. Os artigos consultados nem sempre fazem referência à distribuição de frequência das variáveis (simetria/assimetria) nem à magnitude das correlações entre os itens. A leitura desta bibliografia serviu de suporte à elaboração de dois artigos, um de revisão sistemática da literatura e outro de reflexão teórica. Apesar de terem sido encontradas algumas respostas às dúvidas com que os investigadores e os profissionais, que trabalham com estes instrumentos, se deparam, verifica-se a necessidade de desenvolver estudos de simulação que confirmem algumas situações reais e alguma teoria já existente, e trabalhem outros aspetos nos quais se possam enquadrar os cenários reais de forma a facilitar a tomada de decisão dos investigadores e clínicos que utilizam escalas de avaliação. Para dar resposta ao segundo objetivo “Comparar a performance, em termos de potência e probabilidade de erro de tipo I, das 4 estatísticas da MANOVA paramétrica com 2 estatísticas da MANOVA não paramétrica quando se utilizam variáveis ordinais correlacionadas, geradas aleatoriamente”, desenvolvemos um estudo de simulação, através do Método de Monte Carlo, efetuado no Software R. O delineamento do estudo de simulação incluiu um vetor com 3 variáveis dependentes, uma variável independente (fator com três grupos), escalas de avaliação com um formato de medida com 3, 4, 5, e 7 pontos, diferentes probabilidades marginais (p1 para distribuição simétrica, p2 para distribuição assimétrica positiva, p3 para distribuição assimétrica negativa e p4 para distribuição uniforme) em cada um dos três grupos, correlações de baixa, média e elevada magnitude (r=0.10, r=0.40, r=0.70, respetivamente), e seis dimensões de amostras (n=30, 60, 90, 120, 240, 300). A análise dos resultados permitiu dizer que a maior raiz de Roy foi a estatística que apresentou estimativas de probabilidade de erro de tipo I e de potência de teste mais elevadas. A potência dos testes apresenta comportamentos diferentes, dependendo da distribuição de frequência da resposta aos itens, da magnitude das correlações entre itens, da dimensão da amostra e do formato de medida da escala. Tendo por base a distribuição de frequência, considerámos três situações distintas: a primeira (com probabilidades marginais p1,p1,p4 e p4,p4,p1) em que as estimativas da potência eram muito baixas, nos diferentes cenários; a segunda situação (com probabilidades marginais p2,p3,p4; p1,p2,p3 e p2,p2,p3) em que a magnitude das potências é elevada, nas amostras com dimensão superior ou igual a 60 observações e nas escalas com 3, 4,5 pontos e potências de magnitude menos elevada nas escalas com 7 pontos, mas com a mesma ma magnitude nas amostras com dimensão igual a 120 observações, seja qual for o cenário; a terceira situação (com probabilidades marginais p1,p1,p2; p1,p2,p4; p2,p2,p1; p4,p4,p2 e p2,p2,p4) em que quanto maiores, a intensidade das correlações entre itens e o número de pontos da escala, e menor a dimensão das amostras, menor a potência dos testes, sendo o lambda de Wilks aplicado às ordens mais potente do que todas as outra s estatísticas da MANOVA, com valores imediatamente a seguir à maior raiz de Roy. No entanto, a magnitude das potências dos testes paramétricos e não paramétricos assemelha-se nas amostras com dimensão superior a 90 observações (com correlações de baixa e média magnitude), entre as variáveis dependentes nas escalas com 3, 4 e 5 pontos; e superiores a 240 observações, para correlações de baixa intensidade, nas escalas com 7 pontos. No estudo de simulação e tendo por base a distribuição de frequência, concluímos que na primeira situação de simulação e para os diferentes cenários, as potências são de baixa magnitude devido ao facto de a MANOVA não detetar diferenças entre grupos pela sua similaridade. Na segunda situação de simulação e para os diferentes cenários, a magnitude das potências é elevada em todos os cenários cuja dimensão da amostra seja superior a 60 observações, pelo que é possível aplicar testes paramétricos. Na terceira situação de simulação, e para os diferentes cenários quanto menor a dimensão da amostra e mais elevada a intensidade das correlações e o número de pontos da escala, menor a potência dos testes, sendo a magnitude das potências mais elevadas no teste de Wilks aplicado às ordens, seguido do traço de Pillai aplicado às ordens. No entanto, a magnitude das potências dos testes paramétricos e não paramétricos assemelha-se nas amostras com maior dimensão e correlações de baixa e média magnitude. Para dar resposta ao terceiro objetivo “Enquadrar os resultados da aplicação da MANOVA paramétrica e da MANOVA não paramétrica a dados reais provenientes de escalas de avaliação com um formato de medida com 3, 4, 5 e 7 pontos, nos resultados do estudo de simulação estatística” utilizaram-se dados reais que emergiram da observação de recém-nascidos com a escala de avaliação das competências para a alimentação oral, Early Feeding Skills (EFS), o risco de lesões da pele, com a Neonatal Skin Risk Assessment Scale (NSRAS), e a avaliação da independência funcional em crianças e jovens com espinha bífida, com a Functional Independence Measure (FIM). Para fazer a análise destas escalas foram realizadas 4 aplicações práticas que se enquadrassem nos cenários do estudo de simulação. A idade, o peso, e o nível de lesão medular foram as variáveis independentes escolhidas para selecionar os grupos, sendo os recém-nascidos agrupados por “classes de idade gestacional” e por “classes de peso” as crianças e jovens com espinha bífida por “classes etárias” e “níveis de lesão medular”. Verificou-se um bom enquadramento dos resultados com dados reais no estudo de simulação.

Efeito do GQ-02, derivado de tiazolidinadionas, sobre a aquisição de fenótipo termogênico pelo adipócito in vivo e em cultura de células

Dissertação (mestrado)—Universidade de Brasília, Faculdade em Ciências da Saúde, Programa de Pós-Graduação em Ciências da Saúde, 2016.

Women-led Community Development Organizations (CDOs) in Miami-Dade County: A Model of Community Development Efforts Impacting the Economic Security of Women

Recent studies on the economic status of women in Miami-Dade County (MDC) reveal an alarming rate of economic insecurity and significant obstacles for women to achieve economic security. Consistent barriers to women’s economic security affect not only the health and wellbeing of women and their families, but also economic prospects for the community. A key study reveals in Miami-Dade County, “Thirty-nine percent of single female-headed families with at least one child are living at or below the federal poverty level” and “over half of working women do not earn adequate income to cover their basic necessities” (Brion 2009, 1). Moreover, conventional measures of poverty do not adequately capture women’s struggles to support themselves and their families, nor do they document the numbers of women seeking basic self-sufficiency. Even though there is lack of accurate data on women in the county, which is a critical problem, there is also a dearth of social science research on existing efforts to enhance women’s economic security in Miami-Dade County. My research contributes to closing the information gap by examining the characteristics and strategies of women-led community development organizations (CDOs) in MDC, working to address women’s economic insecurity. The research is informed by a framework developed by Marilyn Gittell, who pioneered an approach to study women-led CDOs in the United States. On the basis of research in nine U.S. cities, she concluded that women-led groups increased community participation and “by creating community networks and civic action, they represent a model for community development efforts” (Gittell, et al. 2000, 123). My study documents the strategies and networks of women-led CDOs in MDC that prioritize women’s economic security. Their strategies are especially important during these times of economic recession and government reductions in funding towards social services. The focus of the research is women-led CDOs that work to improve social services access, economic opportunity, civic participation and capacity, and women’s rights. Although many women-led CDOs prioritize building social infrastructures that promote change, inequalities in economic and political status for women without economic security remain a challenge (Young 2004). My research supports previous studies by Gittell, et al., finding that women-led CDOs in Miami-Dade County have key characteristics of a model of community development efforts that use networking and collaboration to strengthen their broad, integrated approach. The resulting community partnerships, coupled with participation by constituents in the development process, build a foundation to influence policy decisions for social change. In addition, my findings show that women-led CDOs in Miami-Dade County have a major focus on alleviating poverty and economic insecurity, particularly that of women. Finally, it was found that a majority of the five organizations network transnationally, using lessons learned to inform their work of expanding the agency of their constituents and placing the economic empowerment of women as central in the process of family and community development.

Effectiveness of non-pharmacological interventions to prevent falls in older people: a systematic overview. The SENATOR Project ONTOP Series

Background: Falls are common events in older people, which cause considerable morbidity and mortality. Non-pharmacological interventions are an important approach to prevent falls. There are a large number of systematic reviews of non-pharmacological interventions, whose evidence needs to be synthesized in order to facilitate evidence-based clinical decision making. Objectives: To systematically examine reviews and meta-analyses that evaluated non-pharmacological interventions to prevent falls in older adults in the community, care facilities and hospitals. Methods: We searched the electronic databases Pubmed, the Cochrane Database of Systematic Reviews, EMBASE, CINAHL, PsycINFO, PEDRO and TRIP from January 2009 to March 2015, for systematic reviews that included at least one comparative study, evaluating any non-pharmacological intervention, to prevent falls amongst older adults. The quality of the reviews was assessed using AMSTAR and ProFaNE taxonomy was used to organize the interventions. Results: Fifty-nine systematic reviews were identified which consisted of single, multiple and multi-factorial non-pharmacological interventions to prevent falls in older people. The most frequent ProFaNE defined interventions were exercises either alone or combined with other interventions, followed by environment/assistive technology interventions comprising environmental modifications, assistive and protective aids, staff education and vision assessment/correction. Knowledge was the third principle class of interventions as patient education. Exercise and multifactorial interventions were the most effective treatments to reduce falls in older adults, although not all types of exercise were equally effective in all subjects and in all settings. Effective exercise programs combined balance and strength training. Reviews with a higher AMSTAR score were more likely to contain more primary studies, to be updated and to perform meta-analysis. Conclusions: The aim of this overview of reviews of non-pharmacological interventions to prevent falls in older people in different settings, is to support clinicians and other healthcare workers with clinical decision-making by providing a comprehensive perspective of findings.