A project to improve the information seeking skills and increase the use of evidence-based research in public health practice

The ability of public health practitioners (PHPs) to work efficiently and effectively is negatively impacted by their lack of knowledge of the broad range of evidence-based practice information resources and tools that can be utilized to guide them in their development of health policies and programs. This project, a three-hour continuing education hands-on workshop with supporting resources, was designed to increase knowledge and skills of these resources. The workshop was presented as a pre-conference continuing education program for the Texas Public Health Association (TPHA) 2008 Annual Conference. Topics included: identification of evidence-based practice resources to aid in the development of policies and programs; identification of sources of publicly available data; utilization of data for community assessments; and accessing and searching the literature through a collection of databases available to all citizens of Texas. Supplemental resources included a blog that served as a gateway to the resources explored during the presentation, a community assessment workbook that incorporates both Healthy People 2010 objectives and links to reliable sources of data, and handouts providing additional instruction on the use of the resources covered during the workshop.^ Before- and after-workshop surveys based on Kirkpatrick's 4-level model of evaluation and the Theory of Planned Behavior were administered. Of the questions related to the trainer, the workshop, and the usefulness of the workshop, participants gave "Good" to "Excellent" responses to all one question. Confidence levels overall increased a statistically significant amount; measurements of attitude, social norms, and control showed no significant differences before and after the workshop. Lastly, participants indicated they were likely to use resources shown during the workshop within a one to three month time period on average. ^ The workshop and creation of supplemental resources served as a pilot for a funded project that will be continued with the development and delivery of four 4-week long webinar-based training sessions to be completed by December 2008. ^

The effect of African Americans' ethnographic paradigms and cultural explanatory model of breast cancer in framing the male partner's attitudes and behaviors about the woman's breast cancer diagnosis

The disparate burden of breast cancer-related morbidity and mortality experienced by African American women compared with women of other races is a topic of intense debate in the medical and public health arenas. The anomaly is consistently attributed to the fact that at diagnosis, a large proportion of African American women have advanced-stage disease. Extensive research has documented the impacts of cultural factors and of socioeconomic factors in shaping African American women's breast-health practices; however, there is another factor of a more subtle influence that might have some role in establishing these women's vulnerability to this disease: the lack of or perceived lack of partner support. Themes expressed in the research literature reflect that many African American breast cancer patients and survivors consider their male partners as being apathetic and nonsupportive. ^ The purpose of this study was to learn how African American couples' ethnographic paradigms and cultural explanatory model of breast cancer frame the male partners' responses to the women's diagnosis and to assess his ability to cope and willingness to adapt to the subsequent challenges. The goal of the study was to determine whether these men's coping and adaptation skills positively or negatively affect the women's self-care attitudes and behaviors. ^ This study involved 4 African American couples in which the woman was a breast cancer survivor. Participants were recruited through a community-based cancer support group and a church-based cancer support group. Recruitment sessions were held at regular meetings of these organizations. Accrual took 2 months. In separate sessions, each male partner and each survivor completed a demographic survey and a questionnaire and were interviewed. Additionally, the couples were asked to participate in a communications activity (Adinkra). This activity was not done to fulfill any part of the study purpose and was not included in the data analysis; rather, it was done to assess its potential use as an intervention to promote dialogue between African American partners about the experience of breast cancer. ^ The questionnaire was analyzed on the basis of a coding schema and the interview responses were analyzed on the principles of hermeneutic phenomenology. In both cases, the instruments were used to determine whether the partner's coping skills reflected a compassionate attitude (positive response) versus an apathetic attitude (negative response) and whether his adaptation skills reflected supportive behaviors (the positive response) versus nonsupportive behaviors (the negative response). Overall, the women's responses showed that they perceived of their partners as being compassionate, yet nonsupportive, and the partner's perceived of themselves likewise. Only half of the women said that their partners' coping and adaptation abilities enabled them to relinquish traditional concepts of control and focus on their own well-being. ^ The themes that emerged indicate that African American men's attitudes and behaviors regarding his female partner's diagnosis of breast cancer and his ability to cope and willingness to adapt are influenced by their ritualistic mantras, folk beliefs, religious teachings/spiritual values, existential ideologies, socioeconomic status, and environmental factors and by their established perceptions of what causes breast cancer, what the treatments and outcomes are, and how the disease affects the entire family, particularly him. These findings imply that a culturally specific intervention might be useful in educating African American men about breast cancer and their roles in supporting their female partners, physically and psychologically, during diagnosis, treatment, and recovery. ^

Policy analysis of Texas Senate Bill 532 and the regulation of nurse practitioners in the convenience care model

Background. Retail clinics, also called convenience care clinics, have become a rapidly growing trend since their initial development in 2000. These clinics are coupled within a larger retail operation and are generally located in "big-box" discount stores such as Wal-mart or Target, grocery stores such as Publix or H-E-B, or in retail pharmacies such as CVS or Walgreen's (Deloitte Center for Health Solutions, 2008). Care is typically provided by nurse practitioners. Research indicates that this new health care delivery system reduces cost, raises quality, and provides a means of access to the uninsured population (e.g., Deloitte Center for Health Solutions, 2008; Convenient Care Association, 2008a, 2008b, 2008c; Hansen-Turton, Miller, Nash, Ryan, Counts, 2007; Salinsky, 2009; Scott, 2006; Ahmed & Fincham, 2010). Some healthcare analysts even suggest that retail clinics offer a feasible solution to the shortage of primary care physicians facing the nation (AHRQ Health Care Innovations Exchange, 2010). ^ The development and performance of retail clinics is heavily dependent upon individual state policies regulating NPs. Texas currently has one of the most highly regulated practice environments for NPs (Stout & Elton, 2007; Hammonds, 2008). In September 2009, Texas passed Senate Bill 532 addressing the scope of practice of nurse practitioners in the convenience care model. In comparison to other states, this law still heavily regulates nurse practitioners. However, little research has been conducted to evaluate the impact of state laws regulating nurse practitioners on the development and performance of retail clinics. ^ Objectives. (1). To describe the potential impact that SB 532 has on retail clinic performance. (2). To discuss the effectiveness, efficiency, and equity of the convenience care model. (3). To describe possible alternatives to Texas' nurse practitioner scope of practice guidelines as delineated in Texas Senate Bill 532. (4). To describe the type of nurse practitioner state regulation (i.e. independent, light, moderate, or heavy) that best promotes the convenience care model. ^ Methods. State regulations governing nurse practitioners can be characterized as independent, light, moderate, and heavy. Four state NP regulatory types and retail clinic performance were compared and contrasted to that of Texas regulations using Dunn and Aday's theoretical models for conducting policy analysis and evaluating healthcare systems. Criteria for measurement included effectiveness, efficiency, and equity. Comparison states were Arizona (Independent), Minnesota (Light), Massachusetts (Moderate), and Florida (Heavy). ^ Results. A comparative states analysis of Texas SB 532 and alternative NP scope of practice guidelines among the four states: Arizona, Florida, Massachusetts, and Minnesota, indicated that SB 532 has minimal potential to affect the shortage of primary care providers in the state. Although SB 532 may increase the number of NPs a physician may supervise, NPs are still heavily restricted in their scope of practice and limited in their ability to act as primary care providers. Arizona's example of independent NP practice provided the best alternative to affect the shortage of PCPs in Texas as evidenced by a lower uninsured rate and less ED visits per 1,000 population. A survey of comparison states suggests that retail clinics thrive in states that more heavily restrict NP scope of practice as opposed to those that are more permissive, with the exception of Arizona. An analysis of effectiveness, efficiency, and equity of the convenience care model indicates that retail clinics perform well in the areas of effectiveness and efficiency; but, fall short in the area of equity. ^ Conclusion. Texas Senate 532 represents an incremental step towards addressing the problem of a shortage of PCPs in the state. A comparative policy analysis of the other four states with varying degrees of NP scope of practice indicate that a more aggressive policy allowing for independent NP practice will be needed to achieve positive changes in health outcomes. Retail clinics pose a temporary solution to the shortage of PCPs and will need to expand their locations to poorer regions and incorporate some chronic care to obtain measurable health outcomes. ^

Model results of the impact of climate change on agriculture in China

This paper assesses the impact of climate change on China's agricultural production at a cross-provincial level using the Ricardian approach, incorporating a multilevel model with farm-level group data. The farm-level group data includes 13379 farm households, across 316 villages, distributed in 31 provinces. The empirical results show that, firstly, the marginal effects and elasticities of net crop revenue per hectare with respect to climate factors indicated that the annual impact of temperature on net crop revenue per hectare was positive, and the effect of increased precipitation was negative when looking at the national totals; secondly, the total impact of simulated climate change scenarios on net crop revenues per hectare at a Chinese national total level, was an increase of between 79 USD per hectare and 207 USD per hectare for the 2050s, and an increase from 140 USD per hectare to 355 USD per hectare for the 2080s. As a result, climate change may create a potential advantage for the development of Chinese agriculture, rather than a risk, especially for agriculture in the provinces of the Northeast, Northwest and North regions. However, the increased precipitation can lead to a loss of net crop revenue per hectare, especially for the provinces of the Southwest, Northwest, North and Northeast regions.

What factors affect the visibility of Argentinean publications in humanities and social sciences in Scopus? Some evidence beyond the geographic realm of research

Se analizan los patrones de publicación y citación en ciencias humanas y sociales en Scopus en el período 2003-2012, según el alcance geográfico de la investigación. Los resultados muestran que los temas de alcance nacional tienen un predominio del español como lengua de publicación y una marcada preferencia por la autoría única frente a los patrones observados en el grupo de otros temas, no situados geográficamente, donde el inglés y la colaboración institucional es más fuerte y está más consolidada. La citación no parece estar determinada solo por el alcance geográfico de las investigaciones, sino también por el idioma de publicación, la coautoría y los perfiles de las revistas donde se publica. Se espera que los resultados den lugar a una reflexión constructiva sobre la cultura investigadora y editorial y que sean útiles como referencia para establecer criterios de evaluación en las comisiones evaluadoras y las políticas editoriales a nivel nacional

What factors affect the visibility of Argentinean publications in humanities and social sciences in Scopus? Some evidence beyond the geographic realm of research

Se analizan los patrones de publicación y citación en ciencias humanas y sociales en Scopus en el período 2003-2012, según el alcance geográfico de la investigación. Los resultados muestran que los temas de alcance nacional tienen un predominio del español como lengua de publicación y una marcada preferencia por la autoría única frente a los patrones observados en el grupo de otros temas, no situados geográficamente, donde el inglés y la colaboración institucional es más fuerte y está más consolidada. La citación no parece estar determinada solo por el alcance geográfico de las investigaciones, sino también por el idioma de publicación, la coautoría y los perfiles de las revistas donde se publica. Se espera que los resultados den lugar a una reflexión constructiva sobre la cultura investigadora y editorial y que sean útiles como referencia para establecer criterios de evaluación en las comisiones evaluadoras y las políticas editoriales a nivel nacional

What factors affect the visibility of Argentinean publications in humanities and social sciences in Scopus? Some evidence beyond the geographic realm of research

Se analizan los patrones de publicación y citación en ciencias humanas y sociales en Scopus en el período 2003-2012, según el alcance geográfico de la investigación. Los resultados muestran que los temas de alcance nacional tienen un predominio del español como lengua de publicación y una marcada preferencia por la autoría única frente a los patrones observados en el grupo de otros temas, no situados geográficamente, donde el inglés y la colaboración institucional es más fuerte y está más consolidada. La citación no parece estar determinada solo por el alcance geográfico de las investigaciones, sino también por el idioma de publicación, la coautoría y los perfiles de las revistas donde se publica. Se espera que los resultados den lugar a una reflexión constructiva sobre la cultura investigadora y editorial y que sean útiles como referencia para establecer criterios de evaluación en las comisiones evaluadoras y las políticas editoriales a nivel nacional

Data on multidisciplinary research in the Tajura Rift (Gulf of Aden) during Cruise 7 of R/V Akademik Mstislav Keldysh in winter 1983-1984

In the collective monograph results of geological and geophysical studies in the Tadjura Rift carried out by conventional outboard instruments and from deep/sea manned submersibles "Pisces" in winter 1983-1984 are reported. Main features of rift tectonics, geology, petrology, and geochemistry of basalts from the rift are under consideration. An emphasis is made on lithology, stratigraphy, and geochemistry of bottom sediments. Roles of terrigenous, edafogenic, biogenic, and hydrothermal components in formation of bottom sediments from the rift zone are shown.

Development of land rental market and its effect on household farming in rural China : an empirical study in Zhejiang Province

This paper investigates the impact of land rental market development on the efficiency of labor allocation and land utilization in rural China. To test the hypothesis that the shadow wage of a rent-in household with limited off-farm opportunities will increase with the development of a land rental market for households, a statistical comparison between the shadow wage and the estimated market wage was conducted. The results showed that the shadow wage for both rent-in households and non-rent-in households was significantly lower than the market wage, but that the wage for the rent-in households was statistically higher than that for non-rent-in households in Fenghua and Deqing, the two counties surveyed in this study. In addition, the estimated marginal product of farmland for rent-in households was statistically higher than the actual land rent that those households paid, while a null hypothesis that the actual rental fee accepted by rent-out households is equivalent to the marginal product of farmland for those households was not rejected in Fenghua county where land transactions by mutual agreement were more prevalent. These results indicate that the development of the land rental market facilitates the efficiency of labor allocation and farmland utilization in rural China.

Subjective Evaluation of Transmission Errors in IPTV and 3DTV

The increase of multimedia services delivered over packet-based networks has entailed greater quality expectations of the end-users. This has led to an intensive research on techniques for evaluating the quality of experience perceived by the viewers of audiovisual content, considering the different degradations that it could suffer along the broadcasting system. In this paper, a comprehensive study of the impact of transmission errors affecting video and audio in IPTV is presented. With this aim, subjective assessment tests were carried out proposing a novel methodology trying to keep as close as possible home environment viewing conditions. Also 3DTV content in side-by-side format has been used in the experiments to compare the impact of the degradations. The results provide a better understanding of the effects of transmission errors, and show that the QoE related to the first approach of 3DTV is acceptable, but the visual discomfort that it causes should be reduced.

A model for evaluation of generic competences in engineering: application to the problem. Solving competence at the technical University of Madrid.

The competence evaluation promoted by the European High Education Area entails a very important methodological change that requires guiding support to help teachers carry out this new and complex task. In this regard, the Technical University of Madrid (UPM, by its Spanish acronym) has financed a series of coordinated projects with a two-fold objective: a) To develop a model for teaching and evaluating core competences that is useful and easily applicable to its different degrees, and b) to provide support to teachers by creating an area within the Website for Educational Innovation where they can search for information on the model corresponding to each core competence approved by UPM. Information available on each competence includes its definition, the formulation of indicators providing evidence on the level of acquisition, the recommended teaching and evaluation methodology, examples of evaluation rules for the different levels of competence acquisition, and descriptions of best practices. These best practices correspond to pilot tests applied to several of the academic subjects conducted at UPM in order to validate the model. This work describes the general procedure that was used and presents the model developed specifically for the problem-solving competence. Some of the pilot experiences are also summarised and their results analysed