Measuring health state preferences for hemophilia: Development of a disease-specific utility instrument

Research has shown that disease-specific health related quality of life (HRQoL) instruments are more responsive than generic instruments to particular disease conditions. However, only a few studies have used disease-specific instruments to measure HRQoL in hemophilia. The goal of this project was to develop a disease-specific utility instrument that measures patient preferences for various hemophilia health states. The visual analog scale (VAS), a ranking method, and the standard gamble (SG), a choice-based method incorporating risk, were used to measure patient preferences. Study participants (n = 128) were recruited from the UT/Gulf States Hemophilia and Thrombophilia Center and stratified by age: 0–18 years and 19+. ^ Test retest reliability was demonstrated for both VAS and SG instruments: overall within-subject correlation coefficients were 0.91 and 0.79, respectively. Results showed statistically significant differences in responses between pediatric and adult participants when using the SG (p = .045). However, no significant differences were shown between these groups when using the VAS (p = .636). When responses to VAS and SG instruments were compared, statistically significant differences in both pediatric (p < .0001) and adult (p < .0001) groups were observed. Data from this study also demonstrated that persons with hemophilia with varying severity of disease, as well as those who were HIV infected, were able to evaluate a range of health states for hemophilia. This has important implications for the study of quality of life in hemophilia and the development of disease-specific HRQoL instruments. ^ The utility measures obtained from this study can be applied in economic evaluations that analyze the cost/utility of alternative hemophilia treatments. Results derived from the SG indicate that age can influence patients' preferences regarding their state of health. This may have implications for considering treatment options based on the mean age of the population under consideration. Although both instruments independently demonstrated reliability and validity, results indicate that the two measures may not be interchangeable. ^

Disparities in asthma prevalence: The influence of sociodemographic and workplace factors

Asthma is a serious and continuing health problem that affects millions of Americans. Our study was conducted in response to this serious health problem and for purposes of addressing the issue of potential health disparities as outlined in Healthy People 2010. Data from sub-populations of subjects who participated in the National Health and Nutrition Examination Survey (NHANES) from 1999-2004 were used to complete the following specific aims: (1) to update nationally-based estimates of the prevalence of current and lifetime (ever) asthma among adults in the United States (U.S.) and describe by gender the relationships between potential risk factors (e.g., sociodemographics and lifestyle) and asthma; (2) to describe demographic characteristics among working adults in the U.S. and update estimates of the prevalence of asthma in this sub-population, stratified by occupation and industry; and 3) to determine the utility of adapting a population-based Job Exposure Matrix (JEM) for classifying workplace exposures to asthmagens. ^ Our findings suggest the prevalence of asthma among U.S. adults is continuing to rise, with women having a higher prevalence of asthma than men. Living below the poverty threshold, obesity, and prior history of smoking remain important determinants of asthma. Our study also adds to the increasing evidence that health care workers (HCWs) and those employed in education remain at high risk and that appropriate evaluation and control measures need to be implemented. Over 78% of HCWs and 71% of teachers in our study were females suggesting that further exploration of gender-specific risk factors of asthma in working populations is needed. ^ Our study also addressed the feasibility of adapting a population-based asthma-specific JEM to NHANES (1999-2004). We were not able to apply the asthma-specific JEM due to the broad occupational categories within NHANES. This represents a missed opportunity to examine the association between workplace exposures and asthma in U.S. working adults. However, we have identified steps that may be implemented in future population-based studies that would allow the asthma-specific JEM (and other population-based job exposure matrices) to be used in future studies of the U.S. working population.^

Symposium for dental treatment of medically complex children: Practice based culminating experience a continuing education course

The purpose of this Continuing Education Course is to provide oral health professionals with information to address the unique dental needs of medically complex children. The objective is to train dentists to treat special needs patients so these children have more access to oral healthcare. ^ Under the auspice of Dell Children Hospital of Austin, Lisa Jacob DDS MS is administering this Continuing Education Course for dentists and dental staff from the 46 counties of central Texas served by the hospital.^ Needs assessment was determined through a survey questionnaire to collect data about the number of special needs patients seen by general dentists in Central Texas.^ In recent years, an increasing number of continuing education courses have been developed to help dentists learn techniques for providing dentistry in more understanding ways to patients with special needs. Dentists and dental staff are trained to provide care specifically in dentistry, regardless of who the patient is. This means dentists can perform a clinical examination, carry out procedures to diagnose and treat oral diseases, and provide restorations such as fillings and crowns. ^ Four prominent speakers will provide an instructional tool to address the need for dentists to increase their competence and comfort level in caring for individuals with developmental disabilities. Each speaker will address one of the most frequently encountered cases of medically complex children. The four topics selected by Dr. Lisa Jacob are Cancer, Mental Disability, Downs Syndrome, and Craniofacial Syndromes.^ The public health implications of this continuing education course are presented in providing dental service to this underserved population. When general dentist turn away patients with special needs because of lack of knowledge to treat them, these patients will, more than likely, postpone or abandon needed dental visits because of difficulties reaching pediatric dentists who may not be available in certain areas.^

Interactive Graphic Simulation: An Advanced Methodology to Improve the Teaching-Learning Process in Nuclear Engineering Education and Training

Nowadays, computer simulators are becoming basic tools for education and training in many engineering fields. In the nuclear industry, the role of simulation for training of operators of nuclear power plants is also recognized of the utmost relevance. As an example, the International Atomic Energy Agency sponsors the development of nuclear reactor simulators for education, and arranges the supply of such simulation programs. Aware of this, in 2008 Gas Natural Fenosa, a Spanish gas and electric utility that owns and operate nuclear power plants and promotes university education in the nuclear technology field, provided the Department of Nuclear Engineering of Universidad Politécnica de Madrid with the Interactive Graphic Simulator (IGS) of “José Cabrera” (Zorita) nuclear power plant, an industrial facility whose commercial operation ceased definitively in April 2006. It is a state-of-the-art full-scope real-time simulator that was used for training and qualification of the operators of the plant control room, as well as to understand and analyses the plant dynamics, and to develop, qualify and validate its emergency operating procedures.

An Implemented of a Real-Time Experimental Setup for Robotic Teleoperation System

The development of this work presents the implementation of an experimental platform, which will permit to investigate on a methodology for the design and analysis of a teleoperated system, considering the delay in the communication channel. The project has been developed in partnership with the laboratory of Automatic and Robotics of the Universidad Politécnica de Madrid and the Laboratory at the Centro de Tecnologías Avanzadas de Manufactura at the Pontificia Universidad Católica del Perú. The mechanical structure of the arm that is located in the remote side has been built and the electric servomechanism has been mounted to control their movement. The experimental test of the Teleoperation system has been developed. The PC104 card commands the power interface and sensors of the DC motor of each articulation of the arm. Has developed the drives for the management of the operations of the master and the slave: send/reception of position, speed, acceleration and current data through a CAN network. The programs for the interconnection through a LAN network, between the Windows Operating System and the Real-time Operating System (QNX), has been developed. The utility of the developed platform (hardware and software) has been demonstrated.

Assessment for English language education on the programs at the Agricultural Engineering School of Madrid

The convergence process among European academic degrees pursues the exchange of graduate students and the adaptation of university programs to social demand. Within the framework of the European Higher Education, European universities will need to be more competitive not only by increasing or maintaining the student enrolment, but also in their academic performance. Thus, the reinforcing of English language education within the University Programs might play an important role to reach these objectives. In this sense, a complete survey was accomplished at the Agricultural Egineering School of Madrid (ETSIA ) addressing issues such as: identification the needs for bilingual instruction at ETSIA, identification resources needed and interest and background in English language of students and professors (San José et al., 2013). The conclusions and recommendations to promote the bilingual instruction in the ETSIA, taking into account the approaches followed by other Spanish universities, are presented in this work.

Towards the Consideration of the U.S. Community College Model to Address the Need for Higher Education Reforms in Ghana

ABSTRACT The higher education systems throughout the continent of Africa are undergoing unprecedented challenges and are considered in crisis. African countries, including Ghana, all have in common ties to their colonial legacy whereby they are confronted with weak policies put in place by their colonizers. Having gained their independence, Africans should now take responsibility for the task of reforming their higher education system. To date, nothing substantial has been accomplished, with serious implications for weakening and damaging the structures of the foundation of their educational systems. This qualitative, single case study utilized a postcolonial theory-critical pedagogy framework, providing guidance for coming to grips with the mindset posed by Ghana's colonial heritage in the postcolonial era, especially in terms of its damaging effects on Ghana's higher education system. The study explores alternative pathways for secondary school students to transition to tertiary education--a problematic transition that currently hinders open access to all and equality in educational opportunity, resulting in a tremendous pool of discontinued students. This transitional problem is directly related to Ghana's crisis in higher education with far reaching consequences. The alternative pathway considered in this study is an adaptation of the U.S. community college model or an integration of its applicable aspects into the current structures of the higher education system already in place. In-depth interviews were conducted with 5 Ghanaian professors teaching at community colleges in the United States, 5 Ghanaian professors teaching at universities in Ghana, and 2 educational consultants from the Ghanaian Ministry of Education. Based on their perspectives of the current state of Ghanaian higher education, analyzed in terms of pedagogy, structure/infrastructure, and curriculum, the participants provided their perceptions of salient aspects of the U.S. community college model that would be applicable to Ghana's situation, along with other recommendations. Access to all, including equality of educational opportunity, was considered essential, followed by adaptability, affordability, practicality, and quality of curriculum content and delivery. Canada's successful adaptation of the U.S. model was also discussed. Findings can help guide consideration of alternative pathways to higher education in Ghana and Africa as a whole.

Successful Navigation of the Conflict between Doctoral Education and Cultural Expectations of Child Rearing in Hispanic Culture

While the numbers are slowly rising, Hispanic students continue to be disproportionately underrepresented in all levels of higher education, including doctoral education. There are many factors that may contribute to the low numbers of Hispanic doctoral students; for Hispanic women, one of these factors may be the perceived conflict between cultural expectations of childrearing and doctoral education. For Hispanic students who hold strong cultural values, this conflict may prevent enrollment in, or result in attrition from, doctoral education. As the number of Hispanic college enrollment increases, we will see more students trying to navigate between the collectivistic value of childrearing and the individualistic value of pursuing higher education. Thus, it is important to understand the needs of these students to aid in recruitment and retention of student-parents in all levels of higher education. This paper explores the barriers and supportive factors for current Hispanic doctoral student-parents. Suggestions are made to increase support which will allow these individuals to successfully complete a doctoral education, while attending to the responsibilities of parenting.

Evaluation of hybrid and distance education learning environments in Spain

This article describes the adaptation and validation of the Distance Education Learning Environments Survey (DELES) for use in investigating the qualities found in distance and hybrid education psycho-social learning environments in Spain. As Europe moves toward post-secondary student mobility, equanimity in access to higher education, and more standardised degree programs across the European Higher Education Area (EHEA) the need for a high quality method for continually assessing the excellence of distance and hybrid learning environments has arisen. This study outlines how the English language DELES was adapted into the new Spanish-Distance Education Learning Environments Survey (S-DELES) for use with a Bachelor of Psychology and Criminology degree program offering both distance and hybrid education classes. We present the relationships between psycho-social learning environment perceptions and those of student affect. We also present the asynchronous aspects of the environment, scale means, and a comparison between the perceptions of distance education students and their hybrid education counterparts that inform the university about the baseline health of the information and communication technologies (ICT) environment within which the study was conducted.

Representation of 2D objects with a topology preserving network

Comunicación presentada en el 2nd International Workshop on Pattern Recognition in Information Systems, Alicante, April, 2002.

Reducing visual deficits caused by refractive errors in school and preschool children: results of a pilot school program in the Andean region of Apurimac, Peru

Background: Refractive error is defined as the inability of the eye to bring parallel rays of light into focus on the retina, resulting in nearsightedness (myopia), farsightedness (Hyperopia) or astigmatism. Uncorrected refractive error in children is associated with increased morbidity and reduced educational opportunities. Vision screening (VS) is a method for identifying children with visual impairment or eye conditions likely to lead to visual impairment. Objective: To analyze the utility of vision screening conducted by teachers and to contribute to a better estimation of the prevalence of childhood refractive errors in Apurimac, Peru. Design: A pilot vision screening program in preschool (Group I) and elementary school children (Group II) was conducted with the participation of 26 trained teachers. Children whose visual acuity was<6/9 [20/30] (Group I) and≤6/9 (Group II) in one or both eyes, measured with the Snellen Tumbling E chart at 6 m, were referred for a comprehensive eye exam. Specificity and positive predictive value to detect refractive error were calculated against clinical examination. Program assessment with participants was conducted to evaluate outcomes and procedures. Results: A total sample of 364 children aged 3–11 were screened; 45 children were examined at Centro Oftalmológico Monseñor Enrique Pelach (COMEP) Eye Hospital. Prevalence of refractive error was 6.2% (Group I) and 6.9% (Group II); specificity of teacher vision screening was 95.8% and 93.0%, while positive predictive value was 59.1% and 47.8% for each group, respectively. Aspects highlighted to improve the program included extending training, increasing parental involvement, and helping referred children to attend the hospital. Conclusion: Prevalence of refractive error in children is significant in the region. Vision screening performed by trained teachers is a valid intervention for early detection of refractive error, including screening of preschool children. Program sustainability and improvements in education and quality of life resulting from childhood vision screening require further research.

Inclusive education in Spain: how do skills, resources, and supports affect regular education teachers’ perceptions of inclusion?

This study examined regular education teachers’ perceptions of inclusion in elementary and secondary schools in Spain and how these perceptions may differ depending on teaching experience, skills, and the availability of resources and supports. Stratified random sampling procedures were used to draw a representative sample of 336 general education teachers (68 kindergarten, 133 elementary, and 135 secondary teachers) from the province of Alicante. The results indicated the acceptance of the principles of inclusion, although teacher skills, time, material resources, and personal supports for inclusion were deemed insufficient. Kindergarten and elementary teachers showed more positive perceptions of inclusion than secondary education teachers, and so did teachers with more personal supports and material resources than those with less supports and resources. The results are discussed in terms of its implications for practice in order to promote more inclusive classrooms in Spain.

Assessment of Web Content Accessibility Levels in Spanish Official Online Education Environments

Diversity-based designing, or the goal of ensuring that web-based information is accessible to as many diverse users as possible, has received growing international acceptance in recent years, with many countries introducing legislation to enforce it. This paper analyses web content accessibility levels in Spanish education portals according to the international guidelines established by the World Wide Web Consortium (W3C) and the Web Accessibility Initiative (WAI). Additionally, it suggests the calculation of an inaccessibility rate as a tool for measuring the degree of non-compliance with WAI Guidelines 2.0 as well as illustrating the significant gap that separates people with disabilities from digital education environments (with a 7.77% average). A total of twenty-one educational web portals with two different web depth levels (42 sampling units) were assessed for this purpose using the automated analysis tool Web Accessibility Test 2.0 (TAW, for its initials in Spanish). The present study reveals a general trend towards non-compliance with the technical accessibility recommendations issued by the W3C-WAI group (97.62% of the websites examined present mistakes in Level A conformance). Furthermore, despite the increasingly high number of legal and regulatory measures about accessibility, their practical application still remains unsatisfactory. A greater level of involvement must be assumed in order to raise awareness and enhance training efforts towards accessibility in the context of collective Information and Communication Technologies (ICTs), since this represents not only a necessity but also an ethical, social, political and legal commitment to be assumed by society.

Considering Efficacy of an Outdoor Environmental Education Program: Facilitating Elementary Students’ Environmental Knowledge, Attitudes, and Behaviours

Various sources have sought to consider the educational interventions that foster changes in perception of and attitudes toward nature, with the ultimate intent of understanding how education can be used to encourage environmentally responsible behaviours. With these in mind, the current study identified an outdoor environmental education program incorporating these empirically supported interventions, and assessed its ability to influence environmental knowledge, attitudes, and behaviours. Specifically, this study considered the following research questions: 1) To what degree can participation in this outdoor education program foster environmental knowledge and encourage pro-environmental attitudes and self-reported pro-environmental behaviours? 2) How is this effect different among students of different genders, and those who have different prior experiences in nature? Two motivational frameworks guided inquiry in the current study: the Value-Belief-Norm Model of Environmentalism (VBN) and the Theory of Planned Behaviour (TPB). The study employed a quantitative survey methodology, combining contemporary data measuring knowledge, attitudes, and behaviours with archived data collected by program staff, reflecting frequency of environmentally responsible behaviour. Further, a single qualitative item was included for which students provided “the first three words that [came] to mind when [they] think of the word nature.” Terms provided before and after the program were compared for differences in theme to detect subtle or underlying changes. Quantitative results indicated no significant change in student knowledge or attitudes through the outdoor environmental education program. However, a significant change in self-reported behaviour was identified from both the contemporary and archived data. This agreement in positive findings across the two data sets, collected using different measures and different participants, lends evidence of the program’s ability to encourage self-reported pro-environmental behaviour. Further, qualitative results showed some change in students’ perceptions of nature through the program, providing direction for future research. These findings suggest that this particular outdoor education program was successful in encouraging students’ self-reported environmentally responsible behaviour. This change was achieved without significant change in knowledge or environmental attitudes, suggesting that external factors not measured in this study might have played a role in affecting behaviour.

Jewish vocational education; history and appraisal of training in Europe.

"The story of Jewish vocational education and occupational redistribution ... between the French Revolution and World War II."